ObjectiveTo investigate the intervention effects of modified Linggui Zhugan Tang （LGZGT） on patients with obstructive sleep apnea-hypopnea syndrome （OSAHS） of the spleen deficiency and dampness obstruction with blood stasis type， reveal its possible mechanisms， and provide a theoretical basis for the clinical treatment of OSAHS with traditional Chinese medicine （TCM）. MethodsEighty OSAHS patients with spleen deficiency and dampness obstruction with blood stasis were randomly assigned to a control group and an observation group （1∶1） using a random number table， with 40 patients in each group. The control group received standard basic treatment combined with oral Doxofylline tablets， while the observation group received standard basic treatment combined with modified LGZGT. Serum levels of macrophage migration inhibitory factor （MIF）， microRNA-223 （miR-223）， and interleukin-18 （IL-18） were measured by enzyme-linked immunosorbent assay （ELISA）， and the mRNA expression levels of MIF， miR-223， and IL-18 were measured by real-time quantitative polymerase chain reaction （Real-time PCR）. After two months of treatment， the total clinical efficacy， apnea-hypopnea index （AHI）， lowest nocturnal oxygen saturation （LSpO₂）， body mass index （BMI）， TCM syndrome scores， and expression levels of MIF， miR-223， and IL-18 before and after treatment were compared between the two groups. Correlations between MIF， miR-223， IL-18 and AHI and LSpO₂ were also analyzed. ResultsCompared with the control group， the observation group showed a significantly higher total clinical effective rate （P<0.01， Z=-3.49）. Within the control group， no significant changes were observed in AHI， LSpO₂， BMI， TCM syndrome scores， or MIF， miR-223， IL-18 levels and their mRNAs after treatment. In the observation group， AHI， BMI， TCM syndrome scores， and MIF and IL-18 levels and their mRNAs decreased significantly， while LSpO₂ increased significantly （P<0.01）. After treatment， compared with the control group， the observation group exhibited significantly lower AHI， BMI， TCM syndrome scores， and MIF and IL-18 levels and their mRNAs， and significantly higher LSpO₂ （P<0.01）. Correlation analysis showed that MIF and IL-18 were positively correlated with AHI （P<0.01） and negatively correlated with LSpO₂ （P<0.01）， whereas miR-223 was negatively correlated with AHI （P<0.01） and positively correlated with LSpO₂ （P<0.01）. ConclusionModified LGZGT may improve OSAHS of the spleen deficiency and dampness obstruction with blood stasis type by reducing airway inflammatory factors， alleviating airway inflammation， relieving airway edema and stenosis， and improving airway obstruction.

Background: and Purpose Ruptured intracranial aneurysms (RIA) are associated with a mortality rate of up to 40% in the Chinese population, highlighting the critical need for targeted treatment interventions for at-risk individuals. Although the impact of aldehyde dehydrogenase 2 (ALDH2) gene mutations on susceptibility to intracranial aneurysms (IA) is well documented, the potential connection between ALDH2 rs671 single-nucleotide polymorphism (SNP) and RIA remains unexplored. Given the increased prevalence of ALDH2 gene mutations among Chinese Han individuals, it is clinically relevant to investigate the link between ALDH2 rs671 SNP and IA rupture. Methods: A prospective study was conducted on 546 patients diagnosed with IA to investigate the association between ALDH2 rs671 SNP and the risk of IA rupture. Results: The ALDH2 rs671 SNP (ALDH2*2) was significantly more prevalent in patients with unruptured IA (UIA) than in those with RIA (32.56% vs. 18.58%, P=0.004). Multivariate logistic regression analysis revealed that people with the ALDH2 mutation (ALDH2*1/*2 and ALDH2*2/*2 gene type) had a significantly reduced odds ratio (OR=0.49; 95% confidence level [CI] 0.27–0.88; P=0.018) for RIAs. Age-specific subgroup analysis indicated that the ALDH2 mutation provided a stronger protective effect in individuals aged 60 years and above with IA compared to those under 60 years old (OR=0.38 vs. OR=0.52, both P<0.05). Conclusion The incidence of RIA was significantly higher in individuals with a normal ALDH2 gene (ALDH2*1/*1) than in those with an ALDH2 rs671 SNP (ALDH2*1/*2 or ALDH2*2/*2). ALDH2 rs671 SNP may serve as a protective factor against RIA in the Chinese Han population.

OBJECTIVE: Hepatocellular carcinoma (HCC) is sensitive to ferroptosis, a new form of programmed cell death that occurs in most tumor types. However, the mechanism through which ferroptosis modulates HCC remains unclear. This study aimed to investigate the oncogenic role and prognostic value of FANCD2 and provide novel insights into the prognostic assessment and prediction of immunotherapy. METHODS: Using clinicopathological parameters and bioinformatic techniques, we comprehensively examined the expression of FANCD2 macroscopically and microcosmically. We conducted univariate and multivariate Cox regression analyses to identify the prognostic value of FANCD2 in HCC and elucidated the detailed molecular mechanisms underlying the involvement of FANCD2 in oncogenesis by promoting iron-related death. RESULTS: FANCD2 was significantly upregulated in digestive system cancers with abundant immune infiltration. As an independent risk factor for HCC, a high FANCD2 expression level was associated with poor clinical outcomes and response to immune checkpoint blockade. Gene set enrichment analysis revealed that FANCD2 was mainly involved in the cell cycle and CYP450 metabolism. CONCLUSION To the best of our knowledge, this is the first study to comprehensively elucidate the oncogenic role of FANCD2. FANCD2 has a tumor-promoting aspect in the digestive system and acts as an independent risk factor in HCC; hence, it has recognized value for predicting tumor aggressiveness and prognosis and may be a potential biomarker for poor responsiveness to immunotherapy.
Humans ; Carcinoma, Hepatocellular/diagnosis* ; Liver Neoplasms/diagnosis* ; Immunotherapy ; Fanconi Anemia Complementation Group D2 Protein/metabolism* ; Prognosis ; Male ; Female ; Middle Aged ; Biomarkers, Tumor/metabolism*

Objective : To explore whether chrysophanol(CHR) affects macrophage polarization by promoting mitochondrial biosynthesis through AMPK/PGC-1α pathway. Methods : The molecular docking and binding ability of CHR with AMPK and PGC-1α were predicted by Autodock vina software. Human monocytes(THP-1) were induced to M0 macrophages by phorbol myristate acetate(PMA), and to M1 macrophages by lipopolysaccharide(LPS) combined with interferon-γ(IFN-γ), which were set as Control group. M1 macrophages treated with CHR were set as CHR group. M1 macrophages treated with CHR combined with AMPK inhibitor(Compound C) were set as CHR+Compound C group. The mRNA expression levels of M1 macrophage markers(iNOS, CD86) and mitochondrial biosynthesis related genes(PGC-1α, NFR-1, TFAM) were detected by Quantitative real time polymerase chain reaction(qRT-PCR). The expression level of M1 macrophage marker iNOS was detected by immunofluorescence. The protein expression levels of AMPK, p-AMPK and PGC-1α were detected by Western blot. Results : The docking results showed that the binding energies of CHR with AMPK and PGC-1α were-8.4 kcal/mol and-7.4 kcal/mol, respectively. qRT-PCR results showed that the in vitro model of M1 macrophages was successfully established. Compared with the Control group, CHR treatment significantly increased the mRNA expression of mitochondrial biosynthesis-related genes PGC-1α, NFR-1, and TFAM(P<0.001). Compared with CHR treatment group, CHR combined with Compound C treatment significantly decreased the mRNA expression levels of mitochondrial biosynthesis-related genes PGC-1α, NFR-1, and TFAM(P<0.05). Immunofluorescence results showed that CHR treatment inhibited the protein expression of iNOS compared with the Control group(P<0.001). Compared with CHR treatment group,CHR combined with Compound C treatment reversed the inhibitory effect of CHR on i NOS protein expression(P<0.05). Western blot results showed that compared with the Control group,the CHR treatment group had significant increase in the protein expression levels of p-AMPK and PGC-1α(P<0.001).Compared with CHR treatment group,CHR combined with Compound C treatment significantly decreased the protein expression levels of p-AMPK and PGC-1α(P<0.05). Conclusion Chrysophanol may inhibit macrophage polarization to M1 by activating AMPK/PGC-1α signaling pathway to promote mitochondrial biosynthesis.

This article reviews the benifits and challenges of nano-microspheres (NPs) in the treatment of osteoarthritis (OA). OA is a degenerative disease associated with aging, trauma, and excessive loading, with treatment strategies including basic therapy, drug therapy, reparative therapy, and reconstructive surgery. As emerging nanomaterials, NPs offer unique advantages in promoting cartilage repair due to their high surface area, excellent drug-loading capacity, and good biocompatibility. These advantages include facilitating chondrocyte generation through magnetic-mechanical control of mesenchymal stem cell microspheres and enhancing antioxidant levels using biomimetic liposomal NPs combined with glucosamine. Additionally, NPs can effectively modulate inflammatory responses, such as by inhibiting the formation of M1 macrophages and promoting their polarization to the M2 type to alleviate inflammation. Some NPs also enhance joint lubrication and relieve pain, such as hyaluronic acid-based NPs modified with choline phosphate groups. However, the application of NPs faces challenges such as high production costs, poor biocompatibility for certain types, and unknown long-term safety. Despite these challenges, with advancements in nanotechnology and a deeper understanding of the pathological mechanisms of OA, NPs are expected to provide new therapeutic approaches and more comprehensive and effective treatment options for OA patients in the future.

Objective:To quantitatively evaluate the effects of left bundle branch block（LBBB）on left ventricular structure，function and myocardial perfusion using left ventricular pressure-strain loop and single photon emission computed tomography（SPECT），and to investigate the relationship between myocardial work，myocardial perfusion and pathological changes of left ventricular remodeling in left bundle branch block induced cardiomyopathy（LBBB-CM）.Methods:Fourteen male beagle dogs were selected，and the main trunk of the left bundle branch was ablated to create an LBBB dog model. Electrocardiogram（ECG），transesophageal echocardiography and arterial blood pressure data of LBBB dogs were collected before and 12 months after the ablation of left bundle branch trunk. Global and segmental myocardial work parameters were obtained by left ventricular pressure-strain loop. The differences of above parameters between baseline and 12 months after the ablation of left bundle branch were compared. SPECT was performed in LBBB dogs 12 months after the creation of LBBB. The hearts were harvested for anatomy observation and histopathological analysis in LBBB dogs and another 7 male beagle dogs（normal control group）matched by age and weight. The correlation between myocardial perfusion（percentage of regional tracer uptake）and myocardial work parameters，myocardial fibrosis in LBBB dogs were analyzed.Results:Compared with baseline，the left ventricular end-diastolic volume of 12 months after the ablation increased［（20.78 ± 5.32）ml vs（26.71 ± 7.94）ml， P = 0.003］，left ventricular ejection fraction decreased［（59.17 ± 5.67）% vs（47.69 ± 5.45）%， P<0.001］；left ventricular global/segmental longitudinal strain，global/segmental constructive work and global/segmental work efficiency decreased（all P<0.05），left ventricular global/segmental wasted work increased（all P<0.001）. Heterogenous perfusion defect was observed in LBBB dogs by SPECT，compared with lateral wall segments，the percentage of regional tracer uptake of septum was decreased（all P<0.05）. Gross anatomical and myocardial pathological changes were manifested as cardiomegaly，flaky or focal grayish thickening of endocardium，cardiomyocyte degeneration and fibrosis. Compared with normal control group，the collagen fiber volume fraction（CVF）in all segmental endocardium and partial segmental myocardium of LBBB dogs were significantly increased（all P<0.05）. Percentage of regional tracer uptake was positively correlated with segmental myocardial work（SMW）and segmental myocardial efficiency（SWE）（ r s = 0.49，0.31；both P<0.001），and negatively correlated with CVF and segmental wasted work（SWW）（ r s = -0.51，-0.49；both P<0.001）. Conclusions:Isolated LBBB is not benign，which can result in left ventricular remodeling，decreased cardiac constructive function，abnormal myocardial perfusion，endocardial fibrosis and myocardial fibrosis.The parameters of myocardial work assecsed by echocardiograpgy and myocardial perfusion，as non-invasive examination，can to some extent reflect the degree of left ventricular remodeling in LBBB-CM.

OBJECTIVE To analyze the status of targeted monitoring of the health care-associated infections in in-tensive care unit(ICU)of a three-A hospital of northwest China in recent 7 years so as to provide bases for formu-lating effective prevention and control measures for the health care-associated infections.METHODS The related data were successively collected from the ICU hospitalized patients of the Second Affiliated Hospital of Air Force Medical University who were under the targeted monitoring by nosocomial infection real-time monitoring system from Jan.2017 to Dec.2023.The data included the incidence of infections,infection sites,use of catheters,inci-dence of catheter-related infections,and distribution and prevalence trend of pathogens.RESULTS A total of 49,137 hospitalized patients from five ICU wards of respiratory medicine department,neurosurgery department,neurology department,thoracic surgery department and critical care medicine department were under the monito-ring,1446(1681 case-times)of whom had health care-associated infections,with the infection rate 2.94％,the case-time infection rate 3.42％.The respiratory system was the major infection site of the patients with the health care-associated infections.Among the patients with instrument-associated infections,20.70％had ventilator-asso-ciated pneumonia(VAP),5.71％had urinary catheter-associated urinary tract infection(CAUTI),and 1.96％had catheter-related bloodstream infection(CRBSI).Totally 405 strains of non-repetitive pathogens were isolated from 477 patients with instruments-associated infections,78.77％of which were gram-negative bacteria.The iso-lation rate of multidrug-resistant organisms(MDROs)was 44.12％,and Acinetobacter baumannii was the pre-dominant species of pathogen isolated from the patients with VAP.CONCLUSIONS The targeted monitoring of health care-associated infections may facilitate the awareness of dynamic changes of the infections in a accurate and timely manner so as to provide bases for developing effective prevention and control measures for the health care-associated infection.It is necessary to strengthen the prevention and control of the infections in critical care medi-cine department,neurosurgery department as well as the lower respiratory tract infections and prevent the MDROs infection in the meantime.

Objective:To explore the application value of radiomics, deep learning, and their combined models in predicting the efficacy of radioiodine adjuvant therapy in patients with papillary thyroid cancer (PTC).Methods:A retrospective analysis was conducted on the clinical and imaging data of 131 PTC patients (38 males, 93 females; age 41(33, 48) years) who received first 131I treatment at the Affiliated Hospital of Guilin Medical University from January 2018 to March 2023. Patients were randomly divided into a training set ( n=105) and a test set ( n=26) at the ratio of 8∶2. Multivariate logistic regression analysis was used to screen clinical features to determine independent predictors affecting the efficacy of 131I therapy. Radiomics and deep learning features were extracted from the enhanced CT scans and were combined by using the extremely randomized trees (ExtraTrees) algorithm to construct radiomics, deep learning, and combined models. The predictive abilities of the models were evaluated by AUC, and the Delong test was applied to compare the difference between AUCs. Results:Higher pre-ablation stimulated thyroglobulin (ps-Tg) levels (odds ratio( OR)=1.060, 95% CI: 1.025-1.095, P=0.004) and bilateral lesions ( OR=5.085, 95% CI: 1.452-17.814, P=0.033) were independent predictors of the efficacy of 131I therapy in intermediate to high-risk PTC patients. In the training set, the radiomics model (AUC=0.853) and combined model (AUC=0.880) significantly outperformed the deep learning model (AUC=0.711; Z values: 2.48, 3.09, P values: 0.013, 0.002), while there was no statistically significant difference between the radiomics and combined models ( Z=0.51, P=0.610). In the test set, AUCs of the radiomics, deep learning, and combined models were 0.746, 0.624, and 0.876, respectively, and the AUC of the combined model was higher than that of the radiomics model or deep learning model ( Z values: 2.05, 1.99, P values: 0.040, 0.047). Conclusion:The combined model demonstrates superior performance over the standalone radiomics model and deep learning model in predicting the efficacy of 131I treatment in PTC patients.

Background: and Purpose Ruptured intracranial aneurysms (RIA) are associated with a mortality rate of up to 40% in the Chinese population, highlighting the critical need for targeted treatment interventions for at-risk individuals. Although the impact of aldehyde dehydrogenase 2 (ALDH2) gene mutations on susceptibility to intracranial aneurysms (IA) is well documented, the potential connection between ALDH2 rs671 single-nucleotide polymorphism (SNP) and RIA remains unexplored. Given the increased prevalence of ALDH2 gene mutations among Chinese Han individuals, it is clinically relevant to investigate the link between ALDH2 rs671 SNP and IA rupture. Methods: A prospective study was conducted on 546 patients diagnosed with IA to investigate the association between ALDH2 rs671 SNP and the risk of IA rupture. Results: The ALDH2 rs671 SNP (ALDH2*2) was significantly more prevalent in patients with unruptured IA (UIA) than in those with RIA (32.56% vs. 18.58%, P=0.004). Multivariate logistic regression analysis revealed that people with the ALDH2 mutation (ALDH2*1/*2 and ALDH2*2/*2 gene type) had a significantly reduced odds ratio (OR=0.49; 95% confidence level [CI] 0.27–0.88; P=0.018) for RIAs. Age-specific subgroup analysis indicated that the ALDH2 mutation provided a stronger protective effect in individuals aged 60 years and above with IA compared to those under 60 years old (OR=0.38 vs. OR=0.52, both P<0.05). Conclusion The incidence of RIA was significantly higher in individuals with a normal ALDH2 gene (ALDH2*1/*1) than in those with an ALDH2 rs671 SNP (ALDH2*1/*2 or ALDH2*2/*2). ALDH2 rs671 SNP may serve as a protective factor against RIA in the Chinese Han population.

Objective To study the carrier rate and mutation spectrum of thalassemia genes in the population in Dehong Prefecture,Yunnan Province,thereby providing a scientific basis for developing precise thalassemia prevention and control strategies in this region.Methods A total of 6946 samples were screened and diagnosed for α-thalassemia and β-thalassemia using genetic screening and diagnostic techniques.The carrier status of thalassemia genes in the population was statistically analyzed.Results Among the 6946 samples,1880 tested positive for thalassemia genes,yielding a positive rate of 27.07%(1880/6946).This study detected 1174 α-thalassemia positive samples,with a positive rate of 16.90%(1174/6946).Among the mutation types,-α3.7/αα was identified as the predominant genotype.There were 493 β-thalassemia positive samples,with a positive rate of 7.10%(493/6946).Among the mutation types,CD26 was the most predominant mutation type.The differences in carrier rates between α-thalassemia and β-thalassemia was statistically significant(P<0.01).Additionally,213 samples were positive for both α-thalassemia and β-thalassemia(compound carriers),with a positive rate of 3.07%(213/6946).There were also 207 intermediate thalassemia positive samples,with a positive rate of 2.98%(207/6946).Among these,the-α3.7/--SEA genotype was the most predominant.Conclusion Dehong region is a high-prevalence area for thalassemia carriers,with a relatively high positive rate for thalassemia.The most common gene mutation type was-α3.7/αα and CD26.