Objective To explore the independent risk factors influencing the poor prognosis after transnasal-intestinal obstruction catheterization under endoscopic ultrasound,construct a nomogram for predicting poor postoperative prognosis,and conduct external validation of the nomogram.Methods Clinical data of 451 patients with intestinal obstruction who underwent endoscopic ultrasound transnasal-intestinal obstruction catheterization from February 2019 to February 2022 were collected to establish a nomogram.Then,194 sets of data with the same conditions from February 2022 to February 2024 were collected as the external validation group to validate the model externally.The recovery at 30 d after operation was observed and divided into good prognosis group and poor prognosis group.Multivariate Logistic regression model was used to analyze the independent risk factors influencing the poor prognosis after transnasal-intestinal obstruction catheterization under endoscopic ultrasound.Using R 3.6.3 software and the RMS package,a nomogram model for predicting the risk of poor prognosis after intestinal obstruction catheterization under endoscopic ultrasound was constructed..The discrimination and consistency of the model were evaluated using receiver operator characteristic curve(ROC curve)and calibration curve.Results The patients in the poor prognosis group were older than those in the good prognosis group,the levels of C-reactive protein(CRP),procalcitonin(PCT)and neutrophil to lymphocyte ratio(NLR)were higher than those in the good prognosis group,the length of hospital stay was longer than that in the good prognosis group,and the proportion of diabetes,abdominal pain and hormone using were higher than those in the good prognosis group,body mass index(BMI),preoperative albumin level and preoperative nutritional support ratio were lower than those of the good prognosis group,with statistical significance(P<0.05).Multivariate Logistic regression analysis(introduction level was 0.05,exclusion level was 0.107)showed that:age≥68 years(OR＾=2.631,95%CI:1.927～3.593),BMI<22.31 kg/m2(OR＾=2.142,95%CI:1.436～3.195),preoperative albumin<32.47g/L(OR＾=1.962,95%CI:1.506～2.556)and preoperative nutritional non-support(OR＾=2.814,95%CI:1.401～5.654)were independent risk factors affecting the poor prognosis after endoscopic transnasal-intestinal obstruction catheterization(P<0.05).The column nomogram showed that old age,low BMI,low preoperative albumin,and no preoperative nutritional support all increased their corresponding weights.Internal and external validation results indicated good consistency and discrimination of the model.Conclusion age≥68 years,BMI<22.31 kg/m2,preoperative albumin<32.47 g/L,and no preoperative nutritional support are all independent risk factors affecting the ineffective of intestinal obstruction catheterization under endoscopic ultrasound.The nomogram model established in this study based on these four factors has high reliability and practicality.

Objective To explore the independent risk factors influencing the poor prognosis after transnasal-intestinal obstruction catheterization under endoscopic ultrasound,construct a nomogram for predicting poor postoperative prognosis,and conduct external validation of the nomogram.Methods Clinical data of 451 patients with intestinal obstruction who underwent endoscopic ultrasound transnasal-intestinal obstruction catheterization from February 2019 to February 2022 were collected to establish a nomogram.Then,194 sets of data with the same conditions from February 2022 to February 2024 were collected as the external validation group to validate the model externally.The recovery at 30 d after operation was observed and divided into good prognosis group and poor prognosis group.Multivariate Logistic regression model was used to analyze the independent risk factors influencing the poor prognosis after transnasal-intestinal obstruction catheterization under endoscopic ultrasound.Using R 3.6.3 software and the RMS package,a nomogram model for predicting the risk of poor prognosis after intestinal obstruction catheterization under endoscopic ultrasound was constructed..The discrimination and consistency of the model were evaluated using receiver operator characteristic curve(ROC curve)and calibration curve.Results The patients in the poor prognosis group were older than those in the good prognosis group,the levels of C-reactive protein(CRP),procalcitonin(PCT)and neutrophil to lymphocyte ratio(NLR)were higher than those in the good prognosis group,the length of hospital stay was longer than that in the good prognosis group,and the proportion of diabetes,abdominal pain and hormone using were higher than those in the good prognosis group,body mass index(BMI),preoperative albumin level and preoperative nutritional support ratio were lower than those of the good prognosis group,with statistical significance(P<0.05).Multivariate Logistic regression analysis(introduction level was 0.05,exclusion level was 0.107)showed that:age≥68 years(OR＾=2.631,95%CI:1.927～3.593),BMI<22.31 kg/m2(OR＾=2.142,95%CI:1.436～3.195),preoperative albumin<32.47g/L(OR＾=1.962,95%CI:1.506～2.556)and preoperative nutritional non-support(OR＾=2.814,95%CI:1.401～5.654)were independent risk factors affecting the poor prognosis after endoscopic transnasal-intestinal obstruction catheterization(P<0.05).The column nomogram showed that old age,low BMI,low preoperative albumin,and no preoperative nutritional support all increased their corresponding weights.Internal and external validation results indicated good consistency and discrimination of the model.Conclusion age≥68 years,BMI<22.31 kg/m2,preoperative albumin<32.47 g/L,and no preoperative nutritional support are all independent risk factors affecting the ineffective of intestinal obstruction catheterization under endoscopic ultrasound.The nomogram model established in this study based on these four factors has high reliability and practicality.

Objective:To investigate the potential value of saccade and antisaccade parameters in early identification of Parkinson′s disease (PD) and its motor subtypes.Methods:A total of 111 PD patients [tremor dominant (TD) type in 45, postural instability/gait difficulty (PIGD) type in 54 and indeterminate type in 12)] and 54 healthy controls were recruited from Department of Neurology, Guangdong Provincial People′s Hospital from July 2022 to July 2023. All subjects underwent oculomotor test including visually guided saccades and volitional antisaccades by the Eyeknow-M10-B Eye tracker. For PD patients, TD and PIGD scores were measured using the Movement Disorder Society Unified Parkinson′s Disease Rating Scale (MDS-UPDRS) Part Ⅱ and Part Ⅲ. Oculomotor parameters among TD, PIGD patients and healthy controls were firstly compared. Multiple linear regression analyses were performed to assess the relationship between ocular parameters with differences and TD/PIGD score. Then receiver operating characteristic (ROC) curve analysis was made between PD patients and healthy controls, as well as between PIGD and TD subtypes.Results:Compared to healthy controls, PD patients showed significantly decreased saccadic accuracy [100.0%(90.0%, 100.0%) vs 100.0%(100.0%, 100.0%), U=1 732.500, P<0.001], prolonged latency [252.2(228.5, 300.1) ms vs 227.7(214.2, 241.8) ms, U=1 401.000, P<0.001], minimum duration [233.6(211.2, 278.8) ms vs 211.0(200.0, 222.5) ms, U=1 534.500, P<0.001], average duration [356.6(313.8, 427.8) ms vs 279.4(267.4, 312.9) ms, U=881.000, P<0.001],as well as decreased peak [444.4(335.0, 593.7) °/s vs 526.7(412.6, 696.2) °/s, U=1 971.000, P=0.007] and average velocity [196.3(144.4, 240.5) °/s vs 256.7(226.7, 312.0) °/s, U=1 330.000, P<0.001] in saccades. And in antisaccades, PD patients also showed prolonged latency [432.0(362.9, 599.8) ms vs 352.9(309.8, 407.6) ms, U=1 553.000, P<0.001], minimum duration [333.4(299.8, 377.6) ms vs 290.1(263.9, 332.9) ms, U=1 608.000, P<0.001], average duration [518.2(462.7, 603.5) ms vs 424.2(377.1, 473.5) ms, U=1 181.000, P<0.001], decreased peak [458.5(327.9, 604.3) °/s vs 560.4(440.3, 698.5) °/s, U=1 838.500, P=0.001] and average velocity [186.6(143.1, 228.1) °/s vs 263.2(217.2, 301.5) °/s, U=1 131.000, P<0.001]. There was no statistically significant difference in antisaccadic accuracy [55.0%(15.0%, 80.0%) vs 66.7%(39.4%, 86.9%), U=2 167.500, P=0.053]. Compared with TD subtype, PIGD patients showed significantly decreased antisaccadic peak velocity [416.2(300.3, 534.3) °/s vs 527.1(402.3, 636.4) °/s, U=-26.474, P=0.009]. After adjusting for age, gender and education, antisaccadic peak velocity was negatively correlated with PIGD score in PD patients (β=-0.296, P=0.001), and no correlation with TD score was found. The ROC analysis was performed on combined saccadic and antisaccade metrics between PD patients and healthy controls, with area under the curve (AUC) as 0.918. For antisaccadic peak velocity between PIGD and TD subtypes, the AUC was 0.690. Conclusions:Eye movement metrics have potential value in distinguishing PD patients from healthy controls. The antisaccadic peak velocity is related to the severity of motor symptoms in PIGD patients, which is helpful for distinguishing the motor subtypes of PD patients.

Objective:To improve the longevity genetic research study design by applying self-organizing maps to select a control group for longevity study.Methods:This study included the Han population aged 90 years and above or less than 80 years who have died (control group) from the natural population-based cohort formed by the fusion of the Chinese Chronic Diseases and Risk Factors Surveillance in 2013 and the China Death Surveillance System. The subjects who died of injury, infectious diseases, parasitic diseases, and malignant tumors were excluded. The self-organizing maps method, with multiple iterations and self-organizing clustering, was used to select similar factors among the population aged 90 years and above and the control group, including demographic characteristics, diseases, living habits, social behaviors, and mental and psychological factors. The study used PLINK 1.9 software to evaluate the quality of whole genome sequencing and to conduct logistic regression of single nucleotide polymorphisms (SNPs) and longevity on autosomes. Q-Q plots were used to visualize the P value associated with SNPs and longevity. Results:There were 1 019 samples selected from the baseline of 177 099 survey participants for genome sequencing, including 517 in the longevity group and 502 in the control group. The longevity and the control groups are generally similar in smoking, drinking, diet, sleep duration, blood lipid level, and self-assessment oral health status but differ significantly in socio-economic status, physical activity time, BMI, and self-assessment health status. The whole genome sequencing results were controlled, and 4 618 216 SNPs were involved in association analysis. The Q-Q plot of longevity-related SNPs analysis results showed that the enrichment of P value 1e-4 was significantly lower than the expected P value, and significant signals were also detected among P<1e-7 regions. Conclusions:The self-organizing maps can comprehensively consider the influence of socioeconomic and behavioral risk factors and select longevity control samples among samples with actual age and cause of death in a large-scale natural population cohort to improve the efficiency of longevity genome association analysis. This study provides a methodological reference for nested case-control study sample selection from the large-scale natural population cohort.

Objective:To evaluate the risk factors of acute kidney injury (AKI) in patients with multiple wasp stings.Methods:Patients with multiple wasp stings were retrospectively enrolled in Hanzhong Central Hospital from September 2010 to November 2020. Based on whether the patients developed AKI, the patients were divided into AKI group and non-AKI group. The general characteristics and laboratory examinations between the two groups were compared. The logistic regression model was used to analyze the risk factors of AKI.Results:A total of 356 patients with multiple wasp stings were recruited in this study, with 196 males (55.1%). The age was 56.0(45.0, 64.0) years old. There were 59 patients (16.6%) with hypertension and 13 patients (3.6%) with diabetes. There were 51 patients (14.3%) in the AKI group and 305 patients (85.7%) in the non-AKI group. Baseline data and biochemical examinations indicated that the two groups showed significant differences in gender, age, sting sites (systemic or local), sting needles, proportions of gross hematuria, leukocyte count, hemoglobin, creatine kinase, alanine transaminase, aspartate aminotransferase, total bilirubin, proportions of urinary protein, and proportions of urine occult blood (all P<0.05). The multivariate logistic regression analysis results showed that the increasing number of sting needles (every 10 needles increase, OR=1.866, 95% CI 1.289-2.071, P=0.001), gross hematuria ( OR=9.770, 95% CI 2.586-36.910, P=0.001), decreasing hemoglobin (every 1 g/L increase, OR=0.016, 95% CI 0.001-0.355, P=0.009), increasing aspartate aminotransferase (every 100 U/L increase, OR=1.311, 95% CI 1.144-1.502, P<0.001), and increasing total bilirubin (every 10 μmol/L increase, OR=1.200, 95% CI 1.008-1.430, P=0.041) were independent influencing factors of AKI. Conclusions:The increasing number of sting needles, gross hematuria, decreasing hemoglobin, increasing aspartate aminotransferase, and increasing total bilirubin are independent risk factors of AKI in patients with multiple wasp stings.

Background::Although various therapies have been developed to treat malalignment in osteoarthritic knees, the pattern of malalignment progression is still unclear. This study aimed to identify homogeneous subgroups with distinct trajectories of malalignment progression in subjects with symptomatic knee osteoarthritis (KOA) and to determine corresponding risk factors.Methods::Eight-year follow-up (from 2004 to 2012) data on 1252 participants with symptomatic KOA from the Osteoarthritis Initiative were included. Varus/valgus angle progression was characterized by group-based trajectory models. Time-varying covariates were introduced into the model to investigate how they affected trajectories. Multinomial logistic regression for trajectory group membership was applied to ascertain risk factors.Results::Five subgroups were identified. Participants in the varus worsening trajectory ( n = 166) or valgus worsening trajectory ( n = 118) proceeded to worsen malalignment over time. The neutral trajectory ( n = 378), varus stable trajectory ( n = 328), and valgus stable trajectory ( n = 262) maintained close to the initial varus/valgus angle over 8 years. Higher baseline Kellgren and Lawrence grade (odds ratio [OR] = 4.35, P < 0.001 for varus; OR= 3.85, P < 0.001 for valgus) and "severe" baseline malalignment (OR = 13.57, P < 0.001 for varus; OR = 23.04, P < 0.001 for valgus) were risk factors for worsening trajectories. The cutoff point of the baseline varus/valgus angle to discriminate between stable or worsening trajectory was -4.5° for varus and 3.6° for valgus. Conclusions::This study identified the malalignment progression pattern — minor malalignment (-4.5° to +3.6°) tends to remain stable, while major baseline malalignment is likely to progress. This provides a reference for therapy to prevent malalignment from deteriorating and emphasizes the necessity of determining the trigger factors for malalignment onset.

OBJECTIVE：To compare the an ti-hepatocarcinoma effects of curcumin （CUR）and its derivative hydrazincurcumin （HZC），and to explore the mechanism. METHODS ：MTT assay was used to detect the effects of CUR or HZC （2.5，5，10，20， 40，80 μmol/L）on the proliferation of HepG 2 cells. Flow cytometry was used to detect the effects of CUR or HZC （10，20，40 μmol/L）on cell cycle distribution and apoptosis of HepG 2 cells. Western blotting assay was used to detect the effects of CUR or HZC（10，20，40 μmol/L）on the expression of apoptosis-related protein in HepG 2 cells. The male SD rats were randomly divided into normal control group （n＝10），CUR control group （n＝10），HZC control group （n＝10），model group （n＝30），CUR protection group （n＝30）and HZC protection group （n＝30）. CUR control group and HZC control group were given CUR 85917439。E-mail：zhaoji-an-88@163.com or HZC （80 mg/kg） intraperitoneally. Model group ，CUR protection group and HZC protection group were given diethylnitrosamine （50 mg/kg）intraperitoneally to establish hepatocarcinoma model ；at the same time ，2 protection groups were given CUR or HZC （80 mg/kg）intraperitoneally，twice a day，for consecutive 12 weeks. During medication ，the change of body weight and death of rats were recorded. Twenty four weeks later，liver index of rats was calculated and appearance was observed ；the number of cancer nodules was counted ；HE staining was used to observe the pathological changes of liver tissue and calculate the nuclear division index of hepatocarcinoma ；the proliferating cell nuclear antigen （PCNA）index was detected by immunohistochemistry. RESULTS ：CUR and HZC could increase the inhibitory rate of HepG 2 cells（P＜0.05），and increased the percentage at G 0/G1 phase and apoptotic rate of HepG 2 cells（P＜ 0.05）. CUR and HZC could significantly decrease the protein expression of p-JAK 2，p-STAT3，Bcl-2 and Bcl-xl ，while increased the protein expression of Bax ，Cyt-c，Caspase-9，Caspase-3 and PAPR （P＜0.05）. Above effects of HZC were significantly better than those of CUR （P＜0.05）. The results of animal experiment showed that there was no death ，no liver canceration and no pathological changes in liver appearance and tissue section of the three control groups ；there was no statistical significance in body weight and its increased weight ，liver index ，nuclear division index of carcinoma or PCNA index （P＞0.05）. Compared with model group， survival rate of rats were increased significantly in CUR protection group and HZC protection group ， while hepatocarcinoma incidence and the number of cancer nodules were decreased significantly （P＜0.05）；body weight and its increased weight were increased significantly ，while liver index ，nuclear division index of carcinoma and PCNA index were decreased significantly （P＜0.05）. There were some pathological changes in liver appearance and tissue section ；cancerous lesions with focal necrosis or cancerous lesions with patchy necrosis were observed. There was no statistical significance in the improvement of above indexes in 2 protection groups （P＞0.05）. CONCLUSIONS ：HZC could inhibit the proliferation and induce apoptosis of HepG 2 cells by inhibiting JAK 2/STAT3 signaling pathway and regulating the activation of mitochondrial endogenous pathway，which shows stronger anti-hepatocarcinoma effect in vitro than CUR. On the other hand ，there was no significant difference in the improvement of liver caner indexes in hepatic cancer model rats between HZC and CUR.

Objective To investigate the level of vitamin D in patients with membranous nephropathy and its correlation with proteinuria. Methods Eighty patients with membranous nephropathy were selected from May 2012 to May 2017 in the Department of Nephrology,Shijiazhuang First Hospital. They were divided into two groups with 40 cases in each group. The control group was given prednisolone acetate orally,while the study group was given prednisolone acetate and active vitamin D orally. All patients were followed up for 1 year. Blood urea nitrogen ( BUN), serum creatinine ( Scr), C-reactive protein ( CRP ), cholesterol (TC),triglyceride (TG),calcium (Ca),phosphorus (P),parathyroid hormone (PTH),urinary protein,1,25-dihydroxyvitamin D3 ( 1, 25 ( OH) 2D3) and transforming growth factor-beta ( TG) were measured monthly. F-beta 1 ) and other related biochemical indicators were recorded. Results Before treatment,the level of 1,25(OH) 2D3 in the control group was (3. 67+3. 67) μg／L,while that in the study group was (3. 69+3. 70) μg／L. There was no significant difference ( t＝1. 259,P＞0. 05) . One year after treatment,the level of 1,25(OH) 2D3 in the control group was (4. 87+2. 92) μg／L,while that in the study group was (19. 58+12. 12) μg／L,which was significantly higher in the study group than in the control group (t＝12. 384,P＜0. 05). Serum 1,25 (OH) 2D3 levels were positively correlated with blood calcium,plasma albumin,podocyte and TGF-β1 (r＝0. 301,0. 387,0. 342 and 0. 181,respectively,P＜0. 05); serum 1,25 ( OH) 2D3 levels were negatively correlated with blood phosphorus content,total cholesterol and 24 h urinary protein quantity (r value was －0. 265,－0. 033 and －0. 265,respectively,P＜0. 05) . Serum albumin was an independent factor of serum 1, 25 ( OH ) 2D3 ( P＜0. 05 ) . Conclusion The serum albumin is an independent risk factor for 1, 25 ( OH ) 2D3 in patients with membranous nephropathy. Vitamin D is negatively correlated with proteinuria. Active vitamin D has a better effect on proteinuria in patients with membranous nephropathy.

Objective To evaluate the effect of an emollient containing Prinsepia utilis Royle oil extracts and other extracts on clinical symptoms and disease recurrence in children aged 2-12 years with atopic dermatitis (AD) in the remission period.Methods A multicenter,randomized,parallel-group,controlled clinical trial was conducted from December 2017 to September 2018.A total of 297 children aged 2-12 years with moderate AD were enrolled from 5 hospitals in China,and randomly divided into the test group (148 cases) and control group (149 cases).In the acute stage,the two groups were both topically treated with mometasone furoate cream once a day on the skin lesions,and with an emollient containing Prinsepia utilis Royle oil extracts and other extracts twice a day throughout the whole body for 2-4 weeks.The children would be enrolled into the remission stage if their Investigator's Global Assessment (IGA) score was ≤ 1 at following visits.In the remission stage,the test group was only topically treated with the emollient twice a day throughout the whole body,while mometasone furoate cream and the emollient were both withdrawn in the control group.At weeks 4,8 and 12 in the remission stage,the recurrence of AD,eczema area and severity index (EASI),children's dermatology life quality index (CDQOL) and adverse events were evaluated.Statistical analysis was carried out with SAS 9.4 software by using t test for comparison of normally distributed continuous data between two groups,chi-square test for comparison of unordered categorical data,Kaplan-Meier method for analysis of survival rates,Cox regression analysis for evaluating the effect of different therapies on AD recurrence in children in the remission stage,and Logistic regression analysis for analysis of odds ratio (OR) of EASI or CDQOL at week 4 in the remission stage between the test group and control group.Results Of the 297 children with AD,31 breached the clinical trial protocol,and 266 were included in the per protocol set (PPS),including 132 in the test group and 134 in the control group.In the PPS,114 and 106 patients completed the follow-up in the test group and control group respectively,and the recurrence rate was significantly lower in the test group (47,41.23％) than in the control group (84,79.25％;x2 =32.96,P ＜ 0.001).The time to recurrence was significantly longer in the test group(61.99 d ± 2.80 d)than in the control group(39.17 d ± 2.54 d,t =6.03,P ＜ 0.001),and the recurrence risk was significantly lower in the test group than in the control group (Log rank test,x2 =32.02,P ＜ 0.001).After adjustment for age and gender,Cox regression analysis showed that the recurrence risk in the test group was 0.35 times that in the control group (HR =0.35,95％ CI:0.24-0.51,P ＜ 0.01).At week 4 in the remission stage,the EASI score at P50-P75 and P75-P100 in the test group were 0.42,0.25 times that in the control group respectively (95％ CI:0.20-0.86,0.12-0.54 respectively;P =0.02,＜ 0.01respectively).Moreover,the CDQOL score at P75-P100 in the test group was 0.33 times that in the control group (95％ CI:0.17-0.65,P ＜ 0.01).No significant difference in the incidence of adverse events was observed between the two groups (P ＞ 0.05).Conclusion Maintenance treatment with the emollient containing Prinsepia utilis Royle oil extracts and other extracts can markedly reduce the recurrence risk in AD children,improve clinical symptoms,and enhance the quality of life.

Objective: To investigate the current status of professional identity among the undergraduates majoring in public affairs management and the related influence factors. Methods: A stratified cluster sampling method was used to conduct a questionnaire survey among the 115 undergraduates majoring in public affairs management in a medical university in Harbin, China, and the contents of the questionnaires included general status and professional identity. The t-test, one-way analysis of variance, and multiple linear regression analysis were used to analyze the influencing factors of professional identity. In-depth interviews were conducted for some students to explore the profound influencing factors for professional identity among the students majoring in public affairs management. Results: The overall level of professional identity was low among the undergraduates majoring in public affairs management in the medical university in Harbin, and the score of professional identity was 3.25±0.56. The scores of cognitive dimension, emotional dimension, behavioral dimension, and applicable dimension were 3.41±0.69, 3.21±0.78, 3.24±0.71, and 3.13±0.72, respectively. The multivariate analysis showed that grade, academic performance, major selection, and children number in family had significant influence on their professional identity. The students who were at grade four, who had high academic record (b=-0.276, P<0.01), who chose this major independently (b=-0.277, P<0.01), and who were the only child (b=-0.233, P<0.05) had a high score of professional identity. As for the undergraduates at different grades, the undergraduates at grades two and three had a significantly lower score of professional identity than those at grade four (b=-0.296 and -0.369, P<0.05), while there was no significant difference between the undergraduates at grades one and four (b=-0.008, P>0.05). Furthermore, the students with a high score of professional identity had higher possibility to pursue the job related to this major than those with a low score (3.39±0.53 vs. 2.92±0.49, t=4.414, P<0.01). Conclusion Universities should strengthen the publicity of the major of public affairs management, optimize the curriculum, and add job experience, so as to enhance professional identity among students with this major and provide talent for the field of public health management.