Objective To assess the nutritional status in elderly patients with chronic renal insufficiency (CRI) and reveal the key factors affecting the nutritional status. Methods A total of 310 elderly patients with CRI who received hospitalization treatment and outpatient follow-up in the hospital from January 2021 to June 2024 were selected as the investigation subjects. The nutritional status of patients was evaluated by mini-nutritional assessment (MNA) questionnaire, and the nutritional status and dietary structure of patients were comprehensively evaluated by anthropometric indicators [height, weight, body mass index (BMI), upper arm circumference, calf circumference], biochemical indicators [serum albumin (ALB), prealbumin (PA), hemoglobin (Hb), transferrin (TF)] and 24-hour dietary review method. According to the investigation results of nutritional status, the patients were divided into good nutrition group (MNA score≥24 points), nutritional risk group (MNA score of 17-23.5 points) and malnutrition group (MNA score<17 points). Univariate analysis was adopted to screen the potential influencing factors of elderly CRI. Multivariate logistic regression model was applied to analyze the influencing factors of malnutrition in elderly CRI patients. Results Among the 325 questionnaires were distributed, but only 310 valid questionnaires were recovered, with an effective recovery rate of 95.38%. Investigation results revealed that among the 310 patients, 29.35% (91 cases) had good nutritional status, and 42.26% (131 cases) had nutritional risk, and 28.39% (88 cases) had malnutrition. Univariate analysis indicated that there were statistical differences in BMI, CRI staging, serum ALB, PA, Hb, TF, protein intake and total calorie intake among the good nutrition group, the nutritional risk group and the malnutrition group (P<0.05). Multivariate logistic regression analysis suggested that low BMI (OR=0.903, 95%CI: 0.867-0.941), high CRI stage (OR=1.091, 95%CI: 1.053-1.130), low serum ALB (OR=0.907, 95%CI: 0.867-0.948), PA (OR=0.918, 95%CI: 0.888-0.949), Hb (OR=0.944, 95%CI: 0.909-0.997), TF (OR=0.912, 95%CI: 0.874-0.952), insufficient protein intake (OR=0.924, 95%CI: 0.882-0.969) and insufficient total calorie intake (OR=0.938, 95%CI: 0.909-0.968) were influencing factors for malnutrition in elderly patients with CRI (all P<0.05). Drawing ROC curve of malnutrition in elderly patients with CRI according to the prediction probability of logistic regression model found that the AUC, sensitivity, specificity, 95%CI and Youden index were 0.976, 93.18%, 92.34%, 0.953-0.990 (P<0.05) and 0.855. Conclusion The incidence rate of malnutrition is high in elderly patients with CRI, and is mainly affected by factors such as low BMI, high CRI stage, low serum ALB, PA, Hb and TF levels and insufficient protein and total calorie intakes. In addition, logistic regression model has high predictive value and can provide a reference for early clinical identification of high-risk population with malnutrition among elderly patients with CRI.

OBJECTIVE To set up normal ranges for indexes in embryo-fetal development toxicity studies in Sprague-Dawley(SD)rats and to establish a background database to provide reference for the embryo-fetal development toxicity evaluation of drugs.METHODS The data on embryonic develop-ment and fetal growth from embryo-fetal development toxicity studies(11 items)conducted by our center between 2013 and 2022 was statistically analyzed,involving 205 pregnant rats and 3037 fetuses in total,with the mean and standard deviation,coefficient of variation and 95%confidence interval calculated.The indexes included body mass,body mass gain and food consumption during pregnancy,pregnancy outcomes(pregnancy rate,average corpora lutea,average Implant sites,average live conceptuses,live conceptuse rate,resorption rate and dead conceptuse rate),fetal growth and development(fetal mass,placental mass and sex ratio),appearance abnormality rate,visceral abnormality rate,and skeletal abnormality rate.RESULTS The mass of pregnant rats trended up during gestation,with significant increases in the late period.Food consumption increased along with gestation.Caesarean section was conducted on gestation day 20,and the pregnancy rate was 93.2%.The average corpora lutea,Implant sites and live conceptuses were 18.0±3.2,15.9±2.8 and 14.8±3.0,respectively.The live conceptuse rate was 93.4%while the total dead embryo rate was 6.6%.The average mass of fetuses and placenta were respectively 3.6±0.3 and(0.6±0.3)g,and the fetal sex ratio(male/female)was 0.94.The incidence of fetal appearance abnormalities was about 0.2%,and that of soft tissue abnormalities was approximately 0.8%.The rate of skeletal abnormalities was about 1.2%,with higher incidence of non-ossification and incomplete ossification mostly identified on sternum and hyoid bone.The numbers of ossifications of metacarpal bones,metatarsal bones and sacrococcygeal vertebrae were 7.0±0.7,8.0±0.1 and 7.4±0.5,respectively.The rate of ossification of sternumⅠtoⅣwas higher,with an average of about 98.6%-99.9%.The ossification rates of sternum Ⅴ and Ⅵ were(68.0±28.4)%and(82.8±23.9)%.CONCLUSION The background database of indexes in the embryo-fetal development toxicity study on SD rats is established for our GLP laboratory,which provides reference for reproductive toxicity studies.

Malignant tumors have become the main cause of human death.With the prolonged use of chemotherapeutic drugs during the treatment process,tumor cell resistance is also constantly increasing.long non-coding RNA(lncRNA)is an important mem-ber of the non-coding RNA family.Cancer susceptibility candidate 2(CASC2)is a type of long non-coding RNA,high expression of CASC2 can inhibit tumor cell development and reduce drug resistance of tumor cells by promoting apoptosis,regulating signaling path-ways,participating in cellular transmission pathways,competitively binding of miRNA,and changing the protein structure or functional status.This article will provide a comprehensive review of the regulatory effects and mechanism of lncRNA CASC2 on chemotherapy resistance in malignant tumors.

Objective To observe the value of the ratio of cerebral hyperdensities(PCHD)/venous sinus maximum density for predicting hemorrhagic transformation(HT)after endovascular treatment(EVT)in patients with acute ischemic stroke(AIS).Methods Data of 79 AIS patients with PCHD immediately after EVT were retrospectively analyzed.The patients were divided into HT group(n=41)or non-HT group(n=38)based on the presence of HT or not.Clinical data and CT parameters were compared between groups.The value of the ratio of PCHD/venous sinus maximum density for predicting HT was evaluated.Results The maximum density of PCHD and the ratio of PCHD/venous sinus maximum density in HT group were both higher than those in non-HT group(both P＜0.001).Taken 87 HU as the best cut-off value of the maximum density of PCHD,the sensitivity,specificity and area under the curve(AUC)for predicting HT after EVT in AIS patients was 90.24%,71.05%and 0.79,respectively.Taken 0.94 as the best cut-off value of the ratio of PCHD/venous sinus maximum density,the sensitivity,specificity and AUC was 97.56%,71.05%and 0.81,respectively.No significant difference of AUC was found between the former and the latter(P＞0.05).Conclusion The ratio of PCHD/venous sinus maximum density immediately after EVT could be used to predict HT in AIS patients.

Objective:To explore the relationship between the triglyceride glucose (TyG) index and the risk of developing hypertension among rural Chinese adults.Methods:A prospective cohort study was conducted from 2007 to 2008, involving 20 194 adults selected through random cluster sampling from a rural community in Luoyang City, Henan Province. Follow-ups were carried out in 2013-2014 and 2018-2020. After excluding participants with hypertension at baseline, those with missing TyG index data, individuals who passed away during follow-up, and those with incomplete hypertension status at the second visit, 9 802 participants were included in the analysis. Baseline and follow-up assessments included questionnaire interviews, physical measurements (including blood pressure), and blood sample collection for fasting lipid and glucose levels. Participants were divided into four groups according to TyG index quartiles, and a modified Poisson regression model was utilized to assess the association between TyG index quartiles and hypertension risk.Results:The study cohort comprised 9 802 participants with a median age of 48 (39, 57) years, including 3 803 males (38.80%). Participants were distributed across TyG index quartiles as follows: TyG<8.2 group (2 224 individuals), TyG 8.2-8.5 group (2 653 individuals), TyG 8.6-8.9 (2 441 individuals), and TyG≥9.0 (2 484 individuals). Over a follow-up period of (11.1±1.3) years, 3 378 subjects developed hypertension, resulting in a cumulative incidence of 34.46% (3 378/9 802). The risk of hypertension increased with higher TyG index quartiles ( Ptrend<0.05). Compared to the TyG<8.2, the TyG 8.2-8.5 ( RR=1.11, 95% CI 1.01-1.22, P=0.023), TyG 8.6-8.9 ( RR=1.16, 95%CI 1.06-1.27, P=0.023), and TyG≥9.0 ( RR=1.20, 95%CI 1.10-1.31, P=0.023) exhibited increased hypertension risk after adjusting for age, gender, educational level, and other potential confounders. Subgroup analyses based on gender and age at baseline yielded results consistent with the main analysis. Conclusions:The TyG index is positively correlated with the risk of developing hypertension in the rural adult population.

Objective:To analyze the short and mid-term efficacy of aortic valvuloplasty with autopericardium on children with aortic valve diseases.Methods:A total of 26 children with aortic valve diseases (stenosis or regurgitation) who underwent aortic valvuloplasty with autopericardium in Fuwai Central China Cardiovascular Hospital from September 2017 to June 2021 were retrospectively analyzed.The short-term and mid-term follow-up data were collected.The maximum aortic valve pressure gradient, subaortic regurgitation area, left ventricular end-diastolic volume (LVEDV) and left ventricular ejection fraction (LVEF) were compared before and after operation.Paired t test was used to analyze the short-term and mid-term efficacy of aortic valvuloplasty with autopericardium on children with aortic valve diseases. Results:All 26 cases were successfully operated, and there were no deaths and serious complications during the follow-up period of (22.96±6.45) months.There was a significant difference between the preoperative and postoperative maximum aortic valve pressure gradient at 1 month ( t=7.85, P<0.05), 6 months ( t=6.43, P<0.05), 1 year ( t=6.16, P<0.05) and 2 years postoperatively ( t=4.22, P<0.05) in children with aortic stenosis or that combined with mild-to-moderate closure.The follow-up data of 9 children with simple aortic stenosis showed that there was a significant difference between the preoperative (8.87±3.57) cm 2 and postoperative aortic regurgitation area at 1 month ( t=6.85, P<0.05), 6 months ( t=5.13, P<0.05), 1 year ( t=6.62, P<0.05) and 2 years postoperatively ( t=5.41, P<0.05). The LVEDV of 26 children was significantly lower at 6 months[(63.54±27.61) mL], 1 year [(53.61±20.20) mL] and 2 years postoperatively [(64.39±17.78) mL] compared with that of preoperative level[(89.42±45.89) mL]( t=3.89, 4.67, 3.58, all P<0.05). The left ventricular pressure and volume decreased, the enlarged heart was narrowed down, and the geometry of the heart was restored.The LVEF of 26 patients also from (61.65±9.67)% before surgery increased to (67.88±4.69)% 6 months after surgery( t=3.68, P<0.05), and increased to (68.62±4.46)% 1 year after surgery( t=4.01, P<0.05), and increased to (67.55±3.09)% 2 years after operation( t=3.01, P<0.05), and the heart function was improved. Conclusions:Aortic valvuloplasty with autopericardium presents an effective short and mid-term efficacy on children with aortic valve diseases, which prevents or delays the aortic valve replacement.

Background::Sirtuin-3 (Sirt3) has been documented to protect against mitochondrial dysfunction and apoptosis. Honokiol (HKL) is a Sirt3 pharmacological activator with reported neuroprotective effects in multiple neurological disorders. The present study aimed to explore the neuroprotective effects of HKL and the role of Sirt3 following intracerebral hemorrhage (ICH).Methods::An in vivo ICH model in rats was established by injecting autologous blood into the right basal ganglia. PC12 cells were stimulated with hemin. For the in vivo investigation, the modified Neurological Severity Scores and the Morris water maze test were performed to assess neurological deficits. Hematoxylin-Eosin and Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling staining were employed to evaluate the histopathology and apoptosis. Immunohistochemical staining was used to investigate the expression of Sirt3. Adenosine triphosphate (ATP) levels were quantified to assess mitochondrial dysfunction. Cell counting kit-8, lactate dehydrogenase assay, and flow cytometry were used to analyze cell vitality and apoptosis in vitro. Immunofluorescence staining was performed to observe mitochondrial morphology and dynamin-related protein 1 (Drp1) localization to mitochondria. Western blot was applied to quantify the expression of Sirt3, Bax, Bcl-2, cleaved-caspase-3, Drp1, phosphorylation of Drp1 at serine-616, and phosphorylation of Drp1 at serine-637 in vivo and in vitro.Results::HKL treatment alleviated neurological deficits, attenuated the histopathological damage and cell apoptosis, and restored the decreased ATP levels in ICH rats. HKL improved cell survival rate, reduced cell apoptosis, and inhibited mitochondrial fission in PC12 cells. Moreover, both in vivo and in vitro models showed increased phosphorylation of Drp1 at Ser616, and reduced phosphorylation of Drp1 at Ser637. Meanwhile, immunofluorescence co-localization analysis revealed that hemin increased the overlap of Drp1 and mitochondria in PC12 cells. The phosphorylation and mitochondrial translocation of Drp1 were effectively reversed by HKL treatment. Importantly, the selective Sirt3 inhibitor 3-(1H-1,2,3-triazol-4-yl) pyridine suppressed these effects. Conclusion::Our findings demonstrated that HKL ameliorated ICH-induced apoptosis and mitochondrial fission by Sirt3, suggesting that HKL has immense prospects for the treatment of ICH.

Objective:To evaluate the right ventricular function in patients with dilated cardiomyopathy (DCM) by four-dimensional automatic right ventricular quantitative analysis (4D Auto RVQ), and compare with the right ventricular ejection fraction measured by cardiac magnetic resonance (CMR-RVEF), and to explore the clinical application value of 4D Auto RVQ technique in evaluating the right ventricular function of patients with DCM.Methods:A prospective study was conducted to select 52 patients with DCM who were treated in Fuwai Central China Cardiovascular Hospital of Zhengzhou University from March to October 2022 as DCM group, and 52 healthy volunteers were selected as the control group during the same period. The four-dimensional right ventricular ejection fraction (4D-RVEF), right ventricular stroke volume index (RVSVI), right ventricular end-diastolic volume index (RVEDVI), right ventricular end-systolic volume index (RVESVI), four-dimensional right ventricular basal diameter (4D-RVDd-base), four-dimensional right ventricular middle diameter (4D-RVDd-mid), four-dimensional right ventricular long axis diameter (4D-RVLd), four-dimensional tricuspid annular plane systolic excursion (4D-TAPSE) and four-dimensional right ventricular fractional area change (4D-RVFAC) were obtained by 4D Auto RVQ technique. The differences of the above parameters between DCM group and control group were compared.Pearson linear correlation analysis was used to evaluate the correlation between echocardiographic parameters and CMR-RVEF. The ROC curve was used to find the most sensitive parameters for evaluating right ventricular function, and the area under the ROC curve ( AUC ) was calculated and compared.Results:Compared with the control group, RVEDVI, RVESVI, 4D-RVDd-base and 4D-RVDd-mid in the DCM group were increased, and the absolute values of 4D-RVEF, 4D-TAPSE, 4D-RVFAC, right ventricular global longitudinal strain(RVGLS) and right ventricular free wall longitudinal strain(RVFWLS) were decreased (all P<0.05). Correlation analysis showed that 4D-RVEF was positively correlated with CMR-RVEF ( r=0.711, P<0.05). ROC curve analysis showed that 4D-RVEF was superior to other parameters in evaluating right ventricular function in DCM patients (AUC: 0.916). Conclusions:4D Auto RVQ technique can quantitatively evaluate right ventricular function in DCM patients. 4D-RVEF has a significant correlation with CMR-RVEF, and 4D-RVEF has the best efficacy in evaluating right ventricular function in DCM patients.

Objective·To explore the immune-related characteristics of non-small cell lung cancer(NSCLC),discover potential tumor markers in V-J genes,and lay the foundation for establishing a TCR-antigen recognition prediction model.Methods·A total of 704 NSCLC samples were collected to establish a comprehensive T-cell receptor(TCR)repertoire analysis workflow.The upstream analysis included steps such as raw data processing,quality control,filtering,TCR sequence identification,and extraction.The downstream analysis included repertoire clone distribution,clone typing,V-J gene sharing,CDR3 distribution characteristics,and clone tracking.The sample clone distribution was analyzed by using indices such as Shannon-Weiner index and Chaol index.Clone typing was performed based on the number of clone amplifications to explore differences among different types.The degree of V-J gene segment sharing was analyzed,and the sharing of low-frequency clone types was determined through clone amplification weight analysis of V-J genes by using two samples of papillary thyroid carcinoma.Finally,analysis of the distribution characteristics of V genes and high-frequency clone type CDR3,and clone tracking analysis were conducted to monitor changes in tumor immune clone frequencies before and after analysis,aiming to identify potential tumor markers.Results·① Significant differences were observed in clone distribution and clone typing among different NSCLC tissues,as well as among different ages and genders.② Specific highly-shared V-J genes were identified in the analysis of V-J gene sharing,and non-normal distribution of high-clone V genes and amino acid high-frequency clone types were found in the CDR3 distribution analysis.③ In the analysis of high-frequency clone type clone tracking,highly expressed or newly expressed high-frequency clone types were observed in NSCLC,suggesting that these clone types could serve as potential tumor-associated antigens or bind with CDR3 reference sequences of new antigens.④ It was found that the expression frequency of TRBJ2-5 gene,originally low-expressed,significantly increased,indicating its potential role as a key low-frequency gene in tumor immune response.Conclusion·The TRAV21 and TRBV6.5 genes show high clone amplification in NSCLC and could serve as potential tumor biomarkers.

Objective:To explore the effect of inpatient palliative care in patients with end-stage heart failure.Methods:From July 2019 to January 2021, convenience sampling was used to select 97 patients with end-stage heart failure admitted to the Cardiovascular Department of Henan Provincial Chest Hospital as the research subject. The patients were divided into the control group ( n=48) and the observation group ( n=49) with the random number table. The control group conducted routine nursing, and the observation group carried out inpatient palliative care on this basis. The 21-Item Depression Anxiety Stress Scale (DASS-21) , General Self-efficacy Scale (GSES) and Minnesota Living with Heart Failure Questionnaire (MLHFQ) were used to compare the adverse psychological state, self-efficacy and quality of life of the two groups of patients. Results:Before intervention, there were no significant differences in DASS-21, MLHFQ and GSES scores between the two groups ( P>0.05) . After intervention, the DASS-21 and MLHFQ scores of the observation group were lower than those of the control group, and the GSES score was higher than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Inpatient palliative care can effectively relieve the adverse psychological state of patients with end-stage heart failure and improve their self-efficacy and quality of life.