Objective To analyze the expression levels of TIPE2 and Ki67 in endometrial carcinoma(EC)and their relationship with clinicopathological parameters and prognosis.Methods Tissue samples and clinical data of 96 patients with EC who underwent surgical resection,120 patients who underwent total hysterec-tomy due to uterine fibroids and 120 patients who underwent total hysterectomy or curettage admitted to our hospital from February 2020 to February 2022 were retrospectively collected as the research objects,which were divided into the EC group,the normal endometrial group and the atypical hyperplasia endometrial group,respectively.All 3 groups were followed up until March 28,2023.Immunohistochemistry was used to detect the expression levels of TIPE2 and Ki67 in tissue samples of the three groups,and to analyze the relationship between the levels of TIPE2 and Ki67 and clinicopathological parameters and prognosis.Receiver operating characteristic curve(ROC)was used to analyze its diagnostic value for poor prognosis.Results The expression levels of TIPE2 and Ki67 in cancer tissues of the EC group were higher than those of the normal endometrial group and the atypical hyperplasia endometrial group,and those of the atypical hyperplasia endometrial group were higher than those of the normal endometrial group(P<0.05).The expression levels of TIPE2 and Ki67 in EC tissues were higher in patients with FIGO stage Ⅲ,lymph node metastasis,postmenopausal status,and ER and PR negative than patients with stageⅡ,no lymph node metastasis,premenopausal status,and ER and PR positive(P<0.05).Moreover,the expres-sion level of Ki67 in EC tissues was higher in p53 positive patients than in p53 negative patients(P<0.05),and there was a positive correlation between the both expression levels of TIPE2 and Ki67 in EC tissues(r=0.569,P<0.05).Compared with the poor prognosis group,the expression levels of TIPE2 and Ki67 in EC tissues in the good prognosis group were downregulated(P<0.05),and the AUC value of the combined detection of TIPE2 and Ki67 expression levels was 0.905,which was significantly higher than that of the single detection(P<0.05),sensitivity was 86.67%and specificity was 87.88%,and the predictive value was higher.Conclusion TIPE2 and Ki67 were highly expressed in EC tissues,and there was a positive correlation between the two,and their high expressions were related to clinicopathological features,and their combined detection had high predictive value for poor prognosis of EC.

Objective To investigate the predictive value of pre-transfer serum fibroblast growth factor 21(FGF-21),anti-Müllerian hormone(AMH),and neuropilin-1(NRP-1)for early pregnancy loss at 6 weeks following in vitro fertilization-embryo transfer(IVF-ET),and to establish an early predictive model based on serum biochemical markers.Methods This prospective study consecutively enrolled 322 women who achieved clinical pregnancy after IVF-ET at our center between September 2022 and September 2024.Participants were randomly divided into a modeling cohort(n=225)and a validation cohort(n=97)at a 7:3 ratio.According to ultrasound findings at 6 weeks of gestation,patients in the modeling cohort were classified into an early pregnancy loss group(n=59)and an ongoing pregnancy group(n=166).Baseline clinical characteristics and pre-transfer serum levels of FGF-21,AMH,and NRP-1 were collected.Multivariate logistic regression was applied to identify inde-pendent risk factors for early pregnancy loss and to construct a predictive model.Model discrimination,calibra-tion,and stability were evaluated using receiver operating characteristic(ROC)curves,the Hosmer-Lemeshow goodness-of-fit test,and bootstrap resampling in both cohorts.Results Univariate analysis revealed that the FSH/LH ratio,antral follicle count,and number of retrieved oocytes were significantly associated with early pregnancy loss(P<0.001).Compared with the ongoing pregnancy group,women with early loss showed significantly elevated pre-transfer serum FGF-21 levels,whereas AMH and NRP-1 levels were markedly reduced(P<0.001).Multivariate logistic regression demonstrated that an FSH/LH ratio<1.8(OR=1.629,P=0.002)and higher FGF-21 levels(OR=1.338,P=0.002)were independent risk factors,while higher AMH(OR=0.741,P=0.010)and NRP-1 levels(OR=0.874,P=0.007)were protective.Stratified analysis indicated that among patients with FSH/LH≥1.8,FGF-21 levels were significantly higher and AMH and NRP-1 levels significantly lower(all P<0.001).Interaction analysis further suggested that the FSH/LH ratio significantly modified the associations between these biomarkers and pregnancy loss risk(P for interaction<0.05).Specifically,in the higher FSH/LH subgroup,the risk effect of FGF-21 was amplified,while the protective effects of AMH and NRP-1 were more pronounced.The combined predictive model achieved C-indices of 0.869(95%CI:0.826～0.926)in the modeling cohort and 0.835(95%CI:0.811～0.907)in the validation cohort.Its AUC for predicting early pregnancy loss was 0.934 in the modeling co-hort and 0.909 in the validation cohort,both significantly outperforming individual markers(AUCs:FGF-21=0.867,AMH=0.881,NRP-1=0.853;Z=2.024,1.831;P<0.001).Decision curve analysis showed that the model provided consistent net clinical benefit across threshold probabilities of 0.1～0.4,underscoring its clinical utility.Conclusions Elevated pre-transfer serum FGF-21 and reduced AMH and NRP-1 levels are strongly associ-ated with early pregnancy loss at 6 weeks after IVF-ET.The predictive model developed in this study demonstrates robust accuracy and stability,offering substantial clinical application value for early risk stratification.

OBJECTIVE To analyze the levels of NOD like receptor thermal protein domain associated protein 3(NLRP3),nuclear factor κB(NF-κB)and Caspase-1 in peripheral blood mononuclear cells in patients with recur-rent spontaneous abortion(RSA)and reproductive tract infection(RTI),and the relationship between above inde-xes and pregnancy outcome.METHODS A total of 136 patients with RSA and RTI who were admitted to Nanyang First People's Hospital from Mar.2021 to Apr.2024 were selected as the study group,70 patients with RSA but without RTI during the same period were selected as the control group,and those patients with RSA and RTI who were pregnant again were divided into the continued pregnancy group and the abortion group based on their preg-nancy outcomes.The levels of NLRP,NF-κB and caspase-1 in peripheral blood mononuclear cells were compared between the study group and the control group,Multivariate logistic regression analysis was used to identify risk factors for adverse pregnancy outcomes in patients with RSA and RTI.Receiver's operating characteristic(ROC)curves were used to evaluate the value of NLRP,NF-κB,and Caspase-1 in peripheral blood mononuclear cells in predicting pregnancy outcomes of patients with RSA and RTI.RESULTS The levels of NLRP,NF-κB and caspase-1 in the study group were(1.93±0.49),(1.82±0.41)and(2.23±0.41)respectively,which were higher than those in the control group(P＜0.05).The proportion of abortion in the study group was 39.79％,which was higher than that in the control group(P=0.036).Pre-pregnancy body mass index(BMI)and the levels of glycated hemoglobin,triacylglycerol,NLRP,NF-κB and Caspase-1 in the abortion group were higher than those in the continued pregnancy group.Multivariate logistic regression analysis showed that NLRP3(OR=4.721,95％CI:1.336-16.680,P=0.016),NF-κB(OR=4.669,95％CI:1.495-14.58,P=0.008),caspase-1(OR=4.358,95％CI:1.260-15.070,P=0.023)and pre-pregnancy BMI(OR=2.927,95％CI:1.280-6.693,P=0.011)were risk factors affecting pregnancy outcomes of patients with RSA and RTI(P＜0.05).ROC curves indicated that the area under the curve(AUC)of NLRP,NF-κB and Caspase-1 for pregnancy outcome in patients with RSA combined with RTI was 0.846,0.885 and 0.938.CONCLUSION The NLRP,NF-κB and Caspase-1 in peripheral blood mononuclear cells is highly expressed in patients with RSA and RTI,and the high expression of the above indicators is closely related to the adverse pregnancy of patients,which can be used as a predictor of pregnancy outcomes in patients with RSA and RTI.

Objective To investigate the predictive value of pre-transfer serum fibroblast growth factor 21(FGF-21),anti-Müllerian hormone(AMH),and neuropilin-1(NRP-1)for early pregnancy loss at 6 weeks following in vitro fertilization-embryo transfer(IVF-ET),and to establish an early predictive model based on serum biochemical markers.Methods This prospective study consecutively enrolled 322 women who achieved clinical pregnancy after IVF-ET at our center between September 2022 and September 2024.Participants were randomly divided into a modeling cohort(n=225)and a validation cohort(n=97)at a 7:3 ratio.According to ultrasound findings at 6 weeks of gestation,patients in the modeling cohort were classified into an early pregnancy loss group(n=59)and an ongoing pregnancy group(n=166).Baseline clinical characteristics and pre-transfer serum levels of FGF-21,AMH,and NRP-1 were collected.Multivariate logistic regression was applied to identify inde-pendent risk factors for early pregnancy loss and to construct a predictive model.Model discrimination,calibra-tion,and stability were evaluated using receiver operating characteristic(ROC)curves,the Hosmer-Lemeshow goodness-of-fit test,and bootstrap resampling in both cohorts.Results Univariate analysis revealed that the FSH/LH ratio,antral follicle count,and number of retrieved oocytes were significantly associated with early pregnancy loss(P<0.001).Compared with the ongoing pregnancy group,women with early loss showed significantly elevated pre-transfer serum FGF-21 levels,whereas AMH and NRP-1 levels were markedly reduced(P<0.001).Multivariate logistic regression demonstrated that an FSH/LH ratio<1.8(OR=1.629,P=0.002)and higher FGF-21 levels(OR=1.338,P=0.002)were independent risk factors,while higher AMH(OR=0.741,P=0.010)and NRP-1 levels(OR=0.874,P=0.007)were protective.Stratified analysis indicated that among patients with FSH/LH≥1.8,FGF-21 levels were significantly higher and AMH and NRP-1 levels significantly lower(all P<0.001).Interaction analysis further suggested that the FSH/LH ratio significantly modified the associations between these biomarkers and pregnancy loss risk(P for interaction<0.05).Specifically,in the higher FSH/LH subgroup,the risk effect of FGF-21 was amplified,while the protective effects of AMH and NRP-1 were more pronounced.The combined predictive model achieved C-indices of 0.869(95%CI:0.826～0.926)in the modeling cohort and 0.835(95%CI:0.811～0.907)in the validation cohort.Its AUC for predicting early pregnancy loss was 0.934 in the modeling co-hort and 0.909 in the validation cohort,both significantly outperforming individual markers(AUCs:FGF-21=0.867,AMH=0.881,NRP-1=0.853;Z=2.024,1.831;P<0.001).Decision curve analysis showed that the model provided consistent net clinical benefit across threshold probabilities of 0.1～0.4,underscoring its clinical utility.Conclusions Elevated pre-transfer serum FGF-21 and reduced AMH and NRP-1 levels are strongly associ-ated with early pregnancy loss at 6 weeks after IVF-ET.The predictive model developed in this study demonstrates robust accuracy and stability,offering substantial clinical application value for early risk stratification.

OBJECTIVE To analyze the levels of NOD like receptor thermal protein domain associated protein 3(NLRP3),nuclear factor κB(NF-κB)and Caspase-1 in peripheral blood mononuclear cells in patients with recur-rent spontaneous abortion(RSA)and reproductive tract infection(RTI),and the relationship between above inde-xes and pregnancy outcome.METHODS A total of 136 patients with RSA and RTI who were admitted to Nanyang First People's Hospital from Mar.2021 to Apr.2024 were selected as the study group,70 patients with RSA but without RTI during the same period were selected as the control group,and those patients with RSA and RTI who were pregnant again were divided into the continued pregnancy group and the abortion group based on their preg-nancy outcomes.The levels of NLRP,NF-κB and caspase-1 in peripheral blood mononuclear cells were compared between the study group and the control group,Multivariate logistic regression analysis was used to identify risk factors for adverse pregnancy outcomes in patients with RSA and RTI.Receiver's operating characteristic(ROC)curves were used to evaluate the value of NLRP,NF-κB,and Caspase-1 in peripheral blood mononuclear cells in predicting pregnancy outcomes of patients with RSA and RTI.RESULTS The levels of NLRP,NF-κB and caspase-1 in the study group were(1.93±0.49),(1.82±0.41)and(2.23±0.41)respectively,which were higher than those in the control group(P＜0.05).The proportion of abortion in the study group was 39.79％,which was higher than that in the control group(P=0.036).Pre-pregnancy body mass index(BMI)and the levels of glycated hemoglobin,triacylglycerol,NLRP,NF-κB and Caspase-1 in the abortion group were higher than those in the continued pregnancy group.Multivariate logistic regression analysis showed that NLRP3(OR=4.721,95％CI:1.336-16.680,P=0.016),NF-κB(OR=4.669,95％CI:1.495-14.58,P=0.008),caspase-1(OR=4.358,95％CI:1.260-15.070,P=0.023)and pre-pregnancy BMI(OR=2.927,95％CI:1.280-6.693,P=0.011)were risk factors affecting pregnancy outcomes of patients with RSA and RTI(P＜0.05).ROC curves indicated that the area under the curve(AUC)of NLRP,NF-κB and Caspase-1 for pregnancy outcome in patients with RSA combined with RTI was 0.846,0.885 and 0.938.CONCLUSION The NLRP,NF-κB and Caspase-1 in peripheral blood mononuclear cells is highly expressed in patients with RSA and RTI,and the high expression of the above indicators is closely related to the adverse pregnancy of patients,which can be used as a predictor of pregnancy outcomes in patients with RSA and RTI.

Objective To analyze the expression levels of TIPE2 and Ki67 in endometrial carcinoma(EC)and their relationship with clinicopathological parameters and prognosis.Methods Tissue samples and clinical data of 96 patients with EC who underwent surgical resection,120 patients who underwent total hysterec-tomy due to uterine fibroids and 120 patients who underwent total hysterectomy or curettage admitted to our hospital from February 2020 to February 2022 were retrospectively collected as the research objects,which were divided into the EC group,the normal endometrial group and the atypical hyperplasia endometrial group,respectively.All 3 groups were followed up until March 28,2023.Immunohistochemistry was used to detect the expression levels of TIPE2 and Ki67 in tissue samples of the three groups,and to analyze the relationship between the levels of TIPE2 and Ki67 and clinicopathological parameters and prognosis.Receiver operating characteristic curve(ROC)was used to analyze its diagnostic value for poor prognosis.Results The expression levels of TIPE2 and Ki67 in cancer tissues of the EC group were higher than those of the normal endometrial group and the atypical hyperplasia endometrial group,and those of the atypical hyperplasia endometrial group were higher than those of the normal endometrial group(P<0.05).The expression levels of TIPE2 and Ki67 in EC tissues were higher in patients with FIGO stage Ⅲ,lymph node metastasis,postmenopausal status,and ER and PR negative than patients with stageⅡ,no lymph node metastasis,premenopausal status,and ER and PR positive(P<0.05).Moreover,the expres-sion level of Ki67 in EC tissues was higher in p53 positive patients than in p53 negative patients(P<0.05),and there was a positive correlation between the both expression levels of TIPE2 and Ki67 in EC tissues(r=0.569,P<0.05).Compared with the poor prognosis group,the expression levels of TIPE2 and Ki67 in EC tissues in the good prognosis group were downregulated(P<0.05),and the AUC value of the combined detection of TIPE2 and Ki67 expression levels was 0.905,which was significantly higher than that of the single detection(P<0.05),sensitivity was 86.67%and specificity was 87.88%,and the predictive value was higher.Conclusion TIPE2 and Ki67 were highly expressed in EC tissues,and there was a positive correlation between the two,and their high expressions were related to clinicopathological features,and their combined detection had high predictive value for poor prognosis of EC.

Objective:To investigate the efficacy of excimer laser atherectomy (ELA) combined with drug-coated balloon (DCB) in the treatment of femoropopliteal arteriosclerosis obliterans (ASO) and its influencing factors.Methods:The clinical data of patients with femoropopliteal ASO treated by ELA combined with DCB from July 2019 to March 2022 were retrospectively analyzed, including technical success rate, ankle-brachial index(ABI), primary patency rate and freedom from target lesion revascularization (TLR) rate. Cox regression was applied to analyze the risk factors affecting the decline in the rate of primary patency and freedom from TLR.Results:All 82 patients were treated with ELA+DCB. The technical success was 91.5%. The post-operative ABI (0.73±0.13) was significantly higher than preoperative ABI (0.39±0.11) ( t=35.26, P<0.001). The 24-month cumulative primary patency and TLR-free rates were 64.1% and 76.8%, respectively. Lesion length>15 cm ( HR=2.57, P=0.047) and severe calcification ( HR=3.26, P=0.021) were associated with loss of primary patency. Having diabetes ( HR=5.24, P=0.010) and a single postoperative outflow tract ( HR=4.18, P=0.008) were associated with a decrease in TLR-free rates. Conclusions:ELA combined with DCB for femoropopliteal ASO is safe and has good intermediate efficacy. Lesion length>15 cm and severe calcification were independent risk factors for primary patency rate, and diabetes and a single postoperative outflow tract were independent risk factors for TLR-free rate.

Based on the strategy of metabolomics combined with bioinformatics, this study analyzed the potential allergens and mechanism of pseudo-allergic reactions (PARs) induced by the combined use of Reduning injection and penicillin G injection. All animal experiments and welfare are in accordance with the requirements of the First Affiliated Experimental Animal Ethics and Animal Welfare Committee of Henan University of Chinese Medicine (approval number: YFYDW2020002). Based on UPLC-Q-TOF/MS technology combined with UNIFI software, a total of 21 compounds were identified in Reduning and penicillin G mixed injection. Based on molecular docking technology, 10 potential allergens with strong binding activity to MrgprX2 agonist sites were further screened. Metabolomics analysis using UPLC-Q-TOF/MS technology revealed that 34 differential metabolites such as arachidonic acid, phosphatidylcholine, phosphatidylserine, prostaglandins, and leukotrienes were endogenous differential metabolites of PARs caused by combined use of Reduning injection and penicillin G injection. Through the analysis of the "potential allergen-target-endogenous differential metabolite" interaction network, the chlorogenic acids (such as chlorogenic acid, neochlorogenic acid, cryptochlorogenic acid, and isochlorogenic acid A) and β-lactam allergens in the combination of the two may be mainly regulated by PLD1, PLA2G12A and CYP1A1. The three upstream signal target proteins mainly activate the arachidonic acid metabolic pathway, promote the degranulation of mast cells, release downstream endogenous inflammatory mediators, and induce PARs.

Objective To evaluate the efficacy and safety of laser-assisted balloon angioplasty(LABA)in treating patients with infrapopliteal arterial occlusion complicated by critical limb ischemia(CLI).Methods The clinical data of patients with infrapopliteal artery occlusion complicated by CLI,who were admitted to the Fuwai Central China Cardiovascular Hospital to receive LABA(LABA group)or balloon angioplasty alone(BA group)between January 2019 and December 2021,were retrospectively analyzed.The incidence of perioperative complications and postoperative clinical efficacy were compared between the two groups.Results A total of 32 patients received LABA therapy and 40 patients received BA alone.The technical success rate,the postoperative ankle-brachial index(ABI),the numerical value of postoperative ABI value deducting preoperative ABI value,the postoperative 24-month continuous improvement rate of clinical symptoms and the primary patency rate of target vessels in the LABA group were remarkably higher than those in the BA group(all P＜0.05).No procedure-related target vessel perforation,amputation,or death occurred in both groups.No statistically significant differences in the target vessel dissection,distal embolism,remedial stenting,and postoperative 24-month amputation-free survival existed between the groups(all P＞0.05).Conclusion For the infrapopliteal arterial occlusion complicated by CLI,LABA therapy is clinically safe and effective,and its mid-term efficacy is superior to BA alone.

Objective:To explore the mediating role of mindfulness between professional identity and positive emotions among medical students.Methods:From February to April 2022, a total of 878 undergraduates from a medical school in Shandong Province were selected by cluster sampling method. The medical professional identity questionnaire, positive and negative affective scale, and mindful attention awareness scale were utilized for cross-sectional investigation. SPSS 22.0 software was used for descriptive and correlation analysis, and AMOS 25.0 software was used to test the mediating effect.Results:(1) The scores for medical students' professional identity, positive emotions, and mindfulness were 140.00 (125.00, 150.00), 30.00 (28.00, 35.00), and 52.00 (44.00, 63.00), respectively. The dimension scores of occupational cognition, occupational emotion, occupational commitment, occupational behavior, occupational expectation and occupational sense of value in the medical professional identity questionnaire were 23.00 (20.00, 25.00), 19.00 (16.00, 20.00), 19.00 (16.00, 21.00), 16.00 (13.00, 16.00), 32.00 (28.00, 36.00), and 31.00 (29.00, 34.00), respectively. (2) The total and dimension scores of professional identity, positive emotions, and mindfulness were significantly and positively correlated with each other( r=0.125-0.390, all P<0.001). (3) Mindfulness partially mediated the relationship between professional identity and positive emotions (effect size=0.02, 95% CI=0.01-0.04), and the mediating effect accounted for 4.76%(0.02/0.42) of the total effect. Conclusion:Professional identity can directly affect the positive emotions of medical students, and indirectly affect the positive emotions through the mediating role of mindfulness.