Objective To explore the potential characteristics of self-management behavior in maintenance hemodialysis patients with hypertension and determine the influencing factors of different characteristics,so as to provide reference for improving self-management behavior.Methods A total of 192 maintenance hemodialysis patients with hypertension who received dialysis in The First Hospital Affiliated to Naval Medical University from May to September 2022 were enrolled by convenience sampling.A general information questionnaire,hypertension self-management behavior scale,Morisky medication adherence scale-8 items,and medication adherence self-efficacy scale-revision(MASES-R)were used to investigate the potential categories of self-management behavior in maintenance hemodialysis patients with hypertension,and the predictive indicators of each category were analyzed by latent profile analysis.Results Three latent categories of self-management behavior in maintenance hemodialysis patients with hypertension were identified:low self-management behavior,moderate self-management behavior,and high self-management behavior.Medication adherence and medication adherence self-efficacy were predictors of high self-management behavior.Monitoring blood pressure once daily was a predictor of moderate self-management behavior.Conclusion There is significant self-management characteristics among maintenance hemodialysis patients with hypertension.These characteristics and risk factors should be identified early to help patients improving their self-management.

Histone methylation modification,as one of the post-translational modifications,has been increasingly shown by studies to play a crucial role in the development of cardiovascular diseases(CVD).Due to its reversibility,tar-geting related modifying enzymes is expected to provide new strategies for the clinical diagnosis and treatment of CVD.This article reviews the relevant methylation modifications and their important regulatory mechanisms in CVD,and discusses the research progress of histone methylation inhibitors in the cardiovascular field.

The escalating phenomenon of global population aging is posing multi-dimensional challenges to society, the economy and medical healthcare system.Among the significant health threats to the elderly population are cardiovascular diseases(CVD)and cognitive frailty(CF), both of which profoundly affect the quality of life and increase the risks of adverse health outcomes, including disability, hospitalization, and death.The concurrent presence of CVD and CF in elderly patients is prevalent, as these conditions share many common risk factors and underlying pathophysiological mechanisms, such as atherosclerosis, microcirculation dysfunction, and inflammation, which interact to perpetuate a vicious cycle.Notably, CF exhibits a certain degree of reversibility; thus, the implementation of a diagnosis and treatment paradigm that incorporates "comprehensive geriatric assessment and geriatric interdisciplinary teams" should be established as a conventional management strategy for elderly patients affected by both CVD and CF.Cognitive digital therapeutics, along with personalized exercise prescriptions based on cardiopulmonary exercise tests, may represent more appropriate precision interventions for these patients.Consequently, there is a necessity for further in-depth research in this area moving forward.

Metabolic dysfunction-associated fatty liver disease (MAFLD), characterized by fatty acid overload, secondary chronic inflammation, and fibrosis, has become the most prevalent chronic liver disease globally. While no effective pharmacotherapy exists for MAFLD, mitigating inflammatory responses represents a promising approach to preventing the progression from steatosis to severe steatohepatitis. The NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome, which detects endogenous danger and stress signals, has emerged as a significant target for inflammatory disease treatment, as transcriptional inactivation of its components demonstrates the therapeutic potential for MAFLD. Natural products targeting NLRP3 inflammasome activation have shown promising efficacy in MAFLD therapy. This review synthesizes the current understanding of NLRP3 inflammasome activation and therapeutic targets for NLRP3 homeostasis. Additionally, natural products reported to inhibit NLRP3 inflammasome for MAFLD improvement are categorized according to their mechanisms of action. The review also addresses limitations and future directions regarding natural products targeting NLRP3 inflammasome in MAFLD treatment. Enhanced understanding of NLRP3 inflammasome activation mechanisms in MAFLD and the identification of novel natural products supported by mechanistic research will significantly advance MAFLD treatment.
Humans ; NLR Family, Pyrin Domain-Containing 3 Protein/immunology* ; Inflammasomes/metabolism* ; Biological Products/therapeutic use* ; Animals ; Fatty Liver/immunology*

Histone methylation modification,as one of the post-translational modifications,has been increasingly shown by studies to play a crucial role in the development of cardiovascular diseases(CVD).Due to its reversibility,tar-geting related modifying enzymes is expected to provide new strategies for the clinical diagnosis and treatment of CVD.This article reviews the relevant methylation modifications and their important regulatory mechanisms in CVD,and discusses the research progress of histone methylation inhibitors in the cardiovascular field.

The escalating phenomenon of global population aging is posing multi-dimensional challenges to society, the economy and medical healthcare system.Among the significant health threats to the elderly population are cardiovascular diseases(CVD)and cognitive frailty(CF), both of which profoundly affect the quality of life and increase the risks of adverse health outcomes, including disability, hospitalization, and death.The concurrent presence of CVD and CF in elderly patients is prevalent, as these conditions share many common risk factors and underlying pathophysiological mechanisms, such as atherosclerosis, microcirculation dysfunction, and inflammation, which interact to perpetuate a vicious cycle.Notably, CF exhibits a certain degree of reversibility; thus, the implementation of a diagnosis and treatment paradigm that incorporates "comprehensive geriatric assessment and geriatric interdisciplinary teams" should be established as a conventional management strategy for elderly patients affected by both CVD and CF.Cognitive digital therapeutics, along with personalized exercise prescriptions based on cardiopulmonary exercise tests, may represent more appropriate precision interventions for these patients.Consequently, there is a necessity for further in-depth research in this area moving forward.

Objective:To explore the relationship between the clinical outcome of emotional symptoms and cognitive performance and related cerebral oxygenated hemoglobin in adolescents with depression.Methods:Through subject recruitment, 46 adolescent patients with depression (patient group) from the First Hospital of Shanxi Medical University were selected as the subjects for this study from December 2020 to December 2021, including 8 males and 38 females, aged 12-18 (15.7±2.3) years old. All patients received sertraline treatment for 8 weeks and were further followed into responders ( n=24) and non-responders ( n=22) according to the outcome of emotional symptoms. In the meantime, 51 healthy controls (control group) were enrolled, including 7 males and 44 females, aged 12-18 (16.1±1.5) years old. The repeatable battery for the assessment of neuropsychological status (RBANS) was conducted to measure the multi-dimensional neurocognitive performance, and the functional near-infrared spectroscopy (fNIRS) was used to assess changes in the concentration of oxyhemoglobin (HBO) during the verbal fluency test. The differences were compared in multi-dimensional cognitive performance and cerebral HBO level between each patient group and control group and between responders and non-responders. The changes were analyzed in cognitive performance and cerebral HBO level after intervention in responders and non-responders. Results:At baseline, compared to the control group, the patient group performed decreased scores of RBANS, immediate memory, speech function, attention, and delayed memory (88.0 (82.8, 100.0) M ( Q1, Q3) vs. 100.0 (90.0, 110.0) scores; 78.0 (73.0, 87.8) vs.85.0 (78.0, 94.0) scores; (84.4±16.1) vs. (95.7±15.7) scores; 106.0 (99.5, 115.0) vs.118.0 (109.0, 128.0) scores; 94.0 (84.5, 99.0) vs.97.0 (91.0, 101.0) scores), and lower HBO levels in 7 channels (all P<0.05). Compared to responders, non-responders showed more severe impairment of visual-spatial and attention performance (103.9±11.0 vs. 94.4±16.7 scores; 112.5±12.1 vs. 98.0±21.2 scores) ( t=2.30 or 2.87; all P<0.05). After treatment, the scores of RBANS and immediate memory improved significantly in responders (98.8±11.2 vs. 93.0±9.7 scores; 95.2±13.8 vs.83.0±14.6 scores) ( t=-3.00 or-4.97; both P<0.05), but the scores of attention and the HBO level of two channels in the prefrontal cortex were still significantly lower than those of the control group (Z=2.27, 3.02 or 3.04; all P<0.05). Besides, there were no significant differences in the scores of immediate memory and the HBO levels of 3 channels in the temporal lobe between the no-responders and the control group (all P>0.05). Conclusion:Immediate memory injure, attention injure and HBO levels of frontal-temporal lobes may be independent of emotional symptoms among adolescents with depression.

Objective:To explore the relationship between the clinical outcome of emotional symptoms and cognitive performance and related cerebral oxygenated hemoglobin in adolescents with depression.Methods:Through subject recruitment, 46 adolescent patients with depression (patient group) from the First Hospital of Shanxi Medical University were selected as the subjects for this study from December 2020 to December 2021, including 8 males and 38 females, aged 12-18 (15.7±2.3) years old. All patients received sertraline treatment for 8 weeks and were further followed into responders ( n=24) and non-responders ( n=22) according to the outcome of emotional symptoms. In the meantime, 51 healthy controls (control group) were enrolled, including 7 males and 44 females, aged 12-18 (16.1±1.5) years old. The repeatable battery for the assessment of neuropsychological status (RBANS) was conducted to measure the multi-dimensional neurocognitive performance, and the functional near-infrared spectroscopy (fNIRS) was used to assess changes in the concentration of oxyhemoglobin (HBO) during the verbal fluency test. The differences were compared in multi-dimensional cognitive performance and cerebral HBO level between each patient group and control group and between responders and non-responders. The changes were analyzed in cognitive performance and cerebral HBO level after intervention in responders and non-responders. Results:At baseline, compared to the control group, the patient group performed decreased scores of RBANS, immediate memory, speech function, attention, and delayed memory (88.0 (82.8, 100.0) M ( Q1, Q3) vs. 100.0 (90.0, 110.0) scores; 78.0 (73.0, 87.8) vs.85.0 (78.0, 94.0) scores; (84.4±16.1) vs. (95.7±15.7) scores; 106.0 (99.5, 115.0) vs.118.0 (109.0, 128.0) scores; 94.0 (84.5, 99.0) vs.97.0 (91.0, 101.0) scores), and lower HBO levels in 7 channels (all P<0.05). Compared to responders, non-responders showed more severe impairment of visual-spatial and attention performance (103.9±11.0 vs. 94.4±16.7 scores; 112.5±12.1 vs. 98.0±21.2 scores) ( t=2.30 or 2.87; all P<0.05). After treatment, the scores of RBANS and immediate memory improved significantly in responders (98.8±11.2 vs. 93.0±9.7 scores; 95.2±13.8 vs.83.0±14.6 scores) ( t=-3.00 or-4.97; both P<0.05), but the scores of attention and the HBO level of two channels in the prefrontal cortex were still significantly lower than those of the control group (Z=2.27, 3.02 or 3.04; all P<0.05). Besides, there were no significant differences in the scores of immediate memory and the HBO levels of 3 channels in the temporal lobe between the no-responders and the control group (all P>0.05). Conclusion:Immediate memory injure, attention injure and HBO levels of frontal-temporal lobes may be independent of emotional symptoms among adolescents with depression.

Aristolochic acids (AAs) have long been considered as a potent carcinogen due to its nephrotoxicity. Aristolochic acid I (AAI) reacts with DNA to form covalent aristolactam (AL)-DNA adducts, leading to subsequent A to T transversion mutation, commonly referred as AA mutational signature. Previous research inferred that AAs were widely implicated in liver cancer throughout Asia. In this study, we explored whether AAs exposure was the main cause of liver cancer in the context of HBV infection in mainland China. Totally 1256 liver cancer samples were randomly retrieved from 3 medical centers and a refined bioanalytical method was used to detect AAI-DNA adducts. 5.10% of these samples could be identified as AAI positive exposure. Whole genome sequencing suggested 8.41% of 107 liver cancer patients exhibited the dominant AA mutational signature, indicating a relatively low overall AAI exposure rate. In animal models, long-term administration of AAI barely increased liver tumorigenesis in adult mice, opposite from its tumor-inducing role when subjected to infant mice. Furthermore, AAI induced dose-dependent accumulation of AA-DNA adduct in target organs in adult mice, with the most detected in kidney instead of liver. Taken together, our data indicate that AA exposure was not the major threat of liver cancer in adulthood.

Objective:To evaluate the value of vasoactive-inotropic Score (VIS) at different time points in predicting the 28-day mortality of patients with septic shock, so as to reduce the risk of death and improve the prognosis of patients.Methods:This experiment was a single-center retrospective cohort study. The clinical data of 275 adult patients with septic shock who were treated with vasoactive drugs in the intensive care unit of the Affiliated Hospital of Xuzhou Medical University from February 2016 to February 2020 were collected. According to the 28-day survival condition, all recruited patients were divided into the death group and the survival group, and the maximum vasoactive-inotropic score of all patients at the first 24 h and the second 24 h were calculated, which were expressed as VIS max24 and VIS max48. Multivariate logistic regression analysis was used to find the independent risk factors that influencing the prognosis. The receiver operating characteristic curve was used to analyze the predictive value of VIS. Results:There was no significant difference between the death group and the survival group in the characteristics including age, sex, weight, infection sites, blood culture results, cardiac arrest, hormone use, and 24 h rehydration volume ( P>0.05). APACHE II score, basic lactic acid, and lactic acid after 24 h of treatment were increased significantly in the death group ( P<0.05). VIS max24 could accurately predict the 28-day mortality (AUC=0.953, 95% CI: 0.924-0.982), which were more efficent compared to VIS max48 (AUC=0.919, 95% CI: 0.881-0.957), basic lactic acid (AUC=0.937, 95% CI: 0.900-0.966) and APACHEⅡ score (AUC=0.865, 95% CI: 0.818-0.913). Conclusion:VIS max24 can more accurate predict the 28-day mortality in patients with septic shock.