Objective:To investigate the impact of frailty on post-stroke depression (PSD) in patients with acute ischemic stroke and to identify risk factors for PSD in order to construct a risk prediction model.Methods:A convenience sampling method was used to recruit a total of 450 patients with acute ischemic stroke who were treated in the Department of Neurology at the Affiliated Hospital of Jining Medical University from March 2023 to April 2024. Data were collected using the Edmonton Frail Scale, Hamilton Depression Rating Scale, Barthel Index (Activities of Daily Living, ADL), Pittsburgh Sleep Quality Index, and Morse Fall Scale. Binary logistic regression analysis was performed to explore the impact of frailty on PSD and to identify other risk factors. Based on the results, a predictive model was developed.Results:A total of 450 questionnaires were distributed, with 412 valid responses returned, yielding a valid response rate of 91.56%. The incidence of PSD among the 412 patients was 45.63% (188/412). Binary Logistic regression analysis showed that frailty, sleep disturbance, C-reactive protein (CRP), and ADL score were the influencing factors for PSD in patients with acute ischemic stroke ( P<0.05). These factors were incorporated into the predictive model, and a risk nomogram was constructed. The area under the curve of the model was 0.764 [95% CI (0.716, 0.811) ], indicating good discriminative ability. Internal validation of the nomogram using the Hosmer-Lemeshow goodness-of-fit test showed χ 2=5.883, P=0.66 ( P>0.05), suggesting good calibration of the model. Conclusions:Frailty increases the risk of post-stroke depression in patients with acute ischemic stroke. Sleep disturbance, CRP level, and ADL score are important screening indicators for PSD risk. Targeted assessment and early intervention are recommended to reduce the likelihood of PSD.

Objective:To investigate the impact of frailty on post-stroke depression (PSD) in patients with acute ischemic stroke and to identify risk factors for PSD in order to construct a risk prediction model.Methods:A convenience sampling method was used to recruit a total of 450 patients with acute ischemic stroke who were treated in the Department of Neurology at the Affiliated Hospital of Jining Medical University from March 2023 to April 2024. Data were collected using the Edmonton Frail Scale, Hamilton Depression Rating Scale, Barthel Index (Activities of Daily Living, ADL), Pittsburgh Sleep Quality Index, and Morse Fall Scale. Binary logistic regression analysis was performed to explore the impact of frailty on PSD and to identify other risk factors. Based on the results, a predictive model was developed.Results:A total of 450 questionnaires were distributed, with 412 valid responses returned, yielding a valid response rate of 91.56%. The incidence of PSD among the 412 patients was 45.63% (188/412). Binary Logistic regression analysis showed that frailty, sleep disturbance, C-reactive protein (CRP), and ADL score were the influencing factors for PSD in patients with acute ischemic stroke ( P<0.05). These factors were incorporated into the predictive model, and a risk nomogram was constructed. The area under the curve of the model was 0.764 [95% CI (0.716, 0.811) ], indicating good discriminative ability. Internal validation of the nomogram using the Hosmer-Lemeshow goodness-of-fit test showed χ 2=5.883, P=0.66 ( P>0.05), suggesting good calibration of the model. Conclusions:Frailty increases the risk of post-stroke depression in patients with acute ischemic stroke. Sleep disturbance, CRP level, and ADL score are important screening indicators for PSD risk. Targeted assessment and early intervention are recommended to reduce the likelihood of PSD.

The pathogenesis theory of"spleen deficiency and stasis toxin"in gastric cancer holds that spleen is the source of generation and transformation of qi and blood,that spleen deficiency is the internal basis of disease and throughout the disease.Stasis toxin is based on spleen deficiency,which is the fundamental pathogenesis of gastric cancer.In the pathological process of gastric cancer,a variety of metabolic substances in tumor cells and tumor microenvironment,mainly glucose metabolic reprogramming,undergo metabolic changes to reconstruct the phenotype and function of tumor-related macrophages,which is consistent with the pathogenesis theory of"spleen deficiency and stasis toxin".Therefore,this article focused on the reprogramming of glucose metabolism in tumor microenvironment to drive the phenotypic remodeling of tumor-related macrophages,explored the scientific connotation of the pathogenesis theory of"spleen deficiency and stasis toxin"of gastric cancer,and provided references for the theoretical and clinical research on the treatment of gastric cancer by TCM.

Objective:To investigate the characteristics of obesity in adolescents with major depressive disorder (MDD) and its association with the depressed severity.Methods:A total of 278 adolescents with MDD were recruited according to the inclusion and exclusion criteria. Their demographic data were collected and 24-item Hamilton depression scale (HAMD-24) was used to evaluate their severity of depression. According to the body mass index (BMI) classification standard of adolescents in China, all subjects were classified into four groups(wasting group, normal BMI group, overweight group and obesity group). SPSS 26.0 statistical software was used for data analysis. The Kruskal-Wallis test and the Chi-square test were separately used for the comparison of the four groups.Spearman correlation was used to explore the relationship between BMI and HAMD-24 scores and severity.Results:Among 278 adolescents with MDD, the prevalence of body abnormality was 32.4% (90/278), among which wasting, overweight and obesity were 9.0% (25/278), 14.4% (40/278) and 9.0% (25/278) respectively. There were statistically differences in gender ( χ2=17.018, P<0.001), HAMD-24 scores ( H=9.427, P=0.024) and depressed severity( H=8.508, P=0.037) among the four groups. Multiple comparisons showed that there were only statistically differences between obesity group and normal BMI group, that was the prevalence of obesity in males was higher than that in females ( χ2=13.631, P<0.001), and the level in HAMD-24 scores ( Z=2.956, P=0.003) and depressed severity ( Z=2.832, P=0.005) was lower in obesity group than that in normal BMI group.Spearman correlation analysis showed that BMI was negatively correlated with HAMD-24 scores ( r=-0.162, P=0.007). Conclusion:There is gender difference in obesity rates among the adolescent patients with first-episode untreated MDD. And the obese patients are less depressed than those with normal BMI.

Objective:To screen risk factors for carotid plaque vulnerability in patients with ischemic stroke and construct a risk prediction model.Methods:From November 2019 to January 2021, a total of 164 patients with ischemic stroke hospitalized in the Neurology Department of the Affiliated Hospital of Jining Medical University were selected as the study subjects by convenience sampling method. Color doppler ultrasound was used to measure carotid plaques in patients with ischemic stroke to determine whether they were vulnerable plaques. The patients were surveyed using the General Information Questionnaire and the Type D Personality Scale. Binary Logistic regression analysis was used to explore the risk factors of carotid plaque vulnerability in ischemic stroke patients, and based on this, a risk prediction model for carotid plaque vulnerability in ischemic stroke patients was constructed.Results:A total of 87 patients with ischemic stroke had vulnerable carotid plaques. The results of binary Logistic regression analysis showed that age ( OR=1.136, 95% CI: 1.052-1.226), total score of Type D Personality Scale ( OR=1.170, 95% CI: 1.043-1.312), smoking history ( OR=3.058, 95% CI: 1.054-8.875), homocysteine ( OR=1.400, 95% CI: 1.179-1.664), triglycerides ( OR=2.356, 95% CI: 1.534-3.619) were risk factors for carotid plaque vulnerability in stroke patients ( P<0.05). The results of risk prediction model based on risk factors show that, the area under the receiver operating characteristic of the subjects was 0.935, indicating good clinical predictive ability. Conclusions:Age, total score of Type D Personality Scale, smoking history, homocysteine and triglyceride are risk factors of carotid plaque vulnerability in stroke patients. The risk prediction model can early identify and screen high-risk factors for carotid plaque vulnerability in ischemic stroke patients, and is worthy of clinical promotion and practice.

Ras-associated domain family 1A (RASSF1A) genes are members of the RASSF family, which bind to Ras in a guanosine triphosphate(GTP)-dependent manner and then induce Ras-mediated apoptosis. The protein encoded by the RASSF1A gene is similar to the Ras effector protein, which can interact with DNA repair protein XPA, and can also inhibit the accumulation of cyclin D1, thereby inducing cell cycle arrest. The deletion or abnormal expression of RASSF1A gene is related to the pathogenesis of various malignant tumors, indicating that it has tumor suppressor function. RASSF1A gene methylation has been found in at least 37 tumors, and RASSF1A gene may be the most frequently described methylated gene in human cancers. In this paper, the abnormal methylation of RASSF1A gene in different malignant tumors was introduced, and the research progress of its related effects and mechanisms in malignant tumors of the respiratory system, digestive system, genitourinary system, and nervous system in recent years was reviewed, with a view to malignant tumors early diagnosis, individual molecular targeted therapy and prognostic evaluation provide important guidance.

Objective To investigate the relationship between disrupted corticospinal tract (CST) and motor recovery after stroke by using diffusion tensor tracking (DTT). Methods From March, 2012 to June, 2013, 15 chronic stroke patients with left subcortical lesions and 15 age- and sex- matched healthy subjects were performed diffusion tensor imaging (DTI) examination. The CST was tracked by DTT technique, and the damaged values of the CST caused by the stroke lesions were quantified using a CST template generated from healthy controls. Furthermore, the correlations of the damaged values of the CST with Fugl-Meyer Assessment (FMA) were performed. Results The range of the damaged values of CST in stroke patients was 0.00% to 29.6%. There were very strong negative correlation between the damaged values of the CST and FMA scores (the wrist, r = -0.660; hand, r = -0.813; wrist plus hand, r = -0.795, respectively, P < 0.01). It also showed strong negative correlation between the damaged values of the CST and FMA scores (upper limb, r = -0.614; upper limb plus lower limb, r = -0.563, respectively, P < 0.05). Whereas, there was no correlation between the damaged values of the CST and FMA scores of lower limb (r = -0.270, P = 0.331). In addition, the lesion volumes of stroke and FMA scores were not significantly correlated (P > 0.05). Conclusion The severity of motor deficit after stroke was closely related to the overlap of lesions with CST. The damaged values of the CST based on DTT may be used as a potential biomarker to assess motor impairments of upper limbs, especially hand and wrist in stroke patients.

Objective To investigate the relationship between serum vitamin B12 level and arsenic methylation and the risk of arsenic poisoning in the arsenic exposed population.Methods Three villages in Midu County,Dali City,Yunnan Province were investigated.Cross-sectional study was used to select 103 subjects.The population was divided into three groups according to drinking water arsenic exposure situation and whether arsenic poisoning patients:28 cases of control group (not exposed to high arsenic),30 cases of arsenic patient group and 45 cases of non patient group.Instant peripheral blood samples and urine samples were collected.The content of arsenic in urine was determined by hydride generation cold trap and atomic absorption spectrophotometry.The levels of vitamin B12 in serum were determined by chemiluminescence immunoassay.The urine arsenic and serum vitamin B12 contents in different groups were compared,the arsenic poisoning prevalence rate in people with different levels of serum vitamin B12 was investigated,and the correlation between serum vitamin B12 level and the metabolism of arsenic methylation was analyzed.Results The level of urinary inorganic arsenic (iAs),monomethylated arsenic (MMA) and dimethylated arsenic (DMA),total arsenic (tAs) were significantly different between groups (F =13.032,20.778,21.978,22.155,all P ＜ 0.05).The levels of urine arsenic in patients with arsenic exposure [(94.56 ± 107.62),(75.76 ± 54.31),(270.19 ± 185.10),(444.02 ± 323.28) μg/g Cr] and non patient with arsenic exposure [(40.05 ± 47.47),(45.11 ± 46.06),(183.91± 151.45),(270.84 ± 231.45) μg/g Cr] were significantly higher than those in control group [(7.58 ± 4.82),(4.27 ± 2.01),(26.89 ± 11.45),(38.91 ± 13.34) μg/g Cr,all P ＜ 0.05].The serum levels of vitamin B12 were significantly different between groups (F =6.650,P ＜ 0.05),patients exposed to arsenic [(366.05 ± 120.03) ng/L] was significantly lower than the control group [(533.70 ± 180.12) ng/L,P ＜ 0.05].There were significant differences in the detection rate of arsenic poisoning among different levels of serum vitamin B12 (x2=8.13,P ＜ 0.05),the lower dose of vitamin B12,the more serious the incidence of arsenic poisoning.The content of vitamin B12 was negatively correlated with MMA％ (r =-0.21,P ＜ 0.05),and positively correlated with SMR (r =0.21,P ＜ 0.05).Conclusion Low levels of vitamin B12 in serum may increase the risk of arsenic poisoning.

Objective To explore the effect of time nursing in patients with gastrointestinal bleeding by endoscopic therapy.Methods A total of 172 gastrointestinal hemorrhage patients by endoscopic therapy in our hospital were randomly divided into two groups, 86 cases in the control group was given routine nursing, and anther 86 cases in the observation group was given time nursing based on the control group, hemostatic effect, re-bleeding rate, hospitalization time and compliance were compared.Results The hematemesis disappeared time, occult blood clearance time and drainage tube cleaning time and hospitalization time in the observation group were shorter than that in the control group, and the differences were statistically significant (P<0.05).The 72 h re-bleeding rate in the observation group was lower, and the bleeding volume was less than that in the control group, the differences were statistically significant (P<0.05).Compliance of reasonable diet, prescribed medication, alcohol control, timely rest in the observation group during the follow-up was better than that in the control group, the differences was statistically significant(P<0.05).Conclusion Time nursing conforms to physiological characteristics of patients with gastrointestinal bleeding by endoscopic therapy, and it can reduce the rate of re-bleeding, shorten the course of disease, and improve the compliance behavior of patients.

Objective To explore the effect of time nursing in patients with gastrointestinal bleeding by endoscopic therapy.Methods A total of 172 gastrointestinal hemorrhage patients by endoscopic therapy in our hospital were randomly divided into two groups, 86 cases in the control group was given routine nursing, and anther 86 cases in the observation group was given time nursing based on the control group, hemostatic effect, re-bleeding rate, hospitalization time and compliance were compared.Results The hematemesis disappeared time, occult blood clearance time and drainage tube cleaning time and hospitalization time in the observation group were shorter than that in the control group, and the differences were statistically significant (P<0.05).The 72 h re-bleeding rate in the observation group was lower, and the bleeding volume was less than that in the control group, the differences were statistically significant (P<0.05).Compliance of reasonable diet, prescribed medication, alcohol control, timely rest in the observation group during the follow-up was better than that in the control group, the differences was statistically significant(P<0.05).Conclusion Time nursing conforms to physiological characteristics of patients with gastrointestinal bleeding by endoscopic therapy, and it can reduce the rate of re-bleeding, shorten the course of disease, and improve the compliance behavior of patients.