AIM: To investigate the distribution characteristics of pathogens in patients with post-traumatic infectious endophthalmitis(PTIE)and their relationship with serum levels of macrophage inflammatory protein 1α(MIP-1α), heat shock protein 70(HSP70), and soluble triggering receptor expressed on myeloid cells 1(sTREM-1).METHODS:A total of 157 patients with PTIE from the Handan City Eye Hospital(The Third Hospital of Handan)from May 2023 to May 2025 were selected as the study group. They were divided into a good prognosis group and a poor prognosis group based on their uncorrected visual acuity at discharge. Meanwhile, 157 patients with ocular trauma but without endophthalmitis during the same period were selected as control group 1, and 157 healthy volunteers who underwent physical examinations during the same period were selected as control group 2. Aqueous humor and vitreous fluid samples were collected from the study group to detect the distribution of pathogens. The levels of serum MIP-1α, HSP70, and sTREM-1 were measured using the enzyme-linked immunosorbent assay. Multivariate Logistic regression analysis was performed to identify risk factors for poor prognosis. The predictive value of serum MIP-1α, HSP70, and sTREM-1 levels for poor prognosis was evaluated using receiver operating characteristic(ROC)and decision curve analysis(DCA).RESULTS: The general data of the participants in the three groups was comparable. A total of 173 pathogens were detected in the 157 patients with PTIE, with Gram-positive bacteria being the predominant type. The levels of serum MIP-1α and sTREM-1 in the study group were higher than those in control groups 1 and 2, while the level of HSP70 was lower than those in control groups 1 and 2(all P<0.05). There were no significant differences in the levels of serum MIP-1α, HSP70, and sTREM-1 between control groups 1 and 2(all P>0.05). In the poor prognosis group, the time of wound suture was ≥24 h, the wound location was in zones II/III, the type of trauma was rupture, the proportion of rupture injuries, and the levels of serum C-reactive protein, MIP-1α, and sTREM-1 were higher than those in the good prognosis group, while the level of HSP70 was decreased(all P<0.001). Multivariate Logistic regression analysis showed that the time of wound suture, wound location, type of trauma, C-reactive protein, MIP-1α, HSP70, and sTREM-1 were risk factors for poor visual prognosis in patients with PTIE(all P<0.05). The ROC curve results showed that the combined prediction of serum MIP-1α, HSP70, and sTREM-1 for poor visual prognosis in PTIE patients had an AUC value of 0.965, which was significantly higher than that of individual predictions(ZMIP-1α, ZHSP70, ZsTREM-1=3.628, 4.705, 3.930, all P<0.05). Additionally, the DCA curve showed that the combined prediction had a higher net benefit rate than individual predictions in the high-risk threshold range of 0.03-0.97.CONCLUSION:Gram-positive bacteria are the predominant type of pathogenic bacteria in patients with PTIE, with elevated levels of serum MIP-1α and sTREM-1 and decreased levels of HSP70. The combined detection of these three factors has a high predictive efficacy for visual prognosis in patients.

ObjectiveTo evaluate the clinical efficacy and safety of acupuncture combined with levodopa in the treatment of Parkinson's disease（PD）. MethodsA total of 60 patients with PD were enrolled and randomly assigned to test group or control group， with 30 patients in each group. The control group received levodopa only， starting at 100 mg per dose， three times daily， with gradual increases not exceeding a maximum daily dose of 800 mg. The test group received acupuncture three times per week in addition to levodopa. Both groups were treated for 12 weeks. Assessments were conducted before treatment， after 6 and 12 weeks treatment， using the Unified Parkinson's Disease Rating Scale（UPDRS）， Wearing-Off Questionnaire-9（WOQ-9）， Montreal Cognitive Assessment（MoCA）， Mini-Mental State Examination（MMSE）， Depression Rating Scale（DRS）， Hamilton Depression Scale（HAMD）， Hamilton Anxiety Scale（HAMA）， PD Questionnaire-39（PDQ-39）， and Pittsburgh Sleep Quality Index（PSQI）. Repeated measures ANOVA was utilized to evaluate the effects of time， group， and their interaction on each index. Spearman correlation analysis was conducted to examine the relationships between combined treatment and outcome scores. Adverse events in both groups were recorded throughout the study. ResultsBoth groups showed significant improvements after 6 and 12 weeks treatment， with decreases in UPDRS total score， WOQ-9 total score， DRS score， HAMD score， HAMA score， PDQ-39 score， and PSQI score， and increases in MoCA and MMSE scores（P＜0.05）. Compared with the control group， the test group demonstrated significantly greater improvements in all the above indicators after 6 and 12 weeks （P＜0.05）. Repeated measures ANOVA showed significant time main effects， group main effects， and their interaction across all outcome measures（P＜0.01）. Spearman correlation analysis revealed that combined therapy was significantly negatively correlated with UPDRS， WOQ-9， DRS， HAMD， HAMA， PDQ-39， and PSQI scores， while positively correlated with MoCA and MMSE scores after 12 weeks of treatment（P＜0.05）. Both groups did not experience any serious adverse events and did not affect treatment. ConclusionAcupuncture combined with levodopa is more effective than levodopa alone in improving motor function， non-motor symptoms， cognitive function， depression and anxiety， quality of life， and sleep quality in patients with PD， with good safety.

OBJECTIVE: Exposure to polycyclic aromatic hydrocarbons (PAHs) or metal(loid)s individually has been associated with neural tube defects (NTDs). However, the impacts of PAH and metal(loid) co-exposure and potential interaction effects on NTD risk remain unclear. We conducted a case-control study in China among population with a high prevalence of NTDs to investigate the combined effects of PAH and metal(loid) exposures on the risk of NTD. METHODS: Cases included 80 women who gave birth to offspring with NTDs, whereas controls were 50 women who delivered infants with no congenital malformations. We analyzed the levels of placental PAHs using gas chromatography and mass spectrometry, PAH-DNA adducts with ³²P-post-labeling method, and metal(loid)s with an inductively coupled plasma mass spectrometer. Unconditional logistic regression was employed to estimate the associations between individual exposures and NTDs. Least absolute shrinkage and selection operator (LASSO) penalized regression models were used to select a subset of exposures, while additive interaction models were used to identify interaction effects. RESULTS: In the single-exposure models, we found that eight PAHs, PAH-DNA adducts, and 28 metal(loid)s were associated with NTDs. Pyrene, selenium, molybdenum, cadmium, uranium, and rubidium were selected through LASSO regression and were statistically associated with NTDs in the multiple-exposure models. Women with high levels of pyrene and molybdenum or pyrene and selenium exhibited significantly increased risk of having offspring with NTDs, indicating that these combinations may have synergistic effects on the risk of NTDs. CONCLUSION Our findings suggest that individual PAHs and metal(loid)s, as well as their interactions, may be associated with the risk of NTDs, which warrants further investigation.
Humans ; Neural Tube Defects/chemically induced* ; Polycyclic Aromatic Hydrocarbons/adverse effects* ; Female ; Case-Control Studies ; China/epidemiology* ; Adult ; Pregnancy ; Environmental Pollutants ; Maternal Exposure/adverse effects* ; Metals/toxicity* ; Young Adult ; Risk Factors

Objective:To analyze the influence of embolic agent type selection on the clinical efficacy of transfemoral artery interventional therapy for hepatocellular carcinoma.Methods:The clinical data of 140 cases of hepatocellular carcinoma patients treated with femoral artery interventional therapy in the 960th Hospital of the Joint Logistic Support Force of the PLA from January 2020 to December 2022 were retrospectively analyzed. Among them, 35 patients treated with iodized oil was in group A, 35 patients treated with anhydrous ethanol was in group B, 35 patients treated with gelatin sponge granule embolization agent was in group C, 35 patients treated with drug-loaded microsphere embolization agents was in group D. The clinical efficacy and serum tumor markers before and after treatment of the four groups were compared, and the occurrence of adverse reactions in the four groups were analyzed.Results:There was statistical significance in the total effective rate of the four groups ( P<0.05), among which the total effective rate of group D was the highest [97.14% (34/35)], followed by group C [85.71% (30/35)], and the total effective rate of group A and B [54.29% (19/35), 62.86% (22/35)] was lower.After treatment, the levels of alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), alkaline phosphatase (ALP), γ-glutamyltransferase (GGT) and alpha-fetoprotein anisoplast L3 (AFP-L3) were all decreased compared with those before treatment ( P<0.05), and there were statistically significant differences in the above indexes among the four groups ( P<0.05). Among them, the levels of AFP, CEA, ALP, GGT and AFP-L3 in group D were the lowest, followed by group C, and higher in group A and B. There was no significant difference in the total incidence of adverse reactions among the four groups ( P>0.05). Conclusions:There is no significant difference in the safety of oil iodide, anhydrous ethanol, gelatin sponge particles embolic agent and drug-carrying microspheres embolic agent applied in transfemoral interventional therapy of hepatocellular carcinoma, and in the comparison of the efficacy, it is found that the drug-carrying microspheres embolic agent have the best efficacy, followed by gelatin sponge particles embolic agent, and oil iodide embolic agent and anhydrous ethanol are poor.

Objective:To develop and validate clinical predictive models for identifying poor short-term response to recombinant human growth hormone(rhGH) treatment in children with short stature.Methods:A retrospective analysis was conducted on 118 children diagnosed with growth hormone deficiency or idiopathic short stature who were treated at the First Affiliated Hospital of Zhengzhou University and two other hospitals between January 1, 2020, and January 1, 2024. A poor response to rhGH was defined as a height increase of less than 0.2 standard deviation score(SDS) after 6 months of rhGH treatment. LASSO regression was used to identify predictive variables from baseline and follow-up data. Two logistic regression models were conducted: Model A(incorporating baseline variables only) and model B(incorporating both baseline and follow-up variables), and nomograms were created for visualization. External data and internal resampling were used for dual validation of the models, and their performance was compared.Results:A total of 118 children with short stature were included. Six baseline predictive variables(diagnosis, initial height SDS, bone age, bone age-chronological age difference, rhGH dose, and gender) and one follow-up variable(height SDS after 3 months of rhGH treatment) were identified. Area under the curve values for Model A and Model B were 0.753(95% CI 0.696-0.811) and 0.930(95% CI 0.891-0.975), respectively. Calibration curves, decision curve analysis, and other evaluation metrics demonstrated good discrimination and clinical utility for both models. Model B, incorporating the 3-month follow-up variable, showed superior predictive performance compared to Model A. Conclusions:The clinical prediction models developed in this study(Model A and Model B) are practical and reliable tools for quantitatively, conveniently, and intuitively identifying children with short stature at risk of poor response to rhGH treatment.

Objective:To analyze the influence of embolic agent type selection on the clinical efficacy of transfemoral artery interventional therapy for hepatocellular carcinoma.Methods:The clinical data of 140 cases of hepatocellular carcinoma patients treated with femoral artery interventional therapy in the 960th Hospital of the Joint Logistic Support Force of the PLA from January 2020 to December 2022 were retrospectively analyzed. Among them, 35 patients treated with iodized oil was in group A, 35 patients treated with anhydrous ethanol was in group B, 35 patients treated with gelatin sponge granule embolization agent was in group C, 35 patients treated with drug-loaded microsphere embolization agents was in group D. The clinical efficacy and serum tumor markers before and after treatment of the four groups were compared, and the occurrence of adverse reactions in the four groups were analyzed.Results:There was statistical significance in the total effective rate of the four groups ( P<0.05), among which the total effective rate of group D was the highest [97.14% (34/35)], followed by group C [85.71% (30/35)], and the total effective rate of group A and B [54.29% (19/35), 62.86% (22/35)] was lower.After treatment, the levels of alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), alkaline phosphatase (ALP), γ-glutamyltransferase (GGT) and alpha-fetoprotein anisoplast L3 (AFP-L3) were all decreased compared with those before treatment ( P<0.05), and there were statistically significant differences in the above indexes among the four groups ( P<0.05). Among them, the levels of AFP, CEA, ALP, GGT and AFP-L3 in group D were the lowest, followed by group C, and higher in group A and B. There was no significant difference in the total incidence of adverse reactions among the four groups ( P>0.05). Conclusions:There is no significant difference in the safety of oil iodide, anhydrous ethanol, gelatin sponge particles embolic agent and drug-carrying microspheres embolic agent applied in transfemoral interventional therapy of hepatocellular carcinoma, and in the comparison of the efficacy, it is found that the drug-carrying microspheres embolic agent have the best efficacy, followed by gelatin sponge particles embolic agent, and oil iodide embolic agent and anhydrous ethanol are poor.

Objective:To develop and validate clinical predictive models for identifying poor short-term response to recombinant human growth hormone(rhGH) treatment in children with short stature.Methods:A retrospective analysis was conducted on 118 children diagnosed with growth hormone deficiency or idiopathic short stature who were treated at the First Affiliated Hospital of Zhengzhou University and two other hospitals between January 1, 2020, and January 1, 2024. A poor response to rhGH was defined as a height increase of less than 0.2 standard deviation score(SDS) after 6 months of rhGH treatment. LASSO regression was used to identify predictive variables from baseline and follow-up data. Two logistic regression models were conducted: Model A(incorporating baseline variables only) and model B(incorporating both baseline and follow-up variables), and nomograms were created for visualization. External data and internal resampling were used for dual validation of the models, and their performance was compared.Results:A total of 118 children with short stature were included. Six baseline predictive variables(diagnosis, initial height SDS, bone age, bone age-chronological age difference, rhGH dose, and gender) and one follow-up variable(height SDS after 3 months of rhGH treatment) were identified. Area under the curve values for Model A and Model B were 0.753(95% CI 0.696-0.811) and 0.930(95% CI 0.891-0.975), respectively. Calibration curves, decision curve analysis, and other evaluation metrics demonstrated good discrimination and clinical utility for both models. Model B, incorporating the 3-month follow-up variable, showed superior predictive performance compared to Model A. Conclusions:The clinical prediction models developed in this study(Model A and Model B) are practical and reliable tools for quantitatively, conveniently, and intuitively identifying children with short stature at risk of poor response to rhGH treatment.

There are a total of 16 couplet medicines of Paeoniae Radix Alba and Glycyrrhizae Radix et Rhizoma in the book FU Qingzhu Nüke, covering a wide range of diseases such as leukorrheal diseases, menopathy, pregnancy, and puerperal diseases, and there is a fine sense of the dosage, processing, and proportion of the couplet medicines. Through analyzing the cases of Paeoniae Radix Alba and Glycyrrhizae Radix et Rhizoma couplet medicines and the characteristics of dosage, processing, and proportion, we conclude that Paeoniae Radix Alba and Glycyrrhizae Radix et Rhizoma couplet medicines are mainly as followed: smoothing liver and strengthening spleen in treating leukorrheal diseases to remove dampness and stop leucorrhoea; regulating liver and tonifying spleen in menopathy to regulate menstruation and relieve pain; nourishing blood and benefiting qi in pregnancy to lower adverse qi and tranquilize fetus to prevent miscarriage; regulating and tonifying qi and blood in puerperal diseases to eliminate pathogenic factors and promote lactation; suppressing hyperactive liver for descending adverse qi, and relieving spasm and pain in cases of miscarriage due to rage. In terms of dosage, Paeoniae Radix Alba is mainly used for three to five qian, and Glycyrrhizae Radix et Rhizoma is primarily used for one qian, and the dosage of the two medicinals is adjusted according to the degree of primary and secondary liver stagnation and spleen deficiency. In terms of processing, wine Paeoniae Radix Alba and raw Glycyrrhizae Radix et Rhizoma are primarily used. Stir-frying with wine can help Paeoniae Radix Alba nourish blood and promote blood circulation, tonifying without stagnation, and it is used in most of the diseases caused by liver qi stagnation or qi and blood deficiency. Glycyrrhizae Radix et Rhizoma used in raw is tonifying without causing stagnation, and it can also have the effect of purging fire. In terms of proportion, the ratio of Paeoniae Radix Alba to Glycyrrhizae Radix et Rhizoma is 5∶1 for liver stagnation restraining spleen, 3∶1 for qi and blood deficiency, and 1∶1 for obvious fire-heat. This paper analyses the application of Paeoniae Radix Alba and Glycyrrhizae Radix et Rhizoma couplet medicines in FU Qingzhu Nüke, aiming to deeply study and inherit the academic thought of FU Qingzhu, and to provide new ideas and method for the precise application of Paeoniae Radix Alba and Glycyrrhizae Radix et Rhizoma couplet medicines in clinical practice and researches.

Objective To compare the effects of dulaglutide and liraglutide combined with metformin on serum C1q/TNF-related protein 3(CTRP3)and vascular cell adhesion molecule 1(VCAM-1)in obese patients with type 2 diabetes mellitus(T2DM).Methods A total of 89 obese T2DM patients who were admitted to Affiliated Nantong Hospital of 3 Nantong University from March 2019 to September 2022 were selected as research subjects.They were randomly divided into liraglutide group(n=45,liraglutide+metformin)and dulaglutide group(n=44,dulaglutide+metformin).Body mass index(BMI),obesity degree,waist circumference,hip circumference,glucolipid metabolism related indexes,insulin resistance related indexes,CTRP3,and VCAM-1 were compared between the two groups.Results Compared with those before treatment,BMI,obesity degree,hip circumference,waist circumference,glucolipid metabolism related indexes,insulin resistance related indexes,CTRP3,and VCAM-1 were significantly changed after treatment(all P<0.05).Mean amplitude of glucose fluctuation(MAGE)and VCAM-1 in the dulaglutide group were significantly lower than those in the liraglutide group after treatment,while time in target glucose range(TIR)and CTRP3 in the dulaglutide group were significantly higher than those in the liraglutide group after treatment(all P<0.05).There was no statistically significant difference in the other indexes between the two groups after treatment(all P>0.05).Conclusion Both dulaglutide and liraglutide combined with metformin can control blood glucose levels and improve glucolipid metabolism in obese T2DM patients.But dulaglutide is more effective in controlling MAGE and TIR than liraglutide,which may be related to the ability of dulaglutide to regulate the levels of CTRP3 and VCAM-1.