Introduction: The occurrence of rotator cuff tendinopathy, which is invariably symptomatic, increases as populations age, being largely observed among patients with diabetes. The objective of the present study is to find out the occurrence of rotator cuff tendinopathy in elderly diabetic patients who were asymptomatic, composed of healthy individuals and those with diabetes mellitus. Materials and methods: The participants in this study included 87 elderly diabetic patients and 56 controls (mean age: 69.3±4.9 and 71.8±3.6, respectively), who were asymptomatic from shoulder. All patients, including, underwent shoulder MRI examination using 1.5 tesla MRI. Results: We recorded greater tendons thickness in the diabetic patients as compared with the controls (supraspinatus tendon: 6.6±0.7mm vs 5.3±0.8mm, p<0.001; biceps tendon: 3.9±0.7mm vs 3.1±0.8mm, p<0.002). Moreover, higher incidence of supraspinatus tendon tear was noted in diabetics as compared to biceps tendon (major tears: 32 (36.7%) vs 6 (10.7%), p=0.052; minor tears: 51 (58.6%) vs 11 (19.6%), p=0.032). Conclusions: The present study suggests that age-related rotator cuff tendinopathy is more prevalent among patients with diabetes. Therefore, MRI is an investigation of choice for early detection i.e., at pre-symptomatic stages of rotator cuff tendinopathy, as the patients may develop symptoms later. Keywords: asymptomatic

ObjectiveTo explore the mechanism by which Yinchenhao Tang intervenes in α-naphthylisothiocyanate （ANIT）-induced cholestatic liver injury by regulating the Takeda G-protein-coupled receptor 5（TGR5）/NOD-like receptor protein 3（NLRP3）/cysteine aspartate-specific protease-1 （Caspase-1） pyroptosis signaling pathway. MethodsForty male Wistar rats were randomly assigned into blank， model， ursodeoxycholic acid， and Yinchenhao Tang groups. Except the blank group， other groups were treated with ANIT dissolved in olive oil for the modeling of cholestatic liver injury. Ursodeoxycholic acid （0.1 g·kg^-1） and Yinchenhao Tang （9.23 g·kg^-1） were administered by gavage. The blank group and the model group were administrated with the same amount of pure water， once a day for 3 days. The blood and liver tissue samples were collected， and the serum levels of liver function indicators were measured by an automatic biochemical analyzer. Hematoxylin-eosin staining was employed to observe the pathological changes of the liver. The levels of interleukin （IL）-1β and IL-18 in the liver tissue were determined by ELISA. The mRNA levels of IL-1β， IL-18， TGR5， NLRP3， apoptosis-associated speck-like protein containing a CARD （ASC）， Caspase-1， and GSDMD in the liver tissue were assessed by Real-time PCR. The protein levels of TGR5， NLRP3， ASC， Caspase-1， and GSDMD in the liver tissue were determined by Western blot. ResultsCompared with the blank group， the model group showed elevated levels of alanine amino-transferase （ALT）， aspartate transferase （AST）， alkaline phosphatase （ALP）， total bile acid （TBA）， and total bilirubin （TBil） in the serum （P<0.01）， inflammatory cell infiltration， hepatocyte swelling， and bile duct epithelial cell proliferation in the liver， raised levels of IL-1β and IL-18 in the liver tissue （P<0.01）， down-regulated mRNA and protein levels of TGR5 （P<0.01）， up-regulated mRNA levels of IL-18 （P<0.01）， ASC （P<0.01）， Caspase-1 （P<0.01）， GSDMD （P<0.01）， IL-1β （P<0.05）， and NLRP3 （P<0.05）， and up-regulated protein levels of NLRP3 （P<0.01）， ASC （P<0.01）， Caspase-1 （P<0.01）， and GSDMD （P<0.05）. Compared with the model group， the ursodeoxycholic acid group showed declined levels of AST （P<0.01）， TBA （P<0.01）， TBil （P<0.01）， and ALT （P<0.05） in the serum， lowered levels of IL-1β and IL-18 in the liver tissue （P<0.01）， down-regulated mRNA levels of NLRP3 （P<0.01）， Caspase-1 （P<0.01）， GSDMD （P<0.01）， IL-1β （P<0.05）， IL-18 （P<0.05）， and ASC （P<0.05）， up-regulated mRNA and protein levels of TGR5 （P<0.05）， and down-regulated protein levels of NLRP3， ASC， Caspase-1， and GSDMD （P<0.05）. Compared with the model group， the Yinchenhao Tang group showed lowered levels of ALT， AST， ALP， TBA， and TBil in the serum （P<0.01）， declined levels of IL-1β and IL-18 in the liver tissue （P<0.01）， down-regulated mRNA levels of IL-1β （P<0.01）， NLRP3 （P<0.01）， ASC （P<0.01）， Caspase-1 （P<0.01）， GSDMD （P<0.01）， and IL-18 （P<0.05）， up-regulated mRNA and protein levels of TGR5 （P<0.01）， and down-regulated protein levels of Caspase-1 and GSDMD （P<0.05）. The liver tissue of the administration groups showed reduced infiltration of inflammatory cells， reduced swelling of hepatocytes， and alleviated proliferation of bile duct epithelial cells. ConclusionYinchenhao Tang can ameliorate ANIT-induced cholestatic liver injury by regulating the hepatocyte pyroptosis mediated by the TGR5/NLRP3/Caspase-1 signaling pathway.

Cholestatic liver injury refers to the bile production， secretion， and excretion disorder caused by various reasons. It induces liver injury， metabolic disorders， and dysfunction of the hepatobiliary system， which can further develop into liver fibrosis， cirrhosis， liver failure， and even death. At present， the preferred drug for clinical treatment is ursodeoxycholic acid， which， however， induces adverse reactions and is intolerant in some patients. Yinchenhao Tang is a representative prescription of traditional Chinese medicine for the treatment of jaundice due to Yang jaundice. It has the effects of clearing heat， eliminating dampness， and removing jaundice and has shown good therapeutic effect in long-term clinical application. Modern pharmacological studies have found that this prescription has anti-inflammatory， anti-oxidation， bile acid balance-regulating， hepatocyte apoptosis-inhibiting and other liver-protecting effects. This paper reviews the relevant clinical and animal experimental studies on Yinchenhao Tang in the treatment of cholestatic liver injury in recent years. Yinchenhao Tang can intervene in the progression of cholestatic liver injury by regulating bile acid metabolism and excretion， reducing inflammatory response， inhibiting oxidative stress， alleviating endoplasmic reticulum stress， inhibiting hepatocyte apoptosis， and protecting intestinal mucosal barrier. This paper systematically expounds the molecular mechanisms by which Yinchenhao Tang regulates cholestatic liver injury that are confirmed by current research， aiming to provide reference for the clinical application and in-depth study of Yinchenhao Tang.

Objective To analyze the clinical characteristics and risk factors of noninfectious fever after endovascular repair of aortic dilatation diseases, and to explore management strategies. Methods A retrospective analysis was conducted on the clinical data of patients who underwent endovascular aortic repair for aortic dilatation diseases from January 2021 to October 2023. Based on inclusion and exclusion criteria, the enrolled patients were divided into a febrile group and an afebrile group according to the presence of postoperative fever. Clinical data, including demographics and surgical details, were compared between the two groups. Multivariate logistic regression analysis was performed on indicators with P≤0.05 in the univariate analysis, and receiver operating characteristic (ROC) curves were generated to analyze the predictive value of risk factors for postoperative noninfectious fever. Results A total of 305 patients were included in the final analysis. Postoperative noninfectious fever occurred in 75.08% (229/305) of the patients, with 98.25% of cases occurring within the first two postoperative days. The febrile group (n=229) had a median age of 65.0 (IQR: 53.0, 73.0) years with 83.4% males, while the afebrile group (n=76) had a median age of 71.0 (IQR: 65.0, 76.7) years with 84.2% males. Univariate analysis showed that the age, prevalence of coronary heart disease, preoperative statin use, and prevalence of aortic aneurysm were significantly lower in the febrile group compared to the afebrile group. Logistic regression analysis indicated that age, surgical site, disease type, preoperative elevated body temperature, and stent type were significantly associated with noninfectious fever, while preoperative statin use was negatively correlated. ROC curve analysis demonstrated that age, surgical site, preoperative elevated body temperature, and stent type had significant predictive value for postoperative noninfectious fever (P<0.01). Conclusion Noninfectious fever is highly prevalent following aortic repair. The relationship between fever and infection should be comprehensively evaluated based on risk factors and changes in the patient's condition to promote the rational use of antibiotics.

BACKGROUND

Acne vulgaris is one of the common skin diseases prompting dermatologic consult. Although prevalent worldwide, knowledge of the public about acne is still lacking. Due to this, content related to acne vulgaris has been a topic of choice on social media platforms.

A cross-sectional study was conducted among 120 patients diagnosed with acne vulgaris aged 18-50 years-old consulting via teledermatology and face-to-face consultation at the Rizal Medical Center. Patients completed a self-administered questionnaire and global acne severity was assessed.

A total of 120 newly d iagnosed patients with acne vulgaris were included in the study, with a mean age of 23.25 years, with a female predominance, household average monthly income less than PhP 10,957 and with mild to moderate acne severity. Majority of the participants used social media to look for treatment options and to gain more knowledge about the disease. The most used platforms were Youtube, Facebook and Tiktok. Short videos were viewed more often and content from dermatologists were preferred. Most commonly tried products are over-the-counted non-pharmaceutical topical products. There was a significant association between the use of social media with age and educational attainment. Furthermore, a significant association between self-medication practices and average household monthly income was seen. No association was seen between acne severity, social media use and self-medication practices.

In summary, the use of social media to access acne-related content was prevalent among young female patients, of lower socioeconomic status diagnosed with mild-moderate acne severity at a tertiary hospital in the Philippines.

Endovascular interventional therapy is currently the main treatment for acute ischemic stroke，but some patients still have not achieved neurological function independence. Analysis of the predictive value of various factors for postoperative neurological function changes can provide more reference for selecting appropriate patient groups and treatment plans.

Objective To explore the mediating role of activities of daily living (ADL) in pain and depressive symptoms in the elderly in China. Methods Utilizing the data from 2020 China Health and Retirement Longitudinal Study, 4403 Chinese elderly individuals aged ≥ 60 years old were selected as the research subjects. Depression Scale (CES-D 10) of the Center for Epidemiological Survey and ADL scale were used in the study. The PROCESS4.1 macro was used to test the mediating effect of daily living activities between pain and depressive symptoms, and the Bootstrap method was applied for verification of the mediating variables. Results A total of 2368 cases of depressive symptoms were detected in the elderly in China, with a detection rate of 53.78%. Pain was positively correlated with depressive symptoms (r=0.27, P<0.01), and activities of daily living were negatively correlated with pain and depressive symptoms (r=-0.27, -0.337, P<0.01). The results showed that the total effect value of pain on depressive symptoms was 0.33, the direct effect value was 0.24, and the mediating effect value of daily living activities was 0.09, accounting for 27.27%. Conclusion Pain and activities of daily living are important factors influencing depressive symptoms in the elderly, and activities of daily living play a partial mediating role in the relationship between pain and depressive symptoms in the elderly.

[摘 要] 目的：探究β-半乳糖苷α-2-6唾液酸转移酶1（ST6GAL1）对结直肠癌（CRC）HCT116细胞糖酵解和迁移、侵袭的作用及可能的分子机制。方法：通过检索GEPIA2数据库，分析ST6GAL1在CRC患者和健康人群中的表达差异；WB法检测ST6GAL1在CRC细胞HCT116、SW480、Caco-2、HT29、LoVo和人正常结肠上皮细胞NCM460细胞中的表达差异；免疫组织化学法分析ST6GAL1在CRC组织和对应癌旁组织中的表达差异。通过慢病毒转染细胞的方法构建稳定敲低或过表达ST6GAL1的HCT116细胞，通过划痕愈合实验检测细胞迁移能力，Transwell实验检测细胞侵袭能力，WB法检测细胞糖酵解相关蛋白、Notch1受体胞内段（Notch1 ICD）以及PI3K/AKT/mTOR通路磷酸化水平，细胞免疫荧光实验观察Notch1 ICD表达水平和进入细胞核情况；加入Notch1受体激动剂Jagged1处理HCT116细胞，通过WB法检测糖酵解相关蛋白、Notch1 ICD表达水平以及PI3K/AKT/mTOR通路磷酸化水平。结果：ST6GAL1在CRC组织和细胞中均表达上调（均P < 0.05）。与对照组和过表达组相比，敲低ST6GAL1导致HCT116细胞内Notch1 ICD表达水平和PI3K/AKT/mTORC1磷酸化水平显著降低，细胞糖酵解相关蛋白表达水平降低，细胞迁移和侵袭能力减弱（均P < 0.05）；过表达ST6GAL1增加了HCT116细胞内Notch1 ICD表达水平并促进其进入细胞核，细胞糖酵解相关蛋白表达水平升高，细胞迁移和侵袭能力增强（均P < 0.05）。结论：ST6GAL1通过活化Notch1受体进而磷酸化激活PI3K/AKT/mTORC1通路，并增强CRC细胞糖酵解水平和迁移、侵袭能力。

[摘 要] 目的：探讨同源框蛋白C4（HOXC4）在胃癌组织和细胞中的表达及其对胃癌细胞增殖、迁移与侵袭的作用及其机制。方法：收集2020年5月至2021年4月期间在南阳市第一人民医院肿瘤科手术切除的16例进展期胃癌患者的癌及癌旁组织标本，以及人胃正常上皮细胞GES-1和胃癌细胞AGS、SGC-790和MGC-803，采用WB法检测胃癌组织和细胞中HOXC4的表达。通过RNA干扰技术对SGC-790及AGS细胞中HOXC4进行敲低或过表达，实验分为sh-HOXC4#1组、sh-HOXC4#2组、sh-Con组、sh-HOXC4 + pc-integrin β1组、pc-HOXC4组、pc-Con组、pc-HOXC4 + pc-integrin β1组。利用EdU、CCK-8、Transwell实验分别检测敲低或过表达HOXC4对各组细胞活力、增殖、侵袭、迁移和integrin β1表达的影响。用敲低HOXC4的胃癌AGS细胞构建荷瘤小鼠模型，观察敲低HOXC4对移植瘤体积及组织中Ki67和integrin β1蛋白表达的影响。结果：胃癌组织和细胞中HOXC4的表达均显著上调（均P < 0.01）。与sh-Con组相比，sh-HOXC4#1组和sh-HOXC4#2组SGC-790及AGS细胞中HOXC4、integrin β1蛋白表达水平，以及细胞的活力、增殖、迁移及侵袭能力均显著降低（均P < 0.01）。与sh-HOXC4组相比，sh-HOXC4 + pc-integrin β1组细胞活力、增殖、迁移及侵袭能力均显著增加（均P < 0.01）；与pc-Con组相比，pc-HOXC4组细胞活力、侵袭及迁移能力均显著增加（均P < 0.01）；与pc-HOXC4组相比，pc-HOXC4 + pc-integrin β1组细胞活力、迁移及侵袭能力均显著降低（均P < 0.01）。与sh-Con组相比，sh-HOXC4#1组和sh-HOXC4#2组小鼠移植瘤生长缓慢、体积变小，组织中Ki67和integrin β1表达均显著降低（均P < 0.01）。结论：HOXC4在胃癌组织与细胞中表达上调，其通过激活integrin β1信号促进胃癌细胞的增殖、迁移与侵袭。

[摘 要] 目的：探索预后营养指数（PNI）在接受诱导化疗联合免疫（化免）序贯放疗的局部晚期食管鳞状细胞癌（ESCC）中的疗效预测价值及预后影响。方法: 回顾性分析浙江省肿瘤医院2019年5月至2023年8月期间收治的126例行诱导化免序贯放疗的局部晚期ESCC患者的临床资料。绘制受试者工作特征曲线（ROC曲线），确定患者诱导化免前1周内、放疗前1周内、放疗开始后4 ± 1周的PNI最佳临界值并对患者进行分组。采用Kaplan-Meier法绘制生存曲线，并用Log-Rank法比较组间患者的总生存期（OS）及无进展生存期（PFS），采用Cox回归分析探讨诱导化免序贯放疗的局部晚期ESCC患者的预后影响因素。结果: 共纳入126例局部晚期ESCC患者，男性118例，女性8例，中位年龄65岁（44~78岁）。运用ROC曲线确认的患者诱导化免前、放疗前和放疗中PNI最佳临界值为46.2、48.3和37.9。放疗前PNI ≥ 48.3组中位OS、PFS分别为47.3、28.2个月，放疗前PNI < 48.3组中位OS、PFS分别为18.7、15.2个月（P < 0.01，P < 0.05）。放疗中PNI ≥ 37.9组中位OS未达到，中位PFS为25.7个月，放疗中PNI < 37.9组中位OS、PFS分别为17.0、12.5个月（P < 0.01，P < 0.05）。诱导化免后PNI升高组中位OS未达到，中位PFS为28.4个月；PNI降低组中位OS、PFS分别为20.4、16.0个月（P < 0.01，P < 0.05）。多因素分析显示，放疗中PNI[HR = 2.292，95% CI（1.264,4.159），P < 0.05]、诱导化免后PNI变化[HR = 2.120, 95% CI（1.007, 4.463），P < 0.05]为影响OS因素。结论: 放疗中PNI、诱导化免后PNI变化与患者治疗疗效及预后有一定相关性，可作为预测ESCC化免序贯放疗获益的重要指标。