Objective:This study used non-invasive diagnostic techniques to assess microcirculatory dysfunction in the lower extremities, investigate its influencing factors in elderly patients with type 2 diabetes, and explore its correlation with diabetic microvascular complications.Methods:A total of 417 elderly patients with type 2 diabetes mellitus(T2DM)hospitalized in the Department of Endocrinology at Beijing Hospital between March 2024 and January 2025 were retrospectively enrolled.Based on transcutaneous oxygen pressure(TcPO2)and/or temperature-controlled laser Doppler flowmetry(LDF)blood flow changes in the lower limbs, participants were categorized into a microcirculatory dysfunction group(290 cases, 69.54%)and a normal microcirculation group(127 cases, 30.46%).Statistical analyses, including independent samples t-tests, Mann-Whitney U tests, and χ2 tests, were applied to compare intergroup differences.Multivariate stepwise logistic regression was conducted to identify risk factors for microcirculatory dysfunction. Results:After adjusting for confounding factors, multivariate regression analysis revealed female sex as a protective factor for microcirculation dysfunction( OR=0.456, 95% CI: 0.291-0.715, P<0.001).Gender-stratified analysis further demonstrated indicated that in elderly male T2DM patients, diabetes duration( OR=1.075, 95% CI: 1.024-1.128, P=0.004), hemoglobin A 1c( OR=1.346, 95% CI: 1.101-1.645, P=0.004), body mass index( OR=1.244, 95% CI: 1.095-1.412, P<0.001)and clinically diagnosed diabetic peripheral neuropathy( OR=2.576, 95% CI: 1.181-5.619, P=0.017)were significant risk factors for microcirculatory dysfunction.In elderly female T2DM patients, clinically diagnosed diabetic peripheral neuropathy( OR=2.869, 95% CI: 1.480-5.562, P=0.002), abnormal nerve conduction study( OR=2.023, 95% CI: 1.080-3.790, P=0.028), and diabetic nephropathy( OR=2.451, 95% CI: 1.130-5.317, P=0.023)were identified as significant risk factors. Conclusions:Significant gender disparities exist in microcirculatory dysfunction among elderly T2DM patients.Male patients exhibit a higher prevalence of lower limb microcirculatory impairment, highlighting the need for intensified management of cardiovascular risk factors.In contrast, female patients face elevated risks of microvascular complications, emphasizing the importance of early screening for microcirculatory dysfunction and related microvascular pathologies.

Objective To investigate the therapeutic efficacy of artesunate(AS)on polycystic ovary syndrome(PCOS)in mice and explore the potential mechanism primarily.Methods Twenty-five female C57BL/6J mice were randomly divided into Control group,model group(PCOS group),low-and high-dose AS groups(AS15 and AS30 groups)and metformin group(Met group).In addition to the Control group,the mouse model of PCOS was established by subcutaneous injection of dehydroepiandrosterone(DHEA,60 mg/kg)following by a high-fat diet for 21 d.After modeling,AS of 15 and 30 mg/kg was intraperitoneally injected into the mice of the AS 15 and AS30 groups,respectively,and 200 mg/kg Met was given to those of the Met group by gavage,once per day,for 6 weeks.ELISA was used to detect serum testosterone(T),fasting insulin(FINS),luteinizing hormone(LH)and follicle-stimulating hormone(FSH),and the LH/FSH ratio was calculated.The levels of fasting blood glucose(FBG),triglyceride(TG)and total cholesterol(TC)were detected by automatic biochemical analyzer,and the homeostasis model assessment of insulin resistance(HOMA-IR)was calculated.The estrous cycle was observed,and HE staining was performed for pathological changes in the ovary and uterus.Immunofluorescence assay was employed to measure the expression of p-eIF2α,ATF4 and CHOP in the ovarian tissue.After steroidogenic human granulosa-like tumor cell line KGN were exposed to 100 μmol/L DHEA to simulate the hyperandrogen environment of PCOS,and then treated with 5 and 10 μg/mL AS for 24 h,the protein levels of endoplasmic reticulum stress signaling pathway was detected by Western blotting.Results Compared with the Control group,the PCOS mice had disturbed estrous cycle,polycystic changes in the ovaries,and significantly increased serum T level and LH/FSH ratio(P＜0.05),and obviously elevated HOMA-IR,TC and TG levels in terms of metabolism(P＜0.01).The expression levels of p-eIF2α,ATF4 and CHOP were notably up-regulated in the ovarian granulosa cells of PCOS mice and KGN cells after DHEA exposure(P＜0.05).Additionally,AS treatment attenuated the pathological changes of ovary and uterine expression,decreased the serum T level and the LH/FSH ratio(P＜0.05),and reduced HOMA-IR,TC and TG levels(P＜0.05)when compared with the PCOS mice.Moreover,the expression levels of p-eIF2α,ATF4 and CHOP were significantly down-regulated after AS treatment in both ovarian granulosa cells of PCOS mice and KGN cells(P＜0.05).Conclusion AS significantly improves glycolipid metabolic disorder and reproductive dysfunction in PCOS mice,which may be associated with its suppressing endoplasmic reticulum stress by inhibiting the PERK/eIF2α/ATF4/CHOP pathway.

Objective:To evaluate the predictive performance of machine learning methods for predicting the risk of death in traumatic hemorrhage, and address the low prediction accuracy of traditional trauma scores, provide a reference for developing a more robust prediction method for severe trauma patients.Methods:Clinical data of severe trauma patients from the National Trauma Medical Center between April 1, 2023, and March 31, 2024 were collected. ElasticNet, Recursive Feature Elimination, and Mutual Information-based feature selection methods were used to screen variables and compared with traditional hypothesis testing methods. Built the prediction models for mortality risk in traumatic hemorrhage using Logistic Regression, ElasticNet, and Support Vector Machine (SVM) and compared the predictive performance.Results:The study included 5,601 trauma patients, the results of the variable screening and importance ranking were consistent with three feature selection methods. The classification accuracy and AUC values for the three models were as follows: Overall accuracy was 83.2%, survival accuracy was 84.0%, death accuracy was 76.3%, and an AUC was 0.86 in logistic regression; Overall accuracy was 78.9%, survival accuracy was 78.5%, death accuracy was 81.7%, and an AUC was 0.88 in ElasticNet; Overall accuracy was 84.7%, survival accuracy was 86.1%, death accuracy was 72.4%, and an AUC was 0.86 in SVM. The prediction performance of three models is quite little.Conclusion:Machine learning methods can effectively improve the prediction of death risk for traumatic hemorrhage,and has wide applications.

Objective To investigate the value of multimodal model integrating digital mammography(MG)and MRI radiomics features for preoperative prediction of lymphovascular invasion(LVI)status in breast cancer.Methods The clinical and imaging data from 336 patients with pathologically confirmed invasive breast cancer were retrospectively analyzed and randomly divided into a training group(235 cases)and a test group(101 cases)according to the ratio of 7∶3.Feature dimensionality reduction was carried out by Pearson correlation analysis followed by least absolute shrinkage and selection operator(LASSO)regression.Radiomics models were constructed based on MG craniocaudal(CC),dynamic contrast enhancement(DCE),T2 WI,and integrated MRI sequences;a multimodal model was further developed by incorporating clinical high-risk factors.The predictive efficiency of each model was evaluated by plotting receiver operating characteristic(ROC)curve.Results The ROC curve analysis showed that the multimodal model performed the best predictive efficiency,with area under the curve(AUC)of 0.989 and 0.861,accuracy of 0.949 and 0.782,sensitivity of 0.923 and 0.828,and specificity of 0.962 and 0.764 in the training group and test group respectively.Conclusion The multimodal model,integrating MG and MRI radiomics features,show optimal performance and can be served as a preoperative prediction of LVI status in breast cancer.

Objective To investigate the value of multimodal model integrating digital mammography(MG)and MRI radiomics features for preoperative prediction of lymphovascular invasion(LVI)status in breast cancer.Methods The clinical and imaging data from 336 patients with pathologically confirmed invasive breast cancer were retrospectively analyzed and randomly divided into a training group(235 cases)and a test group(101 cases)according to the ratio of 7∶3.Feature dimensionality reduction was carried out by Pearson correlation analysis followed by least absolute shrinkage and selection operator(LASSO)regression.Radiomics models were constructed based on MG craniocaudal(CC),dynamic contrast enhancement(DCE),T2 WI,and integrated MRI sequences;a multimodal model was further developed by incorporating clinical high-risk factors.The predictive efficiency of each model was evaluated by plotting receiver operating characteristic(ROC)curve.Results The ROC curve analysis showed that the multimodal model performed the best predictive efficiency,with area under the curve(AUC)of 0.989 and 0.861,accuracy of 0.949 and 0.782,sensitivity of 0.923 and 0.828,and specificity of 0.962 and 0.764 in the training group and test group respectively.Conclusion The multimodal model,integrating MG and MRI radiomics features,show optimal performance and can be served as a preoperative prediction of LVI status in breast cancer.

Objective:This study used non-invasive diagnostic techniques to assess microcirculatory dysfunction in the lower extremities, investigate its influencing factors in elderly patients with type 2 diabetes, and explore its correlation with diabetic microvascular complications.Methods:A total of 417 elderly patients with type 2 diabetes mellitus(T2DM)hospitalized in the Department of Endocrinology at Beijing Hospital between March 2024 and January 2025 were retrospectively enrolled.Based on transcutaneous oxygen pressure(TcPO2)and/or temperature-controlled laser Doppler flowmetry(LDF)blood flow changes in the lower limbs, participants were categorized into a microcirculatory dysfunction group(290 cases, 69.54%)and a normal microcirculation group(127 cases, 30.46%).Statistical analyses, including independent samples t-tests, Mann-Whitney U tests, and χ2 tests, were applied to compare intergroup differences.Multivariate stepwise logistic regression was conducted to identify risk factors for microcirculatory dysfunction. Results:After adjusting for confounding factors, multivariate regression analysis revealed female sex as a protective factor for microcirculation dysfunction( OR=0.456, 95% CI: 0.291-0.715, P<0.001).Gender-stratified analysis further demonstrated indicated that in elderly male T2DM patients, diabetes duration( OR=1.075, 95% CI: 1.024-1.128, P=0.004), hemoglobin A 1c( OR=1.346, 95% CI: 1.101-1.645, P=0.004), body mass index( OR=1.244, 95% CI: 1.095-1.412, P<0.001)and clinically diagnosed diabetic peripheral neuropathy( OR=2.576, 95% CI: 1.181-5.619, P=0.017)were significant risk factors for microcirculatory dysfunction.In elderly female T2DM patients, clinically diagnosed diabetic peripheral neuropathy( OR=2.869, 95% CI: 1.480-5.562, P=0.002), abnormal nerve conduction study( OR=2.023, 95% CI: 1.080-3.790, P=0.028), and diabetic nephropathy( OR=2.451, 95% CI: 1.130-5.317, P=0.023)were identified as significant risk factors. Conclusions:Significant gender disparities exist in microcirculatory dysfunction among elderly T2DM patients.Male patients exhibit a higher prevalence of lower limb microcirculatory impairment, highlighting the need for intensified management of cardiovascular risk factors.In contrast, female patients face elevated risks of microvascular complications, emphasizing the importance of early screening for microcirculatory dysfunction and related microvascular pathologies.

OBJECTIVE To establish the HPLC fingerprint and content determination of five components in Ranunculus sceleratus L.. METHODS The separation was developed on an Agilent ZORBAX SB C18 chromatographic (4.6 mm×250 mm, 5 μm)column by gradient elution with methanol(A)-0.1 % phosphoric acid aqueous solution(B) as mobile phase to establish HPLC fingerprint of Ranunculus sceleratus L.. Combined with similarity evaluation, cluster analysis, principal component analysis, and orthogonal partial least squares-discriminant analysis, the quality of 13 batches of Ranunculus sceleratus L. was evaluated. RESULTS Thirteen batches of Ranunculus sceleratus L. samples were calibrated with 20 common peaks, of which 5 common peaks were identified, and the similarity ranged from 0.874 to 0.984. The results of cluster analysis and principal component analysis were basically the same, indicating that there might be differences in the content of chemical components of Ranunculus sceleratus L. in different regions. Protocatechuic aldehyde, caffeic acid, ferulic acid, hyperoside and isoquercitrin were determined in thirteen batches of Ranunculus sceleratus L., and their contents were 0.016−0.035, 0.010−0.070, 0.010−0.029, 0.016−0.051, 0.028−0.086 mg·g–1, respectively. CONCLUSION The established HPLC fingerprint and content determination method is simple, stable, and reliable, which can be used for qualitative analysis and provide reference to quality evaluation and resource utilization of Ranunculus sceleratus L..

Elderly patients with diabetes often have multiple co-morbidities, comprehensive geriatric health assessment and highly individualized management should be emphasized for them. In recent years, with the emerging of new hypoglycemic drugs the treatment for elderly diabetic patients has advanced, which offers new options and challenges in the management and treatment of elderly diabetic patients with multiple comorbidities.

Objective:To investigate the effect of huaier granule combined with docetaxel + epirubicin + cyclophosphamide (TEC) neoadjuvant chemotherapy on the disease control rate and the levels of extracellular fragment of human epidermal growth factor receptor 2 (HER2-ECD) and tumor abnormal protein (TAP) in patients with advanced breast cancer.Methods:From April 2013 to June 2016, 94 patients with advanced breast cancer in Shengjing Hospital Affiliated to China Medical University were selected and randomly divided into observation group ( n=47) and control group ( n=47). The control group was treated with TEC neoadjuvant chemotherapy, and the observation group was treated with TEC neoadjuvant chemotherapy combined with huaier granules for 12 weeks. The curative effect, incidence of adverse reactions, cellular immune function indexes (CD8 + , CD4 + , CD4 + /CD8 + ), serum HER2-ECD and TAP levels were compared before and 12 weeks after treatment. The patients were followed up for 3 years after treatment, and the 1-year, 2-year and 3-year survival rates were compared between the two groups. Results:After 12 weeks of treatment, the disease control rate of the observation group was higher than that of the control group, with statistically significant difference ( P<0.05); during the treatment, the incidence of gastrointestinal reaction, neutropenia, thrombocytopenia and abnormal liver function of the observation group was lower than that of the control group, with statistically significant difference ( P<0.05); after 12 weeks of treatment, the serum CD8 + level of the observation group was lower than that of the control group, and the serum CD4 + , CD4 + /CD8 + level was higher than that of the control group, with statistically significant difference ( P<0.05); after 12 weeks of treatment, the serum levels of HER2-ECD and TAP in the observation group were lower than those in the control group, with statistically significant difference ( P<0.05); the 3-year survival rate in the observation group was higher than that in the control group, with statistically significant difference ( P<0.05). Conclusions:Huaier granules combined with TEC neoadjuvant chemotherapy in patients with advanced breast cancer can reduce serum HER2-ECD, TAP levels, which can enhance the immune function of the body, reduce the toxic and side effects, improve the long-term survival rate, and have a significant effect.

To test the therapeutic effect of recombinant fusion polypeptide hEGF-AWRK6 (EK) on burn infection of model mice. EK6 was expressed and purified with Escherichia coli expression system, and the Ⅱ degree burns and Pseudomonas aeruginosa infection model mouse were established. Experiment group was treated with EK (30 mg/L), and the control group was treated with PBS, gentamicin (30 mg/L), burn ointment (10 mg/L). The wound healing rate and colony count were calculated. Wound and surrounding skin were taken for HE staining and collagen western-blot analysis, and the wound pathological changes were observed after 10 days of drug delivery. The results showed that fusion peptide EK was successfully expressed and purified with significant antibacterial activities against Pseudomonas aeruginosa. Compared to the control group, the colony count (CFU) of the wound surface in EK mouse had a remarkable decrease (P<0.01) and healing rate had a significant increase in group EK6 (P<0.01). Pathological analysis result showed that compared to the control group, wound dermal cells in group EK arranged regularly, had more hair growth and a faster epithelization. These results indicated that the fusion peptide EK would be a good candidate for the drug development for the treatment of burning wounds.