AIM: To investigate the expression of Ficolin-3 and secreted frizzled-related protein 5(SFRP5)in the serum of patients with type 2 diabetes mellitus(T2DM)combined with diabetic retinopathy(DR)and their diagnostic value.METHODS: Prospectively selected patients with T2DM combined with DR admitted to the hospital from May 2023 to May 2025 were divided into non-proliferative and proliferative groups according to the severity of DR. Another patients with T2DM alone during the same period were selected as the T2DM group. ELISA was used to detect Ficolin-3 and SFRP5 levels; Correlation of serum Ficolin-3, SFRP5 levels, and inflammatory markers in T2DM patients with DR were analyzed using Pearson method; Logistic regression was used to analyze related influencing factors; ROC curve analysis was used to evaluate the diagnostic value of serum Ficolin-3 and SFRP5 for DR in T2DM patients.RESULTS: This study included a total of 108 patients with T2DM combined with DR(57 cases in the non-proliferative group, 51 cases in the proliferative group)and 108 cases in the T2DM group. The non-proliferative group had an average age of 59.01±6.28 y, with 34 males and 23 females. The proliferative group had an average age of 59.09±6.35 y, with 30 males and 21 females. The T2DM group had an average age of 58.96±6.18 y, with 62 males and 46 females.The serum levels of Ficolin-3, TNF-α, and IL-6 in the non-proliferative and proliferative groups were higher than those in the T2DM group(all P<0.05), while the level of SFRP5 was lower than that in the T2DM group(all P<0.05). The serum levels of Ficolin-3, TNF-α, and IL-6 in the proliferative group were higher than those in the non-proliferative group(all P<0.05), and the level of SFRP5 was lower than that in the non-proliferative group(P<0.05).Complying with Pearson correlation analysis showed that serum Ficolin-3 was negatively correlated with SFRP5(P<0.05), and both were related to TNF-α and IL-6(all P<0.001). Logistic analysis showed that the course of diabetes, SUA, HbA1c, Ficolin-3, TNF-α, and IL-6 were the risk factors for T2DM patients with DR(all P<0.05), and SFRP5 was a protective factor(P<0.05). Complying with the ROC curve, the AUC values of serum Ficolin-3 and SFRP5 alone and their combination for diagnosing T2DM patients with DR were 0.774, 0.793, and 0.864, respectively. The AUC of combined diagnosis was better than that of single diagnosis(Z=2.694, Z=2.708, both P<0.05).CONCLUSION: In patients with T2DM complicated by DR, serum levels of Ficolin-3 and SFRP5 are abnormally expressed. Both are influencing factors for T2DM with DR, and the combined detection can improve the diagnostic value in these patients.

Objective To analyze the value of abnormal expression of platelet membrane P-selectin(CD62p)and zonula occluden-1 in predicting the instability of carotid atherosclerotic plaques in elderly patients with cerebral infarction.Methods A total of 203 elderly patients with cerebral in-farction admitted to our department from March 2021 to July 2023 were enrolled,and based on their status of carotid plaques,they were divided into a unstable plaque group(45 cases),a stable plaque group(89 cases),a no-plaque group(69 cases).General information was collected,and the serum levels of CD62p and zonula occluden-1 were measured.The risk factors for carotid athero-sclerotic plaque instability and their predictive value were analyzed.Results Statistical differences were observed in the levels of low-density lipoprotein,homocysteine(Hcy),C-reactive protein,IL-6,fibrinogen,and intercellular adhesion molecule-1(ICAM-1)among the three groups(P＜0.05,P＜0.01),so were in the serum levels of CD62p and zonula occluden-1(P＜0.05).In the un-stable plaque group,the serum levels of CD62p and zonula occluden-1 were positively correlated with the levels of low-density lipoprotein,Hcy,C-reactive protein,IL-6,fibrinogen,and ICAM-1(P＜0.05,P＜0.01).In the stable plaque group,the serum levels of CD62p and zonula occluden-1 were positively correlated with the levels of low-density lipoprotein,Hcy,C-reactive protein,IL-6 and ICAM-1(P＜0.05,P＜0.01).Logistic regress analysis showed that the serum levels of low-density lipoprotein,Hey,C-reactive protein,IL-6,fibrinogen,ICAM-1,CD62p and zonula occlu-den-1 were risk factors for plaque instability(P＜0.01).ROC curve analysis indicated that the AUC value of CD62p and zonula occluden-1 in predicting plaque instability was 0.850 and 0.838,respectively(P＜0.01).Conclusion Abnormal expression of serum CD62p and zonula occluden-1 can effectively predict the instability of carotid atherosclerotic plaques in elderly patients with cer-ebral infarction.

Objective:To screen bile acid-related characteristic genes in IgA nephropathy (IgAN) based on the feature gene selection algorithm in the machine learning method, aiming to exploring the molecular biological mechanisms and biomarkers of IgAN.Methods:The gene expression data and sample grouping information of GSE93798, GSE116626 and GSE35487 were downloaded from the Gene Expression Omnibus (GEO). Bile acid-related gene sequences were obtained from the Molecular Signatures Database (MSigDB). R language was used to identify differentially expressed genes between IgAN samples and healthy control samples. Candidate genes were obtained by intersecting differentially expressed genes and bile acid-related genes. The least absolute shrinkage and selection operator (LASSO) algorithm in machine learning was used to screen the feature genes in the candidate genes as biomarkers, and the feature genes in the training set and validation set were analyzed by the rate of change index. Receiver operating characteristic curve (ROC) method was used to evaluate the diagnostic value of identified bile acid related characteristic genes for IgAN. Gene set enrichment analysis (GSEA) was used to analyze the Spearman correlation between the characteristic genes and all other genes and their related metabolic pathways. The expression of disease-characteristic genes in the kidney tissues of IgAN rats was validated by real-time PCR.Results:Gene expression information from kidney tissue samples of 20 IgAN cases and 22 healthy controls were obtained from GEO database. A total of 204 bile acid-related genes including 24 pathways were obtained from MSigDB. The results of gene differential expression analysis showed that 333 genes in the kidney tissues of IgAN patients were differentially expressed compared with those of healthy controls, including 102 up-regulated genes and 231 down-regulated genes, among which 12 differentially expressed genes were related to bile acid genes, as follows: NR1H4,SLC23A1, ALDH8A1, FABP1, ALB, SLC27A2, DIO1, CYP8B1, BBOX1, PIPOX, AKR1C1 and SLC10A2. Five characteristic genes ( NR1H4, SLC23A1, FABP1, ALB and AKR1C1) were screened by LASSO regression algorithm.ROC analysis results showed that in GSE93798 cohort genes, the AUC of NR1H4, SLC23A1, FABP1 and ALB genes with differential expression was >0.95 respectively in diagnosing IgAN, and that of AKR1C1 genes with differential expression was >0.85 in diagnosing IgAN. The gene expression data of SLC23A1 in GSE35487 cohort was missing. ROC analysis results of other four genes showed that the AUC of differential expression of ALB gene for IgAN was >0.95 respectively, that of NR1H4 gene was >0.70, and that of both FABP1 and AKR1C1 gene was >0.60. In the GSE116626 cohort genes, the AUC of five disease characteristic genes ( NR1H4, SLC23A1, FABP1, ALB, AKR1C1) for diagnosing IgAN was >0.60, respectively. These results suggested that 5 characteristic genes have certain distinguishing ability between IgAN group and control group. GSEA results were displayed that the characteristic genes were related to butyric acid metabolism, propionic acid metabolism, arginine and proline metabolism, valine leucine and isoleucine degradation, fatty acid metabolism, etc. These results suggested that five characteristic genes might be related to IgAN through the above metabolic mechanisms. The verification results of five bile acid characteristic genes in the rat model of IgAN in the kidney tissue showed that the expressions of four genes, NR1H4, SLC23A1, FABP1 and ALB, were higher than those of the control group, and there was no statistical significance in the expression of AKR1C1 gene between the two groups. Conclusions:The expression of bile acid-related characteristic genes is abnormal in the kidney tissue of IgAN patients. Four bile acid-related differentially expressed genes, NR1H4, SLC23A1, FABP1 and ALB, are expected to be biomarkers for non-invasive diagnosis and therapeutic targets .

Objective:To screen bile acid-related characteristic genes in IgA nephropathy (IgAN) based on the feature gene selection algorithm in the machine learning method, aiming to exploring the molecular biological mechanisms and biomarkers of IgAN.Methods:The gene expression data and sample grouping information of GSE93798, GSE116626 and GSE35487 were downloaded from the Gene Expression Omnibus (GEO). Bile acid-related gene sequences were obtained from the Molecular Signatures Database (MSigDB). R language was used to identify differentially expressed genes between IgAN samples and healthy control samples. Candidate genes were obtained by intersecting differentially expressed genes and bile acid-related genes. The least absolute shrinkage and selection operator (LASSO) algorithm in machine learning was used to screen the feature genes in the candidate genes as biomarkers, and the feature genes in the training set and validation set were analyzed by the rate of change index. Receiver operating characteristic curve (ROC) method was used to evaluate the diagnostic value of identified bile acid related characteristic genes for IgAN. Gene set enrichment analysis (GSEA) was used to analyze the Spearman correlation between the characteristic genes and all other genes and their related metabolic pathways. The expression of disease-characteristic genes in the kidney tissues of IgAN rats was validated by real-time PCR.Results:Gene expression information from kidney tissue samples of 20 IgAN cases and 22 healthy controls were obtained from GEO database. A total of 204 bile acid-related genes including 24 pathways were obtained from MSigDB. The results of gene differential expression analysis showed that 333 genes in the kidney tissues of IgAN patients were differentially expressed compared with those of healthy controls, including 102 up-regulated genes and 231 down-regulated genes, among which 12 differentially expressed genes were related to bile acid genes, as follows: NR1H4,SLC23A1, ALDH8A1, FABP1, ALB, SLC27A2, DIO1, CYP8B1, BBOX1, PIPOX, AKR1C1 and SLC10A2. Five characteristic genes ( NR1H4, SLC23A1, FABP1, ALB and AKR1C1) were screened by LASSO regression algorithm.ROC analysis results showed that in GSE93798 cohort genes, the AUC of NR1H4, SLC23A1, FABP1 and ALB genes with differential expression was >0.95 respectively in diagnosing IgAN, and that of AKR1C1 genes with differential expression was >0.85 in diagnosing IgAN. The gene expression data of SLC23A1 in GSE35487 cohort was missing. ROC analysis results of other four genes showed that the AUC of differential expression of ALB gene for IgAN was >0.95 respectively, that of NR1H4 gene was >0.70, and that of both FABP1 and AKR1C1 gene was >0.60. In the GSE116626 cohort genes, the AUC of five disease characteristic genes ( NR1H4, SLC23A1, FABP1, ALB, AKR1C1) for diagnosing IgAN was >0.60, respectively. These results suggested that 5 characteristic genes have certain distinguishing ability between IgAN group and control group. GSEA results were displayed that the characteristic genes were related to butyric acid metabolism, propionic acid metabolism, arginine and proline metabolism, valine leucine and isoleucine degradation, fatty acid metabolism, etc. These results suggested that five characteristic genes might be related to IgAN through the above metabolic mechanisms. The verification results of five bile acid characteristic genes in the rat model of IgAN in the kidney tissue showed that the expressions of four genes, NR1H4, SLC23A1, FABP1 and ALB, were higher than those of the control group, and there was no statistical significance in the expression of AKR1C1 gene between the two groups. Conclusions:The expression of bile acid-related characteristic genes is abnormal in the kidney tissue of IgAN patients. Four bile acid-related differentially expressed genes, NR1H4, SLC23A1, FABP1 and ALB, are expected to be biomarkers for non-invasive diagnosis and therapeutic targets .

Objective To investigate and analyze the various reasons that affect the accuracy of ICD-9-CM-3 classifica-tion coding,identify key factors,and propose improvement strategies to enhance the accuracy and standardization level of surgical operation coding.Methods Using case analysis method,various factors affecting the accurate coding of ICD-9-CM-3 were sys-tematically listed and analyzed in detail.Through specific examples,this article analyzes the non-standard behavior of clinical physicians in writing surgical operation names,as well as the problems of coders relying on doctors to write,ignoring coding rules,and not fully reading medical records and surgical records during the coding process.It further explores how these factors lead to surgical classification errors.Results The main reasons affecting the accuracy of ICD-9-CM-3 coding include:lack of standardization in writing surgical operation names by clinical physicians,and failure to provide detailed descriptions of key ele-ments of the surgery;The coder overly relied on the doctor's written content during the coding process,failed to strictly follow the coding rules,and did not fully and deeply read and analyze medical records and surgical records,resulting in errors and devia-tions in surgical classification.Conclusion Each component of the surgical procedure name is an important factor affecting the accuracy of coding.Ensuring the completeness and accuracy of surgical operation names is crucial for improving the precision of ICD-9-CM-3 coding.In order to improve the quality of coding,clinical physicians need to enhance writing standards,while cod-ers need to strengthen their professional knowledge learning,strictly abide by coding rules,and comprehensively and meticulously review medical records and surgical records to achieve precise classification and coding of surgical operations.

Objective To analyze the value of abnormal expression of platelet membrane P-selectin(CD62p)and zonula occluden-1 in predicting the instability of carotid atherosclerotic plaques in elderly patients with cerebral infarction.Methods A total of 203 elderly patients with cerebral in-farction admitted to our department from March 2021 to July 2023 were enrolled,and based on their status of carotid plaques,they were divided into a unstable plaque group(45 cases),a stable plaque group(89 cases),a no-plaque group(69 cases).General information was collected,and the serum levels of CD62p and zonula occluden-1 were measured.The risk factors for carotid athero-sclerotic plaque instability and their predictive value were analyzed.Results Statistical differences were observed in the levels of low-density lipoprotein,homocysteine(Hcy),C-reactive protein,IL-6,fibrinogen,and intercellular adhesion molecule-1(ICAM-1)among the three groups(P＜0.05,P＜0.01),so were in the serum levels of CD62p and zonula occluden-1(P＜0.05).In the un-stable plaque group,the serum levels of CD62p and zonula occluden-1 were positively correlated with the levels of low-density lipoprotein,Hcy,C-reactive protein,IL-6,fibrinogen,and ICAM-1(P＜0.05,P＜0.01).In the stable plaque group,the serum levels of CD62p and zonula occluden-1 were positively correlated with the levels of low-density lipoprotein,Hcy,C-reactive protein,IL-6 and ICAM-1(P＜0.05,P＜0.01).Logistic regress analysis showed that the serum levels of low-density lipoprotein,Hey,C-reactive protein,IL-6,fibrinogen,ICAM-1,CD62p and zonula occlu-den-1 were risk factors for plaque instability(P＜0.01).ROC curve analysis indicated that the AUC value of CD62p and zonula occluden-1 in predicting plaque instability was 0.850 and 0.838,respectively(P＜0.01).Conclusion Abnormal expression of serum CD62p and zonula occluden-1 can effectively predict the instability of carotid atherosclerotic plaques in elderly patients with cer-ebral infarction.

Objective To investigate and analyze the various reasons that affect the accuracy of ICD-9-CM-3 classifica-tion coding,identify key factors,and propose improvement strategies to enhance the accuracy and standardization level of surgical operation coding.Methods Using case analysis method,various factors affecting the accurate coding of ICD-9-CM-3 were sys-tematically listed and analyzed in detail.Through specific examples,this article analyzes the non-standard behavior of clinical physicians in writing surgical operation names,as well as the problems of coders relying on doctors to write,ignoring coding rules,and not fully reading medical records and surgical records during the coding process.It further explores how these factors lead to surgical classification errors.Results The main reasons affecting the accuracy of ICD-9-CM-3 coding include:lack of standardization in writing surgical operation names by clinical physicians,and failure to provide detailed descriptions of key ele-ments of the surgery;The coder overly relied on the doctor's written content during the coding process,failed to strictly follow the coding rules,and did not fully and deeply read and analyze medical records and surgical records,resulting in errors and devia-tions in surgical classification.Conclusion Each component of the surgical procedure name is an important factor affecting the accuracy of coding.Ensuring the completeness and accuracy of surgical operation names is crucial for improving the precision of ICD-9-CM-3 coding.In order to improve the quality of coding,clinical physicians need to enhance writing standards,while cod-ers need to strengthen their professional knowledge learning,strictly abide by coding rules,and comprehensively and meticulously review medical records and surgical records to achieve precise classification and coding of surgical operations.

Objective To analyze the relationship between serum a proliferation inducing ligand(APRIL)and galactin-1(Gal-1)levels with clinical features and prognosis in patients with epithelial ovarian cancer(EOC).Methods EOC patients(n=132)who admitted in Handan Hangang Hospital of Hebei Province from January 2018 to June 2020 were selected as the cancer group,and were grouped into a survival group(n=56)and a death group(n=76)based on their three-year survival after discharge.Meanwhile,healthy in-dividuals(n=68)who underwent physical examination were regarded as the healthy group.Enzyme linked immunosorbent assay was applied to detect serum APRIL and Gal-1 levels in all subjects.Clinical data of all patients were collected and their relationship with serum APRIL,Gal-1 levels and prognosis was analyzed.Ka-plan-Meier method was applied to analyze the relationship between serum APRIL and Gal-1 levels and the prognosis of EOC patients.Cox regression was applied to analyze the relevant factors affecting the prognostic death of EOC patients.The prognostic value of serum APRIL in patients with EOC was analyzed by receiver operating characteristic(ROC)curve.Results The serum APRIL and Gal-1 expression levels in the cancer group were greatly higher than those in the healthy group,and the differences were statistically significant(P＜0.05).The serum APRIL and Gal-1 levels in the death group were greatly higher than those in the sur-vival group,and the differences were statistically significant(P＜0.05).Clinical data analysis showed that se-rum APRIL and Gal-1 levels were not related to the age of EOC patients(P＞0.05),but were related to tumor location,tumor diameter,The International Febderation of Gynecology and Obstetrics(FIGO)staging,differentiation degree,lymph node metastasis,histological classification,and levels of cancer antigen 125(CA125)and human epididymis protein 4(HE4),and FIGO staging,differentiation degree,lymph node me-tastasis,histological classification,and levels of CA125 and HE4 also significantly affected the prognosis of pa-tients(P＜0.05).FIGO stage Ⅲ+Ⅳ,low differentiation,lymph node metastasis,serous tissue classification,CA125≥200 U/mL,HE4≥200 pmol/L,and high expression of APRIL and Gal-1 were all risk factors for prognostic death in EOC patients(P＜0.05).The three-year survival rate of APRIL high expression patients(25.37％)was greatly lower than that of APRIL low expression patients(60.00％),and the three-year sur-vival rate of Gal-1 high expression patients(27.94％)was greatly lower than that of Gal-1 low expression pa-tients(57.81％),,and the differences were statistically significant(P＜0.05).ROC curve showed that the ar-ea under the curve(AUC)of the combination of APRIL and Gal-1 for predicting the prognosis was 0.925,which was significantly higher than that of the diagnosis of the two alone,(Zcombined-APRIL=4.061,P＜0.001,Zcombined-Gal-1=3.424,P＜0.001),with a sensitivity and specificity of 86.84％and 83.93％,respectively.Conclu-sion The expression levels of serum APRIL and Gal-1 are greatly elevated in EOC patients,and their levels are related to tumor location,tumor diameter,FIGO staging,lymph node metastasis,histological classifica-tion,CA1 25,HE4,and differentiation degree.The expression levels of both have great application value in the prognosis evaluation of EOC patients.

Objective To analyze the characteristics of visceral leishmaniasis cases in Henan Province, so as to provide insights into formulation of the visceral leishmaniasis control srtrategy. Methods All epidemiological data of reported visceral leishmaniasis cases in Henan Province from 2021 to 2023 were retrieved from the National Notifiable Disease Report Information Management System of Chinese Center for Disease Control and Prevention, and the epidemiological features and diagnosis of visceral leishmaniasis cases were descriptively analyzed. Results A total of 93 visceral leishmaniasis cases were reported in Henan Province from 2021 to 2023, with a male to female ratio of 2.58∶1, and including 2 imported cases from other provinces and 91 local cases. The number of visceral leishmaniasis cases peaked during the period between March and May, and between July and October. The reported visceral leishmaniasis cases had ages of 7 months to 74 years, with the largest number of cases found at ages of 0 to 9 years (26 cases, 27.96%), followed by at ages of 60 to 70 years (24 cases, 25.81%). Farmer (47 cases, 50.54%) and diaspora children (19 cases, 20.43%) were predominant occupations, and 91 local visceral leishmaniasis cases were found in 6 cities of Zhengzhou, Luoyang, Anyang, Hebi, Sanmenxia and Xuchang. The median duration from onset of visceral leishmaniasis to diagnosis was 20 days, and there were 25.81% (24/93) cases with 10 days and less duration from onset to diagnosis, 38.71% (36/93) cases receiving diagnosis at 11 to 30 days following onset, and 35.48% (33/93) cases receiving diagnosis for more than 30 days following onset. All cases were predominantly diagnosed in province- (60.00%) and city-level (28.89%) medical institutions. Conclusions The number of visceral leishmaniasis is on the rise in Henan Province, with a gradually expanding coverage. Intensified monitoring of visceral leishmaniasis cases, dogs, and vectors, dog management, sandflies control and improved individual protection are recommended to prevent the spread of visceral leishmaniasis.

To promote the development of extracellular vesicles of herbal medicine especially the establishment of standardization, led by the National Expert Committee on Research and Application of Chinese Herbal Vesicles, research experts in the field of herbal medicine and extracellular vesicles were invited nationwide with the support of the Expert Committee on Research and Application of Chinese Herbal Vesicles, Professional Committee on Extracellular Vesicle Research and Application, Chinese Society of Research Hospitals and the Guangdong Engineering Research Center of Chinese Herbal Vesicles. Based on the collation of relevant literature, we have adopted the Delphi method, the consensus meeting method combined with the nominal group method to form a discussion draft of "Consensus statement on research and application of Chinese herbal medicine derived extracellular vesicles-like particles (2023)". The first draft was discussed in online and offline meetings on October 12, 14, November 2, 2022 and April and May 2023 on the current status of research, nomenclature, isolation methods, quality standards and research applications of extracellular vesicles of Chinese herbal medicines, and 13 consensus opinions were finally formed. At the Third Academic Conference on Research and Application of Chinese Herbal Vesicles, held on May 26, 2023, Kewei Zhao, convenor of the consensus, presented and read the consensus to the experts of the Expert Committee on Research and Application of Chinese Herbal Vesicles. The consensus highlights the characteristics and advantages of Chinese medicine, inherits the essence, and keeps the righteousness and innovation, aiming to provide a reference for colleagues engaged in research and application of Chinese herbal vesicles at home and abroad, decode the mystery behind Chinese herbal vesicles together, establish a safe, effective and controllable accurate Chinese herbal vesicle prevention and treatment system, and build a bridge for Chinese medicine to the world.