Objective To investigate the expression of Cyclin F in clear cell renal cell carcinoma (ccRCC), its clinicopathological characteristics, and its effect on the biological behavior of renal cancer cell lines Methods RT-qPCR and Western blot were used to detect the mRNA and protein expression of Cyclin F in fresh ccRCC specimens. Immunohistochemistry assay was performed to detect the expression of Cyclin F protein in 80 paraffin samples. CCK-8 assay, scratch assay, and flow cytometry were conducted to determine the effects of Cyclin F overexpression on the proliferation, migration, and apoptosis of renal cancer cell lines. Results The expression of Cyclin F in cancer tissues was higher than that in adjacent tissues at the mRNA level (P<0.0285). The expression of Cyclin Fprotein in cancer tissues was lower than that in adjacent tissues (P<0.001). The analysis of clinicopathological parameters showed that the low expression of Cyclin F was correlated with WHO/ISUP grade, Ki67 index, and age (P=0.041, 0.047, 0.008,). In vitro experiments confirmed that overexpression of Cyclin F promoted the proliferation (P<0.001) and migratory ability (24 h P=0.003, 48 h P=0.0058) of the RCC 786-O cell line, while inhibiting apoptosis (P=0.0019). Conclusion The low expression of Cyclin F protein in ccRCC tissuesis associated with high ISUP grade, high Ki67 index, oldage, and prognosis of patients.

Objective To analysis the relationship between the lactate-to-albumin ratio(LAR)and the 28-day prognosis in patients with sepsis.Methods Based on the Medical Information Mart for Intensive Care-Ⅳ(MIMIC-Ⅳ)database,patients with sepsis aged≥18 years were selected.Patients were divided into survival and death groups according to their 28-day prognosis.The LAR was divided into quartiles:Q1(LAR<0.45),Q2(0.45≤LAR<0.70),Q3(0.70≤LAR<1.18),and Q4(LAR≥1.18);and into two groups based on the median LAR:low LAR group(LAR≤0.70)and high LAR group(LAR>0.70).Demographic characteristics,comorbidities,laboratory indicators,clinical treatments,and disease severity scores of patients were extracted.LAR was included as a continuous variable and a four-category variable in multiple Logistic regression models,with trend tests performed.Subgroup analyses were conducted based on gender,age,comorbidities,and sequential organ failure assessment(SOFA)score.Receiver operator characteristic curve(ROC curves)were plotted to analyze the predictive efficacy of lactate,albumin(Alb),LAR and SOFA score for the prognosis of sepsis patients.Kaplan-Meier survival curves were plotted to compare the difference of 28-day cumulative survival rates of sepsis patients in the high and low LAR groups.Results A total of 9 169 patients with sepsis were included,with 6 799 in the survival group and 2 370 in the death group.Compared with the survival group,the death group had older age[years:70.80(58.64,82.25)vs.65.07(53.56,76.92)],higher levels of potassium,creatinine,blood urea nitrogen(BUN),white blood cell count(WBC),lactate,LAR,SOFA score,simplified acute physiology scoreⅡ(SAPSⅡ),and higher proportions of chronic obstructive pulmonary disease(COPD),heart failure,use of vasopressors within 48 hours,and continuous renal replacement therapy(CRRT)[potassium(mmol/L):5.0(4.5,5.7)vs.4.8(4.4,5.4),creatinine(μmol/L):132.60(88.40,212.16)vs.97.24(70.72,159.12),BUN(mmol/L):11.42(7.14,18.56)vs.7.85(5.25,13.57),WBC(×109/L):13.1(8.7,19.1)vs.11.4(7.6,16.4),lactate(mmol/L):2.9(1.8,5.1)vs.2.0(1.4,3.1),LAR:1.03(0.63,1.88)vs.0.62(0.42,0.98),SOFA score:9(6,12)vs.6(4,8),SAPSⅡscore:52(42,64)vs.38(30,47),COPD:8.19%(194/2 370)vs.6.57%(447/6 799),heart failure:29.96%(710/2 370)vs.26.31%(1 789/6 799),use of vasopressors within 48 hours:62.19%(1 474/2 370)vs.37.56%(2 554/6 799),CRRT:19.45%(461/2 370)vs.9.56%(650/6 799),all P<0.05],while lower levels of body weight,chloride,calcium,hemoglobin(Hb),platelet count(PLT),Alb and lower proportions of hypertension were observed in the death group[body weight(kg):75.8(63.6,92.3)vs.78.7(66.5,95.0),chloride(mmol/L):104(98,109)vs.104(100,108),calcium(mmol/L):1.07(1.00,1.15)vs.1.09(1.03,1.15),Hb(g/L):103(87,120)vs.105(90,121),PLT(×109/L):173(104,246)vs.174(118,243),Alb(g/L):29(24,34)vs.33(28,37),hypertension:35.36%(838/2 370)vs.38.34%(2 607/6 799),all P<0.05].In the Logistic regression model adjusted for all confounding factors,the odds ratio(OR)and 95%confidence interval(95%CI)of LAR were 1.74(1.64-1.85),P<0.001;when LAR was treated as a four-category variable,the OR values of Q2,Q3,and Q4 increased progressively compared with Q1,being 1.49(1.22-1.82),2.27(1.88-2.75),and 5.05(4.20-6.08),respectively,P<0.001.Subgroup analyses showed that LAR was an independent risk factor for the 28-day prognosis of sepsis in different subgroups based on gender,age,comorbidities,and SOFA score(all P<0.001),with no interaction effects with the subgroup variables(all P>0.05).ROC curve analysis showed that the AUC of LAR predicted the 28-day prognosis of patients with sepsis was 0.688(0.675-0.700),higher than that of lactate[0.655(0.642-0.668)]and Alb[0.636(0.623-0.649)],both P<0.001,and not significantly lower than that of SOFA score[0.699(0.687-0.712),P=0.108].Kaplan-Meier survival analysis showed that the 28-day cumulative survival rate was significantly higher in the low LAR group than in the high LAR group(Log-Rank test:χ2=533.24,P<0.001).Conclusion LAR is an independent risk factor for the 28-day prognosis of sepsis patients.Higher LAR is associated with adverse outcomes,and its predictive efficacy is superior to that of lactate and albumin.

In patients with heart failure with reduced ejection fraction(HFrEF),some individuals demonstrate significant improvement in left ventricular ejection fraction(LVEF)during subsequent evaluations after treatment.The 2022 American Heart Association/American College of Cardiology/Heart Failure Society of America(AHA/ACC/HFSA)heart failure management guidelines introduced the term"heart failure with improved ejection fraction(HFimpEF)"to describe patients with prior LVEF≤40%that subsequently increased above 40%during follow-up.Studies indicate that HFimpEF patients exhibit lower all-cause mortalities and heart failure rehospitalization rates,with a significantly better prognosis compared to HFrEF patients,establishing HFimpEF as a staged therapeutic target for HFrEF.Current discussion on HFimpEF primarily focuses on two aspects:characteristics of the target population and effective methods for LVEF improvement,and maintenance strategies for cardiac function preservation in HFimpEF patients;particularly the latter lacks clear clinical-guideline recommendations.Therefore,reviewing existing research to systematically summarize therapeutic strategies that promote the HFrEF-to-HFimpEF transition and effective maintenance approaches for HFimpEF becomes crucial.This article comprehensively reviews the LVEF-improving effects of current pharmacological,device-based,and surgical interventions,along with monitoring and management strategies for HFimpEF patients.In HFrEF patients,clinical evidence suggests that β-blockers and cardiac resynchronization therapy can significantly improve LVEF beyond 40%.Regarding HFimpEF management,sodium-glucose cotransporter-2 inhibitors(SGLT2i)and renin-angiotensin system inhibitors(RASi)demonstrate efficacy in maintaining LVEF and cardiac function.Additionally,this review identifies current research limitations in HFimpEF and proposes potential future research directions.

In patients with heart failure with reduced ejection fraction(HFrEF),some individuals demonstrate significant improvement in left ventricular ejection fraction(LVEF)during subsequent evaluations after treatment.The 2022 American Heart Association/American College of Cardiology/Heart Failure Society of America(AHA/ACC/HFSA)heart failure management guidelines introduced the term"heart failure with improved ejection fraction(HFimpEF)"to describe patients with prior LVEF≤40%that subsequently increased above 40%during follow-up.Studies indicate that HFimpEF patients exhibit lower all-cause mortalities and heart failure rehospitalization rates,with a significantly better prognosis compared to HFrEF patients,establishing HFimpEF as a staged therapeutic target for HFrEF.Current discussion on HFimpEF primarily focuses on two aspects:characteristics of the target population and effective methods for LVEF improvement,and maintenance strategies for cardiac function preservation in HFimpEF patients;particularly the latter lacks clear clinical-guideline recommendations.Therefore,reviewing existing research to systematically summarize therapeutic strategies that promote the HFrEF-to-HFimpEF transition and effective maintenance approaches for HFimpEF becomes crucial.This article comprehensively reviews the LVEF-improving effects of current pharmacological,device-based,and surgical interventions,along with monitoring and management strategies for HFimpEF patients.In HFrEF patients,clinical evidence suggests that β-blockers and cardiac resynchronization therapy can significantly improve LVEF beyond 40%.Regarding HFimpEF management,sodium-glucose cotransporter-2 inhibitors(SGLT2i)and renin-angiotensin system inhibitors(RASi)demonstrate efficacy in maintaining LVEF and cardiac function.Additionally,this review identifies current research limitations in HFimpEF and proposes potential future research directions.

Objective To analysis the relationship between the lactate-to-albumin ratio(LAR)and the 28-day prognosis in patients with sepsis.Methods Based on the Medical Information Mart for Intensive Care-Ⅳ(MIMIC-Ⅳ)database,patients with sepsis aged≥18 years were selected.Patients were divided into survival and death groups according to their 28-day prognosis.The LAR was divided into quartiles:Q1(LAR<0.45),Q2(0.45≤LAR<0.70),Q3(0.70≤LAR<1.18),and Q4(LAR≥1.18);and into two groups based on the median LAR:low LAR group(LAR≤0.70)and high LAR group(LAR>0.70).Demographic characteristics,comorbidities,laboratory indicators,clinical treatments,and disease severity scores of patients were extracted.LAR was included as a continuous variable and a four-category variable in multiple Logistic regression models,with trend tests performed.Subgroup analyses were conducted based on gender,age,comorbidities,and sequential organ failure assessment(SOFA)score.Receiver operator characteristic curve(ROC curves)were plotted to analyze the predictive efficacy of lactate,albumin(Alb),LAR and SOFA score for the prognosis of sepsis patients.Kaplan-Meier survival curves were plotted to compare the difference of 28-day cumulative survival rates of sepsis patients in the high and low LAR groups.Results A total of 9 169 patients with sepsis were included,with 6 799 in the survival group and 2 370 in the death group.Compared with the survival group,the death group had older age[years:70.80(58.64,82.25)vs.65.07(53.56,76.92)],higher levels of potassium,creatinine,blood urea nitrogen(BUN),white blood cell count(WBC),lactate,LAR,SOFA score,simplified acute physiology scoreⅡ(SAPSⅡ),and higher proportions of chronic obstructive pulmonary disease(COPD),heart failure,use of vasopressors within 48 hours,and continuous renal replacement therapy(CRRT)[potassium(mmol/L):5.0(4.5,5.7)vs.4.8(4.4,5.4),creatinine(μmol/L):132.60(88.40,212.16)vs.97.24(70.72,159.12),BUN(mmol/L):11.42(7.14,18.56)vs.7.85(5.25,13.57),WBC(×109/L):13.1(8.7,19.1)vs.11.4(7.6,16.4),lactate(mmol/L):2.9(1.8,5.1)vs.2.0(1.4,3.1),LAR:1.03(0.63,1.88)vs.0.62(0.42,0.98),SOFA score:9(6,12)vs.6(4,8),SAPSⅡscore:52(42,64)vs.38(30,47),COPD:8.19%(194/2 370)vs.6.57%(447/6 799),heart failure:29.96%(710/2 370)vs.26.31%(1 789/6 799),use of vasopressors within 48 hours:62.19%(1 474/2 370)vs.37.56%(2 554/6 799),CRRT:19.45%(461/2 370)vs.9.56%(650/6 799),all P<0.05],while lower levels of body weight,chloride,calcium,hemoglobin(Hb),platelet count(PLT),Alb and lower proportions of hypertension were observed in the death group[body weight(kg):75.8(63.6,92.3)vs.78.7(66.5,95.0),chloride(mmol/L):104(98,109)vs.104(100,108),calcium(mmol/L):1.07(1.00,1.15)vs.1.09(1.03,1.15),Hb(g/L):103(87,120)vs.105(90,121),PLT(×109/L):173(104,246)vs.174(118,243),Alb(g/L):29(24,34)vs.33(28,37),hypertension:35.36%(838/2 370)vs.38.34%(2 607/6 799),all P<0.05].In the Logistic regression model adjusted for all confounding factors,the odds ratio(OR)and 95%confidence interval(95%CI)of LAR were 1.74(1.64-1.85),P<0.001;when LAR was treated as a four-category variable,the OR values of Q2,Q3,and Q4 increased progressively compared with Q1,being 1.49(1.22-1.82),2.27(1.88-2.75),and 5.05(4.20-6.08),respectively,P<0.001.Subgroup analyses showed that LAR was an independent risk factor for the 28-day prognosis of sepsis in different subgroups based on gender,age,comorbidities,and SOFA score(all P<0.001),with no interaction effects with the subgroup variables(all P>0.05).ROC curve analysis showed that the AUC of LAR predicted the 28-day prognosis of patients with sepsis was 0.688(0.675-0.700),higher than that of lactate[0.655(0.642-0.668)]and Alb[0.636(0.623-0.649)],both P<0.001,and not significantly lower than that of SOFA score[0.699(0.687-0.712),P=0.108].Kaplan-Meier survival analysis showed that the 28-day cumulative survival rate was significantly higher in the low LAR group than in the high LAR group(Log-Rank test:χ2=533.24,P<0.001).Conclusion LAR is an independent risk factor for the 28-day prognosis of sepsis patients.Higher LAR is associated with adverse outcomes,and its predictive efficacy is superior to that of lactate and albumin.

ObjectiveTo establish an allele-specific polymerase chain reaction （PCR） method for identifying Scolopendra dispensing granules， so as to ensure the quality and therapeutic effects of Scolopendra and its preparations. MethodThe primer interval suitable for the PCR was selected based on the cytochrome c oxidase subunit 3（COX-3） gene sequence of Scolopendra， and the single nucleotide polymorphism （SNP） loci of Scolopendra and its adulterants were mined from the interval for the design of specific primers. The samples of Scolopendra and its adulterants were collected. The PCR system was established and optimized regarding the annealing temperature， cycles， Taq enzymes， DNA template amount， PCR instruments， and primer concentrations， and the specificity and applicability of this method were evaluated. ResultThe PCR system was composed of 12.5 μL 2×M5 PCR Mix， 0.4 μL forward primer （10 μmol·L^-1）， 0.4 μL reverse primer （10 μmol·L^-1）， 2.5 μL DNA template， and 9.2 μL sterile double distilled water. PCR parameters： Pre-denaturation at 94 ℃ for 3 min， 30 cycles （94 ℃ for 20 s， 62 ℃ for 20 s， 72 ℃ for 45 s）， and extension at 72 ℃ for 5 min. After PCR amplification with the system and parameters above， the electrophoresis revealed a bright band at about 135 bp for Scolopendra and no band for the adulterants. ConclusionThe established allele-specific PCR method can accurately identify the medicinal materials， decoction pieces， and standard decoction freeze-dried powder of Scolopendra， as well as the intermediates and final products of Scolopendra dispensing granules， which is of great significance for ensuring the quality and clinical efficacy of Scolopendra and its preparations.

ObjectiveTo explore the clinical efficacy and safety of Qifu Yixin prescription in treating chronic heart failure in the patients with the syndrome of heart Qi deficiency， so as to provide clinical evidence for the treatment of chronic heart failure with this prescription and promote the clinical application and transformation of this prescription. MethodA total of 106 chronic heart failure patients with the syndrome of heart Qi deficiency who met the criteria in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine （TCM） from September 2022 to May 2023 were selected and randomized into an observation group （53 cases） and a control group （53 cases）. Both groups received routine Western medicine treatment. In addition， the observation group received Qifu Yixin prescription， while the control group received placebo. The treatment course for both groups was 12 weeks. The New York heart association （NYHA） cardiac function grading， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， soluble growth-stimulating expression gene 2 （sST2）， left ventricular ejection fraction （LVEF）， the ratio of early diastolic maximum mitral flow velocity （E） to early diastolic mitral annular motion velocity （e'） （E/e'）， left ventricular end diastolic diameter （LVEDD）， TCM syndrome scores， 6-minute walking test （6MWT）， Minnesota Living with Heart Failure Questionnaire （MLHFQ）， and Kansas City Cardiomyopathy Questionnaire （KCCQ） were determined before and after treatment. ResultFinally， 102 patients were included for analysis， including 51 patients in the observation group and 51 patients in the control group. After treatment， 42 patients in the observation group showed improved cardiac function grading， with a total response rate of 82.35%， and 32 patients in the control group showed improved cardiac function grading， with a total response rate of 62.75%. The total response rate regarding the cardiac function in the observation group was higher than that in the control group （χ²=4.923， P<0.05）. The observation group outperformed the control group in lowering the NT-proBNP level， elevating LVEF， decreasing the E/e' ratio （P<0.05）， reducing LVEDD and sST2 levels， and recovering TCM syndrome score， 6MWT score， MLHFQ score， and KCCQ score （P<0.05）. None of the safety indexes in the two groups showed abnormal values before and after treatment， and no serious adverse reaction was observed. ConclusionQifu Yixin prescription can improve the heart function， exercise tolerance， and quality of life and alleviate the TCM syndrome of the chronic heart failure patients with the syndrome of heart Qi deficiency by inhibiting myocardial fibrosis.

Objective To study the value of breast vascularity in differential diagnosis of benign and malignant breast lesions. Methods The data of 37 patients with benign and malignant breast lesions in the Second Hospital of Shanxi Medical University from February 2017 to November 2017 were respectively analyzed. The number, diameter, length and breast-feeding arteries of bilateral breast vessel were recorded in the maximal intensity projection (MIP) of magnetic resonance imaging (MRI) and were scored according to Sardanellie. The patients were divided into the benign group and the malignant group according to the pathological results. Besides, ≥2 cm group and <2 cm group was also divided according to the maximum diameter of lesions. The differences in number and score of vascularity in both groups were compared. And the diagnostic efficacy of MRI was evaluated based on Sardanellie score and breast-feeding arteries. Results There were no significant differences in the number and score of vascularity between bilateral breast in benign breast lesions group (1.11 ±0.35 vs. 1.22 ±0.45, t= 0.19, P= 0.85; 0.89 ±0.38 vs. 0.95 ±0.21, t= 0.25, P=0.80). The number and score of vascularity of the affected side were higher than those of the healthy side in breast malignant lesions group (2.61 ±1.29 vs. 0.61 ±0.21, t= 6.18, P= 0.00; 1.78 ±0.65 vs. 0.61 ±0.21, t=6.30, P=0.00 respectively). The number and score of vascularity were statistically different between benign and malignant breast lesions (t= 8.57, P< 0.001; t= 12.61, P< 0.001). The number of vascularity in the malignant group was higher than that in the benign group with the maximum diameter of lesion<2 cm (1.27 ± 0.59 vs. 2.57±0.98, t=90.5, P< 0.05), and there was no significant difference in the scores of vascularity in the malignant group and the benign group (1.09 ±0.43 vs. 1.86 ±0.38, t= 87.0, P> 0.05); The number and score of vascularity in the malignant group were higher than those in the benign group with the maximum diameter ≥2 cm (0.92±0.63 vs. 2.64±1.50, t=47.5, P<0.05; 0.92±0.33 vs. 1.73±0.79, t=53.5, P< 0.05). There was no significant improvement in the diagnostic efficacy of MRI based on the score of vascularity and positive breast-feeding arteries in the identification of benign and malignant lesions when the maximum diameter of lesions were<2 cm, and it had a high diagnostic efficacy when the maximum diameter of lesions were ≥2 cm. Conclusions The vascularity of breast can be clearly seen by using breast dynamic contrast enhanced (DCE) MRI. The increase and score of vascularity in the differential diagnosis of benign and malignant breast lesions have a certain application value. The positive of breast-feeding arteries may increase the diagnostic efficiency of MRI.

OBJECTIVETo compare the clinical therapeutic effects on intractable facial paralysis among acupuncture, acupoint catgut embedding and PDS embedding.

METHODSTwo hundred and seventy-nine patients of intractable facial paralysis were randomized into an acupuncture group, a catgut embedding group and a PDS embedding group, 93 cases in each one. Cuanzhu (BL 2), Yuyao (EX-HN 4), Taiyang (EX-HN 5), Xuanlu (GB 5), Dicang (ST 4), Jiache (ST 6), Quanliao (SI 18), Qianzheng (Extra), Xiaguan (ST 7) and Fengchi (GB 20) on the affected side and bilateral Hegu (LI 4) and Zusanli (ST 36) were selected in the three groups. In the acupuncture group, acupuncture was applied to those acupoints, once every two days; 10 treatments made one session; the successive three sessions were required. In the catgut embedding group and the PDS embedding group, catgut and PDS were embedded separately, once every 10 days; 3 treatments made one session and the successive two sessions were required. The therapeutic cycle was 2 months in the three groups. The therapeutic results were analyzed statistically 2 months later. The scores of Sunnybrook facial nerve grading system and the facial nerve electroneurography (ENoG) were used for the efficacy assessment before and after treatment in the three groups.

RESULTSAfter treatment, the score of Sunnybrook facial nerve grading system was improved apparently after treatment as compared with that before treatment in any of the three groups (all P < 0.05). The score in either of the embedding groups was better than that in the acupuncture group (both P < 0.05). The difference was not significant between the catgut embedding group and the PDS embedding group (P > 0.05). After treatment, ENoG wave ampli tude values in the frontal muscle and orbicularisoris muscle on the affected side were improved as compared with those before treatment in the three groups (all P < 0.05). Those in the catgut embedding group and the PDS embedding group were better than those in the acupuncture group (all P < 0.05), and had no significant difference as compared with those on the healthy side (P > 0.05). In the acupuncture group, ENoG wave amplitudes on the affected side were lower than those on the healthy side (both P < 0.05).

CONCLUSIONAcupuncture, catgut embedding and PDS embedding at acupoints all achieve the therapeutic effects on intractable facial paralysis. However, the acupoint embedding therapy presents more advantages on the recovery of facial nerve function. The efficacy is similar between the catgut embedding and the PDS embedding.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Catgut ; utilization ; Facial Paralysis ; therapy ; Female ; Humans ; Male ; Middle Aged ; Young Adult

OBJECTIVETo synthesize and evaluate a novel injectable and water-swelling gingival displacement materials.

METHODSA kind of water-swelling polymer, kaolin and aluminum chloride were mechanically mixed at certain ratio in water solution, resulting to a novel paste materials for gingival displacement. Then, its stability in aqueous solution and water swelling properties were evaluated in vitro. The effect on gingival displacement was evaluated by animal experiments in dogs. A commercial gingival displacement materials paste of Expasyl was used as control.

RESULTSWhile contacting with water, the novel gingival displacement paste did not collapse, maintained its integrity structure, and could expand for adsorbing water. Animal experiments in dogs showed that the materials could lead to displace the gingival margins from the dental root surfaces.

CONCLUSIONThe novel injectable and expanded gingival displacement material is efficient to retract free gingival margin with potential clinical application.

Aluminum Compounds ; Animals ; Chlorides ; Dogs ; Gingiva ; Water