Abdominal aortic aneurysm (AAA) is a deadly condition of the aorta, carrying a significant risk of death upon rupture. Currently, there is a dearth of efficacious pharmaceutical interventions to impede the advancement of AAA and avert it from rupturing. Here, we investigated dihydromyricetin (DHM), one of the predominant bioactive flavonoids in Ampelopsis grossedentata (A. grossedentata), as a potential agent for inhibiting AAA. DHM effectively blocked the formation of AAA in angiotensin II-infused apolipoprotein E-deficient (ApoE^-/-) mice. A combination of network pharmacology and whole transcriptome sequencing analysis revealed that DHM's anti-AAA action is linked to heme oxygenase (HO)-1 (Hmox-1 for the rodent gene) and hypoxia-inducible factor (HIF)-1α in vascular smooth muscle cells (VSMCs). Remarkably, DHM caused a robust rise (∼10-fold) of HO-1 protein expression in VSMCs, thereby suppressing VSMC inflammation and oxidative stress and preserving the VSMC contractile phenotype. Intriguingly, the therapeutic effect of DHM on AAA was largely abrogated by VSMC-specific Hmox1 knockdown in mice. Mechanistically, on one hand, DHM increased the transcription of Hmox-1 by triggering the nuclear translocation and activation of HIF-1α, but not nuclear factor erythroid 2-related factor 2 (NRF2). On the other hand, molecular docking, combined with cellular thermal shift assay (CETSA), isothermal titration calorimetry (ITC), drug affinity responsive target stability (DARTS), co-immunoprecipitation (Co-IP), and site mutant experiments revealed that DHM bonded to HO-1 at Lys243 and prevented its degradation, thereby resulting in considerable HO-1 buildup. In summary, our findings suggest that naturally derived DHM has the capacity to markedly enhance HO-1 expression in VSMCs, which may hold promise as a therapeutic strategy for AAA.

Objective To systematically evaluate the methodological quality and the measurement attributes of the assessment tools for risk of falls perception in the elderly,therefore to provide evidence-based references for medical staff to select a proper assessment tool.Methods Literature on studies of the assessment tools for risk of falls perception in the elderly was retrieved across databases and websites including Medline,Embase,PubMed,Web of Science,CINAHL,China National Knowledge Infrastructure(CNKI),Wanfang Data,VIP and China Biology Medicine(CBM).The retrieval period was from the inception of the databases to 1st June,2024.Two researchers independently screened the retrieved literature and extracted the data.The bias risk list and quality standards of the consensus-based standards for the selection of health measurement instruments(COSMIN)were used to systematically evaluate the attributes of the assessment tools.Results A total of 22 studies were included,covering 21 scales for the risk of falls perception in the elderly.All the scales had certain risks of bias,and none of them reported cross-cultural validity/measurement equivalence and measurement error.The fall risk questionnaire(FRQ)was rated as Class C recommendation due to the high-quality evidences indicated its"inadequate"internal consistency and responsiveness.The remaining scales were rated as Class B recommendation due to their uncertainty in content validity.Conclusion In comparison with the assessment tools for risk of falls perception in the elderly,the self-awareness of falls in elderly scale(SAFE,a primary choice)and the fall risk perception scale for the elderly in community(FRPSE,the secondary choice)are recommended for their comprehensive structure of measurement and relatively complete evaluation of measurement.However,further studies are required to validate the clinical applicability and measurement attributes of the SAFE and FRPSE.

Objective:To investigate the correlation of systemic immune inflammatory index (SII) and monocyte-to-lymphocyte ratio (MLR) with chronic kidney disease-mineral and bone disorder (CKD-MBD) in patients with stage 5 chronic kidney disease (CKD).Methods:A cross-sectional survey method was used to select 152 patients with stage 5 CKD who received treatment in the Department of Nephrology, Hefei First People's Hospital from January 2023 to January 2024 as research subjects. Based on the patients' intact parathyroid hormone (iPTH) levels, they were divided into three groups: low iPTH group ( n = 63), normal iPTH group ( n = 46), and high iPTH group ( n = 43). The differences in SII and MLR among the three groups were analyzed. The relationship between SII and the occurrence of high iPTH was analyzed to assess the predictive efficacy of SII for high iPTH. Results:Among the 152 patients with stage 5 CKD, the low iPTH group accounted for 41.45% (63/152), the normal iPTH group for 30.26% (46/152), and the high iPTH group for 28.29% (43/152). The prevalence of hypertension in each group was as follows: 85.71% (54/63) in the low iPTH group, 89.13% (41/46) in the normal iPTH group, and 60.77% (30/43) in the high iPTH group ( χ2 = 6.60, P = 0.037). Other parameters showed significant differences among the groups: neutrophil count was 3.60 (2.94, 4.79) × 10 9/L in the low iPTH group, 4.08 (3.16, 4.88) × 10 9/L in the normal iPTH group, and 5.21 (4.08, 6.75) ×10 9/L in the high iPTH group ( Z = 25.64, P < 0.001); lymphocyte count was 1.51 (1.13, 1.85) × 10 9/L, 1.18 (1.00, 1.68) × 10 9/L, and 1.10 (0.75, 1.66) × 10 9/L, respectively ( Z = 8.25, P = 0.016); monocyte count was 0.47 (0.36, 0.62) × 10 9/L, 0.53 (0.42, 0.70) × 10 9/L, and 0.43 (0.33, 0.54) × 10 9/L, respectively ( Z = 8.15, P = 0.017); serum albumin levels were (37.26 ± 5.77) g/L, (36.31 ± 5.68) g/L, and (41.53 ± 4.90) g/L, respectively ( t = 10.85, P < 0.001); creatinine levels were 214.00 (148.00, 343.00) μmol/L, 462.00 (338.50, 682.25) μmol/L, and 835.50 (702.50, 960.75) μmol/L, respectively ( Z = 74.65, P < 0.001); serum calcium levels were 2.19 (2.11, 2.28) mmol/L, 2.16 (2.04, 2.26) mmol/L, and 2.32 (2.10, 2.49) mmol/L, respectively ( Z = 11.77, P = 0.003); serum phosphate levels were 1.21 (1.04, 1.49) mmol/L, 1.47 (1.27, 1.83) mmol/L, and 1.99 (1.65, 2.49) mmol/L, respectively ( Z = 48.72, P < 0.001); SII values were 362.75 (292.68, 639.92), 491.03 (380.12, 715.77), and 851.50 (525.23, 1 149.72), respectively ( Z = 33.02, P < 0.001); and MLR values were 0.30 (0.24, 0.43), 0.43 (0.30, 0.52), and 0.35 (0.28, 0.61), respectively ( Z = 9.02, P = 0.011). All differences among the three groups were statistically significant (all P < 0.05). There were no statistically significant differences among the groups regarding age, gender, height, body mass index, smoking history, alcohol consumption history, prevalence of diabetes, platelet count, serum total protein, uric acid, triglycerides, total cholesterol, high-density lipoprotein cholesterol, or low-density lipoprotein cholesterol (all P > 0.05). Multivariate logistic regression analysis indicated that elevated SII ( OR = 1.003, P = 0.024) was an independent risk factor for increased serum iPTH ( P < 0.05). Receiver operating characteristic analysis showed that the area under the curve for SII predicting high iPTH in patients with stage 5 CKD was 0.774 ( P < 0.001). Conclusions:In patients with stage 5 CKD, elevated creatinine, serum calcium, and SII are independent risk factors for increased serum iPTH, and SII has predictive value for the occurrence of high iPTH in patients with CKD.

Objective:To analyze the risk factors associated with intradialytic hypotension (IDH) in patients undergoing maintenance hemodialysis (MHD).Methods:This study used a cross-sectional design and included 150 adult patients who underwent MHD at The Third Affiliated Hospital of Anhui Medical University from January 2023 to March 2024. Relevant clinical data were collected to analyze the occurrence of IDH in patients undergoing MHD over 3 months, and the associated risk factors.Results:Among the 150 patients undergoing MHD, there were 67 in the IDH group and 83 in the non-IDH group. The IDH group had a higher fibrinogen/albumin ratio (FAR) [89.41 (73.30, 114.50) vs. 76.56 (65.80, 89.60), χ2 = -3.55, P < 0.001], an older age [(68.46 ± 14.10) years vs. (61.30 ± 12.23) years, t = -3.33, P = 0.001], a longer dialysis duration [(4 (3.5, 4.0) hours vs. (4 (4.0, 4.0) hours), U = -2.11, P = 0.044], a greater ultrafiltration volume [(2.20 ± 0.74) L vs. (1.92 ± 0.82) L, t = -2.16, P = 0.032], a higher ultrafiltration rate [(8.90 ± 2.64) mL·h?1·kg?1 vs. (7.75 ± 2.91) mL·h?1·kg?1, t = -2.51, P = 0.013], and a higher ultrafiltration volume/dry body mass ratio [(33.75 ± 9.76) mL/kg vs. (30.21 ± 11.39) mL/kg, t = -2.11, P = 0.046] compared with the non-IDH group. In the IDH group, the proportion of patients with primary chronic glomerulonephritis was lower (19.4% vs. 37.3%, χ2 = 5.76, P = 0.016), fibrinogen levels were higher [(3.63 (3.15, 4.50) μg/L vs. (3.34 (2.90, 3.74) μg/L, U = -2.61, P = 0.009], albumin levels were lower [(41.26 ± 4.03) g/L vs. (43.42 ± 4.29) g/L, t = 3.15, P = 0.002], high-density lipoprotein cholesterol (HDL-C) levels were lower [0.90 (0.77, 1.09) mmol/L vs. 1.05 (0.84, 1.34) mmol/L, U = -2.77, P = 0.006], and C-reactive protein levels were higher [5.92 (2.79, 9.61) mg/L vs. 2.70 (0.99, 6.49) mg/L, U = -2.27, P = 0.023] compared with the non-IDH group. Multivariate logistic regression analysis indicated that higher FAR values ( OR = 1.030, P = 0.025), a history of chronic glomerulonephritis ( OR = 10.408, P = 0.012), older age ( OR = 1.062, P = 0.043), a high ultrafiltration volume/dry body mass ratio ( OR = 1.072, P = 0.037), and low HDL-C levels ( OR = 0.046, P = 0.015) are independent risk factors for IDH. The area under the receiver operating characteristic curve for FAR predicting IDH was 0.699 (95% CI: 0.571-0.827, P = 0.003). The combination of age, chronic glomerulonephritis, ultrafiltration volume/dry body mass ratio, HDL-C levels, and FAR for predicting IDH resulted in a receiver operating characteristic curve area of 0.839 (95% CI: 0.750-0.929, P < 0.001). Conclusions:Among the risk factors for IDH in patients undergoing MHD, FAR is independently associated with an increased risk of IDH and serves as a valuable predictor for its occurrence in these patients.

Objective:To investigate the correlation of systemic immune inflammatory index (SII) and monocyte-to-lymphocyte ratio (MLR) with chronic kidney disease-mineral and bone disorder (CKD-MBD) in patients with stage 5 chronic kidney disease (CKD).Methods:A cross-sectional survey method was used to select 152 patients with stage 5 CKD who received treatment in the Department of Nephrology, Hefei First People's Hospital from January 2023 to January 2024 as research subjects. Based on the patients' intact parathyroid hormone (iPTH) levels, they were divided into three groups: low iPTH group ( n = 63), normal iPTH group ( n = 46), and high iPTH group ( n = 43). The differences in SII and MLR among the three groups were analyzed. The relationship between SII and the occurrence of high iPTH was analyzed to assess the predictive efficacy of SII for high iPTH. Results:Among the 152 patients with stage 5 CKD, the low iPTH group accounted for 41.45% (63/152), the normal iPTH group for 30.26% (46/152), and the high iPTH group for 28.29% (43/152). The prevalence of hypertension in each group was as follows: 85.71% (54/63) in the low iPTH group, 89.13% (41/46) in the normal iPTH group, and 60.77% (30/43) in the high iPTH group ( χ2 = 6.60, P = 0.037). Other parameters showed significant differences among the groups: neutrophil count was 3.60 (2.94, 4.79) × 10 9/L in the low iPTH group, 4.08 (3.16, 4.88) × 10 9/L in the normal iPTH group, and 5.21 (4.08, 6.75) ×10 9/L in the high iPTH group ( Z = 25.64, P < 0.001); lymphocyte count was 1.51 (1.13, 1.85) × 10 9/L, 1.18 (1.00, 1.68) × 10 9/L, and 1.10 (0.75, 1.66) × 10 9/L, respectively ( Z = 8.25, P = 0.016); monocyte count was 0.47 (0.36, 0.62) × 10 9/L, 0.53 (0.42, 0.70) × 10 9/L, and 0.43 (0.33, 0.54) × 10 9/L, respectively ( Z = 8.15, P = 0.017); serum albumin levels were (37.26 ± 5.77) g/L, (36.31 ± 5.68) g/L, and (41.53 ± 4.90) g/L, respectively ( t = 10.85, P < 0.001); creatinine levels were 214.00 (148.00, 343.00) μmol/L, 462.00 (338.50, 682.25) μmol/L, and 835.50 (702.50, 960.75) μmol/L, respectively ( Z = 74.65, P < 0.001); serum calcium levels were 2.19 (2.11, 2.28) mmol/L, 2.16 (2.04, 2.26) mmol/L, and 2.32 (2.10, 2.49) mmol/L, respectively ( Z = 11.77, P = 0.003); serum phosphate levels were 1.21 (1.04, 1.49) mmol/L, 1.47 (1.27, 1.83) mmol/L, and 1.99 (1.65, 2.49) mmol/L, respectively ( Z = 48.72, P < 0.001); SII values were 362.75 (292.68, 639.92), 491.03 (380.12, 715.77), and 851.50 (525.23, 1 149.72), respectively ( Z = 33.02, P < 0.001); and MLR values were 0.30 (0.24, 0.43), 0.43 (0.30, 0.52), and 0.35 (0.28, 0.61), respectively ( Z = 9.02, P = 0.011). All differences among the three groups were statistically significant (all P < 0.05). There were no statistically significant differences among the groups regarding age, gender, height, body mass index, smoking history, alcohol consumption history, prevalence of diabetes, platelet count, serum total protein, uric acid, triglycerides, total cholesterol, high-density lipoprotein cholesterol, or low-density lipoprotein cholesterol (all P > 0.05). Multivariate logistic regression analysis indicated that elevated SII ( OR = 1.003, P = 0.024) was an independent risk factor for increased serum iPTH ( P < 0.05). Receiver operating characteristic analysis showed that the area under the curve for SII predicting high iPTH in patients with stage 5 CKD was 0.774 ( P < 0.001). Conclusions:In patients with stage 5 CKD, elevated creatinine, serum calcium, and SII are independent risk factors for increased serum iPTH, and SII has predictive value for the occurrence of high iPTH in patients with CKD.

Objective:To analyze the risk factors associated with intradialytic hypotension (IDH) in patients undergoing maintenance hemodialysis (MHD).Methods:This study used a cross-sectional design and included 150 adult patients who underwent MHD at The Third Affiliated Hospital of Anhui Medical University from January 2023 to March 2024. Relevant clinical data were collected to analyze the occurrence of IDH in patients undergoing MHD over 3 months, and the associated risk factors.Results:Among the 150 patients undergoing MHD, there were 67 in the IDH group and 83 in the non-IDH group. The IDH group had a higher fibrinogen/albumin ratio (FAR) [89.41 (73.30, 114.50) vs. 76.56 (65.80, 89.60), χ2 = -3.55, P < 0.001], an older age [(68.46 ± 14.10) years vs. (61.30 ± 12.23) years, t = -3.33, P = 0.001], a longer dialysis duration [(4 (3.5, 4.0) hours vs. (4 (4.0, 4.0) hours), U = -2.11, P = 0.044], a greater ultrafiltration volume [(2.20 ± 0.74) L vs. (1.92 ± 0.82) L, t = -2.16, P = 0.032], a higher ultrafiltration rate [(8.90 ± 2.64) mL·h?1·kg?1 vs. (7.75 ± 2.91) mL·h?1·kg?1, t = -2.51, P = 0.013], and a higher ultrafiltration volume/dry body mass ratio [(33.75 ± 9.76) mL/kg vs. (30.21 ± 11.39) mL/kg, t = -2.11, P = 0.046] compared with the non-IDH group. In the IDH group, the proportion of patients with primary chronic glomerulonephritis was lower (19.4% vs. 37.3%, χ2 = 5.76, P = 0.016), fibrinogen levels were higher [(3.63 (3.15, 4.50) μg/L vs. (3.34 (2.90, 3.74) μg/L, U = -2.61, P = 0.009], albumin levels were lower [(41.26 ± 4.03) g/L vs. (43.42 ± 4.29) g/L, t = 3.15, P = 0.002], high-density lipoprotein cholesterol (HDL-C) levels were lower [0.90 (0.77, 1.09) mmol/L vs. 1.05 (0.84, 1.34) mmol/L, U = -2.77, P = 0.006], and C-reactive protein levels were higher [5.92 (2.79, 9.61) mg/L vs. 2.70 (0.99, 6.49) mg/L, U = -2.27, P = 0.023] compared with the non-IDH group. Multivariate logistic regression analysis indicated that higher FAR values ( OR = 1.030, P = 0.025), a history of chronic glomerulonephritis ( OR = 10.408, P = 0.012), older age ( OR = 1.062, P = 0.043), a high ultrafiltration volume/dry body mass ratio ( OR = 1.072, P = 0.037), and low HDL-C levels ( OR = 0.046, P = 0.015) are independent risk factors for IDH. The area under the receiver operating characteristic curve for FAR predicting IDH was 0.699 (95% CI: 0.571-0.827, P = 0.003). The combination of age, chronic glomerulonephritis, ultrafiltration volume/dry body mass ratio, HDL-C levels, and FAR for predicting IDH resulted in a receiver operating characteristic curve area of 0.839 (95% CI: 0.750-0.929, P < 0.001). Conclusions:Among the risk factors for IDH in patients undergoing MHD, FAR is independently associated with an increased risk of IDH and serves as a valuable predictor for its occurrence in these patients.

Bioactive compounds derived from herbal medicinal plants modulate various therapeutic targets and signaling pathways associated with cardiovascular diseases (CVDs), the world's primary cause of death. Ginkgo biloba, a well-known traditional Chinese medicine with notable cardiovascular actions, has been used as a cardio- and cerebrovascular therapeutic drug and nutraceutical in Asian countries for centuries. Preclinical studies have shown that ginkgolide B, a bioactive component in Ginkgo biloba, can ameliorate atherosclerosis in cultured vascular cells and disease models. Of clinical relevance, several clinical trials are ongoing or being completed to examine the efficacy and safety of ginkgolide B-related drug preparations in the prevention of cerebrovascular diseases, such as ischemia stroke. Here, we present a comprehensive review of the pharmacological activities, pharmacokinetic characteristics, and mechanisms of action of ginkgolide B in atherosclerosis prevention and therapy. We highlight new molecular targets of ginkgolide B, including nicotinamide adenine dinucleotide phosphate oxidases (NADPH oxidase), lectin-like oxidized LDL receptor-1 (LOX-1), sirtuin 1 (SIRT1), platelet-activating factor (PAF), proprotein convertase subtilisin/kexin type 9 (PCSK9) and others. Finally, we provide an overview and discussion of the therapeutic potential of ginkgolide B and highlight the future perspective of developing ginkgolide B as an effective therapeutic agent for treating atherosclerosis.

Objective:To investigate the relationship between protein-energy wasting (PEW) and parathyroid hormone (PTH) levels in patients undergoing maintenance hemodialysis.Methods:A cross-sectional study was conducted to enroll 150 adult patients undergoing maintenance hemodialysis at The Third Affiliated Hospital of Anhui Medical University from January 2022 to May 2023. These patients were categorized into four groups based on their PTH levels: low PTH group (< 150 ng/L), standard PTH group (150-300 ng/L), very high PTH group (300-600 ng/L), and extreme high PTH group (> 600 ng/L). The diagnosis of PEW was determined using the diagnostic criteria proposed by the International Society of Renal Nutrition and Metabolism (ISRNM). Logistic regression analysis was performed to investigate the association between PEW and PTH levels.Results:Among the 150 patients undergoing maintenance dialysis, 52 (34.7%) were diagnosed with PEW. The prevalence of PEW was significantly higher in the low PTH group compared with the standard, very high, and extreme high PTH groups ( χ2 = 20.64, all P < 0.05). Univariate logistic regression analysis revealed a strong association between low PTH levels ( OR = 13.810, 95% CI: 2.907-65.603, P = 0.001) and an increased risk of PEW. The risk of PEW in the low PTH group was 13.810 times higher than that in the extreme high PTH group. Multivariate logistic regression analysis further confirmed that low PTH levels ( OR = 19.891, 95% CI: 1.810-218.620, P = 0.014) and low C-reactive protein levels ( OR = 1.056, 95% CI: 1.015-1.099, P = 0.007) were independently associated with an increased risk of PEW. Higher hemoglobin levels ( OR = 0.959, 95% CI: 0.931-0.988, P = 0.005) and a larger middle upper arm circumference ( OR = 0.544, 95% CI: 0.338-0.875, P = 0.012) were independently associated with a reduced risk of PEW. The risk of PEW in the low PTH group was 19.891 times higher than that in the extreme high PTH group. However, there was no significant difference in the risk of PEW in the standard and very high PTH groups compared with the extreme high PTH group (both P > 0.05). Conclusion:The risk of PEW is markedly elevated in patients with low PTH levels, emphasizing the importance of clinical attention to the prevention and treatment of low PTH levels. Addressing this issue may hold great value in reducing the risk of PEW.

Objective To examine the precise function of influenza A virus target genes(IATGs)in malignancy. Methods Using multi-omics data from the TCGA and TCPA datasets,33 tumor types were evaluated for IATGs.IATG expression in cancer cells was analyzed using transcriptome analysis.Copy number variation(CNV)was assessed using GISTICS 2.0.Spearman's analysis was used to correlate mRNA expression with methylation levels.GSEA was used for the enrichment analysis.Pearson's correlation analysis was used to examine the association between IATG mRNA expression and IC50.The ImmuCellAI algorithm was used to calculate the infiltration scores of 24 immune cell types. Results In 13 solid tumors,IATG mRNA levels were atypically expressed.Except for UCS,UVM,KICH,PCPG,THCA,CHOL,LAMI,and MESO,most cancers contained somatic IATG mutations.The main types of CNVs in IATGs are heterozygous amplifications and deletions.In most tumors,IATG mRNA expression is adversely associated with methylation.RT-PCR demonstrated that EGFR,ANXA5,CACNA1C,CD209,UVRAG were upregulated and CLEC4M was downregulated in KIRC cell lines,consistent with the TCGA and GTEx data. Conclusion Genomic changes and clinical characteristics of IATGs were identified,which may offer fresh perspectives linking the influenza A virus to cancer.

Objective:To explore the effects of mindfulness-based stress reduction(MBSR)on pain relief,anxiety and depression and quality of life in naval personnel with chronic pain.Methods:A total of 72 naval person-nel with chronic pain were randomly divided into MBSR group and routine intervention group.The routine interven-tion group received routine care,while the MBSR group received MBSR in addition to routine care.The Short-Form McGill Pain Questionnaire(SF-MPQ),Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),and 36-item Short Form Health Survey Scale(SF-36)were used at baseline and after 8 weeks of intervention.Results:The differences in the scores of 3 subjects of SF-MPQ,SAS,SDS and SF-36 in MBSR group at baseline and 8 weeks after intervention were higher than those in routine intervention group(Ps＜0.05).Conclusion:It suggests that mindfulnecs-based stress reduction could alleviate the degree of pain,anxiety and depression of patients with chronic pain in naval personnel and improve their quality of life.