Objective To reveal the effects of sulforaphane(SFN)on the ferroptosis pathway and iron homeostasis in rats with diabetic retinopathy(DR).Methods A DR rat model was established by a single intraperitoneal injection of streptozotocin at 65 mg·kg-1.After modeling,the rats were randomly divided into six groups(n=12 per group):Group C(control group),DR group,0.5SFN group,1.0SFN group,2.0SFN group,and 2.0SFN+Erastin group.Group C con-sisted of non-intervention control rats,while the other groups were DR model rats.Groups C and DR were orally adminis-tered 0.5 g·L-1 sodium carboxymethyl cellulose(CMC-Na).The 0.5SFN,1.0SFN,and 2.0SFN groups were orally ad-ministered SFN at 0.5,1.0,and 2.0 mg·kg-1,respectively.The 2.0SFN+Erastin group was orally administered 2.0 mg·kg-1 SFN and simultaneously received a tail intravenous injection of the ferroptosis inducer Erastin at 10.0 mg·kg-1.The intervention lasted for 4 weeks.Fasting blood glucose(FPG)was measured with a glucometer,glycosylated hemoglo-bin(GHb)was detected by visible spectrophotometry,and fasting insulin(FINS)was measured by ELISA.Retinal tissues were subjected to hematoxylin-eosin(HE)staining and periodic acid-Schiff(PAS)staining.The level of reactive oxygen species(ROS)in the retina was detected using the DCFH-DA probe,malondialdehyde(MDA)was measured by the TBA method,and reduced glutathione(GSH)was assessed by spectrophotometry.Retinal Fe2+content was determined by spectrophotometry.The mRNA expression levels of ferritin heavy chain 1(FTH1),ferroportin 1(FPN1),transferrin re-ceptor(TFRC),glutathione peroxidase 4(GPX4),solute carrier family 7 member 11(SLC7A11),thioredoxin 1(Trx1),and thioredoxin-interacting protein(TXNIP)in the retina were detected by qRT-PCR.GPX4 protein expression in the retina was detected by Western blot.Results Compared with the DR group,the 0.5SFN,1.0SFN,and 2.0SFN groups showed decreased FPG and GHb,increased FINS,improved retinal morphology with reduced neovascular capillaries,decreased levels of ROS and MDA,increased GSH levels,decreased retinal Fe2+content,increased FTH1 and FPN1 mRNA levels,de-creased TFRC mRNA levels,increased retinal GPX4,SLC7A11,and Trx1 mRNA levels,decreased TXNIP mRNA levels,and increased retinal GPX4 protein levels(all P＜0.05).Compared with the 2.0SFN group,the 2.0SFN+Erastin group showed increased FPG and GHb,decreased FINS,aggravated retinal damage with increased neovascular capillaries,elevat-ed levels of ROS and MDA,decreased GSH levels,increased retinal Fe2+content,decreased FTH1 and FPN1 mRNA levels,increased TFRC mRNA levels,decreased retinal GPX4,SLC7A11,and Trx1 mRNA levels,increased TXNIP mRNA levels,and decreased retinal GPX4 protein levels(all P＜0.05).Conclusion SFN alleviates DR in rats by inhibiting the ferrop-tosis pathway and maintaining iron homeostasis.

Purpose To investigate the value of 18F-FDG PET/CT combined with MRI for detecting occult lymph node metastases in head and neck squamous cell carcinoma(HNSCC).Materials and Methods Eighteen patients with clinically node-negative,pathologically confirmed HNSCC were retrospectively enrolled from the Third Affiliated Hospital of Air Force Medical University from January 2022 to December 2023.All patients underwent preoperative 18F-FDG PET/CT and MRI,including 3D BRAVO high-resolution structural imaging,T2WI and diffusion-weighted imaging.Two nuclear medicine physicians qualitatively and semi-quantitatively assessed cervical lymph nodes for glucose metabolism and apparent diffusion coefficient(ADC)abnormalities.Using postoperative pathology as the gold standard,the diagnostic performance of PET,ADC and their combination for detecting occult metastases was compared.Results Among 54 dissected lymph nodes from 18 patients,12(22.2%)were pathologically confirmed as metastatic.Of 7 false-negative lymph nodes on diffusion weighted imaging,18F-FDG PET/CT correctly identified 4 as positive.18F-FDG PET/CT showed 6 false negatives and 6 false positives.The accuracies of 18F-FDG PET/CT and MRI for detecting occult metastases were 77.8%and 55.6%,respectively,while their combination achieved 91.1%accuracy(41/45).Metastatic lymph nodes exhibited higher maximum standardized uptake values(3.53±0.26 vs.2.71±0.14;t=3.17,P=0.008)and lower ADC values(0.91×10-3 mm2/s vs.1.07×10-3 mm2/s;t=4.15,P=0.001)compared with inflammatory nodes.Conclusion 18F-FDG PET/CT combined with diffusion weighted imaging improves detection of occult lymph node metastases in HNSCC and may guide surgical management.

Objective:To screen serum biomarkers of polycystic ovary syndrome (PCOS) patients by high throughput data independent acquisition (DIA) proteomics technology.Methods:This was a case-control study. A total of 39 peripheral blood samples were collected at Reproductive Medical Center of Jiangxi Maternal and Child Health Hospital from March to November 2021. Among which, 20 cases were from PCOS patients, and 19 cases were from women who underwent assisted reproduction due to male factors causing infertility. DIA proteomics technology combined with bioinformatics analysis were performed to screen for differential protein expression profiles in the serum of PCOS patients. Typical differentially expressed proteins were selected for expression analysis and receiver operating characteristic (ROC) curve analysis, followed by enzyme-linked immunosorbent assay (ELISA) validation.Results:The results of DIA proteomics combined with bioinformatics analysis showed that compared with control group, 194 significantly differentially expressed proteins were screened in the peripheral blood of PCOS patients, including 64 upregulated proteins and 130 downregulated proteins. The ROC curve analysis results showed that the area under curve values of PSMD8, RPS15A, NDUFB1, GM2A, and TOP2A were all above 0.9, indicating that these proteins have good diagnostic value. The ELISA validation results showed that the content of TOP2A in peripheral blood of PCOS patients was significantly upregulated ( P=0.046), while the content of GM2A was significantly downregulated ( P=0.021), when compared with control group, which consistent with the DIA results. Conclusion:DIA proteomics can be used to screen the differential expression of peripheral blood proteins in PCOS patients, among which, PSMD8, RPS15A, NDUFB1, GM2A and TOP2A can be used as serum biomarkers for PCOS diagnosis and treatment.

OBJECTIVE To investigate the risk factors for carbapenem-resistant gram-negative bacteria(GNB)bloodstream infection(BSI)in patients with hematological malignancies(HMs)and their prognosis,and to devel-op a nomogram prediction model.METHODS A total of 316 patients with HMs and GNB-BSI admitted to the First Affiliated Hospital of Xi'an Jiaotong University from Jan.2017 to Dec.2022 were selected as the training set,and 106 patients admitted from Jan.2023 to Oct.2024 were selected as the validation set.Variables were selected by lasso regression and multifactor logistic regression,and a nomogram model was constructed.The prediction model was internally validated by the receiver operating characteristic(ROC)curve,calibration curve and decision curve analysis(DCA),respectively.RESULTS Granulocytopenia for ≥7 days(OR=14.525),use of cephalosporins/β-lactamase inhibitors within 30 days before BSI(OR=3.510),exposure history of carbapenem antibacterial drug(OR=4.840)and albumin＜30 g/L(OR=2.697)were risk factors for CR-GNB BSI in patients with HMs(P＜0.05).Septic shock(OR=6.934),central venous catheterization(OR=5.586),inappropriate empirical antibac-terial drug therapy(OR=4.744),CR-GNB infection(OR=2.916)and albumin＜30 g/L(OR=3.324)were risk factors for 30-day mortality in patients with HMs and GNB-BSI(P＜0.05).Based on these indicators,two nomogram models were constructed.The areas under the ROC curve(AUC)for the internal validation set were 0.775 and 0.849,respectively.The calibration curves demonstrated high predictive performance for the pre-diction models(P=0.998 and 0.660,respectively),and DCA showed high clinical application value for both models.CONCLUSION The nomogram prediction model constructed in this study based on multifactor analy-sis not only demonstrates good predictive value but also exhibits significant clinical efficacy,aiding in the early i-dentification of high-risk patients for targeted therapy.

Objective To reveal the effects of sulforaphane(SFN)on the ferroptosis pathway and iron homeostasis in rats with diabetic retinopathy(DR).Methods A DR rat model was established by a single intraperitoneal injection of streptozotocin at 65 mg·kg-1.After modeling,the rats were randomly divided into six groups(n=12 per group):Group C(control group),DR group,0.5SFN group,1.0SFN group,2.0SFN group,and 2.0SFN+Erastin group.Group C con-sisted of non-intervention control rats,while the other groups were DR model rats.Groups C and DR were orally adminis-tered 0.5 g·L-1 sodium carboxymethyl cellulose(CMC-Na).The 0.5SFN,1.0SFN,and 2.0SFN groups were orally ad-ministered SFN at 0.5,1.0,and 2.0 mg·kg-1,respectively.The 2.0SFN+Erastin group was orally administered 2.0 mg·kg-1 SFN and simultaneously received a tail intravenous injection of the ferroptosis inducer Erastin at 10.0 mg·kg-1.The intervention lasted for 4 weeks.Fasting blood glucose(FPG)was measured with a glucometer,glycosylated hemoglo-bin(GHb)was detected by visible spectrophotometry,and fasting insulin(FINS)was measured by ELISA.Retinal tissues were subjected to hematoxylin-eosin(HE)staining and periodic acid-Schiff(PAS)staining.The level of reactive oxygen species(ROS)in the retina was detected using the DCFH-DA probe,malondialdehyde(MDA)was measured by the TBA method,and reduced glutathione(GSH)was assessed by spectrophotometry.Retinal Fe2+content was determined by spectrophotometry.The mRNA expression levels of ferritin heavy chain 1(FTH1),ferroportin 1(FPN1),transferrin re-ceptor(TFRC),glutathione peroxidase 4(GPX4),solute carrier family 7 member 11(SLC7A11),thioredoxin 1(Trx1),and thioredoxin-interacting protein(TXNIP)in the retina were detected by qRT-PCR.GPX4 protein expression in the retina was detected by Western blot.Results Compared with the DR group,the 0.5SFN,1.0SFN,and 2.0SFN groups showed decreased FPG and GHb,increased FINS,improved retinal morphology with reduced neovascular capillaries,decreased levels of ROS and MDA,increased GSH levels,decreased retinal Fe2+content,increased FTH1 and FPN1 mRNA levels,de-creased TFRC mRNA levels,increased retinal GPX4,SLC7A11,and Trx1 mRNA levels,decreased TXNIP mRNA levels,and increased retinal GPX4 protein levels(all P＜0.05).Compared with the 2.0SFN group,the 2.0SFN+Erastin group showed increased FPG and GHb,decreased FINS,aggravated retinal damage with increased neovascular capillaries,elevat-ed levels of ROS and MDA,decreased GSH levels,increased retinal Fe2+content,decreased FTH1 and FPN1 mRNA levels,increased TFRC mRNA levels,decreased retinal GPX4,SLC7A11,and Trx1 mRNA levels,increased TXNIP mRNA levels,and decreased retinal GPX4 protein levels(all P＜0.05).Conclusion SFN alleviates DR in rats by inhibiting the ferrop-tosis pathway and maintaining iron homeostasis.

Objective:The aim of this study was to explore the risk factors that affect implementation of the innovative technique of single-incision laparoscopic appendectomy (solo-SLA) without assistance in patients with complicated appendicitis, the goal being improving surgical success rates and reducing the incidence of complications.Methods:This was an observational study. Indications for solo-SLA surgery were as follows: (1) computed tomography or ultrasound findings suggestive of acute appendicitis, accompanied by a high white blood cell count and C-reactive protein concentration; (2) disease course exceeding 72 hours, standard anti-infection treatment ineffective, inflammatory reaction not localized, surgery mainly aimed at abscess drainage, and the appendix removed if indicated intraoperatively; (3) acute onset stabilized for more than 3 months after conservative treatment; and (4) recurrent chronic appendicitis. Relative contraindications comprised: (1) cardiopulmonary insufficiency, extremely high risk for general anesthesia for laparoscopic surgery; (2) severe coagulation dysfunction; and (3) imaging findings suggestive of formation of a peri-appendiceal abscess, stable after anti-infection treatment, and a tendency for the inflammatory reaction to localize. We retrospectively collected clinical data of 106 patients with complicated appendicitis who had undergone solo-SLA in the Department of Emergency Surgery, Peking University People's Hospital from February to October 2023. Preoperative computed tomography showed appendiceal fecaliths, blurring of the tissue surrounding fat, intra- and extra-luminal gas and exudate, peri-appendiceal abscess, ascites, and intestinal obstruction by appendicitis. The study cohort comprised 53 male and 53 female patients aged (41.4±17.4) years. The median body mass index was (24.2±3.6) kg/m 2 and median preoperative body temperature (37.3±0.9)℃ Appendicitis had been present for >3 days in 21 of the patients (19.8%) and the maximum diameter of the appendix was (12.4±3.8) mm. The efficacy of the surgery was assessed and logistic regression analysis used to explore the factors affecting the duration of the procedure. The relationship between the maximum diameter of the appendix and duration of surgery was non-linear and was explored using a logistic regression model with restricted cubic spline (RCS). Results:Only one patient required conversion to open surgery; all the other patients successfully completed solo-SLA with a median intraoperative blood loss of 10 (1-100) ml and a surgical time of (65.4±31.7) minutes. Pain scores on postoperative Day 1 and 7 were (3.4±3.2) points and (1.5±1.7) points, respectively. There were no significant postoperative complications .The postoperative hospital stay was (3.5±1.5) days and the interval to resuming normal activities 14 (2-40) days. According to univariate and multivariate analyses, disease course >3 days (OR=5.19, 95%CI: 1.59-16.98, P=0.006) and C-reactive protein >10 mg/L (OR=1.01,95%CI: 1.00-1.02, P=0.003) were independent risk factors for surgical duration >60 minutes, whereas the maximum diameter of the appendix was not independently associated with duration of surgery (OR=1.10, 95%CI: 0.97-1.25, P=0.119). RCS analysis results showed a "U-shaped" association between the maximum diameter of the appendix and duration of surgery, the inflection point of the RCS curve being at a diameter of 10 mm. When the maximum diameter of the appendix was <10 mm, increases in diameter were not associated with longer duration of surgery (OR=1.15,95%CI: 0.55-2.58, P=0.710); whereas when the diameter was ≥10 mm, the maximum diameter of the appendix was associated with increased duration of surgery (OR=1.20, 95% CI: 1.04-1.42, P=0.022). Conclusion:The solo-SLA procedure can be performed to treat complicated appendicitis. A disease course >3 days, C-reactive protein concentration >10 mg/L, and maximum diameter of the appendix ≥10 mm are all associated with greater difficulty of solo-SLA surgery.

Objective To investigate the mechanism underlying the effect of intra-articular injection of ozonated water on cartilage repair in knee osteoarthritis(KOA)rats via the miR-214-3p/nuclear factor(NF)-κB signaling pathway,to provide a theoretical basis for the clinical application of ozonated water.Methods Sixty male Sprague-Dawley rats were divided randomly into ozonated and experimental groups.Rats in the experimental group were further divided randomly into model,ozonated water,ozonated water+AAV-NC,and adeno-associated virus with ozonated water+AAV-miR-214-3p inhibitor groups.The articular cartilage repair status was evaluated after the respective treatments,using articular cartilage surface gross scoring,hematoxylin/eosin staining,and modified Mankin's score.Expression levels of interleukin(IL)-1β,tumor necrosis factor(TNF)-α,and matrix metalloproteinase(MMP)-13 were detected by enzyme-linked immunosorbent assay(ELISA).Protein expression levels of IκB kinase(IKK)β,p65,and phospho(p)-IκBα were detected in cartilage tissues by Western blot,and gene expression levels of IKKβ,p65,IκBα,and miR-214-3p were detected by real-time polymerase chain reaction(RT-PCR).Results Rats in all groups showed different degrees of cartilage damage compared with the control group,and the scores were significantly lower in the ozonated water and ozonated water+AAV-NC groups compared with the ozonated water+AAV-miR-214-3p inhibitor group(P＜0.05).IL-1β,TNF-α,and MMP-13 levels detected by ELISA were significantly lower in cartilage tissues from rats in the ozonated water and ozonated water+AAV-NC groups compared with the model and ozonated water+AAV-miR-214-3p inhibitor groups(P＜0.05).According to RT-PCR,IKKβ and p65 mRNA levels were significantly down-regulated while IκBα mRNA was significantly up-regulated in cartilage tissues from rats in the ozonated water and ozonated water+AAV-NC groups compared with the model and ozonated water+AAV-miR-214-3p inhibitor groups(P＜0.05).Similarly,IKKβ,p65,and p-IκBα protein expression levels detected by Western blot were significantly down-regulated while IκBα protein expression levels were up-regulated in cartilage tissues from rats in the ozonated water and ozonated water+AAV-NC groups compared with the model and ozonated water+AAV-miR-214-3p inhibitor groups(P＜0.05).Conclusions Ozone hydrotherapy significantly ameliorated cartilage damage in KOA rats,possibly via inhibiting activation of the NF-κB signaling pathway through up-regulation of miR-214-3p expression and promoting cartilage repair in KOA rats.

OBJECTIVE To explore the risk factors for polymyxin-and carbapenem-resistant Klebsiella pneumoni-ae(PR-CRKP)infection and establish the prediction model.METHODS The clinical data were retrospectively col-lected from the patients with CRKP infection who were treated in the First Affiliated Hospital of Xi'an Jiaotong University from Jan.2023 to Mar.2024.The enrolled patients were divided into the CRKP group and the PR-CRKP group according to the result of drug susceptibility testing for polymyxin B.Totally 203 patients who were treated from Jan.2023 to Dec.2023 were assigned as the modeling group,and 91 patients who were treated from Jan.2024 to Mar.2024 were assigned as the validation group.Multivariate logistic regression analysis was per-formed for the risk factors for PR-CRKP infection,nomogram was built up for prediction of PR-CRKP infection by R software,and the predictive efficacy of the model was evaluated by means of receiver operating characteristic(ROC)curves.RESULTS The result of univariate analysis showed that the proportions of patients who received fi-berobronchoscopy,endotracheal intubation/tracheotomy,were complicated with other carbapenem-resistant or-ganisms(CROs)infections,bloodstream infections,were treated in intensive care unit(ICU)and had the history of exposure to polymyxins and carbapenems 3 months before the admission were higher in the PR-CRKP group than in the CRKP group(P＜0.05);the length of hospital stay and duration of use of polymyxins and carbapene-ms were longer in the PR-CRKP group than in the CRKP group(P＜0.05).Multivariate logistic regression analy-sis indicated that complication with other CROs infections,history of exposure to polymyxins and carbapenems 3 months before the admission,duration of use of polymyxins and ICU stay were the risk factors for the PR-CRKP infection(P＜0.05).The area under the curve(AUC)of the predictive model was 0.898 in the modeling group,with the sensitivity 80.33％,the specificity 84.51％.ROC curve analysis showed that the AUC was 0.901 in the validation group,with the sensitivity 75.00％,the specificity 92.73％.CONCLUSION The prediction model that is established based on the result of multivariate analysis has high value in prediction of PR-CRKP infection.

Objective:To screen serum biomarkers of polycystic ovary syndrome (PCOS) patients by high throughput data independent acquisition (DIA) proteomics technology.Methods:This was a case-control study. A total of 39 peripheral blood samples were collected at Reproductive Medical Center of Jiangxi Maternal and Child Health Hospital from March to November 2021. Among which, 20 cases were from PCOS patients, and 19 cases were from women who underwent assisted reproduction due to male factors causing infertility. DIA proteomics technology combined with bioinformatics analysis were performed to screen for differential protein expression profiles in the serum of PCOS patients. Typical differentially expressed proteins were selected for expression analysis and receiver operating characteristic (ROC) curve analysis, followed by enzyme-linked immunosorbent assay (ELISA) validation.Results:The results of DIA proteomics combined with bioinformatics analysis showed that compared with control group, 194 significantly differentially expressed proteins were screened in the peripheral blood of PCOS patients, including 64 upregulated proteins and 130 downregulated proteins. The ROC curve analysis results showed that the area under curve values of PSMD8, RPS15A, NDUFB1, GM2A, and TOP2A were all above 0.9, indicating that these proteins have good diagnostic value. The ELISA validation results showed that the content of TOP2A in peripheral blood of PCOS patients was significantly upregulated ( P=0.046), while the content of GM2A was significantly downregulated ( P=0.021), when compared with control group, which consistent with the DIA results. Conclusion:DIA proteomics can be used to screen the differential expression of peripheral blood proteins in PCOS patients, among which, PSMD8, RPS15A, NDUFB1, GM2A and TOP2A can be used as serum biomarkers for PCOS diagnosis and treatment.

Objective:To detect the biological markers related to Alzheimer's disease(AD)in the peripheral blood of AD patients,and to explore the activities and levels of the antioxidant function indexes and the expressions of related genes and proteins in the blood of AD patients and the changes after intervention of selenium-rich food.Methods:The Mini-Mental State Examination(MMSE)combined with electroencephalogram or brain CT and clinician diagnosis were used for screening AD.Fifty-six elderly patients with AD aged 75-90 years old were selected.Among them,28 cases were selected as normal diet group for AD(AD group),and 28 cases were selected as dietary selenium intervention group(Se-AD group).The patients in Se-AD group were given daily dietary selenium supplementation(increaseing dietary selenium by 15-20 μg per day)for 3 months.Meanwhile,30 people with the same age were selected as healthy control group.The activities of serum superoxide dismutase(SOD),cholinesterase(CHE),and glutathione peroxidase(GSH-Px)and the levels of serum malondialdehyde(MDA),homocysteine(Hcy),and nitric oxide(NO)as well as reagent kit the levels of serum β-amyloid protein(Aβ),and microtubule-associated protein(Tau)and phosphorylated microtubule-associated protein(p-Tau)of the subjects in various groups were detected by and enzyme-linked immunosorbent assay(ELISA)method;the expression levels of apolipoprotein E4(ApoE4),presenilin 1(PS1),presenilin 2(PS2),cysteinyl aspartate specific proteinase 3(Caspase3),sorting associated protein receptor 1(SORL1),β-site amyloid precursor protein cleaving enzyme 1(BACE1),hypoxia-inducible factor 1(HIF1),nuclear factor-kappa B(NF-κB),β-amyloid precursor protein(APP),protein kinase C(PKC),and Aβ mRNA in peripheral blood of the subjects various groups were detected by real-time fluorescence quantitative PCR(RT-qPCR)method.Results:Compared with healthy control group,the serum SOD activities of the patients in Se-AD group and AD group were significantly decreased(P＜0.05),while serum CHE activity and the levels of MDA and Hcy were significantly increased(P＜0.05);the serum GSH-Px activity of the patients in AD group was significantly decreased(P＜0.05),and the level of NO was significantly increased(P＜0.05).Compared with Se-AD group,serum CHE activity and the level of Hcy of the patients in AD group were significantly increased(P＜0.05).The expression levels of ApoE4,PS1,Caspase3,BACE1,NF-κB and APP mRNA of the patients in Se-AD group and AD group were significantly increased(P＜0.05),and the expression levels of PKC mRNA were significantly decreased(P＜0.05);the expression level of PS2 mRNA of the patients in AD group was significantly increased(P＜0.05),and the expression levels of Aβ mRNA of the patients in Se-AD group and AD group were significantly increased(P＜0.05).Conclusion:The activities of serum SOD,GSH-Px and CHE and the levels of MDA,Hcy and NO,the levels of Aβ,Tau and p-Tau proteins,and the expression levels of ApoE4,PS1,Caspase3,BACE1,NF-κB,PKC,PS2,Aβ and APP mRNA in peripheral blood of the AD patients may vary and can be used for clinical diagnosis of the AD patients.Selenium-rich food can improve AD to some extent,and its mechanism is related to reducing the oxidative damage of brain tissue and decreasing the expression of AD related genes PS2 and Aβ.