ObjectiveTo investigate the effects of Huangqi Jianzhongtang （HQJZ） on macrophage polarization and fat consumption in cancer cachexia （CC） mice. MethodsUltra-performance liquid chromatography-quadrupole/electrostatic field Orbitrap high-resolution mass spectrometry （UPLC-Q-Orbitrap HRMS） was used to control the quality of HQJZ. （1） In vitro experiment： HQJZ-containing serum was prepared， and the optimal concentration was determined by cytotoxicity assay. Mouse monocyte-derived macrophages （RAW264.7） were cultured and randomly divided into six groups， including a blank group， a classically activated macrophages （M1） group， an alternatively activated macrophages （M2） group， a HQJZ + blank group， a HQJZ+M1 group， and a HQJZ + M2 group. The relative expression of macrophage marker genes CD86， inducible nitric oxide synthase （iNOS）， CD206， and arginase-1 （Arg1） was detected by real-time quantitative polymerase chain reaction （Real-time PCR ）. （2） In vivo experiment： Thirty-two BALB/c mice were randomly divided into a control group， a model group， a medroxyprogesterone acetate （MPA） group， and a HQJZ group. Except for the control group， the other mice were injected with CT-26 colon cancer cells to establish a CC model. Mice in the MPA and HQJZ groups were given MPA （0.13 g·kg^-1·d^-1） or HQJZ （13.13 g·kg^-1·d^-1） by gavage， respectively， while mice in the control and model groups were given an equal volume of saline by gavage， with interventions continued for 10 d. Real-time PCR was used to detect the expression of macrophage markers （iNOS， Arg1， CD86， CD206） and fat browning-related genes uncoupling protein 1 （UCP1） and peroxisome proliferator-activated receptor γ （PPARγ） in epididymal adipose tissue. Western blot （WB） was used to detect protein expression levels of UCP1 and PPARγ. Micro-computed tomography （micro-CT） was used to measure residual fat volume， and hematoxylin-eosin （HE） staining was used to assess fat browning and calculate pathological scores. ResultsIn vitro， the dominant effective concentration of HQJZ-containing serum was 12.5%. Real-time PCR results showed that， compared with the blank group， Arg1 expression decreased in the HQJZ+blank group （P<0.05）， CD206 showed a downward trend without statistical significance， while iNOS and CD86 expression were significantly increased （P<0.05）. Compared with the M1 group， Arg1 and CD206 expression decreased in the HQJZ+M1 group （P<0.05）. Compared with the M2 group， CD206 expression decreased in the HQJZ+M2 group （P<0.05）， CD86 expression increased significantly （P<0.01）. In vivo， Real-time PCR results showed that， compared with the control group， CD86 and CD206 expression levels were significantly increased in the model group （P<0.01）. Compared with the model group， CD206 expression in the MPA group was significantly decreased （P<0.01）. In the HQJZ group， CD206 was significantly decreased （P<0.01）. WB results showed that， compared with the model group， protein expression of UCP1 and PPARγ was significantly reduced in the HQJZ group （P<0.05， P<0.01）. micro-CT results showed that the total white fat volume in the HQJZ group was greater than that in the model group （P<0.05）. HE staining results showed that pathological scores in the HQJZ group were lower than those in the model group （P<0.05）. ConclusionHQJZ may inhibit white adipose tissue browning by promoting macrophage M1 polarization and suppressing M2 polarization， thereby delaying fat consumption in CC mice.

Objective:To explore the diagnostic value of fetal echocardiography (ECHO) for ventricular septal defect (VSD) and the causes of missed diagnosis and misdiagnosis by analyzing the standard of ECHO sections and image quality.Methods:A retrospective analysis was conducted on 94 VSD fetuses diagnosed by ECHO at Xiangtan Maternal and Child Health Care Hospital from January 2022 to June 2024. Clinical data including the anatomic subtypes, associated anomalies, chromosomal karyotype results, pregnancy outcomes, and neonatal ECHO results were collected and analyzed. Besides, by reviewing the ultrasound images from the institution's ultrasound workstation, a descriptive analysis was conducted on the ECHO section criteria and image quality in the missed and misdiagnosed cases.Results:Among 10 984 fetuses undergoing ECHO, a total of 94 cases of fetal VSD were detected (0.7%), including 45 (48%) isolated VSD and 49 (52%) non-isolated VSD cases. Anatomic distribution revealed perimembranous type predominance (67, 71%), followed by muscular (24, 26%), subarterial types (2, 2%), and perimembranous+muscular type (1, 1%). Among 29 missed diagnosis cases (fetal ECHO-negative but neonatal ECHO-confirmed VSDs), all were isolated VSD, muscular types accounted for 19 (66%), perimembranous types for 8 (27%), and subarterial types for 2 (7%). The causes of missed diagnosis include: technical limitation in 14 cases (48%), restricted cardiac acoustic window in 11 cases (38%), and operator-dependent factors in four cases (14%). All 18 misdiagnosed cases occurred in isolated VSD, with 15 cases of perimembranous and three cases of muscular types. The causes of misdiagnosis include: nine cases due to non-perpendicular beam alignment to perimembranous septum, six cases due to excessively high color flow gain,and three cases due to the misinterpretation of the right ventricular outflow tract flow above the aortic valve as VSD septal perforation blood flow. The sensitivity and specificity of fetal ECHO for diagnosing VSD were 76.42% and 99.83%. Among the 94 cases of fetal VSD, 38 cases (40%) underwent chromosomal karyotype analysis and chromosomal microarray analysis, which identified chromosomal karyotype abnormalities or pathogenic gene variants in 4/16 non-isolated VSDs (all perimembranous), while no anomalies were detected in 22 isolated VSDs. Pregnancy outcomes showed 31 terminations due to associated structural or chromosomal abnormalities versus 63 live births. In the live births, who underwent echocardiography in the neonatal period, 19 cases (30%) showed no VSD and were considered to have undergone spontaneous in utero closure, and persistent defects were found in 44 (70%).Conclusions:Fetal ECHO demonstrates high sensitivity and specificity in the diagnosis of fetal VSD. Critical quality control measures include individualized parameter adjustment and systematic multiplanar continuous scanning to minimize diagnostic errors. Isolated small and medium-sized muscular and perimembranous VSD usually have a good prognosis.

Objective: To understand the dynamic temporal evolution pathways of Internet addiction among university students and to identify the core driving nodes, so as to provide theoretical evidences for the precise implementation of targeted interventions. Methods: Using a convenient cluster sampling method, a total of 1 066 full time freshmen and sophomores were recruited from three universities in Guizhou, Jiangxi, and Guangdong Provinces for a follow up survey (T1:January-March 2024; T2:January-March 2025). The Revised Chen Internet Addiction Scale (CIAS-R) was employed to assess the status of Internet addiction among university students, and cross sectional as well as cross lagged panel network models were constructed to analyze Internet addiction and its multidimensional influencing factors. Results: The T1 network comprised 19 nodes and 114 non zero edges, while the T2 network comprised 19 nodes and 126 non zero edges. Cross sectional network analysis revealed the strongest association between "insufficient sleep" and "daytime fatigue"; the core nodes were "first thought upon waking for going online" and "feeling low after disconnection" (characteristics of psychological dependence) at T1, while the core nodes shifted to "impaired health" and "excitement when online" (characteristics of functional impairment and addictive psychodynamic features) at T2. Cross lagged network analysis further indicated that "reduced leisure" directly predicted "sleep compression", and a bidirectional relationship was observed between "needing more time to achieve satisfaction" and "academic decline". Conclusions Internet addiction among university students exhibits dynamic evolutionary characteristics. Stage specific targeted interventions focusing on core driving nodes are needed, integrating behavioral regulation and academic support to break the vicious cycle and enhancing the ability to cope with real life demands.

OBJECTIVE: To observe the effects of acupoint catgut embedding (ACE) on gut microbiota and fecal short-chain fatty acids (SCFAs) levels in patients with Parkinson's disease (PD) with constipation. METHODS: A total of 80 PD patients with constipation were randomly divided into an observation group and a control group, 40 cases in each group. Additionally, 40 healthy individuals were recruited as a healthy control group. The control group received conventional Western medical treatment for PD combined with polyethylene glycol (PEG), once daily for eight weeks. The observation group received additional ACE treatment at bilateral Tianshu (ST25), Zusanli (ST36), and Shangjuxu (ST37), once every two weeks for eight weeks. The healthy control group received no intervention. The spontaneous bowel movements (SBMs) per week and patient assessment of constipation quality of life (PAC-QOL) scores were assessed at baseline and after treatment in the two groups. Fecal samples were collected at the end of treatment for the observation and the control groups and at baseline for the healthy control group. Gut microbiota composition and diversity were analyzed using 16S rRNA method, and SCFA levels were measured using high-performance liquid chromatography (HPLC). RESULTS: Compared before treatment, the observation group showed a significant increase in SBMs (P<0.01), and PAC-QOL scores including physical discomfort, psychosocial discomfort, worry and concern, and total score were significantly reduced (P<0.01) after treatment; the control group also showed a reduction in PAC-QOL total score after treatment (P<0.01). After treatment, the observation group had significantly more SBMs (P<0.01), and lower PAC-QOL physical discomfort, psychosocial discomfort, worry and concern scores, and total score (P<0.01), and higher PAC-QOL satisfaction score (P<0.01) than the control group. Compared with the healthy control group, the control group showed decreased Chao1 and Ace indices (P<0.01). Compared with the healthy control group, the relative abundance of Prevotella and Roseburia was increased (P<0.05), while that of Enterobacter and Ruminococcus torques (six species in total) was decreased (P<0.05) in the control group. Compared with the control group, the observation group had increased relative abundance of Dialister, Parabacteroides, and Ruminococcus torques (P<0.05), and decreased relative abundance of Prevotella and Eubacterium ruminantium (P<0.05). Compared with the healthy control group, the control group had increased fecal SCFA levels (P<0.05); compared with the control group, the observation group had reduced fecal SCFA levels (P<0.05). Compared with the healthy control group, acetic acid, propionic acid, and butyric acid levels were elevated in the control group (P<0.05); compared with the control group, acetic acid, propionic acid, and butyric acid levels were decreased in the observation group (P<0.05). CONCLUSION ACE could increase spontaneous bowel movements and improve the quality of life in PD patients with constipation, which may be related to the regulation of gut microbiota composition and SCFA levels.
Humans ; Constipation/metabolism* ; Male ; Gastrointestinal Microbiome ; Acupuncture Points ; Female ; Middle Aged ; Parkinson Disease/complications* ; Aged ; Fatty Acids, Volatile/metabolism* ; Catgut ; Feces/microbiology* ; Acupuncture Therapy ; Quality of Life ; Adult

Objective:To explore the relationship between mindfulness, optimism, and subjective well-being in post-lung transplantation patients, so as to provide a basis for nursing staff to improve patients' subjective well-being.Methods:This study was a cross-sectional survey. Convenience sampling was used to select 205 post-lung transplantation patients admitted to the First Affiliated Hospital of Guangzhou Medical University from October 2022 to November 2023 for the study. General Information Questionnaire, World Health Organization-Five Well-Being Scale, Mindful Attention Awareness Scale (MAAS) and Life Orientation Test-R (LOT-R) were used to investigate the study participants. Pearson correlation was used to analyze the correlation between subjective well-being and mindfulness and optimism in patients after lung transplantation. AMOS 24.0 software was used to construct a mediating model to analyze the path relationship between mindfulness, optimism and subjective well-being.Results:A total of 205 questionnaires were distributed and 202 valid questionnaires were recovered, with an effective recovery rate of 98.54% (202/205). In 202 patients after lung transplantation, the WHO-5 Well-Being Scale total score, MAAS total score, and LOT-R score were (16.31±4.73), (56.75±9.44), and (18.49±3.85), respectively. Lung transplantation patients' subjective well-being was positively correlated with mindfulness and optimism ( r=0.570, 0.600, both P<0.01). Optimism partially mediated the relationship between mindfulness and subjective well-being, with an effect value of 0.290 and an effect proportion of 52.35% (0.290/0.554) . Conclusions:Mindfulness and optimism are both positively correlated with subjective well-being in post-lung transplantation patients, and mindfulness could also influence subjective well-being through the mediating effect of optimism. Healthcare professionals should fully explore and cultivate positive psychological resources, such as mindfulness, in lung transplant patients, by increasing optimism as the target of intervention, which in turn improves patients' subjective well-being.

Objective:To explore the relationship between mindfulness, optimism, and subjective well-being in post-lung transplantation patients, so as to provide a basis for nursing staff to improve patients' subjective well-being.Methods:This study was a cross-sectional survey. Convenience sampling was used to select 205 post-lung transplantation patients admitted to the First Affiliated Hospital of Guangzhou Medical University from October 2022 to November 2023 for the study. General Information Questionnaire, World Health Organization-Five Well-Being Scale, Mindful Attention Awareness Scale (MAAS) and Life Orientation Test-R (LOT-R) were used to investigate the study participants. Pearson correlation was used to analyze the correlation between subjective well-being and mindfulness and optimism in patients after lung transplantation. AMOS 24.0 software was used to construct a mediating model to analyze the path relationship between mindfulness, optimism and subjective well-being.Results:A total of 205 questionnaires were distributed and 202 valid questionnaires were recovered, with an effective recovery rate of 98.54% (202/205). In 202 patients after lung transplantation, the WHO-5 Well-Being Scale total score, MAAS total score, and LOT-R score were (16.31±4.73), (56.75±9.44), and (18.49±3.85), respectively. Lung transplantation patients' subjective well-being was positively correlated with mindfulness and optimism ( r=0.570, 0.600, both P<0.01). Optimism partially mediated the relationship between mindfulness and subjective well-being, with an effect value of 0.290 and an effect proportion of 52.35% (0.290/0.554) . Conclusions:Mindfulness and optimism are both positively correlated with subjective well-being in post-lung transplantation patients, and mindfulness could also influence subjective well-being through the mediating effect of optimism. Healthcare professionals should fully explore and cultivate positive psychological resources, such as mindfulness, in lung transplant patients, by increasing optimism as the target of intervention, which in turn improves patients' subjective well-being.

Objective:To explore the diagnostic value of fetal echocardiography (ECHO) for ventricular septal defect (VSD) and the causes of missed diagnosis and misdiagnosis by analyzing the standard of ECHO sections and image quality.Methods:A retrospective analysis was conducted on 94 VSD fetuses diagnosed by ECHO at Xiangtan Maternal and Child Health Care Hospital from January 2022 to June 2024. Clinical data including the anatomic subtypes, associated anomalies, chromosomal karyotype results, pregnancy outcomes, and neonatal ECHO results were collected and analyzed. Besides, by reviewing the ultrasound images from the institution's ultrasound workstation, a descriptive analysis was conducted on the ECHO section criteria and image quality in the missed and misdiagnosed cases.Results:Among 10 984 fetuses undergoing ECHO, a total of 94 cases of fetal VSD were detected (0.7%), including 45 (48%) isolated VSD and 49 (52%) non-isolated VSD cases. Anatomic distribution revealed perimembranous type predominance (67, 71%), followed by muscular (24, 26%), subarterial types (2, 2%), and perimembranous+muscular type (1, 1%). Among 29 missed diagnosis cases (fetal ECHO-negative but neonatal ECHO-confirmed VSDs), all were isolated VSD, muscular types accounted for 19 (66%), perimembranous types for 8 (27%), and subarterial types for 2 (7%). The causes of missed diagnosis include: technical limitation in 14 cases (48%), restricted cardiac acoustic window in 11 cases (38%), and operator-dependent factors in four cases (14%). All 18 misdiagnosed cases occurred in isolated VSD, with 15 cases of perimembranous and three cases of muscular types. The causes of misdiagnosis include: nine cases due to non-perpendicular beam alignment to perimembranous septum, six cases due to excessively high color flow gain,and three cases due to the misinterpretation of the right ventricular outflow tract flow above the aortic valve as VSD septal perforation blood flow. The sensitivity and specificity of fetal ECHO for diagnosing VSD were 76.42% and 99.83%. Among the 94 cases of fetal VSD, 38 cases (40%) underwent chromosomal karyotype analysis and chromosomal microarray analysis, which identified chromosomal karyotype abnormalities or pathogenic gene variants in 4/16 non-isolated VSDs (all perimembranous), while no anomalies were detected in 22 isolated VSDs. Pregnancy outcomes showed 31 terminations due to associated structural or chromosomal abnormalities versus 63 live births. In the live births, who underwent echocardiography in the neonatal period, 19 cases (30%) showed no VSD and were considered to have undergone spontaneous in utero closure, and persistent defects were found in 44 (70%).Conclusions:Fetal ECHO demonstrates high sensitivity and specificity in the diagnosis of fetal VSD. Critical quality control measures include individualized parameter adjustment and systematic multiplanar continuous scanning to minimize diagnostic errors. Isolated small and medium-sized muscular and perimembranous VSD usually have a good prognosis.

Objective:To analyze the epidemiological and clinical characteristics of patients with brucellosis.Methods:Medical records of confirmed brucellosis patients ( n = 101) were collected from January 2015 to December 2022 at the First Affiliated Hospital of Nanjing Medical University. Patients were divided into acute phase group (≤3 months, n = 89) and non acute phase group (> 3 months, n = 12) according to the course of the disease. The epidemiological characteristics, clinical symptoms, laboratory indicators, treatment plan and curative effect of the patients were analyzed retrospectively. Results:Data of a total of 101 cases of brucellosis were collected, including 72 males and 29 females. The disease occurred throughout the year, with summer (June to August) being the peak period (43.56%, 44/101); 72.28% (73/101) cases had a clear history of contact with animal. Ninety-two point zero eight percent (93/101) of the patients visited the Department of Infectious Diseases for the first time. Clinical manifestations included fever, accounting for 82.18% (83/101), chills accounting for 36.63% (37/101), backache accounting for 33.66% (34/101), night sweats accounting for 22.77% (23/101), and arthralgia accounting for 20.79% (21/101). The symptoms of backache (75.00%, 9/12) and arthralgia (41.67%, 5/12) were more common in patients in the non acute phase group than those of the acute phase group [28.09% (25/89), 17.98% (16/89), P < 0.05]. The most common laboratory test abnormal items were elevated C-reactive protein (CRP, 68.32%, 69/101), erythrocyte sedimentation rate (ESR, 61.39%, 62/101), aspartate aminotransferase (AST, 58.42%, 59/101), and alanine aminotransferase (ALT, 48.51%, 49/101). Elevated ESR (66.29%, 59/89) was more common in patients in the acute phase group than that of the non acute phase group [25.00 (3/12), χ 2 = 7.48, P = 0.006]. All patients were treated with a combination therapy, with a recovery rate of 100.00% (101/101). Conclusions:Brucellosis patients are more common in males, with a higher incidence in summer and often accompanied by a history of contact with animal. The clinical manifestations are diverse and non-specific.

Objective To investigate the expression of insulin-like growth factor 2 mRNA binding protein 1(IGF2BP1)mRNA and patrilineal expression of genetic imprinting gene 10(PEG10)mRNA in endometrial carcinoma(EC)tissues and their correlation with proliferation gene expression and prognosis.Methods A total of 100 EC patients diagnosed and treated in Hubei Institute of Technology Affiliated Maternal and Child Health Hospital from January 2017 to January 2019 were selected.The expression of IGF2BP1 mRNA,PEG 10 mRNA,proliferating cell nuclear antigen(PCNA),cyclin D1,and cyclin dependent kinase 4(CDK4)mRNA were examined by real-time fluorescence quantitative PCR.The expressions of IGF2BP1 and PEG 10 in tissues were detected by immunochemistry,and their correlation were analyzed by Pearson correlation analysis.Kaplan-Meier curve analysis were used to analyze the prognostic differences in EC patients with different IGF2BP1 and PEG 10 expression groups.COX regression was used to analyze the prognostic factors of EC patients.Results The expression levels of IGF2BP1 mRNA(1.84±0.33),PEG10 mRNA(2.12±0.40),PCNA mRNA(3.14±0.42),cyclinD1 mRNA(2.81±0.36)and CDK4 mRNA(2.37±0.34)in EC cancer tissues were higher than those in adjacent tissues(0.78±0.21,0.91±0.25,0.74±0.13,0.67±0.21,0.59±0.18),and the differences were significant(t=25.652～54.588,all P＜0.05).The positive rates of IGF2BP1(70.00％)and PEG 10(72.00％)in cancer tissues were higher than those in adjacent tissues(10.00％,9.00％),and the differences were statistically significant(x2=75.000,82.363,all P＜0.05).The expressions of IGF2BP1 mRNA and PEG10 mRNA in EC tissues were positively correlated with PCNA mRNA,cyclinD1 mRNA,and CDK4 mRNA(r=0.562～0.625,all P＜0.05).There was a significant positive correlation between IGF2BP1 mRNA and PEG10 mRNA expression in EC tissues(r=0.663,P＜0.05).The positive rates of IGF2BP1(86.49％,87.50％)and PEG10(89.19％,90.63％)protein expression in EC cancer tissues with FIGO stage Ⅲ and combined lymph node metastasis were higher than those in FIGO stage Ⅰ-Ⅱ(60.321％,61.90％)and without lymph node metastasis(61.77％,63.24％),and the differences were sttistically significant(x2=6.863～8.608,all P＜0.05).The overall 3-year survival rate of IGF2BP1 positive patients[70.00％(49/70)]was lower than that of IGF2BP1 negative patients[90.00％(27/30)],the overall 3-year survival rate of patients in PEG10 positive patients[69.40(50/72)]was lower than that in PEG10 negative patients[92.86％(26/28)],and the differences were statistically significant(Log rankx2=4.133,5.491,P=0.042,0.019).FIGO stage Ⅲ(OR=1.449,95％CI:1.148～1.830),combined lymph node metastasis(OR=1.442,95％CI:1.124～1.850),IGF2BP1 positive(OR=1.637,95％CI:1.239～2.163),and PEG10 positive(OR=1.576,95％CI:1.136～1.187)were independent risk factors affecting the survival and prognosis of EC patients(all P＜0.05).Conclusion The expressions of IGF2BP1 and PEG 10 in EC were increased,and they were positively correlated with the proliferation gene expression.They may be potential tumor markers for prognostic evaluation of EC.

Objective:To assess the value of serum tumor specific protein 70 (SP70) for prognostic stratification in acute myeloid leukemia (AML).Methods:A cohort study design was adopted. 129 newly diagnosed AML patients from September 2022 to January 2024 at the Hematology Department of the First Affiliated Hospital of Nanjing Medical University were included, as well as a control group consisted of 120 healthy individuals and 7 cases with benign hematologic diseases during the same period (total 127 cases). Clinical data were collected from Electronic Medical Records. According to the 2023 edition of the Chinese Leukemia Diagnosis and Treatment Guidelines, AML patients with good or moderate prognosis were categorized as low-to-intermediate risk, while those with poor prognosis were high-risk group. Univariate and multivariate logistic regression analyses were used to identify variables significantly associated with AML prognostic risk. ROC analysis was used to evaluate diagnostic performance. A nomogram for predicting patient prognostic risk was constructed by R 4.0.2 software, and the internal validation was performed using bootstrapping.Results:Among 129 AML patients, there were 71 males (55.0%) and 58 females (45.0%), with 42 (32.6%) classified as high-risk and 87 (67.4%) as low-intermediate risk. The high-risk group had a significantly higher median age [62 (48, 67) years] compared to the low-intermediate risk group [50 (35, 63) years, Z=-2.381, P=0.017], and a significantly higher proportion of males (30 patients, 71.4%) compared to the low-intermediate risk group (41 patients, 47.1%, χ 2=6.760, P=0.009). Multivariate logistic regression analysis indicated that serum SP70 ( OR=2.54, 95% CI: 1.68-3.84, P<0.001), hemoglobin (HB) ( OR=0.96, 95% CI: 0.93-0.99, P<0.05), and bone marrow blast (BM blast) ( OR=1.07, 95% CI: 1.02-1.13, P<0.05) were independent risk factors for high-risk prognosis in AML patients. ROC analysis showed that the area under the curve (AUC) for SP70 predicting high-risk patients was 0.908 (cut-off value of 5.74 ng/ml, 95% CI: 0.845-0.952, sensitivity 90.5%, specificity 82.8%). The combined model of serum SP70, HB, and BM blasts had an AUC of 0.931 (95% CI: 0.890-0.973); C-index=0.925 (95% CI: 0.876-0.963),with no statistically significant difference compared to serum SP70 alone ( Z=1.693, P>0.05). Conclusion:Serum SP70 may be a promising non-invasive molecular biomarker for prognostic stratification in AML.