Objective To explore the significance of the toxicity mechanism of butyl benzyl phthalate(BBP)in prevention and treatment of pulmonary fibrosis.Methods In this study,we used network toxicology combined with molecular docking technology to screen the targets of BBP and those related to pulmonary fibrosis through PubChem,GeneCards and other databases,and analyzed the intersecting genes by using a Wayne diagram.Protein-protein interaction networks were constructed to screen the core targets,and the pathway mechanisms were revealed by Gene Ontology and Kyoto Encyclopedia of Genes and Genomes.Finally,molecular docking using AutoDock was performed to verify the binding patterns of core targets and BBP.Results A total of 91 potential targets of BBP-induced lung fibrosis were screened,among which PTGS2 and CYP3A4 were the core targets(binding energies of-1.84 kcal/mol and-1.68 kcal/mol,respectively).Enrichment analysis showed that BBP regulated the fibrosis process through G protein-coupled receptor signaling pathway,calcium signaling pathway and cyclic adenosine monophosphate signaling pathway.Molecular docking confirmed that BBP was stably bound to the core target through hydrogen bonding and hydrophobic interaction.Conclusion This study provides preliminary insights into the molecular mechanism of BBP-induced pulmonary fibrosis through network toxicology,and PTGS2 and CYP3A4 may play key roles in BBP-induced pulmonary fibrosis,which provides a novel reference for the exploration of the mechanism of toxicant-disease association.

Objective:To explore differences in the efficacy and safety of ruxolitinib in patients with myelofibrosis by age and to identify prognostic factors by analyzing clinical features and characteristics of chromosomes and gene mutations.Methods:This study retrospectively analyzed 188 patients with myelofibrosis who received ruxolitinib in the Department of Hematology, Qilu Hospital, Shandong University from January 1, 2017, to July 1, 2024. According to age at diagnosis, the patients were divided into the middle-aged group (≤55 years), young elderly group (56-65 years), and elderly group (>65 years). Clinical features, the characteristics of chromosomes and gene mutations, and the efficacy and safety of ruxolitinib treatment were compared across the three age groups. Independent factors influencing overall survival were identified through Cox proportional risk regression analysis.Results:Before treatment, the elderly group had more underlying comorbidities, a heavier symptom burden, higher leukocyte count, higher proportion and frequency of JAK2 mutations, and lower proportion of CALR mutations. The incidence of nondriver gene mutations was significantly higher in the young elderly group. After ruxolitinib treatment, the degree of reduction in spleen size did not differ significantly among the three groups. The length of the palpable spleen below the left costal margin reduced by more than 50% from baseline in 50.9% (27/53) of the patients in the middle-aged group, 43.5% (27/62) in the young elderly group, and 45.5% (20/44) in the elderly group ( P=0.720). No significant difference was observed among the three groups in the degree of reduction in Myeloproliferative Neoplasm Symptom Assessment Form (10-item version) score ( P=0.153), with a reduction in total symptom score by more than 50% achieved by 54.0% (27/50), 60.3% (41/68), and 66.7% (34/51) of the patients from the three groups, respectively ( P=0.429). The most common hematological adverse events were anemia and thrombocytopenia, while the most common nonhematological adverse events were electrolyte disturbance, elevated transaminase activity, and pulmonary infection. Multivariate analysis indicated that in ruxolitinib-treated patients with myelofibrosis, poor overall survival was independently predicted by increased age, reduced hemoglobin, percentage of bone marrow blasts ≥ 1%, absence of JAK2 mutations, chromosomal abnormalities, ≥2 high-molecular-risk mutations, and TP53 mutations. Conclusions:Patients with myelofibrosis stratified by age exhibited heterogeneous clinical features and gene mutation profiles but similar efficacy of ruxolitinib treatment and occurrence of adverse events.

Objective To explore the changes in trace elements and amino acid profiles in serum of patients with hepatocellular carcinoma(HCC) providing a reference for clinical diagnosis and treatment.Methods A total of 104 patients with HCC who underwent surgical treatment in the Department of Hepatobiliary Surgery of our hospital from January 2024 to April 2024 were selected as the study group, and 139 patients with benign biliary diseases during the same period were selected as the control group. Atomic absorption spectrometry was used to detect the levels of six trace elements (copper, zinc, calcium, magnesium, iron, and lead) in the serum of both groups, and liquid chromatography-tandem mass spectrometry was used to measure the concentrations of 21 amino acids.Results Compared with the control group, the serum copper level in the HCC group was significantly increased (P<0.05), while the levels of zinc and iron were significantly decreased (P<0.05). Amino acid profile analysis revealed that, compared with the control group, the concentrations of tyrosine, methionine, and phenylalanine in the HCC group were increased (P<0.05), while the concentrations of valine, leucine, isoleucine, glutamine, and arginine were decreased (P<0.05). Further analysis of the correlation between trace elements and amino acids with statistical differences between the groups showed that copper was negatively correlated with valine and leucine (P<0.05), while zinc and iron were positively correlated with valine, leucine, and isoleucine (P<0.01).Conclusions Imbalances in trace elements and amino acid metabolism changes are common in patients with HCC, and there may be an intrinsic connection between the two.

Objective To construt and validate a risk prediction model for hepatocellular carcinoma(HCC)in patients with chronic liver disease based on age-male-ALBI-platelets(aMAP)score combined with RAR and PIV.Methods A total of 143 patients with chronic liver disease were divided into the HCC group(32 cases)and the non-HCC group(111 cases)according to whether HCC occurred.General clinical data,aMAP score and peripheral blood indicator level were compared between two groups.Multivariate Logistic regression was used to analyze influencing factors of HCC in inpatients with chronic liver disease.A nomogram risk prediction model was constructed and validated.Results Compared with the non-HCC group,there were higher age,higher proportion of males,higher levels of total bilirubin(TBIL),red blood cell distribution width(RDW),neutrophil count(NEU)and monocyte count(MON),lower levels of albumin(ALB)and lymphocyte count(LYM),higher levels of aMAP score,RDW to ALB(RAR)and pan-immune inflammation value(PIV)in the HCC group(P＜0.05).Multivariate Logistic regression showed that higher levels of aMAP score,RAR and PIV were independent risk factors for HCC in inpatients with chronic liver disease(P＜0.05).The area under receiver operator characteristic(ROC)curve(AUC)of the nomogram risk prediction model constructed based on above factors was 0.823(95%CI:0.747-0.899).The calibration curve showed that the predicted value was basically consistent with the actual observed value,and the Brier score was 0.125.The decision curve showed that the model had a clear positive net benefit.The AUC of internal validation of the prediction model by Bootstrap method was 0.823(95%CI:0.820-0.825),indicating that the model had a good degree of differentiation.Conclusion The nomogram risk prediction model based on aMAP score,RAR and PIV showed a good predictive performance of HCC in patients with chronic liver disease,which could benefits the individualized treatment and follow-up.

Objective:To understand the status and influencing factors of social isolation in elderly individuals with chronic diseases.Methods:A multi-stage sampling method was used to select elderly individuals from eight communities or villages in Hefei from July to September 2022. The study employed a general information survey, the Lubben Social Network Scale (LSNS-6) , the Geriatric Depression Scale (GDS-15) , the Social Support Rating Scale (SSRS) , and the Personal Social Capital Scale 16 (PSCS-16) . Binary Logistic regression analysis was used to explore the factors influencing social isolation in elderly individuals with chronic diseases.Results:A total of 1 133 elderly individuals were surveyed, among which 538 had chronic diseases. Among the 538 elderly individuals with chronic diseases, 209 were socially isolated, resulting in a social isolation rate of 38.8%. Binary Logistic regression analysis revealed that living area, fear of falling, depression, social capital, and social support were significant factors influencing social isolation ( P<0.05) . Conclusions:The social isolation rate among elderly individuals with chronic diseases is high. Special attention should be given to elderly individuals living in rural areas, those who fear falling, and those experiencing depression. Additionally, improving social capital and social support can help alleviate social isolation in these elderly individuals.

Objective:To explore the potential categories and influencing factors of attitudes to aging among the elderly in nursing homes.Methods:Convenience sampling was used to select elderly from 15 nursing homes in Anhui Province from March to July 2024 for the study. The survey was conducted using the General Information Questionnaire, Attitudes to Ageing Questionnaire, Belongingness Scale for Older Adults in Nursing Facilities, and the Lubben Social Network Scale. Mplus 8.3 was used to conduct a latent profile analysis, and multivariate Logistic regression was employed to explore the factors influencing the latent categories of attitudes toward aging among the elderly in nursing facilities.Results:A total of 370 questionnaires were distributed, and 366 valid questionnaires were recovered, with an effective recovery rate of 98.9%. The attitudes to aging of 366 elderly of nursing facilities were expressed in three potential categories, namely, negative-perceived type (48.6%), moderate-low psychosocial loss type (35.0%), and positive and optimistic-comprehensive type (16.4%). Multicategorical Logistic regression analysis showed that the number of children, location of the nursing home, educational level, self-rating health, belongingness to the nursing home, and social network were the influencing factors of the potential categories of attitudes to aging among the elderly in the nursing home, and the difference was statistically significant ( P<0.05) . Conclusions:There is group heterogeneity in the attitudes to aging among the elderly in nursing homes. Healthcare professionals should focus on negative-perceived elderly and provide targeted interventions based on the potential categories of factors influencing their attitudes to aging.

Objective To construt and validate a risk prediction model for hepatocellular carcinoma(HCC)in patients with chronic liver disease based on age-male-ALBI-platelets(aMAP)score combined with RAR and PIV.Methods A total of 143 patients with chronic liver disease were divided into the HCC group(32 cases)and the non-HCC group(111 cases)according to whether HCC occurred.General clinical data,aMAP score and peripheral blood indicator level were compared between two groups.Multivariate Logistic regression was used to analyze influencing factors of HCC in inpatients with chronic liver disease.A nomogram risk prediction model was constructed and validated.Results Compared with the non-HCC group,there were higher age,higher proportion of males,higher levels of total bilirubin(TBIL),red blood cell distribution width(RDW),neutrophil count(NEU)and monocyte count(MON),lower levels of albumin(ALB)and lymphocyte count(LYM),higher levels of aMAP score,RDW to ALB(RAR)and pan-immune inflammation value(PIV)in the HCC group(P＜0.05).Multivariate Logistic regression showed that higher levels of aMAP score,RAR and PIV were independent risk factors for HCC in inpatients with chronic liver disease(P＜0.05).The area under receiver operator characteristic(ROC)curve(AUC)of the nomogram risk prediction model constructed based on above factors was 0.823(95%CI:0.747-0.899).The calibration curve showed that the predicted value was basically consistent with the actual observed value,and the Brier score was 0.125.The decision curve showed that the model had a clear positive net benefit.The AUC of internal validation of the prediction model by Bootstrap method was 0.823(95%CI:0.820-0.825),indicating that the model had a good degree of differentiation.Conclusion The nomogram risk prediction model based on aMAP score,RAR and PIV showed a good predictive performance of HCC in patients with chronic liver disease,which could benefits the individualized treatment and follow-up.

Objective To explore the significance of the toxicity mechanism of butyl benzyl phthalate(BBP)in prevention and treatment of pulmonary fibrosis.Methods In this study,we used network toxicology combined with molecular docking technology to screen the targets of BBP and those related to pulmonary fibrosis through PubChem,GeneCards and other databases,and analyzed the intersecting genes by using a Wayne diagram.Protein-protein interaction networks were constructed to screen the core targets,and the pathway mechanisms were revealed by Gene Ontology and Kyoto Encyclopedia of Genes and Genomes.Finally,molecular docking using AutoDock was performed to verify the binding patterns of core targets and BBP.Results A total of 91 potential targets of BBP-induced lung fibrosis were screened,among which PTGS2 and CYP3A4 were the core targets(binding energies of-1.84 kcal/mol and-1.68 kcal/mol,respectively).Enrichment analysis showed that BBP regulated the fibrosis process through G protein-coupled receptor signaling pathway,calcium signaling pathway and cyclic adenosine monophosphate signaling pathway.Molecular docking confirmed that BBP was stably bound to the core target through hydrogen bonding and hydrophobic interaction.Conclusion This study provides preliminary insights into the molecular mechanism of BBP-induced pulmonary fibrosis through network toxicology,and PTGS2 and CYP3A4 may play key roles in BBP-induced pulmonary fibrosis,which provides a novel reference for the exploration of the mechanism of toxicant-disease association.

Objective:To understand the status and influencing factors of social isolation in elderly individuals with chronic diseases.Methods:A multi-stage sampling method was used to select elderly individuals from eight communities or villages in Hefei from July to September 2022. The study employed a general information survey, the Lubben Social Network Scale (LSNS-6) , the Geriatric Depression Scale (GDS-15) , the Social Support Rating Scale (SSRS) , and the Personal Social Capital Scale 16 (PSCS-16) . Binary Logistic regression analysis was used to explore the factors influencing social isolation in elderly individuals with chronic diseases.Results:A total of 1 133 elderly individuals were surveyed, among which 538 had chronic diseases. Among the 538 elderly individuals with chronic diseases, 209 were socially isolated, resulting in a social isolation rate of 38.8%. Binary Logistic regression analysis revealed that living area, fear of falling, depression, social capital, and social support were significant factors influencing social isolation ( P<0.05) . Conclusions:The social isolation rate among elderly individuals with chronic diseases is high. Special attention should be given to elderly individuals living in rural areas, those who fear falling, and those experiencing depression. Additionally, improving social capital and social support can help alleviate social isolation in these elderly individuals.

Objective:To explore the potential categories and influencing factors of attitudes to aging among the elderly in nursing homes.Methods:Convenience sampling was used to select elderly from 15 nursing homes in Anhui Province from March to July 2024 for the study. The survey was conducted using the General Information Questionnaire, Attitudes to Ageing Questionnaire, Belongingness Scale for Older Adults in Nursing Facilities, and the Lubben Social Network Scale. Mplus 8.3 was used to conduct a latent profile analysis, and multivariate Logistic regression was employed to explore the factors influencing the latent categories of attitudes toward aging among the elderly in nursing facilities.Results:A total of 370 questionnaires were distributed, and 366 valid questionnaires were recovered, with an effective recovery rate of 98.9%. The attitudes to aging of 366 elderly of nursing facilities were expressed in three potential categories, namely, negative-perceived type (48.6%), moderate-low psychosocial loss type (35.0%), and positive and optimistic-comprehensive type (16.4%). Multicategorical Logistic regression analysis showed that the number of children, location of the nursing home, educational level, self-rating health, belongingness to the nursing home, and social network were the influencing factors of the potential categories of attitudes to aging among the elderly in the nursing home, and the difference was statistically significant ( P<0.05) . Conclusions:There is group heterogeneity in the attitudes to aging among the elderly in nursing homes. Healthcare professionals should focus on negative-perceived elderly and provide targeted interventions based on the potential categories of factors influencing their attitudes to aging.