Objective:To conduct a survey on the influence of personality trait on depres-sive symptom and obesity in patients before bariatric and metabolic surgery.Methods:The retros-pective cross-sectional investigation study was conducted. Patients who underwent bariatric and metabolic surgery in The Third Xiangya Hospital of Central South University and The First Affiliated Hospital of Ji′nan University from January 1 to June 1,2024 were recruited. The survey was conducted in electronic format using the general information survey questionnaire, the patient health question-naire-9 (PHQ-9), and the Chinese big five personality inventory brief version (CBF-PI-B). Observa-tion indicators: (1) results of the questionnaire; (2) general data of patient; (3) personality trait scores for patient with different subtypes of obesity; (4) depression symptom scores for patient with different subtypes of obesity; (5) correlation analysis for patient personality trait, depressive symptom and body mass index (BMI). Comparison of measurement data with normal distribution between groups was conducted using the independent t test, and one-way analysis of variance was used for comparison among multiple groups. LSD test was used for pairwise comparison. Comparison of measurement data with skewed distribution among multiple groups was conducted using the Kruskal-Wallis H test, and Dunn Bonferroni test was used for pairwise comparison. The Spearman correlation analysis and Pearson correlation analysis were used for correlation analysis, and the mediation effect analysis was conducted using the Process 4.0 model and the Bootstrap test. Results:(1)Results of the questionnaire. A total of 146 questionnaires were distributed and collected, including 83 questionnaires from The Third Xiangya Hospital of Central South University and 63 questionnaires from The First Affiliated Hospital of Ji′nan University. Of 146 questionnaires, 137 questionnaires were valid, yielding an effective response rate of 93.836%(137/146). (2)General data of patient. Of the 137 patients who completed valid questionnaires, 52 were male with BMI of (41±5)kg/m 2, 85 were female with BMI of (38±6)kg/m 2, showing a significant difference between them ( t=2.586, P<0.05). There were 40 patients aged ≤25 years, with BMI of (42±5)kg/m 2, 28 patients aged 26-30 years, with BMI of (39±5)kg/m 2, 49 patients aged 31-40 years, with BMI of (38±6)kg/m 2, 14 patients aged 41-50 years, with BMI of (38±7)kg/m 2, 6 patients aged >50 years, with BMI of (37±3)kg/m 2. There were significant differences in BMI of patients of different age groups ( F=2.697, P<0.05). (3)Persona-lity trait scores for patient with different subtypes of obesity. Of the 137 patients who completed valid questionnaires, there were 15 patients of mild obesity, with personality trait neuroticism score of 19.0(14.0,24.0), personality trait strictness score of 32.5±5.2, personality trait extroversion score of 30.0(24.0,40.0), 36 patients of moderate obesity, with personality trait neuro-ticism score of 26.5(22.3,28.8), personality trait strictness score of 32.6±5.9, personality trait extro-version score of 34.0(26.3,39.0), 81 patients of severe obesity, with personality trait neuroticism score of 35.0(29.5,41.0), personality trait strictness score of 26.8±7.4, personality trait extroversion score of 28.0(20.5,35.0), 5 patients of extreme obesity, with personality trait neuroticism score of 28.0(26.5,44.0), personality trait strictness score of 19.6±3.4, personality trait extroversion score of 22.0(18.5,25.0). There were significant differences in personality trait neuroticism, strictness and extroversion among patients of different subtypes of obesity ( H=50.316, F=10.774, H=14.446, P<0.05). (4)Depression symptom scores for patient with different subtypes of obesity. Of the 137 pati-ents who completed valid questionnaires, the depressive symptom score were 4.0(2.0,9.0) for 15 pati-ents of mild obesity, 5.0(3.0,7.0) for 36 patients of moderate obesity, 13.0(8.5,17.0) for 81 patients of severe obesity, and 18.0(9.5,22.0) for 5 patients of extreme obesity, respectively, showing a significant difference among them ( H=50.129, P<0.05). (5) Correlation analysis for patient personality trait, depressive symptom and BMI. Results of Spearman correlation analysis showed that personality trait neuroticism were positively correlated with depressive symptoms and BMI ( r=0.780, 0.557, P<0.05), personality trait strictness was negatively correlated with depressive symptoms ( r=-0.523, P<0.05), personality trait extroversion were negatively correlated with depressive symptoms and BMI ( r=-0.448, -0.323, P<0.05), and depressive symptoms was positively correlated with BMI ( r=0.568, P<0.05). Results of Pearson correlation analysis showed that personality trait strictness was negatively correlated with BMI ( r=-0.489, P<0.05). Conclusion:Preoperative personality trait of patients undergoing bariatric and metabolic surgery can influence their depressive symptom and BMI.

Purpose To explore the influence of thrombolysis therapy before percutaneous coronary intervention(PCI)on long-term left ventricular global and regional function in ST segment elevation myocardial infarction(STEMI)patients by cardiac magnetic resonance(CMR).Materials and Methods A retrospective analysis was conducted on 67 STEMI patients who were enrolled in a prospective study from November 2021 to August 2022 in the First Affiliated Hospital with Nanjing Medical University,the First People's Hospital of Lianyungang,the Affiliated Hospital of Jiangnan University,Changzhou No.2 People's Hospital and Huai'an Second People's Hospital and underwent CMR examination one year later.STEMI patients were divided into thrombolysis group and non-thrombolysis group according to whether a single half-dose of 5 mg recombinant staphylokinase(r-SAK)was given within two hours before the first medical contact and PCI.Based on CMR cine images,the traditional left ventricular function,global and segmental functional parameters were measured,and the differences between the two groups were compared.According to the degree of late gadolinium enhancement involvement,myocardial segments were divided into the following four types:transmural infarcted segments,non-transmural infarcted segments,locally infarcted segments,and non-infarcted segments.The parameters of the two groups were compared across these different segments.Results At the patient level,the cardiac index,left ventricular wall thickening and left ventricular wall motion in r-SAK thrombolysis group were higher than those in non-thrombolysis group(t/Z=-2.426,-4.307,-2.735,all P<0.05).At the segment level,compared with non-thrombolysis group,patients received r-SAK before primary PCI showed greater segmental radial strain in non-transmural infarcted segments(Z=-2.117,P=0.034);larger segmental wall motion in locally infarcted segments(Z=-2.235,P=0.025),and better segmental circumference strain in the non-infarcted segments(Z=-3.869,P<0.001).Conclusion The thrombolytic therapy before PCI in STEMI patients retain better long-term left ventricular global and regional function evaluating by CMR.

Objective To investigate the effects of different administration times on the efficacy and safety of subcutaneous immunotherapy using dual mite extracts in patients with allergic rhinitis(AR).Methods This study was designed as a retrospective cohort analysis.Thirty-nine mite-sensitized AR patients who completed three years of standardized dual-mite subcutaneous immunotherapy(SCIT)were included.Based on self-selected and consistently maintained injection schedules,patients were non-randomly assigned to either a morning dosing group(MD group,8:00-12:00,n=19)or an afternoon dosing group(AD group,14:00-18:00,n=20),with further subgroup stratification conducted at 2-hour intervals.Nasal and ocular symptoms were evaluated before and after treatment using the visual analog scale(VAS),and all adverse reactions were systematically recorded.Results The AD group exhibited significantly greater improvement in nasal itching compared to the MD group(median difference:-2 vs.0,U=118.5,P=0.04,effect size r=0.33).The AD group also demonstrated favorable trends toward improved sneezing,nasal congestion,rhinorrhea,and total VAS score,although these differences did not reach statistical significance.In the subgroup analysis by 2-hour intervals,the 16:00-18:00 subgroup showed greater symptom relief than the 8:00-10:00 subgroup,though the difference was not statistically significant.No significant differences were observed between the two groups in the incidence of total,local,or systemic adverse reactions(P>0.05),and no moderate or severe systemic adverse events occurred.Conclusions This preliminary retrospective analysis indicates that afternoon administration of dual-mite SCIT,particularly between 16:00 and 18:00,may enhance the improvement of nasal symptoms without elevating safety concerns.The timing of SCIT administration could therefore represent a promising avenue for treatment optimization.

Purpose To analyze the expression of SNAP23 in esophageal squamous cell carcinoma(ESCC)and its influence on invasion of ESCC cells.Methods A total of 41 cases of ESCC and paired normal adjacent tissue(NAT)were collected.The expression and localization of SNAP23 were detected by immunohistochemical EnVision method.The differences of SNAP23 expression levels between ESCC tissues and NAT tissues were compared to analyze the relationship between SNAP23 expression and clinicopathological characteristics.The expression level of SNAP23 in human immortalized esophageal epithelial cells SHEE and ESCC cell lines TE-1,TE-13 and KYSE150 were detected by Western blot.Lentiviral vector transfection technique was used to construct stable transfection cell lines with knock-down and overexpression of SNAP23 gene.The effect of SNAP23 on invasion of ESCC cell line TE-13 was evaluated by cell invasion experiment.Results The expression of SNAP23 in ESCC was significantly higher(53.7％,22/41)than that in the NAT group(19.5％,8/41),the difference was statistically significant(x2=10.303,P＜0.01).The expression level of SNAP23 in ESCC tissues was significantly correlated with maximum tumor diameter(x2=4.193,P＜0.05)and invasion depth(x2=7.264,P＜0.05),but was not correlated with patient gender,age,tumor site,tumor type,pathologic grade,vascular embolus,nerve invasion and lymph node metastasis(P＞0.05).Compared with human immortalized esophageal epithelial cells SHEE,SNAP23 was highly expressed in ESCC cell lines(P＜0.000 1).Compared with the sh-NT group,the invasion of ESCC cell line TE-13 was inhibited when SNAP23 expression was knocked down(P＜0.000 1);compared with the Vector group,the invasion of ESCC cell line TE-13 was enhanced after overexpression of SNAP23(P＜0.000 1).Conclusion SNAP23 is highly expressed in ESCC tis-sue and cell lines,and its expression level in ESCC tissues is positively correlated with tumor maximum diameter and invasion depth;SNAP23 promotes the invasion of ESCC cells.

Objective To explore the value of MRI quantitative parameters and free/total prostate-specific antigen ratio(f/tPSA)for diagnosing prostate imaging reporting and data system(PI-RADS)3-point clinically significant prostate cancer(csPCa).Methods Totally 57 patients with PI-RADS 3-point prostate lesions were retrospectively enrolled,including 18 prostate cancer(PCa)(PCa group)and 39 benign hyperplasia with chronic prostatitis(non-PCa group).The former included 12 cases of csPCa and 6 cases of clinically insignificant PCa(ciPCa).Taken non-PCa and ciPCa into non-csPCa group(n=45),laboratory and MRI parameters(apparent diffusion coefficient[ADC],T1,T2,proton density[PD]values)were compared between PCa and non-PCa groups,also between csPCa and non-csPCa groups.Based on laboratory and MRI parameters being statistically different between groups according to univariate analysis,combined models were established using logistic regression.The efficacy of laboratory,MRI parameters and combined models for differentiating PCa and non-PCa as well as csPCa and non-csPCa were evaluated.Results ADC,T1,T2,PD values in PCa group were all lower those in non-PCa group(all P＜0.05),and f/tPSA,ADC,T1,T2 and PD values in csPCa group were all lower than those in non-csPCa group(all P＜0.05).AUC of ADC,T1,T2 and PD values for differentiating PCa from non-PCa was 0.662,0.755,0.793 and 0.729 respectively,while of ADC-T1-T2-PD combined model was 0.839,higher than that of ADC alone(P＜0.05)but not significantly different with T1,T2 and PD values alone(all P＞0.05).AUC of f/tPSA,ADC,T1,T2 and PD values for differentiating csPCa from non-csPCa was 0.692,0.759,0.741,0.805 and 0.737,respectively,while of ADC-T1-T2-PD combined model was 0.889,higher than that of f/tPSA,ADC and T1 values alone(all P＜0.05)but not significantly different with that of T2 and PD value alone(both P＞0.05).AUC of f/tPSA-ADC-T1-T2-PD combined model was 0.898,higher than that of f/tPSA,ADC,T1 and PD values alone(all P＜0.05)but not significantly different with T2 value and ADC-T1-T2-PD combined model(both P＞0.05).Conclusion MRI quantitative parameters combined with f/tPSA could effectively diagnose PI-RADS 3-point csPCa.

Aim To evaluate the tyrosine nitration modification of specific proteins in vascular endothelial cells and its impact on mitochondria-mediated apoptosis.Methods Human umbilical vein endothelial cells were cultured in vitro and divided into three groups:control group(treatment with dimethyl sulfoxide),3-morphansulam(SIN-1)group,and SIN-1+Fe(Ⅲ)5,10,15,20-(tetraphenyl)porphyrin(FeTPP)group.After 24 h,the levels of hexokinase 1(HK1)nitration modification,mitochondrial membrane potential,reactive oxygen species(ROS)production,and endothelial cell proliferation and apoptosis were assessed.A human umbilical vein endothelial cell line knockout of HK1 was constructed using gene editing technology,and its proliferation and apoptosis levels were detected.Results After treatment of hu-man umbilical vein endothelial cells with peroxynitrite generator SIN-1,the level of HK1 protein nitration modification sig-nificantly increased(P＜0.01),reactive oxygen species production significantly increased,mitochondrial membrane poten-tial significantly decreased,endothelial cell proliferation ability significantly decreased,and endothelial cell apoptosis level significantly increased(all P＜0.01).Peroxynitrite decomposition catalyst FeTPP could reverse the above effect(P＜0.01).In addition,HK1 gene knockout also exhibited similar antioxidant effects,with a significant decrease in endothe-lial cell proliferation ability and a significant increase in apoptosis levels(P＜0.01).Conclusion Peroxynitrite can induce an increase in the level of nitration modification of HK1 in vascular endothelial cells,which may be achieved by pro-moting the production of mitochondrial reactive oxygen species,thereby accelerating the process of endothelial cell apoptosis.

Purpose To explore the influence of thrombolysis therapy before percutaneous coronary intervention(PCI)on long-term left ventricular global and regional function in ST segment elevation myocardial infarction(STEMI)patients by cardiac magnetic resonance(CMR).Materials and Methods A retrospective analysis was conducted on 67 STEMI patients who were enrolled in a prospective study from November 2021 to August 2022 in the First Affiliated Hospital with Nanjing Medical University,the First People's Hospital of Lianyungang,the Affiliated Hospital of Jiangnan University,Changzhou No.2 People's Hospital and Huai'an Second People's Hospital and underwent CMR examination one year later.STEMI patients were divided into thrombolysis group and non-thrombolysis group according to whether a single half-dose of 5 mg recombinant staphylokinase(r-SAK)was given within two hours before the first medical contact and PCI.Based on CMR cine images,the traditional left ventricular function,global and segmental functional parameters were measured,and the differences between the two groups were compared.According to the degree of late gadolinium enhancement involvement,myocardial segments were divided into the following four types:transmural infarcted segments,non-transmural infarcted segments,locally infarcted segments,and non-infarcted segments.The parameters of the two groups were compared across these different segments.Results At the patient level,the cardiac index,left ventricular wall thickening and left ventricular wall motion in r-SAK thrombolysis group were higher than those in non-thrombolysis group(t/Z=-2.426,-4.307,-2.735,all P<0.05).At the segment level,compared with non-thrombolysis group,patients received r-SAK before primary PCI showed greater segmental radial strain in non-transmural infarcted segments(Z=-2.117,P=0.034);larger segmental wall motion in locally infarcted segments(Z=-2.235,P=0.025),and better segmental circumference strain in the non-infarcted segments(Z=-3.869,P<0.001).Conclusion The thrombolytic therapy before PCI in STEMI patients retain better long-term left ventricular global and regional function evaluating by CMR.

Objective To investigate the effects of different administration times on the efficacy and safety of subcutaneous immunotherapy using dual mite extracts in patients with allergic rhinitis(AR).Methods This study was designed as a retrospective cohort analysis.Thirty-nine mite-sensitized AR patients who completed three years of standardized dual-mite subcutaneous immunotherapy(SCIT)were included.Based on self-selected and consistently maintained injection schedules,patients were non-randomly assigned to either a morning dosing group(MD group,8:00-12:00,n=19)or an afternoon dosing group(AD group,14:00-18:00,n=20),with further subgroup stratification conducted at 2-hour intervals.Nasal and ocular symptoms were evaluated before and after treatment using the visual analog scale(VAS),and all adverse reactions were systematically recorded.Results The AD group exhibited significantly greater improvement in nasal itching compared to the MD group(median difference:-2 vs.0,U=118.5,P=0.04,effect size r=0.33).The AD group also demonstrated favorable trends toward improved sneezing,nasal congestion,rhinorrhea,and total VAS score,although these differences did not reach statistical significance.In the subgroup analysis by 2-hour intervals,the 16:00-18:00 subgroup showed greater symptom relief than the 8:00-10:00 subgroup,though the difference was not statistically significant.No significant differences were observed between the two groups in the incidence of total,local,or systemic adverse reactions(P>0.05),and no moderate or severe systemic adverse events occurred.Conclusions This preliminary retrospective analysis indicates that afternoon administration of dual-mite SCIT,particularly between 16:00 and 18:00,may enhance the improvement of nasal symptoms without elevating safety concerns.The timing of SCIT administration could therefore represent a promising avenue for treatment optimization.

A medical image segmentation network (RPR-MLP) based on multi-scale convolution and parallel reverse attention is presented. In the encoder,Res2net modules and tokenized multi-layer perceptron modules are used as the backbone structure to extract multi-scale information and enhance the diversity of semantic features. Meanwhile,the accuracy of semantic information extraction in the decoder is improved through parallel partial decoder. Additionally,reverse attention module re-emphasizes the focus on important regions for further improving the accuracy of segmentation results. The proposed method achieves Dice scores of 0.8967 and 0.8762 on the Kvasir and ISIC 2018 public datasets,respectively,demonstrating its effectiveness and generalization ability in medical image segmentation. Furthermore,when applied to the lung tumor CT image dataset (LungCancer dataset) collected in the study,the proposed network has Dice score,IoU and F1 score of 0.7278,58.83％and 67.85％,respectively,outperforming baseline network (UNeXt) and common CNN (U-Net,AttU-Net,U-Net++and PraNet) by 0.0301-0.0578、3.16％-4.70％,and 6.72％-18.53％,respectively. The study confirms the effectiveness and generalization ability of RPR-MLP network on different datasets,providing important technical support for lung tumor image segmentation.

Objective:Given the insufficiency of current clinical biomarkers for early diagnosis of esophageal adenocarcinoma(EAC),this study developed a panel of serum protein biomarker assays using liquid-phase chip technology and preliminarily validated the detection capabilities of these markers for EAC.Methods:Collected serum samples from 48 patients with EAC and 33 age-matched healthy controls(HC).The levels of squamous cell carcinoma antigen(SCCA),human cytokeratin 19 fragment(Cyfra21-1),hepatocyte growth factor(HGF)and IL-8 in serum were analyzed by liquid chip technology.The diagnostic efficacy of a single indicator and a combination of four indicators were evaluated by receiver operation characteristic(ROC)curve.Results:The detection ranges of SCCA,Cyfra21-1,HGF and IL-8 were 0.24～1 000 ng/ml,45.72～100 000 pg/ml,21.95～16 000 pg/ml,and 0.61～10 000 pg/ml,respectively.The liquid chip technology shows a strong correlation with clinical chemiluminescence immunoassay(r=0.949 4,P<0.000 1)and ELISA technology(r=0.955 1,P<0.000 1).Compared to the HC group,serum levels of SCCA and HGF were signifi-cantly elevated in the EAC group(P<0.01),IL-8 was significantly decreased(P<0.05),while Cyfra21-1 shows no significant difference(P>0.05).In the early EAC group,serum HGF was significantly higher than in the HC group(P<0.01).ROC curve analysis shows that among individual markers,HGF exhibits the best diagnostic efficacy for early EAC with an area under the curve(AUC)of 0.761,while the AUC for the combination of the four biomarkers was 0.857,both superior to the clinical biomarkers SCCA(AUC=0.604)and Cyfra21-1(AUC=0.515).Conclusion:Liquid chip technology is used to jointly detect SCCA,Cyfra21-1,HGF,and IL-8 in human serum.In the early diagnosis of EAC,the diagnostic efficacy of the combined use of these four biomarkers is superior to that of the commonly used clinical tumor markers SCCA and Cyfra21-1.This advantage stems from the high throughput and high sensitivity characteristics of liquid-phase chip technology.Consequently,this combined detection method holds significant clinical application and is expected to provide a more accurate and reliable tool for the early diagnosis of EAC.