Objective To explore the relationship between the expression of ATP5B mRNA and UBA52 mRNA in the peripheral blood of children with IgA vasculitis(IgA) and kidney injury and disease recurrence. Methods 143 children with IgAV admitted to Shanghai Fengxian District Central Hospital from January 2022 to October 2023 were selected as the study subjects,and were further divided into IgAV kidney injury group(n=82)and IgAV kidney non-injury group (n=61)according to whether they were combined with the involvement of the kidneys . According to the postoperative follow-up,the patients were divided into a relapse group (n=44)and a non-recurrence group (n=99). In addition,60 cases of healthy medical checkups were selected as the control group in the same period. Real-time fluorescence quantitative PCR was used to detect the expression levels of ATP5B mRNA and UBA52mRNA and compared the expression levels of the two in each group. Multivariate Logistic regression analysis was performed to analyze the influencing factors of kidney injury in IgAV children. The predictive value of ATP5BmRNA and UBA52mRNA expression on renal injury and disease recurrence in IgAV children was analyzed by receiver operator characteristic (ROC) curve. Results The levels of ATP5BmRNA(1.01±0.21,1.24±0.26,1.46±0.35),UBA52 mRNA (1.03±0.19,1.19±0.22,1.42±0.28),Scr(55.69±12.78μmol/L,62.85±13.92μmol/L,76.49±15.34μmol/L) and BUN(11.85±2.91mmol/L,13.46±2.78mmol/L,17.54±3.45mmol/L) in peripheral blood of the control group,IgAV renal injury group and IgAV renal injury group were increased successively,and the differences between groups were statistically significant(F=39.666～64.417,all P<0.05). Compared with the non-relapsed group,the expressions of ATP5B mRNA (1.52±0.34 vs 1.19±0.20)and UBA52 mRNA (1.49±0.31 vs 1.08±0.21) in peripheral blood of the relapsed group were increased,and the differences were statistically significant (t=7.253,9.241,all P<0.001). Logistic regression analysis showed that,Scr,BUN,ATP5B and UBA52 were independent risk factors for the development of renal injury in IgAV (all P<0.05). The AUC(95％CI) of ATP5BmRNA combined with UBA52mRNA in peripheral blood was 0.823(0.607～0.914),which was significantly higher than the single prediction of both(Z=1.952,2.021,all P<0.05). The AUC(95％CI) of ATP5BmRNA combined with UBA52mRNA in peripheral blood to predict IgAV disease recurrence was 0.851(0.617～0.958),which was also significantly better than the single prediction of both(Z=2.035,2.098,all P<0.05). Conclusion The expression levels of ATP5B mRNA and UBA52 mRNA in peripheral blood of children with IgAV are associated with renal injury and recurrence of IgAV,which can be used as effective biomarkers for disease diagnosis and prognosis.

OBJECTIVE To evaluate the efficacy and safety of Weiyan Tongluo Granules in treating chronic atrophic gastritis(CAG)and explore its potential mechanisms.METHODS From June 2020 to December 2022,100 CAG patients with spleen defi-ciency and blood stasis syndrome were enrolled and randomly divided into a trial group(n=50)and a control group(n=50)using a random number table.The trial group received Weiyan Tongluo Granules plus a folic acid placebo,while the control group received fo-lic acid tablets plus a traditional Chinese medicine granule placebo.The treatment course for both groups was 24 weeks,with 8 and 10 dropouts in the trial and control groups,respectively.Post-treatment comparisons included OLGA/OLGIM staging reversal rates,low-grade intraepithelial neoplasia regression rate,SSDPRO-CG(Patient-Reported Outcome Scale for Chronic Gastritis in Spleen-Stomach Diseases)scores,TCM syndrome scores,and safety indicators.Serum levels of PG I,PGⅡ,PGR,and G-17 were measured via ELISA before and after treatment.Gastric mucosal p-NF-κB and CDX2 protein expression levels were analyzed by Western blot,while mRNA levels of IL-1β,IL-6,VIL1,and MUC2 were quantified via qPCR.RESULTS After treatment,the trial group showed sig-nificantly higher OLGA and OLGIM stage reversal rates than the control group(P<0.05,P<0.01),though no significant difference was observed in low-grade intraepithelial neoplasia regression.Both groups exhibited significant improvements in physiological domain scores and total SSDPRO-CG scores(P<0.01),with the trial group outperforming the control group in physiological,independence,psychological domains,and total scores(P<0.05,P<0.01).TCM syndrome scores(total and sub-items:gastric distension,pain,poor appetite,bloating)decreased significantly in both groups(P<0.01),while the trial group showed greater reductions in loose stools and dull complexion(P<0.01).After-treatment,the trial group had significantly lower TCM syndrome scores than the control group(P<0.05,P<0.01).Serum PG I,PGⅡ,PGR,G-17,gastric mucosal p-NF-κB,CDX2,and IL-1β,IL-6,VIL1,MUC2 mRNA levels improved significantly in the trial group(P<0.05,P<0.01),while the control group improved only in PGⅡ(P<0.05,P<0.01).The trial group's improvements in these biomarkers surpassed the control group's(P<0.05,P<0.01).No treatment-related adverse events occurred in either group.CONCLUSION Weiyan Tongluo Granules ameliorate gastric mucosal pathology,clinical symptoms,psychological state,and quality of life in CAG patients without significant adverse effects.Its mechanism may involve sup-pressing the NF-κB pathway to reduce IL-1β and IL-6 expression,downregulating CDX2 to inhibit VIL1 and MUC2 transcription,thereby reversing the vicious cycle of inflammation-intestinal metaplasia.

Objective To explore the relationship between the expression of ATP5B mRNA and UBA52 mRNA in the peripheral blood of children with IgA vasculitis(IgA) and kidney injury and disease recurrence. Methods 143 children with IgAV admitted to Shanghai Fengxian District Central Hospital from January 2022 to October 2023 were selected as the study subjects,and were further divided into IgAV kidney injury group(n=82)and IgAV kidney non-injury group (n=61)according to whether they were combined with the involvement of the kidneys . According to the postoperative follow-up,the patients were divided into a relapse group (n=44)and a non-recurrence group (n=99). In addition,60 cases of healthy medical checkups were selected as the control group in the same period. Real-time fluorescence quantitative PCR was used to detect the expression levels of ATP5B mRNA and UBA52mRNA and compared the expression levels of the two in each group. Multivariate Logistic regression analysis was performed to analyze the influencing factors of kidney injury in IgAV children. The predictive value of ATP5BmRNA and UBA52mRNA expression on renal injury and disease recurrence in IgAV children was analyzed by receiver operator characteristic (ROC) curve. Results The levels of ATP5BmRNA(1.01±0.21,1.24±0.26,1.46±0.35),UBA52 mRNA (1.03±0.19,1.19±0.22,1.42±0.28),Scr(55.69±12.78μmol/L,62.85±13.92μmol/L,76.49±15.34μmol/L) and BUN(11.85±2.91mmol/L,13.46±2.78mmol/L,17.54±3.45mmol/L) in peripheral blood of the control group,IgAV renal injury group and IgAV renal injury group were increased successively,and the differences between groups were statistically significant(F=39.666～64.417,all P<0.05). Compared with the non-relapsed group,the expressions of ATP5B mRNA (1.52±0.34 vs 1.19±0.20)and UBA52 mRNA (1.49±0.31 vs 1.08±0.21) in peripheral blood of the relapsed group were increased,and the differences were statistically significant (t=7.253,9.241,all P<0.001). Logistic regression analysis showed that,Scr,BUN,ATP5B and UBA52 were independent risk factors for the development of renal injury in IgAV (all P<0.05). The AUC(95％CI) of ATP5BmRNA combined with UBA52mRNA in peripheral blood was 0.823(0.607～0.914),which was significantly higher than the single prediction of both(Z=1.952,2.021,all P<0.05). The AUC(95％CI) of ATP5BmRNA combined with UBA52mRNA in peripheral blood to predict IgAV disease recurrence was 0.851(0.617～0.958),which was also significantly better than the single prediction of both(Z=2.035,2.098,all P<0.05). Conclusion The expression levels of ATP5B mRNA and UBA52 mRNA in peripheral blood of children with IgAV are associated with renal injury and recurrence of IgAV,which can be used as effective biomarkers for disease diagnosis and prognosis.

OBJECTIVE To evaluate the efficacy and safety of Weiyan Tongluo Granules in treating chronic atrophic gastritis(CAG)and explore its potential mechanisms.METHODS From June 2020 to December 2022,100 CAG patients with spleen defi-ciency and blood stasis syndrome were enrolled and randomly divided into a trial group(n=50)and a control group(n=50)using a random number table.The trial group received Weiyan Tongluo Granules plus a folic acid placebo,while the control group received fo-lic acid tablets plus a traditional Chinese medicine granule placebo.The treatment course for both groups was 24 weeks,with 8 and 10 dropouts in the trial and control groups,respectively.Post-treatment comparisons included OLGA/OLGIM staging reversal rates,low-grade intraepithelial neoplasia regression rate,SSDPRO-CG(Patient-Reported Outcome Scale for Chronic Gastritis in Spleen-Stomach Diseases)scores,TCM syndrome scores,and safety indicators.Serum levels of PG I,PGⅡ,PGR,and G-17 were measured via ELISA before and after treatment.Gastric mucosal p-NF-κB and CDX2 protein expression levels were analyzed by Western blot,while mRNA levels of IL-1β,IL-6,VIL1,and MUC2 were quantified via qPCR.RESULTS After treatment,the trial group showed sig-nificantly higher OLGA and OLGIM stage reversal rates than the control group(P<0.05,P<0.01),though no significant difference was observed in low-grade intraepithelial neoplasia regression.Both groups exhibited significant improvements in physiological domain scores and total SSDPRO-CG scores(P<0.01),with the trial group outperforming the control group in physiological,independence,psychological domains,and total scores(P<0.05,P<0.01).TCM syndrome scores(total and sub-items:gastric distension,pain,poor appetite,bloating)decreased significantly in both groups(P<0.01),while the trial group showed greater reductions in loose stools and dull complexion(P<0.01).After-treatment,the trial group had significantly lower TCM syndrome scores than the control group(P<0.05,P<0.01).Serum PG I,PGⅡ,PGR,G-17,gastric mucosal p-NF-κB,CDX2,and IL-1β,IL-6,VIL1,MUC2 mRNA levels improved significantly in the trial group(P<0.05,P<0.01),while the control group improved only in PGⅡ(P<0.05,P<0.01).The trial group's improvements in these biomarkers surpassed the control group's(P<0.05,P<0.01).No treatment-related adverse events occurred in either group.CONCLUSION Weiyan Tongluo Granules ameliorate gastric mucosal pathology,clinical symptoms,psychological state,and quality of life in CAG patients without significant adverse effects.Its mechanism may involve sup-pressing the NF-κB pathway to reduce IL-1β and IL-6 expression,downregulating CDX2 to inhibit VIL1 and MUC2 transcription,thereby reversing the vicious cycle of inflammation-intestinal metaplasia.

Objective: This study’s objective is to assess the efficacy and safety of Pulsed Magnetic Therapy System (PMTS) in improving insomnia disorder. Methods: Participants with insomnia disorder were randomly assigned to receive either PMTS or sham treatment for four weeks (n= 153; PMTS: 76, sham: 77). Primary outcomes are the Insomnia Severity Index (ISI) scores at week 0 (baseline), 1, 2, 3, 4 (treatment), and 5 (follow-up). Secondary outcomes are the Pittsburgh Sleep Quality Index at baseline and week 4, and weekly sleep diary-derived values for sleep latency, sleep efficiency, real sleep time, waking after sleep onset, and sleep duration. Results: The ISI scores of the PMTS group and the sham group were 7.13±0.50, 11.07±0.51 at week 4, respectively. There was a significant group×time interaction for ISI (F3.214, 485.271=24.25, p<0.001, ηp 2=0.138). Only the PMTS group experienced continuous improvement throughout the study; in contrast, the sham group only experienced a modest improvement after the first week of therapy. At the end of the treatment and one week after it, the response of the PMTS group were 69.7% (95% confidence interval [CI]: 58.6%–79.0%), 75.0% (95% CI: 64.1%–83.4%), respectively, which were higher than the response of the sham group (p<0.001). For each of the secondary outcomes, similar group×time interactions were discovered. The effects of the treatment persisted for at least a week. Conclusion PMTS is safe and effective in improving insomnia disorders.

Purpose: The purpose of the study is to determine the prevalence and predictors of OSA in Chinese bariatric surgery candidates. Materials and Methods: The clinical data were collected from 326 patients evaluated for bariatric surgery and referred for polysomnography. Multiple logistic regression was used for identifying independent predictors of presence of OSA and ROC curve analysis to determine the best cut-off value for continuous variable. Results: Baseline BMI and age were 33.3±3.7 kg/m2 and 24.3±3.1 years. 62.9% of the patients fulfilled the diagnostic criteria for OSA; Of these, 22.7% had mild OSA; 11.3% had moderate OSA, and 28.8% had severe OSA. The prevalence was significantly higher in males (84.2%) than in females (47.3%) (P＜0.001). The superobese patients and the obese patients aged older than 50 years that all of those were diagnosed with OSA. A multivariate logistic regression model displayed that increasing age, BMI and neck circumference together with presence of habitual snoring and male sex were identified as risk factors of OSA. The best cut-off values for the presence of OSA for age, BMI, neck circumference were 24.5 years, 39.45 kg/m2 , 40.40 cm. Conclusion The prevalence of OSA is very prevalent (62.9%) in Chinese bariatric surgery candidates, especially in male patients (84%). Age, BMI and neck circumference together with presence of habitual snoring and male sex are independent predictors of OSA in these patients. As clinical predictors are not enough to be a properly screening for OSA, routine PSG testing should be recommended to bariatric surgery candidates.

Purpose: The purpose of the study is to determine the prevalence and predictors of OSA in Chinese bariatric surgery candidates. Materials and Methods: The clinical data were collected from 326 patients evaluated for bariatric surgery and referred for polysomnography. Multiple logistic regression was used for identifying independent predictors of presence of OSA and ROC curve analysis to determine the best cut-off value for continuous variable. Results: Baseline BMI and age were 33.3±3.7 kg/m2 and 24.3±3.1 years. 62.9% of the patients fulfilled the diagnostic criteria for OSA; Of these, 22.7% had mild OSA; 11.3% had moderate OSA, and 28.8% had severe OSA. The prevalence was significantly higher in males (84.2%) than in females (47.3%) (P＜0.001). The superobese patients and the obese patients aged older than 50 years that all of those were diagnosed with OSA. A multivariate logistic regression model displayed that increasing age, BMI and neck circumference together with presence of habitual snoring and male sex were identified as risk factors of OSA. The best cut-off values for the presence of OSA for age, BMI, neck circumference were 24.5 years, 39.45 kg/m2 , 40.40 cm. Conclusion The prevalence of OSA is very prevalent (62.9%) in Chinese bariatric surgery candidates, especially in male patients (84%). Age, BMI and neck circumference together with presence of habitual snoring and male sex are independent predictors of OSA in these patients. As clinical predictors are not enough to be a properly screening for OSA, routine PSG testing should be recommended to bariatric surgery candidates.

This study was aimed to summarize the clinical medication rule of professor Shi Qi in the treatment of cervical spondylosis of vertebral artery type (CSA),in order to explore the academic ideas.A total of 265 CSA cases from professor Shi Qi's outpatient clinic were collected in Longhua Hospital from 2009 to 2015.Frequency analysis and cluster analysis were conducted on used herbal medicine from included cases by SPSS 21.00 software.The results showed that there were a total of 202 types of herbs used.The five most commonly used herbs were Rhizoma Ligustici Wallichii,Radix bupleuri,Radix Achyranthis Bidentatae,Codonopsis and Gastrodia elata.The cluster analysis revealed that professor Shi Qi frequently used Huo-Xue Hua-Yu herbs,Bu-Xu herbs,Ping-Gan Xi-Feng herbs,Qu-Feng-Shi herbs.Sheng-Yu decoction and Tian-Ma Gou-Teng decoction were the core prescriptions used by professor Shi Qi in the treatment of CSA.It was concluded that the cluster analysis showed that academic ideas of professor She in the treatment of CSA was to pay equal attention to both qi and blood,to focus on liver and kidney,as well as to remove phlegm and blood stagnation,to treat both the branch and the root.The cluster analysis revealed a certain medication rule of professor Shi Qi in the treatment of CSA.It can be used as guidance in the clinical practice.

Objective To explore the correlations of diffusion-weighted imaging (DWI) types and the degree of neurologic impairment in acute ischemic stroke patients with atrial fibrillation.Methods DWI images and National Institutes of Health Stroke Scale(NIHSS) of 186 patients with acute ischemic stroke patients with atrial fibrillation were collected retrospectively.The correlation of DWI features and NIHSS was analyzed.Results On DWI,all acute ischemic stroke patients with atrial fibrillation presented high signal intensity.Single cortex-subcortical infarction mostly appeared in the anterior circulation(94,50.5%);Multi-infarction commonly occurred in the posterior circulation(18,13.0%);The neurological deficit scores of subcortical-cortex infarction in the left anterior circulation(16.75±7.10) were higher than that in the right side(13.50±5.70)(P<0.05).The neurological deficit scores of cortex-subcortical infarction in the posterior circulation (6.38±2.03) were significantly lower than that in the multi-infarction (16.77±8.90) (P<0.05).Conclusion DWI types are valuable for etiological diagnosis in ischemic stroke.Combination with NIHSS score could provide a basis for clinical individual treatment programs selection and prognostic evaluation.

Objective To introduce the surgical strategy of enlarged laminectomy (with partial facet joint dissection to expose the nerve root), and to discuss its benefit for cervical ossification of the posterior longitudinal ligament(OPLL) with myelopathy. Methods Totally 82 patients with cervical OPLL were treated by enlarged laminectomy from January 1998 to December 2005. There were 47 males and 35 females, with an average age of 57 years (ranged, 39-84 years). Among them, there were 31 cases of the solitary type, 40 cases of the continuous type, and 11 cases of the mixed type. JOA scoring system and the visual analogue scale (VAS) scoring were applied to evaluate the neurological function and neck/shoulder pain respectively.Ishihara method was employed to measure cervical curvature index(CCI). The degree of spinal cord backward expanding and displacement were calculated in MR1. Results The mean decompression length was 5.2 (4-6) segments. The mean follow-up duration was 41 months (ranged, 13-58 months). JOA score has improved from 10.9(7-15) preoperatively to 13.9(11-17) postoperatively (t=14.65, P＜0.01). The excellent and good rate was 98.7%. The palsy of C5 nerve root occurred in only 2 patients, both recovered after surgery. Zhe mean postoperative VAS score was 1.4(1-3), comparing with the preoperative score of 5.3 (4-6). The pain in neck/shoulder was alleviated obviously (t=15.46, P＜0.01 ). CCI decreased from 18.8% to 10.5%(t=5.03, P＜0.01 ),but did not follow by neuron function deterioration. MRI indicated that the cross-sectional area at the level of maximum compression of the dural sac increased from 85.4 mm2 preoperatively to 153.8 mm2 postoperatively (t=16.33, P＜0.01), and the mean spinal cord posterior shift was 6.2 mm (t=15.35, P＜0.01). Conclusion The enlarged laminectomy is proved to be effective in treating cervical OPLL, in terms of significant posterior shift of the spinal cord, relief of cervical/shoulder pain, lower rate of the palsy of C5 nerve root, with no recurrence of spinal cord compression symptom.