OBJECTIVE To observe the expression of micro ribonucleic acid-146a(miR-146a)in peripheral blood of the children with hand-foot-mouth disease(HFMD)caused by enterovirus 71(EV71)infection and analyze the clinical significance.METHODS A total of 45 children with HFMD induced by non-EV71 infection who were trea-ted in Hangzhou Children's Hospital from Jul.2023 to Jan.2024 were assigned as the HFMD group,meanwhile,15 healthy children who received physical examination were chosen as the healthy group.The baseline clinical data were compared between the two groups.The expression level of miR-146a in peripheral blood mononuclear cells(PBMCs)was detected by real-time polymerase chain reaction(RT-PCR),the levels of blood routine indexes and relevant biochemical indexes were detected.The association of expression of peripheral blood miR-146a,routine indexes with the HFMD induced by non-EV71 infection was observed.The value of miR-146a in diagnosis of HFMD induced by non-EV71 infection was analyzed by means of receiver operating characteristic(ROC)curves.RESULTS The expression level of miR-146a in PBMCs was 0.78(0.69,1.08)in the HFMD group,1.43(1.11,1.62)in the healthy group,and there was significant difference(Z=-3.927,P＜0.001);there were significant difference values in WBC and CRP between the two groups(t=5.188,P＜0.001;Z=-4.986,P＜0.001).Among the children in the HFMD group,the expression level of miR-146a was 0.83(0.70,1.27)in the children with common HFMD,0.73(0.66,0.79)in the children with severe HFMD,and there was significant difference(Z=-2.130,P=0.032).ROC curve analysis showed that the area under the curve(AUC)of the miR-146a was 0.841 in prediction of HFMD caused by non-EV71 infection.CONCLUSIONS The children with HFMD caused by non-EV71 infection show the remarkable decline of miR-146a in PMMCs.The low expression level of miR-146a may be the predictive factor for risk of HFMD caused by non-EV71 infection and severe HFMD,it has certain predictive value and can be used as blood marker for the children with HFMD.

Background: and Purpose Limited evidence exists on the effectiveness of endovascular treatment (EVT) for acute posterior circulation tandem lesion (PCTL). This study aimed to explore the role of extracranial vertebral artery (VA) stenting in patients with PCTL stroke undergoing EVT. Methods: Individual patient data were pooled from the BASILAR (EVT for Acute Basilar Artery Occlusion Study) and PERSIST (Posterior Circulation Ischemic Stroke) registries. Patients with PCTLs who underwent EVT were included in the present cohort and divided into the stenting and nonstenting groups based on the placement of extracranial VA stents. The primary efficacy outcome was the modified Rankin Scale (mRS) scores at 90 days and 1 year. Safety outcomes included 24-hour symptomatic intracranial hemorrhage (sICH) and all-cause mortality at 90 days and 1 year post-surgery. Results: A combined dataset of 1,320 patients with posterior circulation artery occlusion, including 263 (19.9%) with tandem lesions, of whom 217 (median age, 65 years; 82.9% male) met the inclusion criteria for the analysis. The stenting group had 84 (38.7%) patients, while the non-stenting group had 133 (61.3%). After adjustment for the potential confounders, extracranial VA stenting was associated with favorable shifts in mRS scores at both 90 days (adjusted common odds ratio [OR], 2.30; 95% confidence interval [CI], 1.23–4.28; P<0.01) and 1 year (adjusted OR [aOR], 2.04; 95% CI [1.05–3.97]; P=0.04), along with lower rate of mortality at both 90 days (aOR, 0.45; 95% CI [0.21–0.93]; P=0.01) and 1 year (aOR, 0.36; 95% CI [0.16–0.79]; P=0.01), with no significant difference in sICH incidence (aOR, 0.35; 95% CI [0.06–1.98]; P=0.24). Conclusion Extracranial VA stenting during EVT may improve functional outcomes and reduce mortality in patients with PCTL strokes.

Objective To investigate the mechanism of action of Guizhi Fuling pill in treating chro-nic prostatitis(CP)using network pharmacology and molecular docking techniques.Methods Compo-nents of Guizhi Fuling pill were collected from the Traditional Chinese Medicines Systems Pharmacolo-gy Platform(TCMSP),and target information was obtained from the SwissTarget database.Targets for chronic prostatitis were screened from the GeneCards,OMIM,CTD,and DisGeNET disease data-bases.A protein-protein interaction(PPI)network was established and analyzed.Gene ontology(GO)functional annotation and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway en-richment analysis were performed using the DAVID database.The Cytoscape software was employed to construct an association network linking the components of Guizhi Fuling Pill,their targets,and the targets of chronic prostatitis.Molecular docking was conducted using AutoDock Vina software to verify the binding stability between the components of Guizhi Fuling pill and their targets.Results After screening and deduplication in the TCMSP database,76 components of Guizhi Fuling Pill were iden-tified,and 655 component targets were retrieved from the SwissTarget database.There were 190 intersecting targets between GuizhiFuling Pill and chronic prostatitis.GO analysis indicated that Guizhi Fuling Pill may treat chronic prostatitis by participating in processes such asapoptosis,ATP binding,and signal transduction.KEGG analysis suggested that Guizhi Fuling Pill can regulate pathways such as phosphatidylinositol 3-kinase(PI3K)/protein kinase B(AKT)and mitogen-acti-vated protein kinase(MAPK)to intervene in chronic prostatitis.Molecular docking data demonstra-ted that the components of Guizhi Fuling pill exhibited stable conformations with their targets.Con-clusion The components of Guizhi Fuling Pill can stably bind to their targets and exert therapeutic effects on chronic prostatitis through multiple targets and pathways.

Background: and Purpose Limited evidence exists on the effectiveness of endovascular treatment (EVT) for acute posterior circulation tandem lesion (PCTL). This study aimed to explore the role of extracranial vertebral artery (VA) stenting in patients with PCTL stroke undergoing EVT. Methods: Individual patient data were pooled from the BASILAR (EVT for Acute Basilar Artery Occlusion Study) and PERSIST (Posterior Circulation Ischemic Stroke) registries. Patients with PCTLs who underwent EVT were included in the present cohort and divided into the stenting and nonstenting groups based on the placement of extracranial VA stents. The primary efficacy outcome was the modified Rankin Scale (mRS) scores at 90 days and 1 year. Safety outcomes included 24-hour symptomatic intracranial hemorrhage (sICH) and all-cause mortality at 90 days and 1 year post-surgery. Results: A combined dataset of 1,320 patients with posterior circulation artery occlusion, including 263 (19.9%) with tandem lesions, of whom 217 (median age, 65 years; 82.9% male) met the inclusion criteria for the analysis. The stenting group had 84 (38.7%) patients, while the non-stenting group had 133 (61.3%). After adjustment for the potential confounders, extracranial VA stenting was associated with favorable shifts in mRS scores at both 90 days (adjusted common odds ratio [OR], 2.30; 95% confidence interval [CI], 1.23–4.28; P<0.01) and 1 year (adjusted OR [aOR], 2.04; 95% CI [1.05–3.97]; P=0.04), along with lower rate of mortality at both 90 days (aOR, 0.45; 95% CI [0.21–0.93]; P=0.01) and 1 year (aOR, 0.36; 95% CI [0.16–0.79]; P=0.01), with no significant difference in sICH incidence (aOR, 0.35; 95% CI [0.06–1.98]; P=0.24). Conclusion Extracranial VA stenting during EVT may improve functional outcomes and reduce mortality in patients with PCTL strokes.

Background: and Purpose Limited evidence exists on the effectiveness of endovascular treatment (EVT) for acute posterior circulation tandem lesion (PCTL). This study aimed to explore the role of extracranial vertebral artery (VA) stenting in patients with PCTL stroke undergoing EVT. Methods: Individual patient data were pooled from the BASILAR (EVT for Acute Basilar Artery Occlusion Study) and PERSIST (Posterior Circulation Ischemic Stroke) registries. Patients with PCTLs who underwent EVT were included in the present cohort and divided into the stenting and nonstenting groups based on the placement of extracranial VA stents. The primary efficacy outcome was the modified Rankin Scale (mRS) scores at 90 days and 1 year. Safety outcomes included 24-hour symptomatic intracranial hemorrhage (sICH) and all-cause mortality at 90 days and 1 year post-surgery. Results: A combined dataset of 1,320 patients with posterior circulation artery occlusion, including 263 (19.9%) with tandem lesions, of whom 217 (median age, 65 years; 82.9% male) met the inclusion criteria for the analysis. The stenting group had 84 (38.7%) patients, while the non-stenting group had 133 (61.3%). After adjustment for the potential confounders, extracranial VA stenting was associated with favorable shifts in mRS scores at both 90 days (adjusted common odds ratio [OR], 2.30; 95% confidence interval [CI], 1.23–4.28; P<0.01) and 1 year (adjusted OR [aOR], 2.04; 95% CI [1.05–3.97]; P=0.04), along with lower rate of mortality at both 90 days (aOR, 0.45; 95% CI [0.21–0.93]; P=0.01) and 1 year (aOR, 0.36; 95% CI [0.16–0.79]; P=0.01), with no significant difference in sICH incidence (aOR, 0.35; 95% CI [0.06–1.98]; P=0.24). Conclusion Extracranial VA stenting during EVT may improve functional outcomes and reduce mortality in patients with PCTL strokes.

Objective To explore the correlation between cold-induced RNA binding-protein(CIRP)and NF-κB levels with cognitive dysfunction in elderly patients with ischemic cerebral small vessel disease.Methods 135 elderly patients with ischemic cerebral small vessel disease admitted to our hospital from March 2021 to June 2024 were selected as research subjects.They were divided into a cognitive normal group(n=48)and a cognitive impairment group(n=87)based on whether cognitive dysfunction occurred.Multiple linear regression was used to analyze the relationship between cognitive impairment and inflammatory indicators,while the dose-response relationship of CIRP and NF-κB with cognitive impairment were estimated using restricted cubic spline method.The cognitive impairment group was further divided into mild cognitive impairment group(n=30),moderate cognitive impairment group(n=32),and severe cognitive impairment group(n=25)based on the severity of the condition.Ordered regression analysis was used to investigate the impact of CIRP and NF-κB on patient's condition;ROC curve was used to evaluate the predictive value of CIRP and NF-κB for moderate to severe cognitive impairment,and explore the mediating role of inflammation related factors between CIRP/NF-κB and mini-mental state examination(MMSE)scores.Results TNF-α,IL-6,IL-1β,CIRP and NF-κB are all factors affecting cognitive impairment(P＜0.05).CIRP and NF-κB were significantly positively correlated with TNF-α,IL-4,IL-10,IL-1β,MCP-1,TGF-β1 and hs CRP(P＜0.05),and significantly negatively correlated with TGF-β1(P＜0.05).The correlation of CIRP and NF-κB levels with cognitive impairment showed a non-linear dose-response relationship(P＜0.05).There was still an independent correlation(P＜0.05)of TNF-α,IL-6,IL-1β,CIRP and NF-κB with the severity of cognitive impairment.High levels of CIRP and NF-κB showed a synergistic effect with high levels of TNF-α,IL-6 and IL-1 β.The AUC value of CIRP and NF-κB for predicting severe cognitive impairment were 0.745 and 0.792,respectively,with a combined prediction AUC of 0.840.TNF-α,IL-4,IL-10,IL-1β,MCP-1,TGF-β1 and hs CRP play a mediating regulatory role between MMSE score and CIRP/NF-κB.Conclusion CIRP and NF-κB participate in the regulation of inflammatory responses and are closely related to cognitive dysfunction and severity of elderly patients with ischemic cerebrovascular disease.Monitoring the changes of CIRP and NF-κB are beneficial for clinical evaluation of patients' cognitive function.

OBJECTIVE To observe the expression of micro ribonucleic acid-146a(miR-146a)in peripheral blood of the children with hand-foot-mouth disease(HFMD)caused by enterovirus 71(EV71)infection and analyze the clinical significance.METHODS A total of 45 children with HFMD induced by non-EV71 infection who were trea-ted in Hangzhou Children's Hospital from Jul.2023 to Jan.2024 were assigned as the HFMD group,meanwhile,15 healthy children who received physical examination were chosen as the healthy group.The baseline clinical data were compared between the two groups.The expression level of miR-146a in peripheral blood mononuclear cells(PBMCs)was detected by real-time polymerase chain reaction(RT-PCR),the levels of blood routine indexes and relevant biochemical indexes were detected.The association of expression of peripheral blood miR-146a,routine indexes with the HFMD induced by non-EV71 infection was observed.The value of miR-146a in diagnosis of HFMD induced by non-EV71 infection was analyzed by means of receiver operating characteristic(ROC)curves.RESULTS The expression level of miR-146a in PBMCs was 0.78(0.69,1.08)in the HFMD group,1.43(1.11,1.62)in the healthy group,and there was significant difference(Z=-3.927,P＜0.001);there were significant difference values in WBC and CRP between the two groups(t=5.188,P＜0.001;Z=-4.986,P＜0.001).Among the children in the HFMD group,the expression level of miR-146a was 0.83(0.70,1.27)in the children with common HFMD,0.73(0.66,0.79)in the children with severe HFMD,and there was significant difference(Z=-2.130,P=0.032).ROC curve analysis showed that the area under the curve(AUC)of the miR-146a was 0.841 in prediction of HFMD caused by non-EV71 infection.CONCLUSIONS The children with HFMD caused by non-EV71 infection show the remarkable decline of miR-146a in PMMCs.The low expression level of miR-146a may be the predictive factor for risk of HFMD caused by non-EV71 infection and severe HFMD,it has certain predictive value and can be used as blood marker for the children with HFMD.

Objective To explore the correlation between cold-induced RNA binding-protein(CIRP)and NF-κB levels with cognitive dysfunction in elderly patients with ischemic cerebral small vessel disease.Methods 135 elderly patients with ischemic cerebral small vessel disease admitted to our hospital from March 2021 to June 2024 were selected as research subjects.They were divided into a cognitive normal group(n=48)and a cognitive impairment group(n=87)based on whether cognitive dysfunction occurred.Multiple linear regression was used to analyze the relationship between cognitive impairment and inflammatory indicators,while the dose-response relationship of CIRP and NF-κB with cognitive impairment were estimated using restricted cubic spline method.The cognitive impairment group was further divided into mild cognitive impairment group(n=30),moderate cognitive impairment group(n=32),and severe cognitive impairment group(n=25)based on the severity of the condition.Ordered regression analysis was used to investigate the impact of CIRP and NF-κB on patient's condition;ROC curve was used to evaluate the predictive value of CIRP and NF-κB for moderate to severe cognitive impairment,and explore the mediating role of inflammation related factors between CIRP/NF-κB and mini-mental state examination(MMSE)scores.Results TNF-α,IL-6,IL-1β,CIRP and NF-κB are all factors affecting cognitive impairment(P＜0.05).CIRP and NF-κB were significantly positively correlated with TNF-α,IL-4,IL-10,IL-1β,MCP-1,TGF-β1 and hs CRP(P＜0.05),and significantly negatively correlated with TGF-β1(P＜0.05).The correlation of CIRP and NF-κB levels with cognitive impairment showed a non-linear dose-response relationship(P＜0.05).There was still an independent correlation(P＜0.05)of TNF-α,IL-6,IL-1β,CIRP and NF-κB with the severity of cognitive impairment.High levels of CIRP and NF-κB showed a synergistic effect with high levels of TNF-α,IL-6 and IL-1 β.The AUC value of CIRP and NF-κB for predicting severe cognitive impairment were 0.745 and 0.792,respectively,with a combined prediction AUC of 0.840.TNF-α,IL-4,IL-10,IL-1β,MCP-1,TGF-β1 and hs CRP play a mediating regulatory role between MMSE score and CIRP/NF-κB.Conclusion CIRP and NF-κB participate in the regulation of inflammatory responses and are closely related to cognitive dysfunction and severity of elderly patients with ischemic cerebrovascular disease.Monitoring the changes of CIRP and NF-κB are beneficial for clinical evaluation of patients' cognitive function.

Objective:To investigate the changes of serum complement C1q/tumor necrosis factor-associated protein 3 (CTRP3) in patients with rheumatoid arthritis (RA) and its clinical significance.Methods:A total of 60 RA patients admitted to Chongming Hospital affiliated to Shanghai University of Medicine & Health Sciences (Chongming Branch of Xinhua Hospital) from January 2023 to February 2024 were collected.They were divided into a plaque group (38 cases) and a plaque free group (22 cases) according to the results of carotid intima-media thickness (cIMT) by carotid artery ultrasonography. ESR, CRP, blood lipid, HOMA-IR, RF, CCP antibody and CTRP3 levels were detected, and the relationship between CTRP3 levels and disease activity and atherosclerosis in RA patients was analyzed. The statistical analysis was carried out with independent t-test, analysis of variance, Pearson correlation analysis and logistic regression. Results:Serum CTRP3 level in RA patients was lower than that in healthy control group [(116±44)ng/ml and (184±63)ng/ml, t=-6.54, P=0.004]. The CTRP3 level in RA group with plaque was lower than that in RA group without plaque [(98±28) ng/ml and (123±38)ng/ml, t=-5.57, P=0.008]. Serum CTRP3 levels in RA patients were correlated with LDL-C ( r=-0.68, P=0.011), HOMA-IR ( r=-0.74, P=0.001), RF ( r=-0.46, P=0.042), anti-CCP antibody( r=-0.54, P=0.037), DAS28 ( r=-0.66, P=0.024) were negatively correlated with cIMT ( r=-0.76, P=0.001), and positively correlated with DMARDs duration ( r=0.51, P=0.040) and flow-mediated di latatiton ( r=0.70, P=0.004). The CTRP3 level [( OR(95% CI)=0.683(0.355, 0.807), P=0.023] was an independent correlation factor affecting cIMT. Conclusion:CTRP3 level in RA patients is significantly lower than that in healthy control group, and is negatively correlated with insulin resistance, autoantibody level and disease activity, and has a protective effect on early atherosclerosis in RA patients.

Objective To explore the diagnostic significance of fecal calprotectin(FC)in infectious diarrhea in children.Methods A total of 190 children with infectious diarrhea who were hospitalized in Hangzhou Children's Hospital from August 2021 to July 2024 were selected and divided into bacterial group(115 cases)and viral group(75 cases)according to type of pathogen.48 children who underwent health examination in the hospital during the same period were included in control group.The FC,white blood cell count(WBC),C-reactive protein(CRP),and procalcitonin(PCT)of three groups of children were detected.The diagnostic efficacy of FC,WBC,CRP and PCT for bacterial infectious diarrhea was evaluated by using the receiver operating characteristic(ROC)curve.Results The proportions of fever and hematochezia,the highest body temperature,frequency of defecation,and fecal white blood cells in bacterial group were significantly higher than those in viral group,while the proportion of vomiting was significantly lower than that in viral group(P＜0.05).There were statistically significant differences in levels of WBC,CRP,PCT and FC among three groups of children(P＜0.05),and the levels were all in the order of bacterial group＞viral group＞control group.The results of ROC curve showed that area under the curve(AUC)of FC for diagnosing bacterial diarrhea was 0.941,with a sensitivity of 87.0％and a specificity of 85.4％.The AUC,sensitivity and specificity of the diagnosis by FC combined with CRP were 0.987,93.0％and 97.9％respectively.Correlation analysis indicated that FC was positively correlated with WBC and CRP levels(r-0.221,0.159,P＜0.05).Conclusion FC is helpful in differentiating bacterial diarrhea from viral diarrhea,and the combined detection of FC and CRP can effectively improve the effectiveness of differential diagnosis and reduce the misdiagnosis rate.