BACKGROUND:Osteoarthritis is a complex disease closely related to metabolic abnormalities.However,previous studies only involved limited blood lipid indicators and did not conduct more comprehensive blood lipid profile analysis.An in-depth exploration of the causal relationship between the seven items of blood lipids and osteoarthritis will not only help understand the pathogenesis of osteoarthritis,but also provide new research directions and clinical basis for its prevention and treatment.OBJECTIVE:To explore the causal relationship between blood lipids and osteoarthritis.METHODS:The genome-wide association analysis statistical data of 7 items of blood lipids and osteoarthritis from the IEU OPEN GWAS database were used to summarize,and significant single nucleotide polymorphisms were used as instrumental variables.The causal relationship between seven items(serum total cholesterol,triacylglycerol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,apolipoprotein B,apolipoprotein AI and apolipoprotein A1)of blood lipids and osteoarthritis(osteoarthritis,knee or hip osteoarthritis,knee osteoarthritis and hip osteoarthritis)was determined through two-sample Mendelian randomization analysis.The inverse variance weighting was the main effect,and the MR-Egger regression method and the weighted median method were the supplementary effects.Bonferroni correction and reverse Mendelian randomization analysis could ensure validity.Multivariable Mendelian randomization analysis was used to further eliminate confounding factors.A significant causal relationship between seven items of blood lipids and osteoarthritis was obtained to ensure the robustness of the analysis.Co-localization analysis was used to once again ensure the robustness of the causal relationship and identify significantly influencing gene loci,making the evidence of causality more complete.RESULTS AND CONCLUSION:(1)In the two sample Mendelian randomization analysis,the results from inverse variance weighting indicated negative correlations between osteoarthritis and the following serum lipids:total cholesterol(OR=0.937 2,95%CI=0.885 6-0.991 9,P=0.025),low-density lipoprotein cholesterol(OR=0.959 4,95%CI=0.923 6-0.996 6,P=0.033),high-density lipoprotein cholesterol(OR=0.911 2,95%CI=0.833 5-0.996 2,P=0.04),apolipoprotein B(OR=0.926 7,95%CI=0.887 7-0.967 4,P=0.000 5),and apolipoprotein AI(OR=0.951 2,95%CI=0.911 0-0.993 1,P=0.023).Additionally,total cholesterol(OR=0.892 3,95%CI=0.843 1-0.944 3,P=0.000 08),triglycerides(OR=0.938 5,95%CI=0.884 7-0.995 6,P=0.035),and apolipoprotein B(OR=0.911 6,95%CI=0.865 9-0.959 7,P=0.000 4)were negatively associated with knee or hip osteoarthritis.For knee osteoarthritis specifically,total cholesterol(OR=0.898 3,95%CI=0.841 2-0.959 3,P=0.001),high-density lipoprotein cholesterol(OR=0.881 2,95%CI=0.794 7-0.977 0,P=0.016),and apolipoprotein B(OR=0.919 0,95%CI=0.869 8-0.971 0,P=0.002)also showed negative correlations.Lastly,with respect to hip osteoarthritis,total cholesterol(OR=0.864 5,95%CI=0.797 5-0.937 3,P=0.000 4),low-density lipoprotein cholesterol(OR=0.925 6,95%CI=0.879 5-0.974 1,P=0.003),and apolipoprotein B(OR=0.888 8,95%CI=0.817 6-0.966 3,P=0.005)exhibited negative correlations.No statistically significant differences were found in the reverse Mendelian randomization analysis.(2)In the multivariable Mendelian randomization analysis,the results from inverse variance weighting indicated a negative correlation between high-density lipoprotein cholesterol and osteoarthritis(OR=0.942 7,95%CI=0.896 1-0.991 8,P=0.022).Additionally,total cholesterol(OR=0.799 8,95%CI=0.647 8-0.987 6,P=0.037)and high-density lipoprotein cholesterol(OR=0.865 1,95%CI=0.7781-0.961 9,P=0.007)were also negatively associated with knee osteoarthritis.(3)Colocalization analysis revealed that total cholesterol and low-density lipoprotein were significantly associated with osteoarthritis at single nucleotide polymorphisms rs13107325(H4 posterior probability=99.9%).(4)These findings,using international databases and non-Asian populations,provide valuable insights for early clinical diagnosis,understanding the pathogenesis,and researching prevention and treatment of osteoarthritis in Chinese biomedicine and the Chinese population.

Objective:To analysis of the latent profiles and influencing factors of body image in patients with postoperative oral cancer.Methods:From July 2024 to March 2025, a total of 332 patients with primary oral cancer confirmed by pathology, aged ≥18 years, and undergoing oral cancer surgery at Hunan Cancer Hospital were selected using simple random sampling and cluster sampling. Among them, 25 were female and 307 were male. The body image scale and the Rosenberg self-esteem scale were used to investigate the patients. The main indicators included the total scale scores and scores on various dimensions of body image, such as appearance evaluation and health focus, with particular attention to satisfaction with facial appearance and oral function.The correlation between self-esteem and body image was analyzed, and differences in scores were compared based on gender, age, self-esteem level, and surgical procedure.Results:Among the 332 patients, 93.4% (310/332) were married, and 6.6% (22/332) were unmarried, divorced, or widowed. A total of 84.3% (280/332) underwent flap transplantation surgery, while 15.7% (52/332) did not. The body image distress in the 332 patients could be categorized into a body image adaptation group [80.12% (266/332)] and a body image disorder group [19.88% (66/332)]. Unmarried/divorced/widowed status ( P=0.020), undergoing flap transplantation ( P=0.006), and self-esteem level ( P<0.001) were identified as influencing factors for postoperative body image disorder in oral cancer patients. Conclusions:Given the varying levels of body image concerns among oral cancer patients, healthcare providers can implement targeted, personalized nursing interventions based on their distinct categories and influencing factors.

Objective To investigate the impact of phase Ⅱ cardiac rehabilitation on the rehabilitation needs and physical activity status of patients after coronary heart disease intervention.Methods A total of 90 patients with coronary heart disease who underwent percutaneous coronary intervention(PCI)in the Coronary Heart Disease Center of the hospital from August 2023 to August 2024 were selected as the research subjects.They were subjected to a 12-week standardized phase Ⅱ cardiac rehabilitation training.General data survey forms,cardiac rehabilitation scales,and the International Physical Activity Questionnaire were used for scale surveys to understand the patients' needs before and after rehabilitation and their weekly physical activity en-ergy expenditure.The cardiopulmonary exercise test gold standard,which reflects exercise capacity through three indicators-maximum oxygen uptake(VO2 max),anaerobic threshold(AT),and metabolic equivalents(MET),were used to compare the physical activity status before and after cardiac rehabilitation.Results Compared with before the implementation,after the implementation of cardiac rehabilitation,the autonomy score in-creased(21.36±1.85 vs.16.73±3.28),the process anxiety(12.60±3.87 vs.14.27±2.12)and outcome anxiety scores(2.31±1.76 vs.4.56±3.56)decreased,the level of low-intensity physical activity decreased[(2 711.62±1 487.09)min/week vs.(3 845.97±2 083.71)min/week],the levels of moderate-intensity[(1 314.67±783.54)min/week vs.(686.22±126.79)min/week],high-intensity[(1 861.33±798.27)min/week vs.(112.00±40.77)min/week],and total physical activity increased[(5 887.62±2 843.54)min/week vs.(4 644.19±2 287.16)min/week].The levels of VO2 max[(28.11±14.28)mL·min-1·kg-1 vs.(23.82±12.34)mL·min-1·kg-1],AT[(16.06±5.41)mL·min-1·kg-1 vs.(13.53±4.56)mL·min-1·kg-1],and MET[(6.89±1.59)mL·min-1·kg-1 vs.(5.78±1.21)mL·min-1·kg-1]all in-creased,with statistically significant differences(P＜0.05).Conclusion Phase Ⅱ rehabilitation after PCI can effectively improve patients' physical activity levels.

Objective:To analysis of the latent profiles and influencing factors of body image in patients with postoperative oral cancer.Methods:From July 2024 to March 2025, a total of 332 patients with primary oral cancer confirmed by pathology, aged ≥18 years, and undergoing oral cancer surgery at Hunan Cancer Hospital were selected using simple random sampling and cluster sampling. Among them, 25 were female and 307 were male. The body image scale and the Rosenberg self-esteem scale were used to investigate the patients. The main indicators included the total scale scores and scores on various dimensions of body image, such as appearance evaluation and health focus, with particular attention to satisfaction with facial appearance and oral function.The correlation between self-esteem and body image was analyzed, and differences in scores were compared based on gender, age, self-esteem level, and surgical procedure.Results:Among the 332 patients, 93.4% (310/332) were married, and 6.6% (22/332) were unmarried, divorced, or widowed. A total of 84.3% (280/332) underwent flap transplantation surgery, while 15.7% (52/332) did not. The body image distress in the 332 patients could be categorized into a body image adaptation group [80.12% (266/332)] and a body image disorder group [19.88% (66/332)]. Unmarried/divorced/widowed status ( P=0.020), undergoing flap transplantation ( P=0.006), and self-esteem level ( P<0.001) were identified as influencing factors for postoperative body image disorder in oral cancer patients. Conclusions:Given the varying levels of body image concerns among oral cancer patients, healthcare providers can implement targeted, personalized nursing interventions based on their distinct categories and influencing factors.

BACKGROUND:Osteoarthritis is a complex disease closely related to metabolic abnormalities.However,previous studies only involved limited blood lipid indicators and did not conduct more comprehensive blood lipid profile analysis.An in-depth exploration of the causal relationship between the seven items of blood lipids and osteoarthritis will not only help understand the pathogenesis of osteoarthritis,but also provide new research directions and clinical basis for its prevention and treatment.OBJECTIVE:To explore the causal relationship between blood lipids and osteoarthritis.METHODS:The genome-wide association analysis statistical data of 7 items of blood lipids and osteoarthritis from the IEU OPEN GWAS database were used to summarize,and significant single nucleotide polymorphisms were used as instrumental variables.The causal relationship between seven items(serum total cholesterol,triacylglycerol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,apolipoprotein B,apolipoprotein AI and apolipoprotein A1)of blood lipids and osteoarthritis(osteoarthritis,knee or hip osteoarthritis,knee osteoarthritis and hip osteoarthritis)was determined through two-sample Mendelian randomization analysis.The inverse variance weighting was the main effect,and the MR-Egger regression method and the weighted median method were the supplementary effects.Bonferroni correction and reverse Mendelian randomization analysis could ensure validity.Multivariable Mendelian randomization analysis was used to further eliminate confounding factors.A significant causal relationship between seven items of blood lipids and osteoarthritis was obtained to ensure the robustness of the analysis.Co-localization analysis was used to once again ensure the robustness of the causal relationship and identify significantly influencing gene loci,making the evidence of causality more complete.RESULTS AND CONCLUSION:(1)In the two sample Mendelian randomization analysis,the results from inverse variance weighting indicated negative correlations between osteoarthritis and the following serum lipids:total cholesterol(OR=0.937 2,95%CI=0.885 6-0.991 9,P=0.025),low-density lipoprotein cholesterol(OR=0.959 4,95%CI=0.923 6-0.996 6,P=0.033),high-density lipoprotein cholesterol(OR=0.911 2,95%CI=0.833 5-0.996 2,P=0.04),apolipoprotein B(OR=0.926 7,95%CI=0.887 7-0.967 4,P=0.000 5),and apolipoprotein AI(OR=0.951 2,95%CI=0.911 0-0.993 1,P=0.023).Additionally,total cholesterol(OR=0.892 3,95%CI=0.843 1-0.944 3,P=0.000 08),triglycerides(OR=0.938 5,95%CI=0.884 7-0.995 6,P=0.035),and apolipoprotein B(OR=0.911 6,95%CI=0.865 9-0.959 7,P=0.000 4)were negatively associated with knee or hip osteoarthritis.For knee osteoarthritis specifically,total cholesterol(OR=0.898 3,95%CI=0.841 2-0.959 3,P=0.001),high-density lipoprotein cholesterol(OR=0.881 2,95%CI=0.794 7-0.977 0,P=0.016),and apolipoprotein B(OR=0.919 0,95%CI=0.869 8-0.971 0,P=0.002)also showed negative correlations.Lastly,with respect to hip osteoarthritis,total cholesterol(OR=0.864 5,95%CI=0.797 5-0.937 3,P=0.000 4),low-density lipoprotein cholesterol(OR=0.925 6,95%CI=0.879 5-0.974 1,P=0.003),and apolipoprotein B(OR=0.888 8,95%CI=0.817 6-0.966 3,P=0.005)exhibited negative correlations.No statistically significant differences were found in the reverse Mendelian randomization analysis.(2)In the multivariable Mendelian randomization analysis,the results from inverse variance weighting indicated a negative correlation between high-density lipoprotein cholesterol and osteoarthritis(OR=0.942 7,95%CI=0.896 1-0.991 8,P=0.022).Additionally,total cholesterol(OR=0.799 8,95%CI=0.647 8-0.987 6,P=0.037)and high-density lipoprotein cholesterol(OR=0.865 1,95%CI=0.7781-0.961 9,P=0.007)were also negatively associated with knee osteoarthritis.(3)Colocalization analysis revealed that total cholesterol and low-density lipoprotein were significantly associated with osteoarthritis at single nucleotide polymorphisms rs13107325(H4 posterior probability=99.9%).(4)These findings,using international databases and non-Asian populations,provide valuable insights for early clinical diagnosis,understanding the pathogenesis,and researching prevention and treatment of osteoarthritis in Chinese biomedicine and the Chinese population.

Objective:To compare percutaneous Kirschner wiring and elastic intramedullary nailing after ultrasound-guided reduction in the treatment of radial neck fractures in children.Methods:A retrospective study was conducted to analyze the 96 children with radial neck fracture who had been admitted to Department of Orthopedics, Children's Hospital of Anhui Province from January 2020 to January 2023. They were 51 boys and 45 girls with an age of (7.0±2.5) years. By the Judet classification, there were 74 cases of type Ⅲ and 22 cases of type IV. Twenty-one cases were treated with percutaneous Kirschner wiring after ultrasound-guided reduction (Kirschner wire group) while 75 cases with elastic intramedullary nailing after ultrasound-guided reduction (intramedullary nail group). The surgical time, fluoroscopy frequency, fracture healing time, and incidence of complications were compared between the 2 groups. Their postoperative X-ray films were evaluated according to the Métaizeau criteria, and elbow joint function was evaluated according to the Steel and Gtrham scoring at the last follow-up.Results:There was no statistically significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). The 96 pediatric patients were followed up for (10.6±4.2) months after surgery. The surgical time [(18.5±2.6) minutes] and fluoroscopy frequency [4.0 (3.0, 4.0) times] in the Kirschner wire group were significantly less than those in the intramedullary nail group [(30.9±2.7) minutes, 8.0 (7.0, 9.0) times] ( P<0.05). There was no statistically significant difference in fracture healing time, good and excellent rate of postoperative reduction by the Métaizeau criteria, good and excellent rate of elbow joint function by the Steel and Gtrham scoring at the last follow-up, or incidence of complications ( P>0.05). Conclusion:In the treatment of radial neck fractures in children, both ultrasound-guided percutaneous Kirschner wiring and elastic intramedullary nailing after ultrasound-guided reduction can lead to similar therapeutic effects, but the former can shorten surgical time, reduce intraoperative fluoroscopy frequency, and spare a secondary surgery.

Objective To investigate the current status of knowledge-attitude-practice of cardiac rehabilitation in patients undergoing coronary artery bypass grafting(CABG) and analyze its influencing factors. Methods From July to November 2022, 288 patients with CABG in the coronary heart disease surgery center of Beijing Anzhen Hospital Affiliated to Capital Medical University were conveniently included, and general information questionnaire and cardiac rehabilitation knowledge and practice questionnaire were used to investigate the general situation and the level of knowledge-attitude-practice of cardiac rehabilitation in patients with coronary heart disease. Results A total of 290 questionnaires were sent out in this study, and 288 were effectively collected, with an effective recovery rate of 99.31%. The total score of the questionnaire was (106.81±13.35), and the total score rate was 62.83%, including the knowledge questionnaire scoring (39.34±9.13), belief questionnaire scoring (32.86±3.39) and behavior questionnaire scoring (34.61±3.54). The scoring rates of knowledge, attitude and practice questionnaire were 46.28%, 82.15% and 76.91%, respectively. Multiple linearregression analysis showed that patients who lived in rural areas, had education background of primary school or below, were farmers, had public health insurance, and had no previous coronary intervention, had lower levels of knowledge-attitude-practice of cardiac rehabilitation (P < 0.05). Conclusion The knowledge-attitude-practice of cardiac rehabilitation, especially the level of knowledge, in patients with CABG is needed to be improved. The factors that affect the level of knowledge-attitude-practice of cardiac rehabilitation in this population are diversified, suggesting that individual cardiac rehabilitation guidance should be implemented according to different people and local conditions, and diversified cardiac rehabilitation models should be established to improve the long-term and compliance of cardiac rehabilitation.

Objective:To explore the influencing factors of efficacy of glucocorticoids in the treatment of moderate to severe ulcerative colitis (UC) in children.Methods:A retrospective case-control study was conducted. The clinical data of 38 children with moderate to severe UC treated with glucocorticoids in Beijing Children's Hospital of Capital Medical University from January 2016 to December 2021 were analyzed. According to the response to glucocorticoids therapy, the patients were divided into steroid-intractable group and steroid-effective group. Kaplan-Meier method was used to calculate the cumulative recurrence rate. Univariate analysis was performed to analyze the differences of clinical data between the two groups, and Logistic regression was used to analyze the risk factors of steroid-intractable UC in children.Results:A total of 38 children with moderate to severe UC were enrolled, including 22 males and 16 females. The median onset age was 10.7 (8.5, 12.7) years old, and the median disease duration was 4.3 (1.1, 13.6) months. The cumulative recurrence rates of 38 UC patients at 3 months, 6 months, 1 year and 2 years after glucocorticoids treatment were 26.3%, 52.6%, 63.7% and 69.5%, respectively. There were 17 patients (44.7%) in steroid-effective group. There were 21 patients (55.3%) in steroid-intractable group, including 16 (42.1%) of steroid dependence and 5 (13.2%) of steroid resistance. In the steroid-intractable group, the PUCAI scores at baseline, on the 3rd day and 5th day of glucocorticoids treatment [65.0 (50.0, 70.0) points vs. 50.0 (37.5, 60.0) points, 25.0 (10.0, 37.5) points vs. 10.0 (10.0, 20.0) points, 25.0 (10.0, 37.5) points vs. 10.0 (5.0, 12.5) points] and early recurrence rate (85.7% vs. 35.3%) were higher than those in steroid-effective group, the recurrence time [4.0 (2.0, 5.0) months vs. 19.0 (7.5, 46.5) months] was shorter than that in steroid-effective group, albumin level at baseline [ (33.3 ± 5.5) g/L vs. (37.6 ± 5.9) g/L] was lower than that in steroid-effective group, and the differences were statistically significant (all P<0.05) . Multivariate Logistic regression analysis showed that the PUCAI score at baseline was an independent risk factor for steroid-intractable UC ( OR = 1.070, 95% CI: 1.011-1.132, P = 0.020) . Conclusions:The rates of steroid dependence and the steroid resistance are high in moderate to severe UC children. Children in the steroid-intractable group have an earlier recurrence time, a higher rate of early recurrence, and a lower albumin level at baseline. The steroid dependence and resistance are more likely to occur in children with moderate to severe UC when PUCAI score at baseline is high.

Objective:To analyze the status of the dyadic coping in spouses of young and middle-age cervical cancer patients undergoing synchronous radiotherapy and chemotherapy, and to explore the influencing factors in bi-directional of patients and their spouses.Methods:With the convenience sampling method, a total of 150 cervical cancer patients undergoing synchronous radiotherapy and chemotherapy who were hospitalized in the Radiotherapy Department of Tianjin Medical University Cancer Institute and Hospital from March 2021 to February 2022 and their spouses were selected. A cross-sectional study was conducted by the Dyadic Coping Inventory, the Lock-Wallace Marital Adjustment Test, the General Self-Efficacy Scale, the Hospital Anxiety and Depression Scale, etc. Besides, multiple linear regression was used to identify predictors of the dyadic coping in spouses of cervical cancer patients undergoing synchronous radiotherapy and chemotherapy.Results:The total score of dyadic coping, marital quality, general self-efficacy, anxiety and depression in spouses of cervical cancer patients undergoing synchronous radiotherapy and chemotherapy were (121.69 ± 19.67), (97.23 ± 25.05), (25.13 ± 5.19), (9.98 ± 3.46), (8.19 ± 4.06) points. The scores of anxiety and depression of cervical cancer patients undergoing synchronous radiotherapy and chemotherapy were (10.57 ± 3.60), (9.10 ± 4.12) points. Multiple linear regression analysis showed that factors of the patients′ anxiety and depression, spouse′s perception of marital quality, spouse′s general self-efficacy, changes in family relationship, family income, and period of radiotherapy were the main influencing factors ( P<0.01), which accounted for 55.7% of total variation. Conclusions:The level of dyadic coping in spouses of cervical cancer patients undergoing synchronous radiotherapy and chemotherapy was medium, the marriage quality remains to be further improved,and its influence factors involved in the bi-directional of patient and spouse, including patients′ anxiety and depression, the changes of the family relationship, period of radiotherapy, spouses perception of marital quality and self-efficacy and family income. Clinical medical staff can improve the level of dyadic coping in spouses of cervical cancer patients undergoing synchronous radiotherapy and chemotherapy by improving their cognition of disease, reducing the incongruence of dyadic illness appraisals, and taking multiple measures to reduce the economic burden felt of the spouses.

Diabetic peripheral neuropathy （DPN） is one of the common complications of diabetes. The disease has a long course with nerve pain and other symptoms， seriously affecting the quality of life of patients. DPN is related to high glucose in vivo， inflammation， oxidative stress， apoptosis， and autophagy， involving phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt）， Janus kinase （JAK）/signal transducer and activator of transcription （STAT）， nuclear factor-κB （NF-κB）， mitogen-activated protein kinase （MAPK）， and other signaling pathways. At present， the treatment of DPN mainly focuses on symptomatic treatments such as blood glucose control and neurotrophic therapy， but the effect is not ideal. Therefore， it is particularly important to select a reasonable and effective drug to prevent and treat DPN. In recent years， Chinese medicine has played an important role in the treatment of DPN. Many studies have explored the mechanism of Chinese medicine in the treatment of DPN， and it has been found that some Chinese medicine monomers and compounds can regulate signaling pathways to prevent and treat DPN. This paper reviewed the research results of signaling pathways involved in DPN and the regulation of related pathways by Chinese medicine， aiming to provide references for the clinical treatment of DPN.