Cardiovascular disease has become the main cause of death worldwide,seriously threatening human life and health.Some studies have shown that cluster of differentiation 74(CD74)is involved in the pathology and inflammatory pathways of cardiovascular diseases,which has attracted wide attention from scholars.CD74 is a major histocompatibility complex(MHC)Ⅱ chaperone and macrophage migration inhibitory fac-tor(MIF)receptor.It activates a variety of signaling pathways and plays a biological role in the occurrence and progression of cardiovascular diseases.This article summarizes the relevant lit-erature advances of CD74 in cardiovascular diseases,to explore the pathogenesis from the perspective of CD74 and seek disease protection and more effective therapeutic targets.

Cardiovascular disease has become the main cause of death worldwide,seriously threatening human life and health.Some studies have shown that cluster of differentiation 74(CD74)is involved in the pathology and inflammatory pathways of cardiovascular diseases,which has attracted wide attention from scholars.CD74 is a major histocompatibility complex(MHC)Ⅱ chaperone and macrophage migration inhibitory fac-tor(MIF)receptor.It activates a variety of signaling pathways and plays a biological role in the occurrence and progression of cardiovascular diseases.This article summarizes the relevant lit-erature advances of CD74 in cardiovascular diseases,to explore the pathogenesis from the perspective of CD74 and seek disease protection and more effective therapeutic targets.

AIM:To investigate the preventive and therapeutic effects of sesamin(SES)on fatty liver disease in rats with hypertension combined with dyslipidemia,and to explore the potential mecha-nisms based on mRNA-seq.METHODS:Spontane-ously hypertensive rats(SHRs)were fed a high-fat,high-cholesterol diet to establish a rat model of hy-pertension combined with dyslipidemia,and then treated with SES for 16 weeks continuously.The ex-periment was divided into four groups:WKY,SHR,Model,and Model+SES(160 mg·kg-1·d-1).Blood pressure was measured using the tail-cuff method.Body weight was monitored,and body mass index was calculated.Liver morphology was detected by ultrasound,and liver thickness was measured.Liver wet weight was weighed,and liver index was calcu-lated.Liver volume was detected by the water dis-placement method.Serum triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),alanine aminotransferase(ALT),aspartate amino-transferase(AST),and total bile acids(TBA)were de-tected by ELISA.Liver sequencing analysis was per-formed using mRNA-seq.Liver histomorphological changes were observed by HE staining.The degree of hepatic steatosis was observed by Oil Red O stain-ing,and the degree of hepatic fibrosis was observed by MASSON staining.The mRNA expression of Al-dh1a7,Nnmt,Irs2,Pltp,and Scd was detected by q-PCR.The protein expression of Scd,Nnmt,AMPK,p-AMPK,PPARα,and PPARγ was detected by Western blotting.RESULTS:After 16 weeks of continuous SES administration to rats with hypertension combined with dyslipidemia,blood pressure was significantly reduced(P＜0.01),and body weight was decreased.Serum TG,TC,and LDL-C levels were decreased,while HDL-C levels were increased.Serum ALT and AST levels were decreased.Liver weight,organ in-dex,liver thickness,and liver volume were de-creased.The degree of hepatic steatosis and hepat-ic fibrosis was improved.A total of 545 differentially expressed mRNAs were identified in the livers of rats in each group,of which 278 were upregulated and 267 were downregulated.Among the 27 com-monly differentially expressed mRNAs,five mRNAs related to lipid metabolism were screened,namely Aldh1a7,Nnmt,Irs2,Pltp,and Scd.KEGG enrich-ment analysis showed that the enriched pathways were AMPK and PPAR.Further validation revealed that in the SES-treated group,the mRNA expression of Scd in the liver was decreased,while the mRNA expression of Nnmt was increased.The protein ex-pression of Scd was decreased,while the protein ex-pression of Nnmt,AMPK,p-AMPK,PPARα,and PPARγ was increased.CONCLUSION:SES has preven-tive and therapeutic effects on fatty liver disease in rats with hypertension combined with dyslipidemia,and its mechanism of action may be related to the reduction of Scd expression levels in the liver and the increase in the expression of Nnmt,AMPK,p-AMPK,PPARα,and PPARγ.

Objective:To observe the clinical effect of aripiprazole combined with non-convulsive electroshock(MECT)for children and adolescents with first episode schizophrenia.Methods:94 children and adolescents with first episode schizophrenia who were admitted to Yiling Kangning Mental Hospital of Yichang from August 2022 to August 2024 were divided into control group(received aripiprazole,n=47)and study group(received aripiprazole combined with MECT,n=47)by using random number table method.The clinical efficacy,dysfunction scale[Positive and Negative Symptom Scale(PANSS),Montreal Cognitive Assessment Scale(MoCA),Wechsler Memory Scale(WMS)],glucose and lipid metabolism indexes[low density lipoprotein cholesterol(LDL-C),glycated hemoglobin(HbAlc),total cholesterol(TC),fasting blood glucose(FBG),High density lipoprotein cholesterol(HDL-C),inflammatory factor indexes[interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],neurocytokine levels[serum brain-derived neurotrophic factor(BDNF),s100βprotein(s100β),homocysteine(Hcy)]and the occurrence of adverse reactions were compared between the two groups.Results:Compared with the control group after treatment,the clinical total effective rate,MoCA,WMS score,HDL-C,BDNF were higher,PANSS score,HbAlc,FBG,TC,LDL-C,TNF-α,IL-1β,IL-6,s100β and Hcy were lower in the study group(P＜0.05).There was no difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion:Aripiprazole combined with MECT in the treatment of in children and adolescents with first episode schizophrenia can reduce the degree of inflammation,regulate glucose and lipid metabolism,improve clinical symptoms and neurological function of children,with good safety.

Objective:To investigate the relationship between Ig class switch recombination(CSR)and mismatch repair(MMR)protein,microsatellite phenotype in extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue(MALT lymphoma).Methods:Forty cases of MALT lymphoma archived in the Department of Pathology,Jiading District Central Hospital,Shanghai University of Medicine & Health Sciences were selected as the observation group,and twenty cases of benign lymphoid tissue hyperplasia were as the control group.The expressions of IgG,IgM,IgD,and IgA in both groups were detected by immunohistochemical double staining,and MMR proteins including MLH1,MSH2,MSH6,and PMS2 in both groups were detected by immunohistochemistry.Multiplex fluorescence PCR capillary electrophoresis was used to detect microsatellite phenotype in tumor and adjacent tissues of the experimental group.Results:In the observation group,the proportions of single Ig heavy chain expression(mode Ⅰ),negative expression(mode Ⅱ),and multiple expression(mode Ⅲ)were 65％(26/40),27.5％(11/40),and 7.5％(3/40),respectively,while in the control group were 0(0/20),5％(1/20),and 95％(19/20).The proportion of Ig heavy chain expression mode Ⅰ+Ⅱ in the observation group was 92.5％,which was significantly higher than 5％in the control group(P＜0.0 1).In the observation group,partial deletion of MMR protein was observed in 3 cases(7.5％),including 2 cases of MSH6 deletion and 1 case of both MSH6 and PMS2 deletion.In the control group,there was 1 case(5％)with PMS2 deletion.There was no significant difference in the deletion rate of MMR protein between the two groups(P＞0.05).A total of 5 cases of microsatellite instability(MSI)were detected in the observation group,including 1 case of low-frequency MSI(MSI-L),4 cases of high-frequency MSI(MSI-H),and 2 cases of MSI-H with MSH6 deletion.When the loss expression of MSI-H or MMR protein was counted as a positive result,the MSI-H rate detected by PCR capillary electrophoresis was 10％(4/40),which was slightly higher than the MMR protein deletion rate detected by immunohistochemistry(7.5％,3/40),but there was no statistically significant difference between the two groups(P＞0.05).The MMR protein deletion rates among the Ig heavy chain protein expression mode Ⅰ,mode Ⅱ,and mode Ⅲ groups were 0(0/26),18.2％(2/11),and 33.3％(1/3),respectively.There was a statistically significant difference in the constituent ratios among the three groups(P＜0.05).The MMR protein deletion rates among the MSS,MSI-L,and MSI-H groups were 2.9％(1/35),0(0/1),and 50％(2/4),respectively.There was a statistically significant difference in the constituent ratios among the three groups(P＜0.05).MMR protein deficiency was positively correlated with Ig heavy chain expression pattern and MSI(r=0.41,P＜0.05;r=0.48,P＜0.05),but Ig heavy chain expression pattern was not correlated with MSI(r=0.02,P＞0.05).Conclusion:Ig heavy chain CSR detection is helpful for the differential diagnosis of MALT lymphoma.Low frequency MMR protein deletion and MSI-H phenotype exist in MALT lymphoma,which may be of certain value for the study of its occurrence,development and clinical treatment.

Objective:To explore the predictive value of serum interleukin-6(IL-6)combined with Montreal Cognitive Assessment(MoCA)score and CHANGE risk score for post-stroke cognitive impairment(PSCI),and to provide a basis for early identification and intervention of high-risk patients.Methods:The general data of 200 patients with acute stroke who were admitted to our hospital from October 2022 to September 2024 were retrospectively analyzed,they were divided into PSCI group(49 cases)and non PSCI group(151 cases)based on whether PSCI occurred 3 months after acute stroke.The general data of two groups were compared,multiple logistic regression was used to analyze the influencing factors of PSCI,and receiver operating characteristic(ROC)curves were used to evaluate predictive efficiency of serum IL-6,MoCA score and CHANGE risk score for of PSCI.Results:There was a statistically significant difference in age and education level between the two groups(P＜0.05).The serum IL-6 level and CHANGE risk score in the PSCI group were higher than those in the non PSCI group,while the MoCA score was lower than that in the non PSCI group(P＜0.05).Multivariate logistic regression showed that elevated IL-6 levels(OR=1.851,P=0.001)and elevated CHANGE risk scores(OR=1.076,P=0.016)were independent risk factors of the occurrence of PSCI,while elevated in MoCA score(OR=0.806,P=0.001)was a protective factor(P＜0.05).IL-6 levels,MoCA scores and CHANGE risk scores have high predictive efficiency for the occurrence of PSCI,the area under the curve(AUC)for predicting occurrence of PSCI by the three alone were 0.783,0.825 and 0.857 respectively,the AUC for the combined detection of the three indicators was 0.912,significantly higher than that of each indicator detected separately.Conclusion:Elevated serum IL-6,decreased MoCA score and increased CHANGE risk score are risk factors for PSCI,the combined detection model of the three has the highest predictive efficiency for occurrence of PSCI and can provide scientific basis for early clinical intervention.

OBJECTIVE: This study aimed to explore the association between body mass index (BMI) and mortality based on the 10-year population-based multicenter prospective study. METHODS: A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023. Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality. Stratified analyses were performed based on the individual characteristics of the participants. RESULTS: Overall, 19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died. The underweight (< 18.5 kg/m ²) presented an increase in all-cause mortality (adjusted hazards ratio [ aHR] = 2.00, 95% confidence interval [ CI]: 1.66-2.41), while overweight (≥ 24.0 to < 28.0 kg/m ²) and obesity (≥ 28.0 kg/m ²) presented a decrease with an aHR of 0.61 (95% CI: 0.52-0.73) and 0.51 (95% CI: 0.37-0.70), respectively. Overweight ( aHR = 0.76, 95% CI: 0.67-0.86) and mild obesity ( aHR = 0.72, 95% CI: 0.59-0.87) had a positive impact on mortality in people older than 60 years. All-cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m ² ( aHR = 0.95, 95% CI: 0.92-0.98) and increased slightly above that value, indicating a U-shaped association. The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses. CONCLUSION This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years. Therefore, it is essential to consider age differences when formulating health and weight management strategies.
Humans ; Body Mass Index ; China/epidemiology* ; Male ; Female ; Middle Aged ; Prospective Studies ; Rural Population/statistics & numerical data* ; Aged ; Follow-Up Studies ; Adult ; Mortality ; Cause of Death ; Obesity/mortality* ; Overweight/mortality*

Objective:To explore the predictive value of serum interleukin-6(IL-6)combined with Montreal Cognitive Assessment(MoCA)score and CHANGE risk score for post-stroke cognitive impairment(PSCI),and to provide a basis for early identification and intervention of high-risk patients.Methods:The general data of 200 patients with acute stroke who were admitted to our hospital from October 2022 to September 2024 were retrospectively analyzed,they were divided into PSCI group(49 cases)and non PSCI group(151 cases)based on whether PSCI occurred 3 months after acute stroke.The general data of two groups were compared,multiple logistic regression was used to analyze the influencing factors of PSCI,and receiver operating characteristic(ROC)curves were used to evaluate predictive efficiency of serum IL-6,MoCA score and CHANGE risk score for of PSCI.Results:There was a statistically significant difference in age and education level between the two groups(P＜0.05).The serum IL-6 level and CHANGE risk score in the PSCI group were higher than those in the non PSCI group,while the MoCA score was lower than that in the non PSCI group(P＜0.05).Multivariate logistic regression showed that elevated IL-6 levels(OR=1.851,P=0.001)and elevated CHANGE risk scores(OR=1.076,P=0.016)were independent risk factors of the occurrence of PSCI,while elevated in MoCA score(OR=0.806,P=0.001)was a protective factor(P＜0.05).IL-6 levels,MoCA scores and CHANGE risk scores have high predictive efficiency for the occurrence of PSCI,the area under the curve(AUC)for predicting occurrence of PSCI by the three alone were 0.783,0.825 and 0.857 respectively,the AUC for the combined detection of the three indicators was 0.912,significantly higher than that of each indicator detected separately.Conclusion:Elevated serum IL-6,decreased MoCA score and increased CHANGE risk score are risk factors for PSCI,the combined detection model of the three has the highest predictive efficiency for occurrence of PSCI and can provide scientific basis for early clinical intervention.

Objective:To explore the predictive value of hepatitis B surface antibody (HBsAb) quantitative level for achieving hepatitis B surface antigen (HBsAg) seroclearance and serological conversion in patients with chronic hepatitis B (CHB) treated with nucleos(t)ide analogs (NAs) or interferon (IFN).Methods:A two-center prospective cohort study was conducted, including CHB patients from Nanfang Hospital Southern Medical University and Eastern Theater General Hospital treated with NAs and IFN. All patients were followed up once every three to six months. Basic clinical information and test results were collected at each follow-up. The presence or absence of HBsAg seroclearance and serological conversion rate was evaluated. HBsAg serological conversion was defined as HBsAg quantification continuously below the detection limit (<0.05 IU/mL) at two detection time points at least six months apart. HBsAg serological conversion was defined as HBsAb positivity (≥10 IU/L) at the same time as the first HBsAg seroclearance. The Kruskal-Wallis test was used to compare the quantitative data of multiple groups, and the Wilcoxon rank-sum test was used to compare the data between groups. The chi-square test was used for the count data, and the Fisher exact test was used when the chi-square test was not met. Univariate and multivariate Cox analysis was used to determine the predictors of the study endpoints, and stepwise regression was used for variable screening.Results:A total of 2 266 CHB cases were included, of which 86.5% (1 959/2 266) were NA antiviral-received population. The median treatment duration before baseline was 10.5 (2.5, 37.6) months, and the baseline HBsAg quantification was 3.1 (2.6, 3.5) log 10 IU/mL. A total of 68 cases (3.0%) had HBsAg seroclearance, and 44 cases (1.9%) achieved serological conversion after 85.0 (62.7, 97.3) months of prospective follow-up. The level and positivity rate of HBsAb showed a progressive increase 36 months before and significantly after HBsAg seroclearance. Cox regression analysis results showed that baseline HBsAb level was an independent predictor of HBsAg serological conversion ( HR=2.26, P=0.002) in the overall population, especially in the subgroup with HBsAg between 100 and 1 000 IU/mL, suggesting HBsAb level had important predictive value. In addition, the serological conversion development rate was significantly higher in the GOLDEN model favourable patients than in the unfavourable patients (11.5% vs. 0, P<0.001). Conclusion:The baseline HBsAb quantitative level can predict HBsAg seroclearance and serological conversion for patients with CHB receiving antiviral treatment, which is of significant value in long-term treatment monitoring.

AIM:To investigate the preventive and therapeutic effects of sesamin(SES)on fatty liver disease in rats with hypertension combined with dyslipidemia,and to explore the potential mecha-nisms based on mRNA-seq.METHODS:Spontane-ously hypertensive rats(SHRs)were fed a high-fat,high-cholesterol diet to establish a rat model of hy-pertension combined with dyslipidemia,and then treated with SES for 16 weeks continuously.The ex-periment was divided into four groups:WKY,SHR,Model,and Model+SES(160 mg·kg-1·d-1).Blood pressure was measured using the tail-cuff method.Body weight was monitored,and body mass index was calculated.Liver morphology was detected by ultrasound,and liver thickness was measured.Liver wet weight was weighed,and liver index was calcu-lated.Liver volume was detected by the water dis-placement method.Serum triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),alanine aminotransferase(ALT),aspartate amino-transferase(AST),and total bile acids(TBA)were de-tected by ELISA.Liver sequencing analysis was per-formed using mRNA-seq.Liver histomorphological changes were observed by HE staining.The degree of hepatic steatosis was observed by Oil Red O stain-ing,and the degree of hepatic fibrosis was observed by MASSON staining.The mRNA expression of Al-dh1a7,Nnmt,Irs2,Pltp,and Scd was detected by q-PCR.The protein expression of Scd,Nnmt,AMPK,p-AMPK,PPARα,and PPARγ was detected by Western blotting.RESULTS:After 16 weeks of continuous SES administration to rats with hypertension combined with dyslipidemia,blood pressure was significantly reduced(P＜0.01),and body weight was decreased.Serum TG,TC,and LDL-C levels were decreased,while HDL-C levels were increased.Serum ALT and AST levels were decreased.Liver weight,organ in-dex,liver thickness,and liver volume were de-creased.The degree of hepatic steatosis and hepat-ic fibrosis was improved.A total of 545 differentially expressed mRNAs were identified in the livers of rats in each group,of which 278 were upregulated and 267 were downregulated.Among the 27 com-monly differentially expressed mRNAs,five mRNAs related to lipid metabolism were screened,namely Aldh1a7,Nnmt,Irs2,Pltp,and Scd.KEGG enrich-ment analysis showed that the enriched pathways were AMPK and PPAR.Further validation revealed that in the SES-treated group,the mRNA expression of Scd in the liver was decreased,while the mRNA expression of Nnmt was increased.The protein ex-pression of Scd was decreased,while the protein ex-pression of Nnmt,AMPK,p-AMPK,PPARα,and PPARγ was increased.CONCLUSION:SES has preven-tive and therapeutic effects on fatty liver disease in rats with hypertension combined with dyslipidemia,and its mechanism of action may be related to the reduction of Scd expression levels in the liver and the increase in the expression of Nnmt,AMPK,p-AMPK,PPARα,and PPARγ.