Objective To investigate the effect of bone metabolic markers on sarcopenia in elderly patients with type 2 diabetes mellitus (T2DM). Methods A total of 412 patients with T2DM in the department of endocrinology of Nanjing Central Hospital from May 2020 to June 2025 were selected as the research subjects. According to Asian Working Group for Sarcopenia (AWGS) in 2019, these patients were evaluated for skeletal muscle mass index (ASMI), muscle strength, and muscle function, and were divided into a sarcopenia group (84 cases) and a non-sarcopenia group (328 cases). The glucolipid metabolic indexes were detected in both groups of patients, and the bone metabolic markers were evaluated, including procollagen type 1 N-terminal peptide (P1NP), beta-C-terminal telopeptide of type 1 collagen (β-CTX), and 25-hydroxy vitamin D [25-(OH)D]. The factors influencing the occurrence of sarcopenia in T2DM patients were analyzed by logistic regression analysis, and the diagnostic values of bone metabolic markers on sarcopenia in patients with T2DM were assessed by ROC curve. Results The levels of P1NP and 25-(OH)D were lower, while β-CTX level was higher in the sarcopenia group compared to the non-sarcopenia group, with statistical differences (P<0.05). After logistic correlation analysis, it was found that P1NP, β-CTX and 25-(OH)D were all influencing factors for the occurrence of sarcopenia in T2DM patients. ROC curve analysis suggested that combined detection of PINP, β-CTX, and 25-(OH)D had higher diagnostic value, with an area under the curve up to 0.805. Conclusion The abnormal expression of bone metabolic markers is associated with the increased risk of sarcopenia in patients with T2DM. The detection of serum bone metabolic markers expression level is of certain significance for the assessment of diabetes-related sarcopenia.

ObjectiveTo investigate the application of central auditory testing combined with electroencephalographic features in the early screening of mild cognitive impairment due to Alzheimer's disease. MethodsA convenience sampling method was used to conduct a field survey in the Qixia District of Nanjing City, Jiangsu Province, from July to September, 2025. A total of 40 older adults diagnosed as mild cognitive impairment due to Alzheimer's disease and 23 cognitively normal older adults were recruited. Auditory N-back and dichotic listening paradigms were employed for assessment, while the scores of Montreal Cognitive Assessment Beijing Version (MoCA-BJ) and 32-channel electroencephalogram (EEG) data were simultaneously collected. Binary logistic regression analysis was applied to identify predictive indicators, receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC) was calculated. ResultsThe total score of dichotic listening was positively correlated with overall cognitive function (r = 0.475, P < 0.01), while right-ear advantage showed negative correlations with overall cognition, visuospatial ability, abstract reasoning, and delayed recall (r < -0.276, P < 0.05). Task performance across all conditions of the N-back task was positively correlated with overall cognitive function (r > 0.249, P < 0.05). Regarding EEG features, δ and θ band power and power peaks were positively correlated with delayed recall (r > 0.258, P < 0.05), whereas (α+θ)/(α+β) and θ/(α+β) were positively correlated with naming ability and visuospatial executive function, respectively (r > 0.261, P < 0.05). The results of the binary logistic regression analysis showed that the total score of binaural dichotic listening, the accuracy of 1-back task, the average power of δ waves, and the ratio of θ/(α+β) were independent influencing factors for mild cognitive impairment due to Alzheimer's disease (P < 0.05). The ROC analysis indicated that the AUC for auditory task performance and EEG features were 0.845 and 0.735 respectively, and when combined, the AUC increased to 0.862. ConclusionThe screening model based on the integration of auditory task performance and EEG features can be used in the early identification of mild cognitive impairment due to Alzheimer's disease.

Objective To investigate the expression pattern and potential functional mechanisms of hematological and neurological expressed 1(HN1)in ovarian cancer(OC).Methods The gene expression profiling interactive analysis(GEPIA),Kaplan-Meier plotter,and the University of Alabama at Birmingham Cancer Data Analysis Portal(UALCAN)online databases were utilized to analyze the expression profile of HN1 across pan-cancer datasets,as well as its differential expression and prognostic significance in OC.Co-expressed genes of HN1 were identified based on the cancer genome atlas database,followed by functional enrichment analyses using Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathways.Furthermore,the association between HN1 expression and immune cell infiltration in OC tissues was explored by using R software.Results Analysis of the GEPIA database revealed that HN 1 expression was significantly elevated in 20 types of tumor tissues,including OC,compared to normal tissues(P＜0.05).UALCAN data indicated that HN1 expression was markedly higher in poorly differentiated OC patients(P＜0.05).Kaplan-Meier survival analysis showed that patients with high HN 1 expression had significantly shorter progression-free survival,overall survival,and post-progression survival compared to those with low HN1 expression(P＜0.05).GO and KEGG enrichment analyses suggested that HN1 is mainly involved in the regulation of the cell cycle.Immunological analysis demonstrated that HN 1 expression levels were positively correlated with the infiltration of CD4+Th2 cells and dendritic cells in OC tissues(P＜0.05).Conclusion HN1 is highly expressed in OC and may play a role in tumor progression by regulating cell cycle,promoting epithelial-mesenchymal transition,and modulating immune cell infiltration.HN1 has the potential to serve as a novel biomarker for the diagnosis and targeted therapy of OC.

Oral adenoid cystic carcinoma(OACC)is one of the malignant tumors from the oral cavity,with strong invasion and infiltration ability,and poor prognosis for patients.Studies have shown that epigenetic mechanisms such as DNA methylation,histone modification,non-coding RNAs,and chromatin remodeling are involved in regulating the occurrence,development,invasion,and me-tastasis of OACC.The in-depth research of epigenetic regulatory mechanisms has important clinical significance for the prevention,di-agnosis,and targeted therapy of OACC.This article reviews the epigenetic regulatory mechanisms and new advances in therapeutic re-search of OACC.

Objective:To explore the current status of self-management behavior in patients with inflammatory bowel disease and to construct a structural equation model to explore the mediating role of health literacy between discharge readiness and self-management behavior.Methods:From March to September 2023, 310 hospitalized patients with inflammatory bowel disease in the Tenth People ′s Hospital Affiliated to Tongji University were selected as the research subjects by the convenience sampling method. A cross-sectional survey was conducted using the general information questionnaire, the Health Literacy Management Scale, the Discharge Readiness Scale, and the Self-management Behavior Scale. Results:Eventually, 303 valid questionnaires were retrieved. Among the 303 patients, there were 190 males and 113 females, with an average age of (35.63 ± 16.41) years old. The total score of health literacy of patients with inflammatory bowel disease was (94.35 ± 10.78) points, indicating a health literacy compliance rate of 74.3%(225/303). The total score of discharge readiness was (79.52 ± 9.16) points, and the total score of self-management behavior was (135.22 ± 17.36) points. In patients with inflammatory bowel disease, the discharge readiness was positively correlated with the total score of health literacy ( r=0.748, P<0.01), the discharge readiness was positively correlated with the total score of self-management behavior ( r=0.821, P< 0.01), and the health literacy was positively correlated with the total score of self-management behavior ( r=0.767, P<0.01). Health literacy may serve as a mediating variable, partially explaining the relationship between discharge readiness and self-management behavior in patients with inflammatory bowel disease. The mediating effect accounted for 47.5% of the total effect. Conclusions:Discharge readiness not only positively impacts self-management behavior among patients with inflammatory bowel disease but also indirectly influences this behavior through health literacy. It is essential for clinical healthcare professionals to prioritize the assessment of discharge readiness and health literacy among these patients. By improving discharge readiness and enhancing health literacy, clinical healthcare professionals can effectively support patients with inflammatory bowel disease in their self-management efforts.

China emerges as a major country in nuclear energy development and the application of nuclear and radiologic technology. The diagnosis and treatment of acute radiation syndrom (ARS) caused by external irradiation represent a core function in the country′s medical rescue of nuclear and radiological emergencies. Clinically, ARS manifests hematopoietic, gastrointestinal, cutaneous, and central nervous system syndromes, with specific clinical manifestations, signs, severity, and prognosis strongly correlated with radiation dose. China has established a number of national and provincial centers for treating radiation-induced damage. Nevertheless, most medical staff have limited experience in ARS treatment. This consensus presents a summary of recent experience in treating ARS of China. In combination with recommendations from international organizations such as the World Health Organization (WHO), this consensus proposes key evidence of critical clinical issues of ARS, covering all links in the rescue of external irradiation-induced ARS. Initially, clinical diagnosis, syndromes, and severe degrees should be determined based on clinical symptoms and dose estimates. It is necessary to normalize clinical treatment measures for hematopoietic recovery, gastrointestinal injury treatment, infection control, symptomatic treatment, and multi-organ function preservation. To this end, this consensus offers cautions. This consensus provides principles of treatment with traditional Chinese medicine, psychological intervention, and follow-up. Additionally, it highlights multidisciplinary collaboration. It is recommended that this consensus be applied in relevant treatment centers.

Oral adenoid cystic carcinoma(OACC)is one of the malignant tumors from the oral cavity,with strong invasion and infiltration ability,and poor prognosis for patients.Studies have shown that epigenetic mechanisms such as DNA methylation,histone modification,non-coding RNAs,and chromatin remodeling are involved in regulating the occurrence,development,invasion,and me-tastasis of OACC.The in-depth research of epigenetic regulatory mechanisms has important clinical significance for the prevention,di-agnosis,and targeted therapy of OACC.This article reviews the epigenetic regulatory mechanisms and new advances in therapeutic re-search of OACC.

Objective To investigate the expression pattern and potential functional mechanisms of hematological and neurological expressed 1(HN1)in ovarian cancer(OC).Methods The gene expression profiling interactive analysis(GEPIA),Kaplan-Meier plotter,and the University of Alabama at Birmingham Cancer Data Analysis Portal(UALCAN)online databases were utilized to analyze the expression profile of HN1 across pan-cancer datasets,as well as its differential expression and prognostic significance in OC.Co-expressed genes of HN1 were identified based on the cancer genome atlas database,followed by functional enrichment analyses using Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathways.Furthermore,the association between HN1 expression and immune cell infiltration in OC tissues was explored by using R software.Results Analysis of the GEPIA database revealed that HN 1 expression was significantly elevated in 20 types of tumor tissues,including OC,compared to normal tissues(P＜0.05).UALCAN data indicated that HN1 expression was markedly higher in poorly differentiated OC patients(P＜0.05).Kaplan-Meier survival analysis showed that patients with high HN 1 expression had significantly shorter progression-free survival,overall survival,and post-progression survival compared to those with low HN1 expression(P＜0.05).GO and KEGG enrichment analyses suggested that HN1 is mainly involved in the regulation of the cell cycle.Immunological analysis demonstrated that HN 1 expression levels were positively correlated with the infiltration of CD4+Th2 cells and dendritic cells in OC tissues(P＜0.05).Conclusion HN1 is highly expressed in OC and may play a role in tumor progression by regulating cell cycle,promoting epithelial-mesenchymal transition,and modulating immune cell infiltration.HN1 has the potential to serve as a novel biomarker for the diagnosis and targeted therapy of OC.

Objective:To explore potential risk factors for central lymph node metastasis (CLNM) in papillary thyroid microcarcinoma (PTMC).Methods:The clinicopathological data of 304 PTMC patients admitted to Baotou Cancer Hospital from Oct 2021 to Mar 2023 were retrospectively analyzed. The risk factors of CLNM were analyzed using unifactorial and multifactorial regression.Results:The rate of central regional lymph node metastasis in 304 patients with PTMC was 46.7% (142/304). Univariate analysis showed that male, age <45 years, maximum cancerous lesion diameter ≥5 mm, total cancerous lesion diameter ≥9.5 mm, anterior-posterior lesion diameter ≥5 mm, anterior-posterior lesion diameter ratio of cancerous lesions ≥0.48, breaching of thyroid capsule, number of lymph nodes on the side of cancerous lesions ≥5, and antithyroid peroxidase antibody ≤34 IU/ml were associated with CLNM (all P<0.05); Logistic multivariate regression analysis showed that. male, age <45 years, total diameter of cancer foci ≥9.5 mm ( OR=2.052, 95% CI: 1.176-3.581, P=0.011), anteroposterior diameter ratio of cancer foci ≥0.48 ( OR=2.076, 95% CI: 1.161-3.711, P=0.014), number of lymph nodes on the side of cancer foci ≥5, and anti-thyroid peroxidase antibody ≤34 IU/ml were independent risk factors for CLNM. Conclusion:Male, age ,total diameter of cancer foci, anterior-posterior diameter ratio of cancer foci, number of lymph nodes on the side of cancer foci, and anti-thyroid peroxidase antibody level are all independent risk factors for CLNM in patients with PTMC.

Objective:To evaluate the prevalence, potential risk factors, and correlation between coronary and peripheral microvascular dysfunction in heart failure with non-reduced ejection fraction (nHFrEF) patients.Methods:This was a prospective registry study. nHFrEF patients admitted to Zhongshan Hospital affiliated with Fudan University from December 2021 to December 2023 were enrolled. According to coronary flow reserve (CFR) or reactive congestion index (RHI), enrolled patients were divided into coronary microvascular endothelial dysfunction (CMD) group (CFR<2.5) and no CMD group (CFR≥2.5) or peripheral microvascular endothelial dysfunction (MED) group (RHI<1.67) and no MED group (RHI≥1.67). Patients′ general information, laboratory and auxiliary examination data were collected. Univariate and multivariate logistic regression were used to analyze the influencing factors of CMD and MED in nHFrEF patients, and Spearman correlation analysis was used to evaluate the correlation between MED and CMD.Results:A total of 142 nHFrEF patients were enrolled, aged 69.0 (59.0, 74.0) years, with a male proportion of 66.9% (95/142). The grouping results were as follows: (1) According to CFR, there were 73 cases in the CMD group and 69 cases in the no CMD group; (2) According to RHI, there were 57 cases in the MED group and 85 cases in the no MED group. The prevalence of CMD and MED in this study was 51.4% (73/142) and 40.1% (57/142), respectively. Univariate logistic regression analysis showed that increased heart rate, chronic kidney disease, atrial fibrillation, elevated N-terminal pro-B type natriuretic peptide levels, and increased urinary albumin/creatinine ratio were risk factors for CMD, while increased RHI was a protective factor for CMD; Atrial fibrillation is a risk factor for MED, while increased CFR is a protective factor for MED. Incorporating clinically significant variables from univariate analysis into multivariate analysis, the results showed that increased heart rate and elevated RHI remained risk and protective factors for CMD, respectively; increased CFR remains a protective factor for MED. Spearman correlation analysis showed that CFR was negatively correlated with lg urinary albumin/creatinine ratio, lg cardiac troponin T, lg N-terminal pro-B type natriuretic peptide, and heart rate; RHI is positively correlated with CFR.Conclusions:The prevalence of CMD and MED in nHFrEF patients is high, and the two have a certain positive correlation. Increased heart rate and RHI are risk and protective factors for CMD, respectively, while increased CFR is a protective factor for MED. MED may be a potential therapeutic target for nHFrEF patients.