Objective To investigate the correlation between novel bone metabolism markers and the degree of aortic calcification as well as cardiovascular event risk in elderly patients treated by PD.Methods A prospective trial was conducted on 230 elderly patients receiving continuous am-bulatory PD in our department from February 2022 to February 2024.According to the occur-rence of cardiovascular events during dialysis treatment,they were divided into a cardiovascular event group(n=92)and a control group(n=138).Relevant clinical data were collected,aortic calcification was assessed using AAC scores,and serum levels of bone metabolism markers,inclu-ding osteoprotegerin,TRACP,and PINP were measured.Results The serum levels of osteoprote-gerin,TRACP and PINP were significantly higher in the cardiovascular event group than the con-trol group(P＜0.01).The cardiovascular event group had obviously severe calcification and higher AAC score than the control group(P＜0.01).The serum levels of the three bone metabolism markers were notably higher in the patients with severe calcification than those with moderate calcification,followed by mild calcification in turn(P＜0.01).Spearman correlation analysis indi-cated that the levels of the three indicators were positively correlated with the degree of aortic cal-cification in elderly PD patients(r=0.465,P=0.000;r=0.396,P=0.000;r=0.434,P=0.000).Multivariate logistic regression analysis showed that these three indicators were risk factors for cardiovascular events in elderly PD patients(P＜0.01).Conclusion The three bone metabolism markers are significantly correlated with aortic calcification severity and cardiovascular event risk in elderly PD patients.Monitoring these marker levels may be helpful for the assessment and man-agement of cardiovascular risk.

Objective:To investigate relationship between IL-17/IL-23 immunoinflammatory axis and chronic heart failure(CHF)and clinical prognosis.Methods:A total of 112 patients with CHF in Chengde Central Hospital from January 2020 to Septem-ber 2021 were selected as observation group,and another 112 patients admitted to same period for healthy physical examination were selected as control group.Serum IL-17 and IL-23 levels of two groups were compared,relationship between serum IL-17 and IL-23 levels and degree of disease were analyzed;clinical data,serum IL-17 and IL-23 levels of patients with different prognosis were compared,relationship between serum IL-17 and IL-23 levels and clinical prognosis of CHF patients were analyzed.Predictive value of serum IL-17 and IL-23 levels on clinical prognosis of CHF patients was evaluated,and predictive value of each prediction scheme was compared.Results:Serum IL-17 and IL-23 levels were higher in observation group than control group(P<0.05);serum IL-17 and IL-23 levels of CHF patients were positively correlated with NYHA classification(P<0.05).Serum IL-17 and IL-23 levels were higher in patients with poor prognosis than in those with good prognosis(P<0.05).Serum IL-17 and IL-23 were independently associated with clinical prognosis of CHF patients,and the higher the serum IL-17 and IL-23 levels,the greater risk of poor clinical prognosis of CHF patients.AUC of serum IL-17 and IL-23 levels for predicting clinical prognosis of CHF patients were 0.787 and 0.726,respectively,and combined predicted AUC was 0.918(P<0.001);combined predicted AUC of serum IL-17 and IL-23 was significantly higher than single index(P<0.05).Conclusion:IL-17 and IL-23 levels in IL-17/IL-23 immunoinflammatory axis of CHF patients are significantly elevated and involve in disease occurence and development,whose clinical detection can help predict clinical prognosis of CHF.

Gentianopsis barbata (G. barbata) represents a significant plant species with considerable ornamental and medicinal value in China. This investigation sought to elucidate the primary constituents within the plant and investigate their pharmacological properties. Fifty triterpenoids (1-50), including nine previously undescribed compounds (1, 2, 7, 10, 20, 28, 29, 37, and 41) were isolated and characterized from the whole plants of G. barbata. Notably, compounds 1 and 2 exhibited the novel 3,4;9,10-diseco-24-homo-cycloartane triterpenoid skeleton. The isolated triterpenoids demonstrated substantial anti-inflammatory activity through inhibition of tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) cytokine secretion in LPS-induced RAW264.7 macrophages, and hepatoprotective effects by preventing tert-butyl hydroperoxide (t-BHP)-induced oxidative injury in HepG2 cells. These results demonstrate both the presence of diverse triterpenoids in G. barbata and their therapeutic potential for inflammatory and hepatic conditions, providing scientific evidence supporting the clinical application of this traditional Mongolian medicinal plant.
Triterpenes/isolation & purification* ; Mice ; Anti-Inflammatory Agents/isolation & purification* ; Animals ; Humans ; RAW 264.7 Cells ; Hep G2 Cells ; Interleukin-6/genetics* ; Tumor Necrosis Factor-alpha/genetics* ; Medicine, Mongolian Traditional ; Macrophages/immunology* ; Protective Agents/isolation & purification* ; Liver/drug effects* ; Gentianaceae/chemistry* ; Plant Extracts/chemistry* ; Molecular Structure

Objective To investigate the correlation between novel bone metabolism markers and the degree of aortic calcification as well as cardiovascular event risk in elderly patients treated by PD.Methods A prospective trial was conducted on 230 elderly patients receiving continuous am-bulatory PD in our department from February 2022 to February 2024.According to the occur-rence of cardiovascular events during dialysis treatment,they were divided into a cardiovascular event group(n=92)and a control group(n=138).Relevant clinical data were collected,aortic calcification was assessed using AAC scores,and serum levels of bone metabolism markers,inclu-ding osteoprotegerin,TRACP,and PINP were measured.Results The serum levels of osteoprote-gerin,TRACP and PINP were significantly higher in the cardiovascular event group than the con-trol group(P＜0.01).The cardiovascular event group had obviously severe calcification and higher AAC score than the control group(P＜0.01).The serum levels of the three bone metabolism markers were notably higher in the patients with severe calcification than those with moderate calcification,followed by mild calcification in turn(P＜0.01).Spearman correlation analysis indi-cated that the levels of the three indicators were positively correlated with the degree of aortic cal-cification in elderly PD patients(r=0.465,P=0.000;r=0.396,P=0.000;r=0.434,P=0.000).Multivariate logistic regression analysis showed that these three indicators were risk factors for cardiovascular events in elderly PD patients(P＜0.01).Conclusion The three bone metabolism markers are significantly correlated with aortic calcification severity and cardiovascular event risk in elderly PD patients.Monitoring these marker levels may be helpful for the assessment and man-agement of cardiovascular risk.

Objective:To investigate the prevalence of flight fatigue among helicopter flying personnel and analyze its contributors in order to provide data for related interventions.Methods:A cross-sectional study was conducted among 404 helicopter flying personnel between October 8, 2021 and July 31, 2022. Data was collected using a self-designed questionnaire, involving the demography of these subjects, sleep-related factors, flight fatigue, perceived causes of fatigue and coping strategies. The Pittsburgh Sleep Quality Index (PSQI), National Aeronautics and Space Administration Task Load Index (NASA-TLX) and Modified Fatigue Impact Scale (MFI-20) were used to assess sleep quality, mental workload, and levels of flight fatigue over the past month. The total scores of MFI-20 were compared across demographic groups, and correlations with PSQI and NASA-TLX scores were analyzed. Multiple linear regression was performed to identify the determinants of flight fatigue.Results:①Demography: among the 404 helicopter flying personnel, 92.8% (375/404) were pilots and 7.2% (29/404) navigators. As for years of service, 41.6% (168/404) served less than 5 years, while 58.4% (236/404) served more than 5 years. 37.9% (153/404) had a family history of insomnia. 18.8% (76/404) did not habitually nap, 68.9% (226/328) napped for ≤30 min, 31.1% (102/328) napped over 30 min, and 18.3% (74/404) had insomnia over the past month. As for helicopter flying personnel, 75.5% (305/404) reported experiencing fatigue, with 69.1% (279/404) attributing it to flight-related factors and 51.5% (208/404) using coffee as a countermeasure.②Scale scores: the total score of PSQI was [5 (3, 7)], while the highest daytime dysfunction score was [1(0, 2)]. The total score of NASA-TLX was [39.19 (26.57, 51.97)], and the effort score was the highest [10.31(5.07, 14.60)]. The total score of MFI-20 averaged (47.28±14.88), with the mental fatigue score being the highest [(10.03±4.42)]. ③Comparisons of MFI-20 total scores: flying personnel with ≤5 years of flying experience had higher MFI-20 total scores than those with >5 years, and those with a family history of insomnia had higher scores than those without ( t=3.35, 2.44, P=0.001, 0.015). Individuals with insomnia over the past month had higher scores than non-insomniacs ( t=3.33, P=0.001). Significant differences in MFI-20 scores were observed based on nap duration ( F=19.95, P<0.001). Non-nappers had higher scores than those napping for ≤30 min ( P=0.005). Flying personnel who napped for >30 min had higher scores than those did not ( P=0.043) or napped for ≤30 min ( P<0.001). ④Correlation analysis: the total score of MFI-20 was positively correlated with sleep quality, sleep latency, sleep disturbances, hypnotic medications, daytime dysfunction, and the total score of PSQI ( r=0.118-0.226, all P<0.05), but negatively with sleep duration ( r=-0.136, P=0.006). The total score of MFI-20 was positively correlated with mental demand, physical demand, and the total score of NASA-TLX ( r=0.119, 0.168, 0.184, P=0.017, 0.001, <0.001). ⑤Multiple linear regression analysis: the determinants of flight fatigue included aircraft types ( B=-4.956, 95% CI:-8.124--1.788), nap duration ( B=3.693, 95% CI: 1.267-6.119), sleep latency ( B=2.371, 95% CI: 0.229-4.513), sleep duration ( B=-7.383, 95% CI:-10.008--4.758), daytime dysfunction ( B=5.003, 95% CI: 2.967-7.039) and physical workload ( B=0.611, 95% CI: 0.324-0.898). Conclusions:Helicopter flying personnel are vulnerable to flight fatigue, which is strongly linked to sleep quality and mental workload. It is crucial to address flying personnel′s self-perceived fatigue, care about fatigue manifestations across aircraft types, and implement targeted interventions to improve sleep quality and reduce mental workload.

Objective:To investigate relationship between IL-17/IL-23 immunoinflammatory axis and chronic heart failure(CHF)and clinical prognosis.Methods:A total of 112 patients with CHF in Chengde Central Hospital from January 2020 to Septem-ber 2021 were selected as observation group,and another 112 patients admitted to same period for healthy physical examination were selected as control group.Serum IL-17 and IL-23 levels of two groups were compared,relationship between serum IL-17 and IL-23 levels and degree of disease were analyzed;clinical data,serum IL-17 and IL-23 levels of patients with different prognosis were compared,relationship between serum IL-17 and IL-23 levels and clinical prognosis of CHF patients were analyzed.Predictive value of serum IL-17 and IL-23 levels on clinical prognosis of CHF patients was evaluated,and predictive value of each prediction scheme was compared.Results:Serum IL-17 and IL-23 levels were higher in observation group than control group(P<0.05);serum IL-17 and IL-23 levels of CHF patients were positively correlated with NYHA classification(P<0.05).Serum IL-17 and IL-23 levels were higher in patients with poor prognosis than in those with good prognosis(P<0.05).Serum IL-17 and IL-23 were independently associated with clinical prognosis of CHF patients,and the higher the serum IL-17 and IL-23 levels,the greater risk of poor clinical prognosis of CHF patients.AUC of serum IL-17 and IL-23 levels for predicting clinical prognosis of CHF patients were 0.787 and 0.726,respectively,and combined predicted AUC was 0.918(P<0.001);combined predicted AUC of serum IL-17 and IL-23 was significantly higher than single index(P<0.05).Conclusion:IL-17 and IL-23 levels in IL-17/IL-23 immunoinflammatory axis of CHF patients are significantly elevated and involve in disease occurence and development,whose clinical detection can help predict clinical prognosis of CHF.

Objective:To investigate the prevalence of flight fatigue among helicopter flying personnel and analyze its contributors in order to provide data for related interventions.Methods:A cross-sectional study was conducted among 404 helicopter flying personnel between October 8, 2021 and July 31, 2022. Data was collected using a self-designed questionnaire, involving the demography of these subjects, sleep-related factors, flight fatigue, perceived causes of fatigue and coping strategies. The Pittsburgh Sleep Quality Index (PSQI), National Aeronautics and Space Administration Task Load Index (NASA-TLX) and Modified Fatigue Impact Scale (MFI-20) were used to assess sleep quality, mental workload, and levels of flight fatigue over the past month. The total scores of MFI-20 were compared across demographic groups, and correlations with PSQI and NASA-TLX scores were analyzed. Multiple linear regression was performed to identify the determinants of flight fatigue.Results:①Demography: among the 404 helicopter flying personnel, 92.8% (375/404) were pilots and 7.2% (29/404) navigators. As for years of service, 41.6% (168/404) served less than 5 years, while 58.4% (236/404) served more than 5 years. 37.9% (153/404) had a family history of insomnia. 18.8% (76/404) did not habitually nap, 68.9% (226/328) napped for ≤30 min, 31.1% (102/328) napped over 30 min, and 18.3% (74/404) had insomnia over the past month. As for helicopter flying personnel, 75.5% (305/404) reported experiencing fatigue, with 69.1% (279/404) attributing it to flight-related factors and 51.5% (208/404) using coffee as a countermeasure.②Scale scores: the total score of PSQI was [5 (3, 7)], while the highest daytime dysfunction score was [1(0, 2)]. The total score of NASA-TLX was [39.19 (26.57, 51.97)], and the effort score was the highest [10.31(5.07, 14.60)]. The total score of MFI-20 averaged (47.28±14.88), with the mental fatigue score being the highest [(10.03±4.42)]. ③Comparisons of MFI-20 total scores: flying personnel with ≤5 years of flying experience had higher MFI-20 total scores than those with >5 years, and those with a family history of insomnia had higher scores than those without ( t=3.35, 2.44, P=0.001, 0.015). Individuals with insomnia over the past month had higher scores than non-insomniacs ( t=3.33, P=0.001). Significant differences in MFI-20 scores were observed based on nap duration ( F=19.95, P<0.001). Non-nappers had higher scores than those napping for ≤30 min ( P=0.005). Flying personnel who napped for >30 min had higher scores than those did not ( P=0.043) or napped for ≤30 min ( P<0.001). ④Correlation analysis: the total score of MFI-20 was positively correlated with sleep quality, sleep latency, sleep disturbances, hypnotic medications, daytime dysfunction, and the total score of PSQI ( r=0.118-0.226, all P<0.05), but negatively with sleep duration ( r=-0.136, P=0.006). The total score of MFI-20 was positively correlated with mental demand, physical demand, and the total score of NASA-TLX ( r=0.119, 0.168, 0.184, P=0.017, 0.001, <0.001). ⑤Multiple linear regression analysis: the determinants of flight fatigue included aircraft types ( B=-4.956, 95% CI:-8.124--1.788), nap duration ( B=3.693, 95% CI: 1.267-6.119), sleep latency ( B=2.371, 95% CI: 0.229-4.513), sleep duration ( B=-7.383, 95% CI:-10.008--4.758), daytime dysfunction ( B=5.003, 95% CI: 2.967-7.039) and physical workload ( B=0.611, 95% CI: 0.324-0.898). Conclusions:Helicopter flying personnel are vulnerable to flight fatigue, which is strongly linked to sleep quality and mental workload. It is crucial to address flying personnel′s self-perceived fatigue, care about fatigue manifestations across aircraft types, and implement targeted interventions to improve sleep quality and reduce mental workload.

Objective To comparatively explore the prognosis of hepatocellular carcinoma(HCC)patients with hepatitis B(HB)and hepatitis C(HC)after microwave ablation(MWA).Methods Data of 159 HCC patients with HB(HB-HCC)and 159 HCC patients with HC(HC-HCC)who received MWA treatment were retrospectively collected.The oncologic outcomes were compared between groups,the causes of death were analyzed,and the risk factors of overall survival(OS)in HCC patients after MWA were observed.Results The OS rate in HC-HCC group was lower than that in HB-HCC group(P=0.045),while no significant difference of disease free survival rate(P=0.095)nor cancer specific survival rate(P=0.180)was found between groups.Compared with HB-HCC group,HC-HCC group had higher risk of death due to complications related to liver cirrhosis(HR=2.339,P=0.043).Child-Pugh class B(HR=3.082,P＜0.001),hepatitis viral load＞500 IU/ml(HR=1.654,P=0.006)and the maximum diameter of lesion≥3.0 cm(HR=1.541,P=0.017)were all independent risk factors of OS in HCC patients after MWA.Conclusion Compared with HB-HCC patients,HC-HCC patients had shorter OS after MWA.

Objective To explore the characteristics of echolalic speech of children with moderate to severe autism spectrum disor-der(ASD)aged three to eight. Methods From January to March,2024,15 minutes rehabilitation course video of five children with moderate to severe ASD aged three to eight were collected in institutional and family settings,respectively.Language sample analy-sis and self-compiled coding were used to analyze the echo speech sample content,structure,and collect their oral language ability.The correlation between the echo speech and case oral language ability was analyzed. Results A total of 235 echoic speech-related speech rounds were recorded.Among them,the ratio of immediacy to de-layed echo speech was 7∶1;one echo speech was found in every two to three speech responses,with average sen-tence length of 2.97 and average word length of 2.23.The frequency of verbs and nouns was high,accounting for 45.03%and 38.48%,respectively;and there were many declarative words and sentences,accounting for 72.58%on average.The type of echo speech structure was the most frequently at the end of the reconstructed discourse,accounting for 29.98%on average.The type,frequency,sentence length,sentence pattern and structure of echoic speech were not significantly different in institutional and family settings.The language ability scores of imita-tion sentence length,word understanding and naming were significantly correlated with the number,frequency,sentence length and sentence type frequency of echoic speech(r>0.881,P<0.01). Conclusion Echoic speech activity in children with moderate to severe ASD aged three to eight shows transsituational stability,and is related with their understanding language and expressive language ability;characterized as instant echo speech,short sentence,the advantage of real words,declarative sentences,often repeat the end of the origi-nal sentence.

Objective To explore the correlation between coronary fat attenuation index of perivascular adipose tissue(FAIPVAT),as well as volumetric perivascular characterization index(VPCI),and coronary heart disease(CHD).Methods A total of 112 patients who underwent coronary computed tomography angiography(CCTA)and coronary angiography(CAG)examinations within 2 weeks were selected.The patients were divided into CHD group and control group according to the degree of coronary artery stenosis,and were divided into calcified plaque group,non-calcified plaque group and mixed plaque group according to the nature of plaque.The correlation between FAIPVAT,VPCI and CHD were evaluated.Results Of the 112 patients,71 patients in the CHD group and 41 patients in the control group.There were significant differences in gender,age,FAIPVAT and VPCI between the two groups.FAIPVAT and VPCI were positively correlated with CHD(r=0.445,P＜0.01;r=0.669,P＜0.01).FAIPVAT and VPCI were analyzed by receiver operating characteristic(ROC)curve,the area under the curve(AUC)of FAIPVAT was 0.770,the cut-off value was-81.659 HU,the sensitiv-ity was 0.592,and the specificity was 0.878,while the AUC of VPCI was 0.892,the cut-off value was 8.056,the sensitivity was 0.887,and the specificity was 0.805.There were significant differences in FAIPVAT and VPCI between non-calcified plaque group and calci-fied plaque group.FAIPVAT and VPCI of mixed plaque group and calcified plaque group were significantly different.Conclusion FAIPVAT and VPCI have some certain correlation with CHD.FAIPVAT and VPCI can accurately evaluate the risk level of CHD and coronary artery inflammation,and the value of individualized VPCI is higher.