Objective: To investigate the mechanism of action of Wuzi Yanzong pill (WYP) in rats with oligoasthenozoospermia (OAZ) via metabolomics and to provide a possible basis for improving this WYP-based treatment. Methods: A rat model of OAZ was established by treating male Sprague–Dawley rats with glucosides from Tripterygium wilfordii Hook. F. Seventy-two rats were randomly divided into six groups: control, L-carnitine (positive control), model, and low-, medium-, and high-dose WYP groups. Rats in the experimental groups were treated with WYP for 4 weeks. At the end of the treatment period, sperm cell quality (density, motility, and viability) was assessed using a semen analysis system, mitochondrial membrane potential (MMP) was assessed using flow cytometry, and testicular injury was assessed using hematoxylin and eosin staining to validate the therapeutic effect of WYP in OAZ. Further, serum metabolomics-based analysis was performed using high-performance liquid chromatography-mass spectrometry to identify differential metabolic pathways and possible mechanisms of action of WYP in OAZ treatment. Results: A rat model of OAZ was considered successfully-established after comparing the quality of spermatozoa in the model group to that in the control group. WYP-M and WYP-H treatments significantly improved sperm cell density, motility, and viability compared with those in the model group (all P < .05). Compared with the model group, both WYP-M and WYP-H treatments increased MMP values (P = .006 and P = .021 respectively), while there was no significant difference in the L-carnitine group. L-carnitine and WYP administration reversed damage to the testes to varying degrees compared with that in the model group. Further, 44 differential metabolites and four metabolic pathways, especially autophagy pathway, related to OAZ were identified via metabolomics. Conclusions WYP improves sperm cell quality and MMP in OAZ primarily via autophagy regulation. These findings can be employed to improve the efficacy of WYP in humans.

BACKGROUND:Osteoporotic vertebral compression fractures have a high rate of recurrent fractures in adjacent vertebrae after percutaneous vertebroplasty,but the cause of their occurrence is still controversial. OBJECTIVE:To explore the influencing factors of adjacent vertebral re-fractures after percutaneous vertebroplasty in patients with single-segment osteoporotic vertebral compression fractures. METHODS:A retrospective analysis was performed in 210 patients admitted to the Fifth Hospital of Wuhan City,Second Affiliated Hospital of Jianghan University from June 2016 to June 2020,who had been diagnosed with new single-segment osteoporotic vertebral compression fractures by X-ray and MRI examinations,and received percutaneous vertebroplasty.The patients were followed up for more than 18 months.The general preoperative data and postoperative indicators were collected.The general preoperative data included age,sex,body mass index,fracture segment location,fracture days,fracture cause,whether accompanied by diabetes mellitus,whether accompanied by renal and thyroid dysfunction,and visual analogue scale score on admission.The postoperative indicators included recovery rate of anterior edge of the vertebral body after operation,degree of dispersion of bone cement,leakage of bone cement,use of bone material,single or bilateral injection of bone cement,recovery rate of the injured vertebral mid-column after operation,local Cobb angle of the injured vertebra after operation.According to their real conditions,the patients were divided into a group without adjacent vertebral re-fractures(n=190)and a group with adjacent vertebral re-fractures(n=20).The presence or absence of postoperative re-fracture of the adjacent vertebrae of the injured spine was used as the dependent variable and the categorical variables such as preoperative general data and postoperative indicators were used as independent variables for statistical analysis. RESULTS AND CONCLUSION:After percutaneous vertebroplasty,patients with adjacent vertebral re-fractures showed significant differences in age,body mass index,postoperative vertebral body anterior edge recovery rate,degree of cement dispersion,and cement leakage from those without adjacent vertebral re-fractures(P<0.05).However,sex,time of fracture,cause of fracture,presence of diabetes or kidney disease or thyroid disease,location of the initial vertebral fracture segment,mode of cement injection,local Cobb angle of the injured vertebra,recovery rate of the injured vertebral mid-column,and use of bone tissue were not statistically significant in relation to re-fracture of the adjacent vertebra after percutaneous vertebroplasty(P>0.05).Multivariate Logistic regression analysis showed that age,vertebral body anterior edge recovery rate and cement leakage were independent risk factors for re-fractures of the adjacent vertebra after percutaneous vertebroplasty.To conclude,age,vertebral body anterior edge recovery rate and leakage of bone cement are the influencing factors of adjacent vertebral re-fractures after percutaneous vertebroplasty.However,factors such as the degree of bone cement dispersion and the local Cobb angle of the injured vertebra were not correlated with adjacent vertebral re-fractures after percutaneous vertebroplasty.

Objective:To explore the value of Chinese Group on the Study of Severe Hepatitis B-acute-on-chronic live failure (COSSH-ACLF Ⅱ) score combined with serum alpha-fetoprotein (AFP) in predicting the prognosis of hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) patients treated with artificial liver therapy.Methods:A total of 174 HBV-ACLF patients who underwent initial artificial liver therapy admitted to the Department of Infectious Diseases, The First Hospital of Shanxi Medical University, from March 2023 to April 2024 were enrolled. The model for end-stage liver disease (MELD), MELD combined with serum sodium (MELD-Na), MELD 3.0, and COSSH-ACLF Ⅱ scores were calculated. The 174 patients were divided into a training set and a validation set at a 7∶3 ratio. Based on follow-up survival outcomes, the patients in the training and validation sets were classified into survival and non-survivor groups. Laboratory tests, serum AFP levels, and various model scores were compared between the two groups. Logistic regression analysis was used to identify prognostic factors in HBV-ACLF patients, and a nomogram model was constructed. The predictive value of COSSH-ACLF Ⅱ score combined with serum AFP levels for follow-up deadline (June 14, 2024) prognosis and survival outcomes at 30, 60, and 90 days post-artificial liver therapy in HBV-ACLF patients was assessed using receiver operating characteristic (ROC) curves. Statistical comparisons were performed using the independent sample t test and Mann-Whitney U test. Results:Among the 174 HBV-ACLF patients, 122 were in the training set (80 survivors, 42 non-survivors) and 52 were in the validation set (17 survivors, 35 non-survivors). In the training set, age, neutrophil count, urea, MELD score, MELD-Na score, MELD 3.0 score, COSSH-ACLF Ⅱ score, and AFP levels in the non-survivor group were significantly higher than those in the survivor group ( t=2.82, Z=-3.27, Z=-2.65, t=2.16, t=2.60, t=2.33, t=4.56 and Z=-4.71, respectively, all P<0.05). In the validation set, albumin, COSSH-ACLF Ⅱ score, and AFP levels in the non-survivor group were significantly higher than those in the survivor group ( Z=-2.20, t=2.78 and Z=-2.55, respectively, all P<0.05). Serum AFP (odds ratio ( OR)=1.005, 95% confidence interval (95% CI) 1.001 to 1.008, P=0.010) and COSSH-ACLF Ⅱ score ( OR=2.140, 95% CI 1.410 to 3.240, P<0.001) were independent risk factors for the prognosis of HBV-ACLF patients. A nomogram predicting the prognosis of HBV-ACLF patients was constructed using serum AFP and the COSSH-ACLF Ⅱ score, with a C-index of 0.816 and a well-fitted calibration curve. In the training set, the areas under the curve (AUC) for COSSH-ACLF Ⅱ score, serum AFP levels, and their combined prediction of prognosis were 0.737, 0.760 and 0.816, respectively, and the AUCs for COSSH-ACLF Ⅱ score combined with serum AFP were 0.805, 0.797 and 0.739, respectively, for predicting the prognosis at 30, 60, and 90 days post-artificial liver therapy. In the validation set, the AUCs for COSSH-ACLF Ⅱ score, serum AFP levels, and their combined prediction of prognosis were 0.701, 0.720 and 0.785, respectively, and the AUCs for COSSH-ACLF Ⅱ score combined with serum AFP were 0.729, 0.684 and 0.624, respectively, for predicting prognosis at 30, 60, and 90 days post-artificial liver therapy. Conclusions:Serum AFP and the COSSH-ACLF Ⅱ score are independent risk factors for the prognosis of HBV-ACLF patients. Patients with poor prognosis may have higher COSSH-ACLF Ⅱ scores and serum AFP levels, and the combination of COSSH-ACLF Ⅱ score with serum AFP levels can improve the accuracy of predicting short-term prognosis in these patients.

Objective:To explore the value of Chinese Group on the Study of Severe Hepatitis B-acute-on-chronic live failure (COSSH-ACLF Ⅱ) score combined with serum alpha-fetoprotein (AFP) in predicting the prognosis of hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) patients treated with artificial liver therapy.Methods:A total of 174 HBV-ACLF patients who underwent initial artificial liver therapy admitted to the Department of Infectious Diseases, The First Hospital of Shanxi Medical University, from March 2023 to April 2024 were enrolled. The model for end-stage liver disease (MELD), MELD combined with serum sodium (MELD-Na), MELD 3.0, and COSSH-ACLF Ⅱ scores were calculated. The 174 patients were divided into a training set and a validation set at a 7∶3 ratio. Based on follow-up survival outcomes, the patients in the training and validation sets were classified into survival and non-survivor groups. Laboratory tests, serum AFP levels, and various model scores were compared between the two groups. Logistic regression analysis was used to identify prognostic factors in HBV-ACLF patients, and a nomogram model was constructed. The predictive value of COSSH-ACLF Ⅱ score combined with serum AFP levels for follow-up deadline (June 14, 2024) prognosis and survival outcomes at 30, 60, and 90 days post-artificial liver therapy in HBV-ACLF patients was assessed using receiver operating characteristic (ROC) curves. Statistical comparisons were performed using the independent sample t test and Mann-Whitney U test. Results:Among the 174 HBV-ACLF patients, 122 were in the training set (80 survivors, 42 non-survivors) and 52 were in the validation set (17 survivors, 35 non-survivors). In the training set, age, neutrophil count, urea, MELD score, MELD-Na score, MELD 3.0 score, COSSH-ACLF Ⅱ score, and AFP levels in the non-survivor group were significantly higher than those in the survivor group ( t=2.82, Z=-3.27, Z=-2.65, t=2.16, t=2.60, t=2.33, t=4.56 and Z=-4.71, respectively, all P<0.05). In the validation set, albumin, COSSH-ACLF Ⅱ score, and AFP levels in the non-survivor group were significantly higher than those in the survivor group ( Z=-2.20, t=2.78 and Z=-2.55, respectively, all P<0.05). Serum AFP (odds ratio ( OR)=1.005, 95% confidence interval (95% CI) 1.001 to 1.008, P=0.010) and COSSH-ACLF Ⅱ score ( OR=2.140, 95% CI 1.410 to 3.240, P<0.001) were independent risk factors for the prognosis of HBV-ACLF patients. A nomogram predicting the prognosis of HBV-ACLF patients was constructed using serum AFP and the COSSH-ACLF Ⅱ score, with a C-index of 0.816 and a well-fitted calibration curve. In the training set, the areas under the curve (AUC) for COSSH-ACLF Ⅱ score, serum AFP levels, and their combined prediction of prognosis were 0.737, 0.760 and 0.816, respectively, and the AUCs for COSSH-ACLF Ⅱ score combined with serum AFP were 0.805, 0.797 and 0.739, respectively, for predicting the prognosis at 30, 60, and 90 days post-artificial liver therapy. In the validation set, the AUCs for COSSH-ACLF Ⅱ score, serum AFP levels, and their combined prediction of prognosis were 0.701, 0.720 and 0.785, respectively, and the AUCs for COSSH-ACLF Ⅱ score combined with serum AFP were 0.729, 0.684 and 0.624, respectively, for predicting prognosis at 30, 60, and 90 days post-artificial liver therapy. Conclusions:Serum AFP and the COSSH-ACLF Ⅱ score are independent risk factors for the prognosis of HBV-ACLF patients. Patients with poor prognosis may have higher COSSH-ACLF Ⅱ scores and serum AFP levels, and the combination of COSSH-ACLF Ⅱ score with serum AFP levels can improve the accuracy of predicting short-term prognosis in these patients.

Objective:To evaluate the intervention effect of Naikan cognitive therapy (NCT)on psychosomatic symptoms of female compulsory drug addicts.Methods:Seventy drug addicts who met the inclusion criteria and volunteered to participate in the study were selected and randomly divided into intervention group( n=35) and control group( n=35) with random number table method.The intervention group received 10 consecutive days of NCT, while the control group received the same period of mental health education.Before and after treatment, the two groups were assessed with symptoms check list-90(SCL-90), preceived social support scale(PSSS), simple coping style scale(SCSQ) and inclination of relapse questionnaire of drug rehabilitated addicts. Results:There was no significant difference between the two groups before the intervention (all P>0.05). Compared with pre-intervention, the total score of SCL-90((176.49±40.85) vs (152.60±31.17)), somatization, compulsion, interpersonal sensitivity, depression, anxiety, terror, paranoid and psychiatric factors were significantly decreased and the total scores of PSSS((59.09±14.60) vs (64.43±10.42)) family support, friend support and other support subscales increased significantly post-NCT intervention in the intervention group (all P<0.05). Compared with control group, the scores of positive coping((25.54±6.09) vs (22.37±7.04)) increased significantly, and the tendency of negative coping((8.20±3.59) vs (10.17±4.03)) and relapse((15.66±9.57) vs (22.11±10.18)) decreased significantly (all P<0.05) after intervention in the intervention group.There was no significant difference in the scores of all scales in the control group (all P>0.05). Conclusion:Naikan cognitive therapy can significantly improve the psychosomatic symptoms perceive social support and positive coping styles, and reduce the tendency of negative coping and relapse of female compulsory drug addicts.