Objective To investigate the predictive value of triglyceride glucose-body mass index(TyG-BMI),serum triglyceride-to-high-density lipoprotein cholesterol ratio(TG/HDL-C),and metabolic score for insulin resistance(METS-IR)for fatty pancreatic disease(FPD).Methods A total of 240 patients with FPD treated in The First Affiliated Hospital of Zhengzhou University from January 2020 to November 2023 were included as the case group,while 480 healthy subjects who underwent healthy checks in the same period were randomly selected as the control group.General clinical data and laboratory indicators were collected.The Mann-Whitney U test and chi-square test were used to compare non-normally distributed continuous variables,and categorical variables between groups,respectively.A binary logistic regression model was used to assess the relationship between TyG-BMI,TG/HDL-C,and METS-IR and FPD.The receiver operating characteristic(ROC)curve was plotted,and the area under the curve(AUC)was calculated to evaluate the predictive diagnostic value of those simplified insulin resistance indicators for FPD in the general population and different sex populations.Results Age,BMI,systolic blood pressure,diastolic blood pressure,fasting plasma glucose,uric acid,alanine aminotransferase,aspartate aminotransferase,gamma-glutamyl transferase,total cholesterol,triglyceride,low-density lipoprotein cholesterol,TyG-BMI,TG/HDL-C,and METS-IR in the case group were significantly higher than those in the control group(all P<0.05).The case group had significantly higher proportions of individuals with hypertension,diabetes,and fatty liver disease than the control group(all P<0.05).The high-density lipoprotein cholesterol level was significantly lower in the case group than in the control group(P<0.05).The multivariable Logistic regression analysis showed that after adjusting for various influencing factors,TyG-BMI,TG/HDL-C,and METS-IR remained as independent risk factors for the development of FPD,with the odds ratios(95%confidence intervals)being 1.027(1.018-1.037),6.964(2.022-23.989),and 1.184(1.123-1.248),respectively.In the ROC curve analysis,the AUCs of METS-IR and TyG-BMI were 0.823 and 0.803,respectively,with their sensitivities being 76.3%and 75.8%,specificities being 74.6%and 71.7%,and optimal cut-off values being 34.86 and 196.70,respectively;the next were BMI(AUC=0.758)and TG/HDL-C(AUC=0.734);in the sex-stratified analysis,the AUC values of METS-IR were highest in both the male and female subgroups,which were 0.834 and 0.810,respectively.Conclusion TyG-BMI,TG/HDL-C,and METS-IR show good predictive value for the development of FPD,in which METS-IR is more excellent.

Objective To investigate the proportion of Th17 cells,Th1-like Th17 cells and FoxP3+Th17 cells in bone marrow of patients with myelodysplastic syndrome(MDS),the expression of interleukin-17A(IL-17A)in bone marrow supernatant and its clinical significance.Methods Forty MDS patients(MDS group)and 18 patients with nutritional anemia(control group)were selected.MDS patients were classified into the low blast(MDS-LB)group(19 cases)and the increased blast(MDS-IB)group(21 cases,including 11 cases of type IB1 and 10 cases of type IB2)based on morphological definition.The MDS patients were scored according to the revised International Prognostic Scoring System(IPSS-R),with 18 cases in the low-risk group(≤4.5)and 22 cases in the high-risk group(>4.5).Flow cytometry was used to detect the proportion of Th17 cells,Th1-like Th17 cells and FoxP3+Th17 cells in bone marrow of the MDS group and the control group.Enzyme-linked immunosorbent assay(ELISA)was used to detect the level of IL-17A in bone marrow supernatant of the above samples.Results The proportion of Th17 cells and the level of IL-17A were higher in patients of the MDS group than those in the control group(P＜0.05).According to the median expression level of IL-17A,the MDS group was divided into the low-expression group(＜13.71 ng/L,20 cases)and the high-expression group(≥13.71 ng/L,20 cases).Compared with the low-expression group,there were higher proportion of patients with blast cells＜5%and low-risk patients(P＜0.05)in the high-expression group.Compared with the IL-17A low-expression group,the IL-17A high-expression group had a higher proportion of patients with blast cells＜5%and relatively low-risk patients(P＜0.05).Compared with the low-risk patients,high-risk patients had a lower proportion of Th17 cells,IL-17A levels and Th1-like Th17 cells,and a higher proportion of FoxP3+Th17 cells(P＜0.05).Compared with the MDS-LB group,the MDS-IB group had a lower proportion of Th17 cells,IL-17A levels and Th1-like Th17 cells,and a higher proportion of FoxP3+Th17 cells(P＜0.05).Conclusion The proportion of Th17 cells and the level of IL-17A are significantly increased in MDS patients.The decreased proportion of Th1-like Th17 cells and the increased proportion of FoxP3+Th17 cells may be related to the increased proportion of blast cells and higher risk stratification in patients.

OBJECTIVE To observe the clinical efficacy of Ziyu Prescription in the treatment of polycystic ovary syndrome relat-ed infertility of kidney deficiency and its effect on endometrial receptivity.METHODS A total of 120 patients with polycystic ovary syndrome related infertility of kidney deficiency were enrolled and randomly divided into a control group and a treatment group,with 60 cases in each group.After excluding dropout cases and excluded cases,56 cases were completed in each group.The control group was treated with letrozole and placebo,while the treatment group was treated with letrozole and Ziyu Prescription.The treatment course of both groups was 3 menstrual cycles.The clinical pregnancy rate and ultrasound Salle score during the implantation window were the main outcome indicators.The traditional Chinese medicine(TCM)syndrome score and serum estradial(E2),testosterone(T),anti-Müllerian hormone(AMH),luteinizing hormone(LH),follicle-stimulating hormone(FSH),homeostatic model assessment of insulin resistance(HOMA-IR),serum E2 and progesterone(P)levels during the implantation window were used as secondary outcome indica-tors.Multivariate Logistic regression and ROC curve analysis were used to evaluate the effect and predictive ability of ultrasound Salle score on pregnancy outcome.Multiple linear regression was used to evaluate the effect of estrogen and progesterone levels during the implantation window on ultrasound Salle score.RESULTS After treatment,the clinical pregnancy rate and ultrasound Salle score during the implantation window in the treatment group were significantly higher than those in the control group(P＜0.05,P＜0.01).The total TCM syndrome score of the treatment group was significantly lower than that of the control group(P＜0.01);the ser-um T,LH/FSH,and HOMA-IR levels of the treatment group were significantly lower than those of the control group(P＜0.05,P＜0.01);the serum E2 and P levels of the treatment group were significantly higher than those of the control group during the implanta-tion window period(P＜0.01).Multivariate Logistic regression analysis and ROC curve analysis showed that ultrasound Salle score was significantly positively correlated with pregnancy rate and had a high predictive value for pregnancy outcome.Multiple linear regression analysis found that there was a linear relationship between the ultrasound Salle score and E2 and P during the implantation window peri-od,and the P level had a greater impact.CONCLUSION Ziyu Prescription can improve the clinical pregnancy rate of patients with polycystic ovary syndrome related infertility of kidney deficiency,effectively improve their endometrial receptivity,regulate the levels of sex hormones and glucose metabolism,reduce the TCM syndrome score,and improve the reproductive quality of patients.

OBJECTIVE To observe the clinical efficacy of Ziyu Prescription in the treatment of polycystic ovary syndrome relat-ed infertility of kidney deficiency and its effect on endometrial receptivity.METHODS A total of 120 patients with polycystic ovary syndrome related infertility of kidney deficiency were enrolled and randomly divided into a control group and a treatment group,with 60 cases in each group.After excluding dropout cases and excluded cases,56 cases were completed in each group.The control group was treated with letrozole and placebo,while the treatment group was treated with letrozole and Ziyu Prescription.The treatment course of both groups was 3 menstrual cycles.The clinical pregnancy rate and ultrasound Salle score during the implantation window were the main outcome indicators.The traditional Chinese medicine(TCM)syndrome score and serum estradial(E2),testosterone(T),anti-Müllerian hormone(AMH),luteinizing hormone(LH),follicle-stimulating hormone(FSH),homeostatic model assessment of insulin resistance(HOMA-IR),serum E2 and progesterone(P)levels during the implantation window were used as secondary outcome indica-tors.Multivariate Logistic regression and ROC curve analysis were used to evaluate the effect and predictive ability of ultrasound Salle score on pregnancy outcome.Multiple linear regression was used to evaluate the effect of estrogen and progesterone levels during the implantation window on ultrasound Salle score.RESULTS After treatment,the clinical pregnancy rate and ultrasound Salle score during the implantation window in the treatment group were significantly higher than those in the control group(P＜0.05,P＜0.01).The total TCM syndrome score of the treatment group was significantly lower than that of the control group(P＜0.01);the ser-um T,LH/FSH,and HOMA-IR levels of the treatment group were significantly lower than those of the control group(P＜0.05,P＜0.01);the serum E2 and P levels of the treatment group were significantly higher than those of the control group during the implanta-tion window period(P＜0.01).Multivariate Logistic regression analysis and ROC curve analysis showed that ultrasound Salle score was significantly positively correlated with pregnancy rate and had a high predictive value for pregnancy outcome.Multiple linear regression analysis found that there was a linear relationship between the ultrasound Salle score and E2 and P during the implantation window peri-od,and the P level had a greater impact.CONCLUSION Ziyu Prescription can improve the clinical pregnancy rate of patients with polycystic ovary syndrome related infertility of kidney deficiency,effectively improve their endometrial receptivity,regulate the levels of sex hormones and glucose metabolism,reduce the TCM syndrome score,and improve the reproductive quality of patients.

Objectives:To investigate the mechanism of insulin-like growth factor 1(IGF-1)in mediating intervertebral disc cell aging through regulating the activity of the silent information regulator sirtuin 1(SIRT1).Methods:The intervertebral disc tissues of eight-week old female Spargue Dawley(SD)rats were dissected,from which annulus fibrosus(AF)cells were isolated and cultured in vitro.The effects of IGF-1 on the aging of AF cells were studied by β-galactosidase(SA-β-Gal)staining,cell proliferation assays,and cell migration experiments,in exposure to different concentrations of recombinant rat IGF-1(0,1,10,50,100ng/mL)in culture.The molecular mechanism of IGF-1 on AF cells was further explored by Western blot analysis.Results:After treatment with exogenous IGF-1 at different concentrations,SA-β-Gal staining and western blot results showed that IGF-1 promoted AF cell aging in a concentration-dependent manner.The CCK-8 analysis showed that low concentrations of IGF-1 significantly induced AF cell proliferation.Transwell assay results showed that low concentrations of IGF-1 profoundly enhanced the migratory capability of AF cells,whereas IGF-1 at high concentrations demonstrated no significant effect on AF cell migration.Western blot results showed that IGF-1 could downregulate the expression of SIRT1 and elevate the acetylation of p53.Conclusions:IGF-1 can promote AF cell aging though inhibiting SIRT1 expression and activity.

Background Staff in tertiary hospitals are a high-risk group for occupational burnout. Timely identification and precise intervention are crucial for improving healthcare service quality. However, comparative studies on perceived stress and occupational burnout among hospital staff in different positions are lacking. Objective To describe the status of perceived stress and occupational burnout among hospital staff in different positions and compare the differences, explore the relationship between perceived stress and occupational burnout, and identify the influencing factors of occupational burnout. Methods In May 2022, 1526 hospital staff members were selected by convenience sampling from six tertiary hospitals in Guangzhou. Data were collected using a general information questionnaire, the Chinese Perceived Stress Scale (CPSS), and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) to assess demographic characteristics, perceived stress, and occupational burnout. Chi-square test, one-way ANOVA, and Kruskal-Wallis H test were used to compare differences in perceived stress and occupational burnout among staff in different positions. Pearson correlation analysis was used to explore possible correlation between perceived stress and occupational burnout. Multiple linear regression was conducted to identify influencing factors of occupational burnout. Results A total of 1388 valid questionnaires were collected, with an effective response rate of 90.96%. Among them, 437 nurses (57.0%), 273 physicians (58.6%), 24 pharmacists (57.1%), and 62 administrators (54.9%) reported positive perceived health risk stress (P=0.892). Additionally, 392 nurses (51.1%), 213 physicians (45.7%), 19 pharmacists (45.2%), and 53 administrators (46.9%) reported positive occupational burnout (P=0.005). Perceived stress was positively correlated with occupational burnout among nurses, physicians, pharmacists, and administrators (r=0.5973, 0.5687, 0.5464, and 0.5276, respectively; P＜0.01). The multiple linear regression identified perceived stress (b=1.4587, P＜0.001), job satisfaction (b=−7.4195, P＜0.001), self-rated health (b=−2.0428, P＜0.001), working years (b=−0.1135, P=0.016), and being a nurse (compared with an administrators) (b=3.2435, P=0.045) as significant factors for occupational burnout (P<0.001). Conclusion Perceived health risk stress and occupational burnout are common among hospital staff, with nurses experiencing significantly higher levels of occupational burnout compared to other positions. Hospital managers should pay more attention to staff with higher perceived stress, lower job satisfaction, poorer self-rated health, and shorter working years, particularly nurses.

ObjectiveTo explore the construction of a machine learning model for the diagnosis of traditional Chinese medicine （TCM） syndromes in chronic cough and the optimization of this model using the Voting ensemble algorithm. MethodsA retrospective analysis was conducted using clinical data from 921 patients with chronic cough treated at the Respiratory Department of Dongfang Hospital， Beijing University of Chinese Medicine. After standardized processing， 84 clinical features were extracted to determine TCM syndrome types. A specialized dataset for TCM syndrome diagnosis in chronic cough was formed by selecting syndrome types with more than 50 cases. The synthetic minority over-sampling technique （SMOTE） was employed to balance the dataset. Four base models， logistic regression （LR）， decision tree （dt）， multilayer perceptron （MLP）， and Bagging， were constructed and integrated using a hard voting strategy to form a Voting ensemble model. Model performance was evaluated using accuracy， recall， precision， F1-score， receiver operating characteristic （ROC） curve， area under the curve （AUC）， and confusion matrix. ResultsAmong the 921 cases， six syndrome types had over 50 cases each， phlegm-heat obstructing the lung （294 cases）， wind pathogen latent in the lung （103 cases）， cold-phlegm obstructing the lung （102 cases）， damp-heat stagnating in the lung （64 cases）， lung yang deficiency （54 cases）， and phlegm-damp obstructing the lung （53 cases）， yielding a total of 670 cases in the specialized dataset. High-frequency symptoms among these patients included cough， expectoration， odor-induced cough， throat itchiness， itch-induced cough， and cough triggered by cold wind. Among the four base models， the MLP model showed the best diagnostic performance （test accuracy： 0.9104； AUC： 0.9828）. Compared with the base models， the Voting ensemble model achieved superior performance with an accuracy of 0.9289 on the training set and 0.9253 on the test set， showing a minimal overfitting gap of 0.0036. It also achieved the highest AUC （0.9836） in the test set， outperforming all base models. The model exhi-bited especially strong diagnostic performance for damp-heat stagnating in the lung （AUC： 0.9984） and wind pathogen latent in the lung （AUC： 0.9970）. ConclusionThe Voting ensemble algorithm effectively integrates the strengths of multiple machine learning models， resulting in an optimized diagnostic model for TCM syndromes in chronic cough with high accuracy and enhanced generalization ability.

Objective:To identify potential therapeutic targets for the treatment of hair color and hair shaft abnormalities, providing novel insights and approaches for managing related conditions.Methods:Using the pQTL data from large-scale proteomics studies, a two-sample Mendelian randomization (TwoSampleMR) was conducted to preliminarily identify potential drug therapeutic targets. Subsequently, sensitivity analysis was performed to evaluate potential confounding factors such as heterogeneity and horizontal pleiotropy, and a leave-one-out sensitivity analysis was conducted by eliminating each single nucleotide polymorphism (SNP) one by one. Finally, co-localization analysis was carried out to explore whether there are shared genetic variants between the identified plasma proteins and traits.Results:The proteomic data used in this study included 4, 907 pQTLs, while the genetic data related to hair pigmentation and shaft abnormalities comprised 124 cases and 432, 686 controls. After Mendelian randomization screening, six candidate protein genes were identified: HLA-DQA2, CTSB, KIR2DS2, SVEP1, HOMER2, and HOMER1. Sensitivity analyses revealed no evidence of heterogeneity or horizontal pleiotropy among these proteins. Leave-one-out sensitivity analysis indicated that no single SNP significantly influenced the overall result. Notably, HOMER2 was supported by colocalization analysis with strong evidence, suggesting its potential role in regulating genetic mechanisms underlying hair pigmentation and shaft health.Conclusions:This study identified six potential therapeutic targets for hair pigmentation and shaft abnormalities, with HOMER2 showing stronger evidence. These findings provide novel directions for the treatment of hair color and hair shaft abnormalities.

Gut microbial communities are likely remodeled in tandem with accumulated physiological decline during aging, yet there is limited understanding of gut microbiome variation in advanced age. Here, we performed a metagenomics-based enterotype analysis in a geographically homogeneous cohort of 367 enrolled Chinese individuals between the ages of 60 and 94 years, with the goal of characterizing the gut microbiome of elderly individuals and identifying factors linked to enterotype variations. In addition to two adult-like enterotypes dominated by Bacteroides (ET-Bacteroides) and Prevotella (ET-Prevotella), we identified a novel enterotype dominated by Escherichia (ET-Escherichia), whose prevalence increased in advanced age. Our data demonstrated that age explained more of the variance in the gut microbiome than previously identified factors such as type 2 diabetes mellitus (T2DM) or diet. We characterized the distinct taxonomic and functional profiles of ET-Escherichia, and found the strongest cohesion and highest robustness of the microbial co-occurrence network in this enterotype, as well as the lowest species diversity. In addition, we carried out a series of correlation analyses and co-abundance network analyses, which showed that several factors were likely linked to the overabundance of Escherichia members, including advanced age, vegetable intake, and fruit intake. Overall, our data revealed an enterotype variation characterized by Escherichia enrichment in the elderly population. Considering the different age distribution of each enterotype, these findings provide new insights into the changes that occur in the gut microbiome with age and highlight the importance of microbiome-based stratification of elderly individuals.
Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Bacteroides ; China ; Diabetes Mellitus, Type 2/microbiology* ; Escherichia coli/classification* ; Gastrointestinal Microbiome/genetics* ; Metagenomics ; East Asian People

Objective To analyze the hotspots and trends in the research field of inflammation in polycystic ovary syndrome(PCOS).Methods This study retrieved data from the Web of Science Core Collection database,with the retrieval period spanning from January 2000 to December 2023.The litera-ture types included were papers and review papers in English.The search was conducted using"Poly-cystic Ovarian Syndrome"and its synonyms,along with"inflammation"as subject terms.Visualization analysis was performed using software such as CiteSpace,VOSviewer,and SCImago Graphica.Results A total of 1,803 articles were included in this study.The number of publications in this field had rapidly increased after 2018.China had the highest number of publications,and Tehran University of Medical Sciences was the institution with the most publications.Key scholars included Asemi Z,Gonzalez AM,Escobar-Morreale HF,etc.,and a core group of authors had been formed.The main research hotspots centered around insulin resistance,obesity,oxidative stress,etc.,and five clusters were formed.Highly cited and burst-cited literature were mainly review papers.Conclusion The re-search field of inflammation in PCOS is currently in a stage of rapid development,with research content covering PCOS inflammation markers,the impact of inflammation on PCOS pathophysiology,inflamma-tion-based PCOS treatment and prognosis,etc.The debate on whether the chronic low-grade inflammatory state in PC OS patients is related to obesity or not remains a focal point of contention.