Objective To analyze the prognostic value of carotid ultrasound quantitative parameters combined with serum TNF-α and receptor-interacting protein kinase 1(RIPK1)levels for patients with acute ischemic stroke(AIS).Methods A total of 110 AIS patients admitted in our hospital from February 2020 to May 2024 were enrolled,and according to their modified Rankin scale(mRS)score after 3 months,they were divided into a good prognosis group(76 cases)and a poor prognosis group(34 cases).The carotid ultrasound quantitative parameters such as intima-media thickness(CIMT),end diastolic velocity(EDV)and peak systolic velocity(PSV)and serum TNF-α and RIPK1 levels were detected.The relationship of the parameters and the serum levels with prognosis was analyzed.Results The poor prognosis group had significantly higher carotid CIMT and EDV values and serum levels of TNF-α and RIPK1,and lower PSV value than the good prognosis group(P＜0.01).The CIMT,PSV,EDV,TNF-α and RIPK1 were independent in-fluencing factors of prognosis of AIS patients(P＜0.01).ROC curve analysis showed that the AUC value of CIMT,PSV,EDV,TNF-α and RIPK1 combined together in predicting the poor prognosis of AIS patients was 0.979,with a sensitivity of 94.10％and a specificity of 75.00％.Conclusion Carotid ultrasound quantitative parameters combined with serum TNF-α and RIPK1 levels can effectively assess the prognosis of AIS patients,with high predictive value.

Objective:To develop and validate a predictive model for delayed emergence in patients undergoing thoracoscopic radical lung cancer surgery with general anesthesia.Methods:A total of 1 468 patients admitted to the anesthesia recovery room after thoracoscopic radical lung cancer surgery at the First Affiliated Hospital of Zhejiang University School of Medicine from August 2020 to August 2021 were selected via convenience sampling. Patients who underwent surgery between August 2020 and June 2021 ( n=1 213) were assigned to the modeling group, while those from July to August 2021 ( n=255) were used as the validation group. Logistic regression analysis was used to identify risk factors for delayed emergence and to establish a predictive model. The performance of the model was evaluated using the area under the receiver operating characteristic curve ( AUC) and the Hosmer-Lemeshow goodness-of-fit test. Results:Among the modeling group, 200 patients experienced delayed emergence, with an incidence of 16.49% (200/1 213). Logistic regression analysis revealed that the use of reversal agents, use of neostigmine, albumin level, presence of shivering, pain score≥4 points, extubation time, partial pressure of CO 2, partial pressure of oxygen, serum potassium level, and intraoperative fentanyl dosage were significant influencing factors ( P<0.05). The predictive model demonstrated good performance with an AUC of 0.864 [95% CI (0.828, 0.899) ], a Hosmer-Lemeshow test χ 2=5.299 ( P=0.725), cut-off value of 0.442, sensitivity of 0.794, and specificity of 0.769. In the validation group, delayed emergence occurred in 44 cases (17.25%). The model showed good validation performance with an AUC of 0.852 [95% CI (0.826, 0.878) ], Hosmer-Lemeshow χ 2=5.912 ( P=0.336), cut-off value of 0.754, sensitivity of 0.674, and specificity of 0.877. Conclusions:The predictive model constructed in this study demonstrates strong performance and can assist clinicians in the early identification of patients at risk of delayed emergence following thoracoscopic radical lung cancer surgery under general anesthesia.

Objective:To develop and validate a predictive model for delayed emergence in patients undergoing thoracoscopic radical lung cancer surgery with general anesthesia.Methods:A total of 1 468 patients admitted to the anesthesia recovery room after thoracoscopic radical lung cancer surgery at the First Affiliated Hospital of Zhejiang University School of Medicine from August 2020 to August 2021 were selected via convenience sampling. Patients who underwent surgery between August 2020 and June 2021 ( n=1 213) were assigned to the modeling group, while those from July to August 2021 ( n=255) were used as the validation group. Logistic regression analysis was used to identify risk factors for delayed emergence and to establish a predictive model. The performance of the model was evaluated using the area under the receiver operating characteristic curve ( AUC) and the Hosmer-Lemeshow goodness-of-fit test. Results:Among the modeling group, 200 patients experienced delayed emergence, with an incidence of 16.49% (200/1 213). Logistic regression analysis revealed that the use of reversal agents, use of neostigmine, albumin level, presence of shivering, pain score≥4 points, extubation time, partial pressure of CO 2, partial pressure of oxygen, serum potassium level, and intraoperative fentanyl dosage were significant influencing factors ( P<0.05). The predictive model demonstrated good performance with an AUC of 0.864 [95% CI (0.828, 0.899) ], a Hosmer-Lemeshow test χ 2=5.299 ( P=0.725), cut-off value of 0.442, sensitivity of 0.794, and specificity of 0.769. In the validation group, delayed emergence occurred in 44 cases (17.25%). The model showed good validation performance with an AUC of 0.852 [95% CI (0.826, 0.878) ], Hosmer-Lemeshow χ 2=5.912 ( P=0.336), cut-off value of 0.754, sensitivity of 0.674, and specificity of 0.877. Conclusions:The predictive model constructed in this study demonstrates strong performance and can assist clinicians in the early identification of patients at risk of delayed emergence following thoracoscopic radical lung cancer surgery under general anesthesia.

Objective To analyze the prognostic value of carotid ultrasound quantitative parameters combined with serum TNF-α and receptor-interacting protein kinase 1(RIPK1)levels for patients with acute ischemic stroke(AIS).Methods A total of 110 AIS patients admitted in our hospital from February 2020 to May 2024 were enrolled,and according to their modified Rankin scale(mRS)score after 3 months,they were divided into a good prognosis group(76 cases)and a poor prognosis group(34 cases).The carotid ultrasound quantitative parameters such as intima-media thickness(CIMT),end diastolic velocity(EDV)and peak systolic velocity(PSV)and serum TNF-α and RIPK1 levels were detected.The relationship of the parameters and the serum levels with prognosis was analyzed.Results The poor prognosis group had significantly higher carotid CIMT and EDV values and serum levels of TNF-α and RIPK1,and lower PSV value than the good prognosis group(P＜0.01).The CIMT,PSV,EDV,TNF-α and RIPK1 were independent in-fluencing factors of prognosis of AIS patients(P＜0.01).ROC curve analysis showed that the AUC value of CIMT,PSV,EDV,TNF-α and RIPK1 combined together in predicting the poor prognosis of AIS patients was 0.979,with a sensitivity of 94.10％and a specificity of 75.00％.Conclusion Carotid ultrasound quantitative parameters combined with serum TNF-α and RIPK1 levels can effectively assess the prognosis of AIS patients,with high predictive value.

Objective:To explore the association between cognitive function and the level of gamma-amino-butyric acid(GABA)in anterior cingulate cortex(ACC)before and after treatment in patients with major depres-sion disorder.Methods:Totally 31 medication-naive patients with major depression disorder meeting the criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)and 33 normal controls were col-lected.Each eligible patient received treatment with selective serotonin reuptake inhibitor agents for 8 weeks.The MATRICS Consensus Cognitive Battery(MCCB)was used to evaluate the cognitive function.By means of 1H magnetic resonance spectroscopy,anterior cingulate cortex GABA concentrations were measured.Results:At base-line,the concentration of ACC GABA relative to water(GABA+/W)was lower in the patient group than in the control group(P＜0.05)and increased after treatment(P＜0.05).ACC GABA+/W was negatively associated with verbal learning and visual memory score in patient group at baseline(correlation coefficient and P value were r=-0.40,P＜0.05;r=-0.42,P＜0.05,respectively).The ACC GABA+/W difference resulted of treatment in patient group was positively associated with the difference of working memory score and the difference of reasoning and problem-solving score(correlation coefficient and P value were r=0.58,P＜0.05;r=0.66,P＜0.05,respec-tively).Conclusion:The cognitive dysfunction of patients with major depression disorder may not be related to the degree of depression and anxiety.And improvement of cognitive function may be associated with increase of ACC GABA concentrations.

OBJECTIVE To assess the efficacy of bioabsorbable steroid-releasing sinus stents for improving surgical outcomes and subjective symptoms when placed in the bilateral frontal sinus opening(FSO)following full functional endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyps(CRSwNP).METHODS CRSwNP patients who had under full functional endoscopic sinus surgery with complete data of nasal endoscopy and sinus computed tomography data were identified and included in the study.The patients were divided into a control group consisting of patients receiving only full functional endoscopic sinus surgery(n=92)and a stent group consisting of patients receiving full functional endoscopic sinus surgery combined with placement of steroid implants in both FSO(n=38).The visual analogue scale(VAS)subjective symptom scores and surgical outcomes were compared preoperatively,and on postoperative day(PD30 and PD90)between the two groups.RESULTS Compared to baseline,the overall symptom VAS scores of patients after operation decreased significantly in both groups(P<0.05),and the degree of improvement of overall symptoms in the stent group was significantly better than in the control group(P<0.05).On PD30,the proportion of patients requiring postoperative interventions for bilateral FSO was reduced by 42.3%in the stent group,and was significantly lower than in the control group(P<0.05).Compared to the control group,the proportion of patients needing postoperative intervention in both ethmoid sinus on the stent group decreased by 17.7%(P>0.05).The results at PD90 were consistent with those at PD30.CONCLUSION Full functional endoscopic sinus surgery in combination with bilateral frontal sinus stent implantation is better than full functional endoscopic sinus surgery alone.

A thermosensitive hydrogel system consisting of PLGA-PEG-PLGA hydrogel and Pseudomonas aeruginosa DNA vaccine was constructed and the immune efficacy of the system was evaluated. The PLGA-PEG-PLGA thermosensitive hydrogel containing Pseudomonas aeruginosa DNA vaccine was prepared by a simple physical mixing method. The gelation temperature, cytotoxicity, and release curve in vitro were tested.The degradability of hydrogel in vivo was evaluated. The mice were divided into control group (PBS), hydrogel group (Hydrogel), in vivo-jetPEI/plasmid DNA group (in vivo-jetPEI/pDNA), and hydrogel + in vivo-jetPEI/plasmid group (Gel+in vivo-jetPEI/pDNA). Mice were immunized three times with a ten-day interval. Two weeks after the last immunization, the mice were sacrificed. The proliferation of splenic lymphocytes, serum specific IgG antibodies and IFN-γ in supernatant of splenic lymphocytes were detected. The gelation temperature of PLGA-PEG-PLGA hydrogel was (32 ± 0.5) ℃. There was no obvious toxicity to cells in vitro, and about 80% of plasmid DNA was released after 7 days in vitro. PLGA-PEG-PLGA hydrogel was biodegradable, and degraded almost completely after 15 days in vivo. The spleen lymphocytes proliferated; the levels of specific IgG antibodies and IFN-γ of in vivo-jetPEI/pDNA and Gel+in vivo-jetPEI/pDNA groups increased. The hydrogel could enhance the immune response induced by DNA vaccine.Results suggest that the thermosensitive hydrogel system consisting of PLGA-PEG-PLGA hydrogel and Pseudomonas aeruginosa DNA vaccine is a promising new strategy for the development of PA vaccine.

Recent studies have discovered a selective autophagy-lipophagy, which can selectively identify and degrade lipids and plays an important role in regulating cellular lipid metabolism and maintaining intracellular lipid homeostasis. The process of lipophagy can be directly or indirectly regulated by genes, enzymes, transcriptional regulators and other factors. This review examines the role of lipophagy in reducing liver lipid content, regulating pancreatic lipid metabolism, and regulating adipose tissue differentiation, and summarizes the findings of the molecules (Rab GTPase, enzymes, ion channels, transcription factors, small molecular substances) involved in the regulation of lipophagy, which points to new directions for the treatment of diseases caused by lipid accumulation.
Adipose Tissue ; Autophagy ; Homeostasis ; Lipid Metabolism ; Liver

This study aimed to construct a DC-targeted aptamer-modified Pseudomonas aeruginosa(PA)DNA vaccine delivery system. The cationic liposome was prepared by ethanol injection method. The cationic liposome loading pVAX1-OprF-VP22(Lip-pOprF-VP22)was prepared by electrostatic adsorption method. The encapsulation efficiency of Lip-pOprF-VP22 with different mass ratios of DOTAP/pDNA on pVAX1-OprF-VP22, cytotoxicity and transfection rate to DC2. 4 in vitro were discussed. The particle size and zeta potential of Lip-pOprF-VP22 with best mass ratio were tested. Aptamer-modified cationic liposome loading pVAX1-OprF-VP22(Apt-Lip-pOprF-VP22)was prepared by post-insertion method. The expression of OprF protein after transfection of DC2. 4 and its effect on the maturation of bone marrow-derived dendritic cells(BMDCs)were detected. Data showed that as the mass ratio of DOTAP/pDNA increased, the encapsulation efficiency of Lip-pOprF-VP22 on pVAX1-OprF-VP22 was gradually increased. When the mass ratio was 5 ∶1, pVAX1-OprF-VP22 was encapsulated well. When Lip-pOprF-VP22 with different mass ratios was applied to DC2. 4 for 24 h or 48 h, the survival rates of DC2. 4 were all above 80%. When the mass ratio of DOTAP/pDNA increased from 2 ∶1 to 10 ∶1, the transfection rate increased first and then decreased. When the mass ratios of DOTAP/pDNA were 4 ∶1 and 5 ∶1, the transfection rates were relatively high. When the mass ratio of DOTAP/pDNA was 5 ∶1, the particle size of Lip-pOprF-VP22 was(171. 67±1. 27)nm, and the Zeta potential was(11. 30±0. 57)mV. Furthermore, Apt-Lip-pOprF-VP22 can express more OprF protein and significantly promote the maturation of BMDCs. In conclusion, Apt-Lip-pOprF-VP22 can target to DC and promote the maturation of DC.

Objective: To investigate the expression of DNA damage repair factor PDZ binding kinase (PBK) and matrix metalloproteinase 9 (MMP-9) in cervical cancer and the effect on clinical outcomes of concurrent chemoradiotherapy. Methods: A total of 65 cervical cancer pathological specimens were collected from January 2014 to July 2016. Immunohistochemistry was used to detect PBK and MMP-9 expression in the specimens.External irrsdeation was treated with intensity-modulated radiation therapy at a dose of 50 Gy/25 F. After 18 times of external irradiation, high-dose rate postoperative treatment was giver at a dose of 30-36 Gy/5-6 F which lasts 3-4 weeks. Weekly chemotherapy with Cisplatin(DDP) begins simultaneously at the beginning of external irradiation. DDP was administered intravenously at a dosage of 40 mg/m² for 2 to 6 week. All patients were followed-up as routine. The relationship between clinical characteristics and prognosis of patients and the expression of PBK and MMP-9 were analyzed. Results: PBK was expressed in 92.3% of tissues and MMP-9 was expressed in 69.2% of tissues. The expression of PBK was positively associated with overall survival (OS) and disease progression-free survival (PFS) of cervical cancer patients (χ²=4.324, 8.068, P<0.05). The expression of MMP-9 was related with PFS (χ²=5.134, P<0.05). Patients with PBK and MMP-9 expression suffered poor OS and PFS (χ²=5.382, 9.364, P<0.05). Conclusions PBK and MMP-9 could be a biomarker to predict the prognosis of cervical cancer.