Objective:To investigate the association between single nucleotide polymorphism (SNP) of the protein phosphatase 1 regulatory subunit 1B( PPP1R1B) gene and schizophrenia in the Han population of northern Henan province. Methods:Utilizing Psychiatric Genomics Consortium 3 (PGC3) data, the SNPs of PPP1R1B gene which were significantly associated with schizophrenia were screened.Subsequently, totally 1 721 schizophrenia patients and 6 726 healthy controls from the Han population in northern Henan province were recruited for further analysis. The SNP rs907094, located within the PPP1R1B gene was validated, and the clinical symptoms of 386 schizophrenia patients were evaluated using the positive and negative syndrome scale (PANSS). Additionally, expression quantitative trait loci (eQTL) association analysis was conducted to explore the relationship between the rs907094 polymorphism and PPP1R1B gene expression.The PLINK v1.9, Genetic Power Calculater, SPSS 20.0 softwares were used for data analysis. Results:Significant differences in genotype AA, AG, GG(schizophrenia group: AA, 489(28.4%); AG, 848(49.3%); GG, 384(22.3%); control group: AA, 1 450(21.6%); AG, 3 386(50.3%); GG, 1 890(28.1%), χ2=45.418, P<0.05) and allele frequency(schizophrenia group: A, 1 826(53.1%); G, 1 616(46.9%); control group: A, 6 286(46.7%); G, 7 166(53.3%), χ2=43.877, P<0.05) were observed for SNP rs907094 between the schizophrenia group and control group. Individuals carrying allele A were identified to have a higher risk of developing schizophrenia compared to those carrying allele G ( OR=1.288, 95% CI=1.195-1.388). Furthermore, the genotype PPP1R1B gene was found to be associated with the clinical features of schizophrenia. A statistically significant difference was observed in the excitement/hostility factor between AA and GG patients with rs907094 (13.62±5.65, 15.54±4.66)( P<0.05). Additionally, significant differences were noted in the cognitive factor scores between AA and GA genotypes (17.76±5.58, 19.43±5.73)( P<0.05). Conclusions:In the Han population from northern Henan province, the rs907094 polymorphism of the PPP1R1B gene is associated with schizophrenia.And the specific locus may be implicated in arousal/hostility symptoms and cognitive dysfunction.

Objective To establish an intelligent ICD coding management system to solve the current difficulties in hos-pital ICD coding management,reduce the error rate of information uploading,and improve the accuracy of coding.Methods An ICD coding management system was constructed,with the national clinical version of ICD coding as the main index system.The mapping relationship between the main index coding and the medical insurance version of ICD coding,as well as the hospital ver-sion of ICD coding,was established to achieve real-time maintenance and adjustment.In accordance with the requirements of na-tional public hospital performance evaluation and hospital level assessment,we will establish the ICD coding"label"function and knowledge base for evaluation indicators,embed them into electronic medical record system(EMR),and implement intelligent prompting functions for clinicians to facilitate systematic statistical analysis of data.Results After the establishment of the sys-tem,the error rate of mapping and uploading information such as disease diagnosis and procedures coding decreased significantly(1.2‰ vs 0.3‰,P＜0.05).The accuracy of the main discharge diagnosis and procedures coding has significantly improved(82％vs 91％,P＜0.05;78％vs 88％,P＜0.05).The satisfaction of clinicians and coders increased significantly(65％vs 82％,P＜0.05;79％vs 88％,P＜0.05).Conclusion This system can reduce the error rate of mapping and uploading infor-mation,improve the accuracy and completeness of coding,enhance the management level of ICD coding,and promote the high-quality development of medical care.

Objective:To compare the efficacy and safety of irradiation-incorporated and chemotherapy only-based myeloablative conditioning regimens in haploidentical hematopoietic stem cell transplantation (haplo-HSCT) for patients with high-risk myeloid malignancies.Methods:This study retrospectively collected clinical data from 63 high-risk acute myeloid leukemia/myelodysplastic syndrome (AML/MDS) patients who underwent haplo-HSCT at the Fifth Medical Center of the Chinese PLA General Hospital from January 2015 to December 2019. These patients were classified into the irradiation ( n = 17) and chemotherapy ( n = 46) groups based on different conditioning regimens. The differences between the two groups were compared in terms of hematopoietic reconstitution, cumulative incidence of acute/chronic graft-versus-host diseases (aGVHD and cGVHD), non-relapse mortality (NRM), relapse rate (RR), overall survival (OS), and disease-free survival (DFS), followed by the analysis of prognostic factors. Results:The median follow-up time for the irradiation and chemotherapy groups was 78.5 and 72.3 months, respectively. The median time for neutrophil engraftment was 14.0 days in the irradiation group and 14.5 d in the chemotherapy group, and for platelet engraftment was 15.0 and 13.0 d, respectively. As a result, the two groups showed no statistically significant differences in hematopoietic reconstitution ( P > 0.05). The cumulative incidence of aGVHD and cGVHD was higher in the irradiation group compared to the chemotherapy group, yet showing no statistically significant differences ( P > 0.05). Specifically, the cumulative incidence of grade Ⅱ-Ⅳ aGVHD within 100 d was 29.4% and 21.7% for the irradiation and chemotherapy groups, respectively. The cumulative incidence of grade Ⅲ-Ⅳ aGVHD was 23.5% and 13.0%, respectively. The cumulative incidence of severe cGVHD within five years was 11.8% in the irradiation group and 8.7% in the chemotherapy group. In terms of long-term survival, the cumulative 5\|year RR and NRM were 20.2% and 28.4% in the irradiation group, 5.9% and 23.9% in the chemotherapy group, respectively, showing no statistically significant differences ( P > 0.05). The 5-year DFS and OS rates were 73.9% and 47.7% in the irradiation group, and 81.1% and 54.4% in the chemotherapy group, respectively, without statistically significant differences ( P > 0.05). Notably, the irradiation group manifested more favorable DFS and OS survival curves compared to the chemotherapy group. The survival curves indicate that the irradiation-incorporated regimen exhibited better trends in OS, DFS, and cGVHD-free relapse-free survival (GRFS). However, multivariate analysis did not reveal that irradiation conditioning is an independent prognostic factor affecting survival [ HR = 0.532 (0.163-1.735), 0.370 (0.091-1.516), 0.683 (0.248-1.882), P > 0.05]. Conclusions:In haplo-HSCT for high-risk myeloid malignancies, the irradiation-incorporated conditioning regimen demonstrates lower RR and NRM, higher DFS and OS, and potentially superior survival outcomes compared to the chemotherapy only-based regimen. Therefore, the irradiation-incorporated conditioning regimen may be preferentially considered in haplo-HSCT.

Objective:To investigate the association between single nucleotide polymorphism (SNP) of the protein phosphatase 1 regulatory subunit 1B( PPP1R1B) gene and schizophrenia in the Han population of northern Henan province. Methods:Utilizing Psychiatric Genomics Consortium 3 (PGC3) data, the SNPs of PPP1R1B gene which were significantly associated with schizophrenia were screened.Subsequently, totally 1 721 schizophrenia patients and 6 726 healthy controls from the Han population in northern Henan province were recruited for further analysis. The SNP rs907094, located within the PPP1R1B gene was validated, and the clinical symptoms of 386 schizophrenia patients were evaluated using the positive and negative syndrome scale (PANSS). Additionally, expression quantitative trait loci (eQTL) association analysis was conducted to explore the relationship between the rs907094 polymorphism and PPP1R1B gene expression.The PLINK v1.9, Genetic Power Calculater, SPSS 20.0 softwares were used for data analysis. Results:Significant differences in genotype AA, AG, GG(schizophrenia group: AA, 489(28.4%); AG, 848(49.3%); GG, 384(22.3%); control group: AA, 1 450(21.6%); AG, 3 386(50.3%); GG, 1 890(28.1%), χ2=45.418, P<0.05) and allele frequency(schizophrenia group: A, 1 826(53.1%); G, 1 616(46.9%); control group: A, 6 286(46.7%); G, 7 166(53.3%), χ2=43.877, P<0.05) were observed for SNP rs907094 between the schizophrenia group and control group. Individuals carrying allele A were identified to have a higher risk of developing schizophrenia compared to those carrying allele G ( OR=1.288, 95% CI=1.195-1.388). Furthermore, the genotype PPP1R1B gene was found to be associated with the clinical features of schizophrenia. A statistically significant difference was observed in the excitement/hostility factor between AA and GG patients with rs907094 (13.62±5.65, 15.54±4.66)( P<0.05). Additionally, significant differences were noted in the cognitive factor scores between AA and GA genotypes (17.76±5.58, 19.43±5.73)( P<0.05). Conclusions:In the Han population from northern Henan province, the rs907094 polymorphism of the PPP1R1B gene is associated with schizophrenia.And the specific locus may be implicated in arousal/hostility symptoms and cognitive dysfunction.

Objective To investigate the association between UGT1A1 inhibitors-induced liver injury(DILI)and UGT1A1 gene polymorphisms through a pharmacogenomics approach.Methods Information on relevant drugs that may induce liver injury,blood routine tests,and liver function tests was collected from hospitalized patients diagnosed with DILI between June 2022 and June 2024.Relevant databases were searched to categorize DILI-associated drugs into UGT1A1 enzyme inhibitors and those without interaction with UGT1A1.Sanger sequenc-ing or MassARRAY SNP typing technology was utilized to detect and genotype the UGT1A1 gene.Results A total of 219 patients with drug-induced liver injury(DILI)were enrolled,including 98 males,with a mean age of 46.32±14.95 years.A literature search of relevant databases revealed that 20 drugs(16.26%,20/123)associated with DILI had inhibitory effects on the UGT1A1 enzyme.The proportion of DILI cases related to UGT1A1 inhibitors was 60.73%(133/219).Compared to non-UGT1A1 inhibitor-related DILI group,the UGT1A1 inhibitor-related DILI group exhibited significantly higher levels of ALT,AST,ALP,and GGT(P<0.05),while no significant differences were observed in age,gender,TBIL,IBIL,WBC,Hb,PLT,injury type,or injury grade(P>0.05).The prevalence of UGT1A1 polymorphisms was significantly higher in the UGT1A1 inhibitor-related DILI group(68.42%)com-pared to the non-UGT1A1 inhibitor-related DILI group(51.16%),with an odds ratio(OR)of 2.068(95%CI:1.183 to 3.617;χ2=6.58,P=0.010).There was also a significant difference in the distribution of genotypes between the UGT1A1 inhibitor-related and non-UGT1A1 inhibitor-related DILI groups(χ2=9.60,P=0.022).Univariate logistic regression analysis indicated that ALT and UGT1A1*6 were associated with UGT1A1 inhibitor-related DILI,while multivariate analysis confirmed that UGT1A1*6 was independently associated with UGT1A1 inhibitor-related DILI[OR(95%CI)=3.143(1.398 to 7.067),P=0.006].Conclusion The UGT1A1*6 allele increases the susceptibility to drug-induced liver injury(DILI)associated with UGT1A1 inhibitory drugs.

Objective:To observe the clinical efficacy of unilateral biportal endoscopy (UBE) assisted bilateral decompression in the treatment of lumbar disc herniation with imaging herniation on one side and clinical symptoms on the contralateral side.Methods:A total of 20 patients with lumbar disc herniation with imaging herniation on one side and clinical symptoms on the contralateral side treated with UBE from January 2022 to January 2024 in the Affiliated Hospital of Binzhou Medical University were retrospectively analyzed. There were 9 males and 11 females, aged 50.4±14.0 years (range, 23-72 years). The intervertebral disc herniation level included L 3-4 in 1 case, L 4-5 in 15 cases, and L 5S 1 in 4 cases. There were 10 cases on the left side and 10 cases on the right side. The duration of symptoms was 24.1±33.7 months (range, 1-120 months). Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate postoperative pain relief and functional recovery. The clinical efficacy was evaluated by modified MacNab criteria at 6 months after operation. Results:All patients successfully completed the operation. The operation time was 90.3±24.6 min (range, 55-134 mins). The VAS scores of patients at 3 days, 1 month, 3 months and 6 months after operation were 3.6±0.9, 2.2±0.7, 1.2±0.5 and 1.0±0.6, respectively, which were lower than those before operation (6.4±0.8), and the differences were statistically significant ( F=668.728, P<0.001). The ODI at 3 days, 1 month, 3 months and 6 months after operation were 34.2%±4.7%, 28.7%±2.8%, 24.3%±2.1% and 20.5%±2.0%, respectively, which were lower than 69.4%±5.2% before operation, and the differences were statistically significant ( F=515.578, P<0.001). The clinical efficacy was evaluated by modified MacNab criteria at 6 months after operation. Among 20 patients, 18 cases were excellent, 1 case was good, and 1 case was fair. All patients were followed up for 9.1±2.1 months (range, 6-14 months). One patient had a dural tear during the operation, but the range was small and there was no defect, and no further treatment was performed. Numbness of the lower limbs occurred 1 day after operation, and the symptoms disappeared after symptomatic treatment. There was no recurrence of lower limb symptoms, lumbar instability, intervertebral space infection or other complications at the last follow-up. Conclusion:Bilateral decompression with UBE is effective in the treatment of lumbar disc herniation with imaging herniation on one side and clinical symptoms on the contralateral side, which can improve the lumbar pain and function of patients.

Objective To compare the clinical efficacy of digital 3D technology assisted and traditional one-hole split endoscopic surgery for lumbar spinal stenosis with degenerative scoliosis(LSS-DS).Methods Clinical data of 42 patients with LSS-DS who underwent one-hole split endoscopic surgery from January 2022 to December 2023 were retrospectively analyzed.Among them,20 cases were treated with digital 3D technology assisted one-hole split endoscopic surgery(3D group),and 22 cases were treated with traditional one-hole split endoscopic surgery(traditional group).The operation time,intraoperative blood loss,lateral articular surface preservation rate,Visual Analogue Scale(VAS)of lower extremity pain,Oswestry Disability Index(ODI)and modified MacNab criteria at the last follow-up were compared between the two groups.Results Both groups of patients were operated successfully.The operation time of the 3D group and the traditional group was(73.3±24.0)min and(65.7±23.8)min,respectively,with no significant difference(t=1.020,P=0.314).The intraoperative blood loss was(65.3±14.7)ml and(66.7±17.1)ml,respectively,with no significant difference(t=-0.298,P=0.767).The retention rate of lateral articular surface in the 3D group[(88.2±6.3)%]was significantly higher than that in the traditional group[(82.7±4.6)%,t=3.201,P=0.003].One patient in the traditional group had dural tear and was cured after conservative treatment.There were 3 cases of calf muscle venous thrombosis in the 3D group and 4 cases in the traditional group.All the 7 patients were given anticoagulant therapy and appropriately delayed time of ambulation.In the3D group,20 cases were followed up for6-13 months,with a mean of(8.2±2.0)months;in the traditional group,22 cases were followed up for 6-12 months,with a mean of(7.7±1.7)months.According to the modified MacNab criteria,the excellent and good rate was 95.0%(19/20)in the 3D group and 90.1%(20/22)in the traditional group at the last follow-up,and there was no significant difference between the two groups(Z=-0.311,P=0.756).The VAS score and ODI of the two groups were significantly improved at 3 months and 6 months after operation(all P=0.000),but there was no significant difference between the two groups at each time point(P>0.05).Conclusion The short-term efficacy of digital 3D technology assisted one-hole split endoscopic surgery in the treatment of LSS-DS is definite,and the symptoms of patients are significantly improved.

Objective To observe the value of ultrasonic parameters of diaphragm motion combined with BODE index for predicting acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods Eighty COPD patients were retrospectively collected and divided into stable group(n=45)and acute exacerbation group(n=35).Ultrasonic parameters of diaphragm motion,including diaphragm excursion(DE)under quiet breathing(QB)and deep breathing(DB),i.e.DEQB and DEDB were measured.The general data,ultrasound parameters of diaphragm motion,and BODE index scores were compared between groups.Then logistic regression analysis was used to identify factors which could be used to independently predict acute exacerbations of COPD.The predicting performance of ultrasound parameters of diaphragm motion,BODE index and their combination were evaluated with receiver operating characteristic(ROC)curve and the area under the curve(AUC).Results Compared with stable COPD group,acute exacerbation group had higher BMI and BODE index scores(both P＜0.05),as well as larger DEQB but smaller DEDB(both P＜0.05).DEDB and BODE index were both independent predicting factors of acute exacerbation of COPD,while increased DEDB indicated decreased risk of acute exacerbation(OR[95％CI]=0.673[0.493,0.918],P＜0.05),whereas increased BODE index suggested higher risk(OR[95％CI]=3.678[1.061,12.746],P＜0.05).AUC for DEDB and BODE index alone for predicting acute exacerbation of COPD was 0.788 and 0.799,respectively,and of their combination was 0.979,significant higher than that of each alone(both P＜0.05).Conclusion Ultrasonic parameters of diaphragm motion could be used to evaluate diaphragm function in COPD patients.Combination of DEDB and BODE index had better performances in predicting acute exacerbation of COPD.

ObjectiveTo analyze the changing trend of the disease burden of acute viral hepatitis （AVH） globally and in China from 1990 to 2021， and to provide a basis for optimizing prevention and control strategies. MethodsRelated data were extracted from the Global Burden of Disease 2021 database， including incidence rate， mortality rate， and disability-adjusted life years （DALY） for AVH globally and in China from 1990 to 2021， and the patients were divided into groups according to region， age， sex， and type of hepatitis. The Joinpoint regression model was used to calculate average annual percentage change （AAPC） and its 95% confidence interval （CI）. ResultsFrom 1990 to 2021， there was a tendency of reduction in the age-standardized incidence rate， mortality rate， and DALY rate of AVH globally， with an average annual reduction of 1.02% （95%CI： -1.10% to -0.94%， P<0.001）， 3.97% （95%CI： -4.12% to -3.82%， P<0.001）， and 3.64% （95%CI： -3.84% to -3.44%， P<0.001）， respectively； in China， there was also a tendency of reduction in these indicators， with an average annual reduction of 1.63% （95%CI： -1.70% to -1.57%， P<0.001）， 9.24% （95%CI： -9.51% to -8.97%， P<0.001）， and 7.93% （95%CI： -8.15% to -7.71%， P<0.001）， respectively. In addition， China’s share of the global disease burden of AVH continued to decrease； the proportion of new cases decreased from 24% in 1990 to 15% in 2021， the proportion of deaths decreased from 19% to 4%， and the proportion of DALY decreased from 16% to 4%. From 1990 to 2021 globally， the peaks in the incidence rate， mortality， and DALY of AVH were observed in children under 5 years of age； in China， although the peak incidence rate of the disease was still observed in children under 5 years of age， there was a tendency of increase in the incidence rate of AVH among young adults aged 25 — 29 years in recent years， with the most significant increase in the cases of acute hepatitis B （accounting for 59% of the cases in this age group）， while the disease burden of mortality and DALY mainly affected the middle-aged and elderly populations. The disease burden of AVH in the male population was higher than that in the female population. As for the distribution of disease types， acute hepatitis A was the predominant type of AVH， accounting for 64% globally and 48% in China， whereas acute hepatitis B was the leading cause of mortality and DALY， accounting for 50% of deaths globally， 80% of deaths in China， 47% of DALY globally， and 69% of DALY in China. ConclusionThere is a tendency of reduction in the disease burden of AVH globally and in China from 1990 to 2021， but there is a tendency of increase in the incidence rate of AVH among young adults in China， especially acute hepatitis B. It is necessary to implement targeted prevention and control strategies.

OBJECTIVES: Lymph node metastasis in papillary thyroid cancer (PTC) is closely associated with tumor recurrence and patient survival. However, current technologies have limited sensitivity in detecting occult cervical lymph node metastases. Identifying accurate molecular markers for predicting PTC metastasis holds significant clinical value. This study aims to analyze WNT10A expression in PTC and its clinical significance, and to explore the role of WNT10A gene knockdown in PTC cell proliferation, invasion, and metastasis. METHODS: The expression of WNT10A in thyroid carcinoma was analyzed using the Gene Expression Profiling Interactive Analysis (GEPIA) and University of Alabama at Birminghara Cancer data analysis Portal (UALCAN) databases. Real-time RT-PCR was used to measure WNT10A mRNA levels in tumor and adjacent normal tissues from 32 PTC patients. Immunohistochemistry was conducted on 158 PTC specimens to assess WNT10A protein expression and its correlation with clinicopathological features. In vitro experiments were performed using K1 and TPC-1 cell lines. Cell proliferation was assessed using the Celigo system and methyl thiazolyl tetrazolium (MTT) assays; apoptosis was measured via flow cytometry; invasion and metastasis were evaluated using scratch and Transwell assays. A xenograft model was established in nude mice to observe tumor growth, and tumor weight and volume were compared between cell lines. Differentially expressed genes regulated by WNT10A were identified via mRNA sequencing, followed by Gene Ontology (GO) and ingenuity pathway analysis (IPA). Real-time PCR and Western blotting were used to validate the effects of WNT10A on key downstream mRNA and protein in the Tec kinase signaling pathway. RESULTS: WNT10A mRNA expression was significantly higher in thyroid cancer tissues compared to adjacent normal tissues according to GEPIA and UALCAN (both P<0.01). The real-time RT-PCR result showed that WNT10A mRNA expression in PTC tissues was high than that in adjacent tissues (P<0.01). Immunohistochemistry revealed significantly higher WNT10A protein expression in PTC tissues compared to adjacent tissues (P<0.01), and its expression correlated with multifocality, extrathyroidal invasion, and lymph node metastasis. WNT10A knockdown significantly inhibited proliferation, altered cell cycle distribution, and increased apoptosis in K1 and TPC-1 cells (all P<0.01). WNT10A silencing also reduced migration and invasion abilities in both cell lines. In vivo, WNT10A knockdown in TPC-1 cells suppressed tumor formation in nude mice. GO analysis and IPA suggested that the Tec kinase signaling pathway was a key downstream target of WNT10A. RT-PCR and Western blotting confirmed that WNT10A knockdown downregulated the expression of key genes (STAT3, MAPK8, TNFRSF21, and AKT2) in this pathway. CONCLUSIONS WNT10A is highly expressed in PTC and is associated with tumor proliferation, invasion, and metastasis. Its tumor-promoting effects may be mediated through suppression of the Tec kinase signaling pathway.
Humans ; Cell Proliferation ; Thyroid Cancer, Papillary/pathology* ; Thyroid Neoplasms/metabolism* ; Animals ; Wnt Proteins/metabolism* ; Neoplasm Invasiveness ; Mice ; Cell Line, Tumor ; Female ; Male ; Mice, Nude ; Apoptosis ; Lymphatic Metastasis ; Middle Aged ; Cell Movement ; Adult