OBJECTIVES: To explore the value of ferroptose-related genes in the diagnosis and prediction of ulcerative colitis (UC). METHODS: We used UC dataset from the GEO database to screen for differentially expressed genes (DEGs) in UC. The DEGs related to ferroptositis were screened from the FerrDb database and their functions were analyzed. The hub genes were identified by constructing the protein-protein interaction network (PPI), the differences in immune infiltration levels between UC and the control group were evaluated using CIBERSORT, and the diagnostic values of the hub genes for UC were verified by using the training set. In a mouse model of UC, we examined the expression levels of the hub genes in the colon tissues of the mice using real-time fluorescence quantitative PCR (qPCR). RESULTS: We identified a total of 76 DEGs related to ferroptosis. Functional enrichment analysis showed that these genes were significantly enriched in ferroptosis and hypoxia pathways. The PPI network identified 10 hub genes, and 9 of them were highly expressed in UC. Analysis of immune cell infiltration showed that 27 cell types were significantly increased in UC (P<0.05), and the immune checkpoints-related genes had the strongest correlation with the hub gene PPARG (P<0.05). Verification analysis using the training set showed that P4HB, PPARG and STAT3 had the best predictive value for UC (P<0.05). In the UC mouse model, the expression of PPARG was significantly decreased and the expressions of P4HB and STAT3 were significantly increased in the colon tissues of the mice as compared with the normal mice. CONCLUSIONS Ferroptose-related genes have significant value for diagnosis and prediction of UC.
Colitis, Ulcerative/genetics* ; Animals ; Mice ; Ferroptosis/genetics* ; Humans ; Protein Interaction Maps ; Disease Models, Animal ; Gene Expression Profiling ; STAT3 Transcription Factor/genetics*

Objective:To investigate the clinical characteristics and survival outcomes of patients with nasopharyngeal carcinoma (NPC) complicated by multiple primary malignancies (MPCs) in a real-world setting.Methods:A retrospective study was performed on 238 NPC patients with MPCs who received radical radiotherapy at Fujian Cancer Hospital between January 1st, 2004 and December 31st, 2023. The primary endpoints were overall survival (OS) and cumulative survival rate. Survival analysis was conducted using the Kaplan-Meier method with log-rank / Breslow tests, and univariate analysis of prognostic factors was performed using the Cox proportional hazards model.Results:A total of 246 primary malignant tumors were identified in 238 patients, involving 12 organ systems and 39 tumor types. The most common coexisting malignancies occurred in the respiratory and intrathoracic organs [25.2% (62/246)], followed by digestive organ malignancies [22.8% (56/246)], malignancies of the lip, oral cavity, and pharynx [22.8% (56/246)], and thyroid and other endocrine gland malignancies [15.4% (38/246)]. The median OS was 186 months, and the 3-, 5-, and 10-year cumulative survival rates were 90.84%, 85.25%, and 69.45%, respectively. Poorer survival was associated with male sex, age>48 years at onset, locally advanced disease (stage IVA), synchronous MPCs and/or digestive system malignancies, fewer total cycles of chemotherapy, and lack of concurrent or adjuvant chemotherapy.Conclusions:In patients with NPC, MPCs most frequently involve the respiratory system, digestive system, and head and neck organs (including the thyroid). Male sex, older age, locally advanced primary NPC, synchronous and/or digestive system MPCs, fewer chemotherapy cycles, and lach of concurrent or adjuvant chemotherapy were significantly associated with poorer prognosis.

Objective:To investigate the clinical characteristics and survival outcomes of patients with nasopharyngeal carcinoma (NPC) complicated by multiple primary malignancies (MPCs) in a real-world setting.Methods:A retrospective study was performed on 238 NPC patients with MPCs who received radical radiotherapy at Fujian Cancer Hospital between January 1st, 2004 and December 31st, 2023. The primary endpoints were overall survival (OS) and cumulative survival rate. Survival analysis was conducted using the Kaplan-Meier method with log-rank / Breslow tests, and univariate analysis of prognostic factors was performed using the Cox proportional hazards model.Results:A total of 246 primary malignant tumors were identified in 238 patients, involving 12 organ systems and 39 tumor types. The most common coexisting malignancies occurred in the respiratory and intrathoracic organs [25.2% (62/246)], followed by digestive organ malignancies [22.8% (56/246)], malignancies of the lip, oral cavity, and pharynx [22.8% (56/246)], and thyroid and other endocrine gland malignancies [15.4% (38/246)]. The median OS was 186 months, and the 3-, 5-, and 10-year cumulative survival rates were 90.84%, 85.25%, and 69.45%, respectively. Poorer survival was associated with male sex, age>48 years at onset, locally advanced disease (stage IVA), synchronous MPCs and/or digestive system malignancies, fewer total cycles of chemotherapy, and lack of concurrent or adjuvant chemotherapy.Conclusions:In patients with NPC, MPCs most frequently involve the respiratory system, digestive system, and head and neck organs (including the thyroid). Male sex, older age, locally advanced primary NPC, synchronous and/or digestive system MPCs, fewer chemotherapy cycles, and lach of concurrent or adjuvant chemotherapy were significantly associated with poorer prognosis.

Objective:To analyze the risk factors affecting the efficacy of arterial balloon occlusion intervention in cesarean sections for women with placenta accreta spectrum (PAS).Methods:A retrospective study was conducted on 55 PAS patients who underwent arterial balloon occlusion during cesarean sections in the obstetrics department of the First Affiliated Hospital of Guangxi Medical University from January 2015 to March 2021. The patients were divided into two groups based on surgical blood loss: ≥2 000 ml group (27 cases) and <2 000 ml group (28 cases). Baseline data, surgical management, and pregnancy outcomes were analyzed between the two groups. For patients who underwent MRI, prenatal MRI characteristics were analyzed. Intergroup comparisons were performed using independent samples t-test, Mann-Whitney U test, or Chi-square test (or Fisher's exact test). Bonferroni correction was used for multiple comparisons. Results:(1) The variation in patients' bleeding volume across different years during the study period was not statistically significant. The proportion of placenta percreta in the ≥2 000 ml blood loss group was significantly higher than in the <2 000 ml group [placenta accreta, increta, and percreta in both groups were 0.0% (0/27) vs. 7.1% (2/28); 25.9% (7/27) vs. 53.6% (15/28); and 74.1% (20/27) vs. 39.3% (11/28), respectively; Fisher's exact test, P=0.019]. (2) The ≥2 000 ml group showed a trend towards higher rates of hysterectomy and failed uterine preservation after placental removal compared to the <2 000 ml group [25.9% (7/27) vs. 3.6% (1/28), Fisher's exact test], but the difference was not statistically significant ( P=0.074). (3) The ≥2 000 ml group had significantly higher blood loss, transfusion of ≥5 units of red blood cells, incidence of disseminated intravascular coagulation, longer surgery time, and higher postoperative transfer to intensive care unit rates compared to the <2 000 ml group [3 600 ml (2 550-5 050 ml) vs. 1 100 ml (600-1 500 ml), Z=756.00; 77.8% (21/27) vs. 21.4% (6/28), χ2=17.40; 33.3% (9/27) vs. 0.0% (0/28), Fisher's exact test; (253±94) min vs. (150±57) min, t=4.92; 40.7% (11/27) vs. 3.6% (1/28), χ2=11.13; all P<0.05]. The bladder injury rate in the ≥2 000 ml group showed a trend towards being higher than in the <2 000 ml group, but the difference was not statistically significant [22.2% (6/27) vs. 3.6% (1/28), Fisher's exact test, P=0.051]. There were no statistically significant differences in other maternal and neonatal outcomes between the two groups. (4) Among the study subjects, 50 patients had prenatal MRI data, with 22 in the ≥2 000 ml group and 28 in the <2 000 ml group. The ≥2 000 ml group had a significantly higher proportion of local exophytic masses, asymmetric placental thickening/shape, and placental invasion in the S2 region compared to the <2 000 ml group [81.8% (18/22) vs. 53.6% (15/28), χ2=4.38; 81.8% (18/22) vs. 50.0% (14/28), χ2=5.41; 95.5% (21/22) vs. 53.6% (15/28), χ2=10.72; all P<0.05]. Conclusions:When the placenta invades the S2 region and the depth is invasive, arterial balloon occlusion in cesarean sections for PAS still faces a high risk of massive hemorrhage. Prenatal MRI should focus on assessing the extent and depth of placental invasion to identify potentially severe PAS cases, thereby optimizing the clinical application of arterial balloon occlusion.

Objective:To analyze the risk factors affecting the efficacy of arterial balloon occlusion intervention in cesarean sections for women with placenta accreta spectrum (PAS).Methods:A retrospective study was conducted on 55 PAS patients who underwent arterial balloon occlusion during cesarean sections in the obstetrics department of the First Affiliated Hospital of Guangxi Medical University from January 2015 to March 2021. The patients were divided into two groups based on surgical blood loss: ≥2 000 ml group (27 cases) and <2 000 ml group (28 cases). Baseline data, surgical management, and pregnancy outcomes were analyzed between the two groups. For patients who underwent MRI, prenatal MRI characteristics were analyzed. Intergroup comparisons were performed using independent samples t-test, Mann-Whitney U test, or Chi-square test (or Fisher's exact test). Bonferroni correction was used for multiple comparisons. Results:(1) The variation in patients' bleeding volume across different years during the study period was not statistically significant. The proportion of placenta percreta in the ≥2 000 ml blood loss group was significantly higher than in the <2 000 ml group [placenta accreta, increta, and percreta in both groups were 0.0% (0/27) vs. 7.1% (2/28); 25.9% (7/27) vs. 53.6% (15/28); and 74.1% (20/27) vs. 39.3% (11/28), respectively; Fisher's exact test, P=0.019]. (2) The ≥2 000 ml group showed a trend towards higher rates of hysterectomy and failed uterine preservation after placental removal compared to the <2 000 ml group [25.9% (7/27) vs. 3.6% (1/28), Fisher's exact test], but the difference was not statistically significant ( P=0.074). (3) The ≥2 000 ml group had significantly higher blood loss, transfusion of ≥5 units of red blood cells, incidence of disseminated intravascular coagulation, longer surgery time, and higher postoperative transfer to intensive care unit rates compared to the <2 000 ml group [3 600 ml (2 550-5 050 ml) vs. 1 100 ml (600-1 500 ml), Z=756.00; 77.8% (21/27) vs. 21.4% (6/28), χ2=17.40; 33.3% (9/27) vs. 0.0% (0/28), Fisher's exact test; (253±94) min vs. (150±57) min, t=4.92; 40.7% (11/27) vs. 3.6% (1/28), χ2=11.13; all P<0.05]. The bladder injury rate in the ≥2 000 ml group showed a trend towards being higher than in the <2 000 ml group, but the difference was not statistically significant [22.2% (6/27) vs. 3.6% (1/28), Fisher's exact test, P=0.051]. There were no statistically significant differences in other maternal and neonatal outcomes between the two groups. (4) Among the study subjects, 50 patients had prenatal MRI data, with 22 in the ≥2 000 ml group and 28 in the <2 000 ml group. The ≥2 000 ml group had a significantly higher proportion of local exophytic masses, asymmetric placental thickening/shape, and placental invasion in the S2 region compared to the <2 000 ml group [81.8% (18/22) vs. 53.6% (15/28), χ2=4.38; 81.8% (18/22) vs. 50.0% (14/28), χ2=5.41; 95.5% (21/22) vs. 53.6% (15/28), χ2=10.72; all P<0.05]. Conclusions:When the placenta invades the S2 region and the depth is invasive, arterial balloon occlusion in cesarean sections for PAS still faces a high risk of massive hemorrhage. Prenatal MRI should focus on assessing the extent and depth of placental invasion to identify potentially severe PAS cases, thereby optimizing the clinical application of arterial balloon occlusion.

Objective: To investigate the effects of endurance running at different intensities on self-control of sedentary university students, and to reveal the immediate and sustained effects of exercise on cognitive control. Methods: Ninety students with sedentary behaviors from 7 universities in a university city in Shandong Province were selected by cluster stratified random sampling. 21, 23, 21 and 25 students in the high, medium and low intensity groups and the blank control group completed the 30min endurance running exercise, combined with the willingness of the subjects. The Stroop test was conducted immediately after exercise, 5, 15 and 30 min after exercise, and the correct rate and response time of the Stroop test were used as two indicators of self-control. Results: In the immediate post-exercise period, the correct response time for the control group ( 774.03 ±127.85)ms], the high-intensity group [(745.37±109.59)ms], the moderate-intensity group [(627.90±129.18)ms] and the low-intensity group [(689.90±129.79)ms] were statistically significant ( F =6.27, P <0.05). The correct rate for the control group [(94.40±2.02)%], the low-intensity group [(95.38±1.96)%], the high-intensity group [(92.43±2.32)%] and the moderate-intensity group [(96.39±1.08)%] were statistically significant ( F =14.87, P <0.05). High-intensity endurance running exercise was able to achieve the best performance at 30 min and beyond on the Stroop test response and correctness ( P <0.05), while moderate-intensity endurance running had a better effect on improving self-control than low-intensity endurance running at 30 min post-exercise. Conclusion High and moderate-intensity endurance running exercises can effectively improve self-control in sedentary university students. It is recommended that moderate or high intensity endurance running be performed as the body can tolerate it to improve self-control and cognitive ability.

Objective:To investigate the value of counting microvessel density (MVD) and lymphatic vessel density (LVD) in predicting distant metastasis of pancreatic cancer within 1 year after surgery.Methods:The clinicopathological data of 47 patients with pancreatic cancer who underwent surgery in Laibin People's Hospital from January 2020 to December 2021 were retrospectively analyzed. The patients were divided into non-metastasis group( n=24) and metastasis group( n=23) according to whether distant metastasis occurred during 1-year follow-up. Immunohistochemistry was used to detect the CD 34 expression in microvascular epithelial cells and D2-40 level in lymphatic epithelial cells from pancreatic cancer tissues. MVD and LVD in cancer tissues and adjacent normal tissues were counted. The relationship between MVD and LVD in cancer tissues and clinicopathological characteristics such as gender, age, tumor diameter, tumor differentiation, lymph node metastasis, vascular invasion, nerve invasion and tumor stage were analyzed. The receiver operating characteristic curve (ROC) was drawn and the area under the curve (AUC) was calculated to evaluate the value of MVD and LVD in predicting distant metastasis of pancreatic cancer within 1 year after surgery. The effects of MVD and LVD on the distant metastasis rate of pancreatic cancer within one year after operation were evaluated. Univariate and multivariate logistic regression were used to analyze the independent influencing factors for distant metastasis of pancreatic cancer within 1 year after surgery. Results:MVD and LVD in metastatic cancer tissues were higher than those in adjacent normal tissues [(72.52±9.73) vs (51.73±7.95)/400 times field of view, (23.78±6.87) vs (14.00±5.66)/400 times field of view]. MVD and LVD in the non-metastasis group were also higher than those in the adjacent normal tissues [(63.20±6.52) vs (54.79±5.80)/400 times field of view, (16.25±5.15) vs (13.62±5.03)/400 times field of view], and all the differences were statistically significant ( P<0.05). MVD in cancer tissue was significantly increased in patients with tumor diameter ≥2 cm, lymph node metastasis, vascular invasion and high TNM stage ( P<0.05), and LVD was significantly increased in patients with tumor diameter ≥2 cm, lymph node metastasis, moderate and low differentiation, vascular invasion, nerve invasion and high TNM stage ( P<0.05). The AUC values of MVD and LVD in predicting distant metastasis of pancreatic cancer within 1 year after surgery were 0.799 (95% CI 0.659-0.939) and 0.803(95% CI 0.676-0.929), and the cut-off values were 70.5 and 20.5/400 times field of view, respectively. The sensitivity was 73.9% and 69.6%, and the specificity was 87.5% and 83.7%. The cumulative distant metastasis rate within 1 year after operation in high MVD and high LVD groups was significantly higher than that in low MVD and low LVD groups ( P<0.05). Multivariate logitic regression analysis showed that tumor diameter ≥2 cm ( OR=1.757, 95% CI 1.536-3.846, P<0.05), lymph node metastasis ( OR=2.364, 95% CI 1.036-4.175, P<0.05), high MVD ( OR=4.345, 95% CI 1.245-3.736, P<0.05) and high LVD ( OR=3.637, 95% CI 1.426-4.035, P<0.05) were independent risk factors for distant metastasis of pancreatic cancer within 1 year after surgery. Conclusions:Increased MVD and LVD in pancreatic cancer tissues are independent influencing factors for distant metastasis within 1 year after surgery, which can be used to predict whether patients have distant metastasis within 1 year after surgery.

Silicosis is a leading cause of occupational disease-related morbidity and mortality worldwide, but the molecular basis underlying its development remains unclear. An accumulating body of evidence supports gasdermin D (GSDMD)-mediated pyroptosis as a key component in the development of various pulmonary diseases. However, there is little experimental evidence connecting silicosis and GSDMD-driven pyroptosis. In this work, we investigated the role of GSDMD-mediated pyroptosis in silicosis. Single-cell RNA sequencing of healthy and silicosis human and murine lung tissues indicated that GSDMD-induced pyroptosis in macrophages was relevant to silicosis progression. Through microscopy we then observed morphological alterations of pyroptosis in macrophages treated with silica. Measurement of interleukin-1β release, lactic dehydrogenase activity, and real-time propidium iodide staining further revealed that silica induced pyroptosis of macrophages. Additionally, we verified that both canonical (caspase-1-mediated) and non-canonical (caspase-4/5/11-mediated) signaling pathways mediated silica-induced pyroptosis activation, in vivo and in vitro. Notably, Gsdmd knockout mice exhibited dramatically alleviated silicosis phenotypes, which highlighted the pivotal role of pyroptosis in this disease. Taken together, our results demonstrated that macrophages underwent GSDMD-dependent pyroptosis in silicosis and inhibition of this process could serve as a viable clinical strategy for mitigating silicosis.

Objective:To explore the clinical effectiveness of arthroscopic treatment of tibial eminence avulsion fracture by four-point fixation with suture anchors.Methods:A retrospective analysis was performed of the 58 patients with tibial eminence avulsion fracture who had been treated by the same group of surgeons using four-point fixation technique with suture anchors under arthroscopy at Department of Sports Medicine, The Affiliated Hospital to Qingdao University from January 2015 to December 2018. They were 33 males and 25 females, with an average age of 18.4 years (from 14 to 32 years). By the modified Meyers-McKeever classification, 15 fractures were type Ⅱ, 19 type Ⅲ and 24 type Ⅳ. Recorded and compared were knee Lysholm scores, International Knee Documentation Committee (IKDC) scores and tibial eminence height between preoperation and one year postoperation; recorded at the last follow-up were range of knee motion and results of Lachman and pivot-shift tests.Results:The 58 patients were followed up for a mean of 20.7 months (from 12 to 33 months). Bony union was achieved in all patients within 12 weeks after operation. In this cohort, the Lysholm score (85.2±4.9) and IKDC score (86.2±4.3) at one year postoperation were significantly higher than the preoperative values (43.2±5.2 and 51.2±4.9), and the post-operative tibial eminence height [(9.1±1.2) mm] was significantly lower than the preoperative value [(12.6±1.2) mm] (all P<0.05). The correlation coefficients between the tibial eminence height and the Lysholm & IKDC scores at one year postoperation were -0.16 and -0.17, respectively. The last follow-up showed a 132°±5° range of knee motion for all patients, a positive result of pivot-shift test (grade Ⅱ) for 3 and a positive result of Lachman test (grade Ⅰ) for 2. Conclusion:Arthroscopic treatment of tibial eminence avulsion fracture by four-point fixation with suture anchors can lead to satisfactory effectiveness, showing advantages of minimal invasion, anatomic reduction, reliable fixation, and little impact on the epiphysis plate.

Objective:To study the effect of microglia depletion combined with bone marrow mesenchymal stem cells (BMSC) transplantation for spinal cord injury (SCI) repair.Methods:GFP-BMSCs were cultured, identified and detected for expression levels of growth factors. The effects of BMSCs ondorsal root ganglion (DRG) axon outgrowth were observed by the co-culture of BMSCs with DRGs. Mice were depleted of microglia by administrating the colony stimulating factor 1 receptor (CSF1R) inhibitor PLX3397. The spinal cords of these microglia-depleted mice were subjected to crush injury. BMSCs were transplanted into SCI area after microglia depletion. Mice were randomly divided into control group (SCI+BMSCs) and experimental group (PLX3397+SCI+BMSCs). Mice were sacrificed at corresponding time points after transplantation for observing the survival of transplanted BMSCs and the repair of spinal cord. BMS score was used for evaluation of motor function recovery.Results:BMSCs secreted a large number of neurotrophic factors and promoted the growth of DRG axons when co-cultured with DRGs. Depletion of microglia significantly improved the survival of transplanted BMSCs. Compared with BMSCs transplantation alone, the combined treatments slightly but non-significantly reduced the area of the lesion ( t=2.141, P=0.065). Immunofluorescence staining showed that both BMSC transplantation alone and the combined treatments did not cause the corticospinalaxons across the lesion and into distal spinal cord. BMS scores were (1.20±0.45), (3.20±0.45), (3.80±0.45), (4.20±0.45), and (4.60±0.55) points in control group at 1, 7, 14, 21 and 28 d after injury. The experimental groups were(0.60±0.55), (3.00±0.71), (3.80±0.84), (4.20±0.84), and (4.40±0.89) points, respectively. Conclusion:Depletion of microglia improves the survival of transplanted cells, depletion of microglia combined with BMSC transplantation did not result in a significant reduction in lesion area. At the same time, the damaged CST axons were notregenerated. Thus, combining cell transplantation with axon-promoting strategy may be necessary for SCI repair.