Objective To analyze the influence of anxiety and depression on postoperative recovery of patients with acute coronary syndrome(ACS),and to analyze the relationship with neutrophil to lymphocyte ratio(NLR),lymphocyte to monocyte ratio(LMR)and platelet-to-lymphocyte ratio(PLR).Methods A total of 108 ACS patients undergoing surgical treatment in Hainan Provincial Anning Hospital from March 2022 to March 2024 were retrospectively recruited.According to their scores of Hamilton anxiety scale and Hamilton depression scale,they were divided into an anxiety and depression group(34 cases)and a non-anxiety and depression group(74 cases).The quality of life at 1 month after surgery and serum levels of NLR,LMR and PLR at 3 d after surgery were compared between groups.Spearman correlation analysis was performed to analyze the correlation between serum NLR,LMR and PLR and anxiety as well as depression in the ACS patients.Binary logistic regression analysis was used to construct an evaluation model with NLR,LMR and PLR as variables.Receiver operating characteristic(ROC)curve was plotted to analyze the value of serum NLR,LMR and PLR in evaluating anxiety and depression.Results At 1 month after surgery,the scores of dimensions of Short-Form 36 Questionnaire(SF-36)were significantly lower in the anxiety and depression group than the non-anxiety and depression group(P＜0.01).The levels of serum NLR and PLR at 3 d post-operatively were obviously higher while that of LMR was notably lower in the anxiety and depression group than the non-anxiety and depression group(P＜0.01).Spearman correlation analysis indicated that serum NLR and PLR levels(r=0.500,P=0.000;r=0.215,P=0.026)were positively correlated,and LMR level(r=-0.474,P=0.000)was negatively correlated with co-occurrence of anxiety and depression in the ACS patients.Binary logistic regression analysis suggested that NLR,LMR and PLR were high risk factors for anxiety and depression in ACS patients(OR=6.867,95％CI:2.792-16.887,P=0.000;OR=0.180,95％CI:0.078-0.419,P=0.000;OR=1.285,95％CI:1.038-1.591,P=0.032).ROC curve analysis showed that the AUC value of the three indicators combined together in evaluating anxiety and depression in the ACS patients was 0.900(95％CI:0.827-0.949,P=0.000),with a sensitivity of 73.53％and a specificity of 95.95％.The efficiency of combined evalu-ation was superior to that of each indicator.Conclusion Anxiety and depression can affect the postoperative recovery and serum NLR,LMR and PLR in ACS patients.Early combined detection of the three indicators can provide certain value for whether ACS patients are complicated with anxiety and depression.

ObjectiveTo investigate the effect of icariin （ICA） on the phenotype of dendritic cells （DCs） in heart tissue of the Dahl salt-sensitive myocardial remodeling model of rats and its regulation on the vitamin D system. MethodsMale Dahl salt-resistant rats were divided into a normal group， and male Dahl salt-sensitive rats were divided into a model group， low-， medium-， and high-dose ICA groups （30， 60， 120 mg·kg^-1·d^-1）， and Vitamin D group （3×10^-5 mg·kg^-1·d^-1）. In addition to the normal group， the other groups were given an 8% high salt diet to establish a myocardial remodeling model and received intragastric administration after successful modelling once a day for six weeks. The dynamic changes in tail artery blood pressure were monitored， and detection of cardiac ultrasound function in rats was performed. Hematoxylin-eosin （HE） staining and Masson staining were used to observe the morphological changes in rat heart tissue. The phenotype of DCs and T helper cell 17 （Th17）/regulatory T cell （Treg） ratio were detected by flow cytometry. The mRNA and protein expression of vitamin D receptor （VDR）， 1α-hydroxylase （CYP27B1）， 24-hydroxylase （CYP24A1）， forkhead frame protein 3 （FoxP3）， solitaire receptor γt （RORγt）， myocardial type Ⅰ collagen （ColⅠ）， and type collagen （ColⅢ） in heart tissue was detected by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot. ResultsCompared with the normal group， the model group showed disordered arrangement and rupture of myocardial cells， nuclear condensation， significant edema of myocardial tissue， significant proliferation of collagen fibers in a network distribution， and a significant increase in tail artery blood pressure， left ventricular end diastolic diameter （LVEDD）， and left ventricular end systolic diameter （LVESD） （P<0.05）. The phenotype of cardiac DCs was CD40， CD80， and CD86， and the levels of major histocompatibility complex Ⅱ （MHC-Ⅱ）， Th17 cells， and Th17/Treg were significantly increased （P<0.05）. The mRNA and protein expression of CYP24A1 and RORγt in the heart， as well as the mRNA expression of ColⅠ and ColⅢ， were significantly increased （P<0.05）. The left ventricular ejection fraction （LVEF）， interventricular septal thickness （IVSD）， and left ventricular posterior wall thickness （LVPWD） were significantly decreased （P<0.05）. The phenotype of cardiac DCs such as CD11， CD11b， and Treg cells， were significantly reduced （P<0.05）， while the mRNA and protein expression of cardiac VDR， CYP27B1， and FoxP3 were significantly decreased （P<0.05）. Compared with the model group， the low-， medium-， and high-dose ICA groups and vitamin D group significantly reduced myocardial cell rupture and nuclear consolidation in rats. The high-dose ICA group and vitamin D group showed a small amount of myocardial cell rupture and nuclear consolidation， improving myocardial fiber arrangement to varying degrees and significantly reducing myocardial fiber rupture and proliferation. The tail artery blood pressure， LVEDD， and LVESD were significantly decreased in the low-， medium-， and high-dose ICA groups and vitamin D group （P<0.05）， and the phenotype of cardiac DCs including CD40， CD80， CD86， MHC-Ⅱ， Th17 cells， and Th17/Treg were significantly decreased （P<0.05）. The mRNA and protein expression of CYP24A1 and RORγt， and the mRNA expression of ColⅠ and ColⅢ in the heart were significantly decreased in the medium- and high-dose ICA groups and vitamin D group （P<0.05）. The LVEF， IVSD， and LVPWD of myocardial remodeling model rats in the low-， medium-， and high-dose ICA groups and vitamin D group were significantly increased （P<0.05）. The phenotypes of cardiac DCs including CD11， CD11b， and Treg cells were significantly increased in the medium- and high-dose ICA groups and the Vitamin D group （P<0.05）. The mRNA and protein expressions of VDR， CYP27B1， and FoxP3 in the heart were significantly increased in the medium- and high-dose ICA groups and vitamin D group （P<0.05）. ConclusionICA can regulate tail artery blood pressure， cardiac structural and functional damage， and myocardial tissue fibrosis and inhibit phenotype and functional maturation of DCs in heart tissue in the myocardial remodeling model of Dahl salt-sensitive rats. It can also affect the gene and protein expression of VDR， CYP24A1， and CYP27B1， achieving its intervention in Th17/Treg balance in the immune process of myocardial remodeling possibly by regulating vitamin D/VDR in heart tissue.

OBJECTIVE To optimize the water extraction technology for Kaixin granules. METHODS UPLC-MS/MS method was established for the simultaneous determination of ginsenoside Rg1， ginsenoside Re， ginsenoside Rb1， tenuifolin， polygalaxanthone Ⅲ and 3， 6′-disinapoyl-sucrose. An orthogonal test was designed with extraction times， extraction duration， and the volume of added water as factors. Using the contents of the aforementioned six indicator components and the extract yield as evaluation indexes， analytic hierarchy process-entropy weight method was employed to determine the combined weights of each indicator. Subsequently， process optimization and validation were conducted by integrating grey relational analysis （GRA） and back propagation （BP） neural network. RESULTS The water extraction technology optimized by the orthogonal test and GRA was 10- fold water for the first decoction and 8-fold water for the subsequent two， extracting 3 times，extracting for 1 h each time； the average comprehensive score of the validation experiment was 91.10 （RSD＝0.31%， n＝3）. The water extraction technology optimized by BP neural network was extracting 3 times with 10-fold water added each time， extracting for 1.5 h each time； the average comprehensive score of the validation experiment was 95.89 （RSD＝0.73%， n＝3）. Considering practical production requirements， the optimal water extraction technology was extraction performed three times， with 10-fold water for the first decoction and 8-fold water for the subsequent two extractions， with an extraction time of 1 h each. CONCLUSIONS The optimized water extraction technology for Kaixin granules is stable and feasible.

OBJECTIVE: To explore the genetic etiology of four fetuses with Uniparental disomy (UPD), and analyze their causes. METHODS: Four fetuses undergoing prenatal diagnosis at Wenzhou Central Hospital between November 2021 and July 2024 were selected as the study subjects. Genetic testing and diagnosis were carried out through G-banded chromosomal karyotyping, single nucleotide polymorphism array (SNP-array) and methylation multiplex ligation-dependent probe amplification (MS-MLPA). This study was approved by the Medical Ethics Committee of the Hospital (Ethics No.: L2024-11-028). RESULTS: The four cases of pathogenic UPD had involved chromosomes 2, 11, 15 and 16, respectively, of which 2 cases were accompanied by fetal ultrasound abnormalities, One fetus was shown a high risk by serological screening, while another showed a high risk by non-invasive DNA testing. The karyotype of fetus 1 was 45,X?,rob(13;15)(q10;q10), and its parents had both carried a Robertsonian translocation involving chromosomes 13 and 15, whilst the karyotypes of other three fetuses were all normal. Pedigree analysis indicated that the UPDs in three cases were paternally derived, and the remaining one was unknown. The causes of the four cases included imprinting syndrome in two cases, autosomal recessive disorder in one case, and cryptic mosaic trisomy in one case. CONCLUSION The clinical phenotypes of UPD are diverse, and the mechanisms are complex. Combined chromosomal karyotyping, SNP-array, MS-MLPA and other technologies are required to make a clear diagnosis for prenatal genetic counseling and postnatal management.
Humans ; Uniparental Disomy/diagnosis* ; Female ; Pregnancy ; Prenatal Diagnosis/methods* ; Polymorphism, Single Nucleotide/genetics* ; Karyotyping ; Adult ; Genetic Testing ; Male ; Fetus

AIM:The aim of our study is to investigate the metabolic profile differences during cervical lesion progression and evaluate their potential clinical value in assisting the diagnosis of cervical cancer(CC).METHODS:Ul-tra-high-performance liquid chromatography coupled with high-resolution mass spectrometry(UHPLC-HRMS)was em-ployed to conduct non-targeted metabolomic analysis of cervical swab samples from 43 CC patients,34 high-grade squa-mous intraepithelial lesion(HSIL)patients,and 43 healthy controls.Based on the distinct features among the three groups,principal component analysis(PCA)was used to identify the metabolic differences among CC,HSIL and healthy groups.MetaboAnalyst 5.0 was then employed to perform KEGG pathway enrichment analysis on the differential metabo-lites.Finally,random forest machine learning algorithm was used to construct classification prediction models for distin-guishing CC from healthy,HSIL from healthy,and CC from HSIL.The performance of these models was evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS:A total of 1 543 metabolites were identified across the healthy,HSIL and CC groups after filtration,with 407 metabolites differing between the groups.The study found that metabolite PGE2 was present in all three groups,with its expression levels progressively increasing with the progression of cervical lesions.Differential metabolite enrichment analysis demonstrated that CC is associated with specific cancer-relat-ed metabolic pathways,including the tricarboxylic acid cycle,tyrosine metabolism,tryptophan metabolism,and the pen-tose phosphate pathways.Additionally,the study developed three prediction models based on metabolic products for diag-nosing HSIL and CC:the full model,the simplified model,and the PGE2 model.The results indicated that metabolites ex-hibited strong diagnostic efficiency.Both the full model and the simplified model effectively distinguished CC from HSIL,CC from healthy,and HSIL from healthy.The AUC values for the full model were 0.90,0.92 and 0.84,respectively,while those for the simplified model were 0.81,0.95 and 0.85,respectively.Furthermore,the PEG2 model achieved AUC values of 0.74 and 0.80 for distinguishing CC from healthy and HSIL from healthy,respectively.CONCLUSION:The metabolic profiles of cervical cancer exhibit significant differences during the progression of cervical cancer,and these metabolites hold potential clinical value as biomarkers for cervical lesions.

Based on the"brain-heart-kidney-seminal chamber"axis theory to understand the pathogenesis of coronary heart disease(CHD)complicated with erectile dysfunction(ED),it is considered that the dysfunction of the"brain-heart-kidney-seminal chamber"axis is closely related to the occurrence of CHD complicated with ED,in which kidney deficiency is the initial factor;heart brain disorder,loss of consciousness is the key to the pathogenesis;the loss of seminal chamber is an important link in the pathogenesis.Under the guidance of the concept of"brain-heart-kidney-seminal chamber"axis,Cistanches Herba-Rehmannize Radix et Praeparata-Cuscutae Semen were used to invigorate the kidney and regulate the essence of the brain,heart,kidney and seminal chamber;Salviea Miltiorrhizae Radix et Rhizoma-Chuanxiong Rhizoma-Schisandrae Chinensis Fructus can reach the heart and brain,calm the heart and calm the mind;Cyathulae Radix-Scolopendra-Spatholobi Caulis can adjust and restore the seminal chamber,moistening the tendons and vibrating the flaccidity.In clinical practice,the whole medication should be used to make the brain,heart and kidney in harmony with the seminal chamber at the same time,and the drugs should be flexibly added and subtracted according to the specific symptoms of patients to enhance the curative effect of CHD patients with ED.

Based on the"brain-heart-kidney-seminal chamber"axis theory to understand the pathogenesis of coronary heart disease(CHD)complicated with erectile dysfunction(ED),it is considered that the dysfunction of the"brain-heart-kidney-seminal chamber"axis is closely related to the occurrence of CHD complicated with ED,in which kidney deficiency is the initial factor;heart brain disorder,loss of consciousness is the key to the pathogenesis;the loss of seminal chamber is an important link in the pathogenesis.Under the guidance of the concept of"brain-heart-kidney-seminal chamber"axis,Cistanches Herba-Rehmannize Radix et Praeparata-Cuscutae Semen were used to invigorate the kidney and regulate the essence of the brain,heart,kidney and seminal chamber;Salviea Miltiorrhizae Radix et Rhizoma-Chuanxiong Rhizoma-Schisandrae Chinensis Fructus can reach the heart and brain,calm the heart and calm the mind;Cyathulae Radix-Scolopendra-Spatholobi Caulis can adjust and restore the seminal chamber,moistening the tendons and vibrating the flaccidity.In clinical practice,the whole medication should be used to make the brain,heart and kidney in harmony with the seminal chamber at the same time,and the drugs should be flexibly added and subtracted according to the specific symptoms of patients to enhance the curative effect of CHD patients with ED.

Objective To analyze the influence of anxiety and depression on postoperative recovery of patients with acute coronary syndrome(ACS),and to analyze the relationship with neutrophil to lymphocyte ratio(NLR),lymphocyte to monocyte ratio(LMR)and platelet-to-lymphocyte ratio(PLR).Methods A total of 108 ACS patients undergoing surgical treatment in Hainan Provincial Anning Hospital from March 2022 to March 2024 were retrospectively recruited.According to their scores of Hamilton anxiety scale and Hamilton depression scale,they were divided into an anxiety and depression group(34 cases)and a non-anxiety and depression group(74 cases).The quality of life at 1 month after surgery and serum levels of NLR,LMR and PLR at 3 d after surgery were compared between groups.Spearman correlation analysis was performed to analyze the correlation between serum NLR,LMR and PLR and anxiety as well as depression in the ACS patients.Binary logistic regression analysis was used to construct an evaluation model with NLR,LMR and PLR as variables.Receiver operating characteristic(ROC)curve was plotted to analyze the value of serum NLR,LMR and PLR in evaluating anxiety and depression.Results At 1 month after surgery,the scores of dimensions of Short-Form 36 Questionnaire(SF-36)were significantly lower in the anxiety and depression group than the non-anxiety and depression group(P＜0.01).The levels of serum NLR and PLR at 3 d post-operatively were obviously higher while that of LMR was notably lower in the anxiety and depression group than the non-anxiety and depression group(P＜0.01).Spearman correlation analysis indicated that serum NLR and PLR levels(r=0.500,P=0.000;r=0.215,P=0.026)were positively correlated,and LMR level(r=-0.474,P=0.000)was negatively correlated with co-occurrence of anxiety and depression in the ACS patients.Binary logistic regression analysis suggested that NLR,LMR and PLR were high risk factors for anxiety and depression in ACS patients(OR=6.867,95％CI:2.792-16.887,P=0.000;OR=0.180,95％CI:0.078-0.419,P=0.000;OR=1.285,95％CI:1.038-1.591,P=0.032).ROC curve analysis showed that the AUC value of the three indicators combined together in evaluating anxiety and depression in the ACS patients was 0.900(95％CI:0.827-0.949,P=0.000),with a sensitivity of 73.53％and a specificity of 95.95％.The efficiency of combined evalu-ation was superior to that of each indicator.Conclusion Anxiety and depression can affect the postoperative recovery and serum NLR,LMR and PLR in ACS patients.Early combined detection of the three indicators can provide certain value for whether ACS patients are complicated with anxiety and depression.

AIM:The aim of our study is to investigate the metabolic profile differences during cervical lesion progression and evaluate their potential clinical value in assisting the diagnosis of cervical cancer(CC).METHODS:Ul-tra-high-performance liquid chromatography coupled with high-resolution mass spectrometry(UHPLC-HRMS)was em-ployed to conduct non-targeted metabolomic analysis of cervical swab samples from 43 CC patients,34 high-grade squa-mous intraepithelial lesion(HSIL)patients,and 43 healthy controls.Based on the distinct features among the three groups,principal component analysis(PCA)was used to identify the metabolic differences among CC,HSIL and healthy groups.MetaboAnalyst 5.0 was then employed to perform KEGG pathway enrichment analysis on the differential metabo-lites.Finally,random forest machine learning algorithm was used to construct classification prediction models for distin-guishing CC from healthy,HSIL from healthy,and CC from HSIL.The performance of these models was evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS:A total of 1 543 metabolites were identified across the healthy,HSIL and CC groups after filtration,with 407 metabolites differing between the groups.The study found that metabolite PGE2 was present in all three groups,with its expression levels progressively increasing with the progression of cervical lesions.Differential metabolite enrichment analysis demonstrated that CC is associated with specific cancer-relat-ed metabolic pathways,including the tricarboxylic acid cycle,tyrosine metabolism,tryptophan metabolism,and the pen-tose phosphate pathways.Additionally,the study developed three prediction models based on metabolic products for diag-nosing HSIL and CC:the full model,the simplified model,and the PGE2 model.The results indicated that metabolites ex-hibited strong diagnostic efficiency.Both the full model and the simplified model effectively distinguished CC from HSIL,CC from healthy,and HSIL from healthy.The AUC values for the full model were 0.90,0.92 and 0.84,respectively,while those for the simplified model were 0.81,0.95 and 0.85,respectively.Furthermore,the PEG2 model achieved AUC values of 0.74 and 0.80 for distinguishing CC from healthy and HSIL from healthy,respectively.CONCLUSION:The metabolic profiles of cervical cancer exhibit significant differences during the progression of cervical cancer,and these metabolites hold potential clinical value as biomarkers for cervical lesions.

Atherosclerosis(As)is a chronic inflammatory disease caused by lipid deposition.Panvascular disea-ses,which are mainly caused by As,have gradually attracted the attention of many scholars,and their main pathological features are vascular lesions.Vitamin D plays an important role in anti-As in panvascular diseases.It is involved in the regulation of renin-angiotensin system(RAS),endothelial cell injury,immune response,neutrophil extracellular traps(NET)regulation,apoptosis and autophagy,and is a new target in panvascular diseases research.Traditional Chinese Medicine(TCM)has certain advantages in the prevention and treatment of panvascular diseases.Among them,single herbs,active ingredients and compound prescriptions can regulate vitamin D-related metabolism,and have unique scientific value for the prevention and treatment of As.This article mainly discusses the role of vitamin D in multiple pathological links of panvascular diseases and related Chinese medicine interventions,aiming to provide effective ideas for the prevention and treatment of panvascular diseases from the perspective of vitamin D.