To analyze the clinical and genetic features of oculopharyngodistal myopathy (OPDM) patients and compare the phenotypic differences among various causative genes.

Objective:To evaluate the efficacy of two different approaches:direct anterior approach(DAA)and posterolateral approach(PLA)in total hip arthroplasty(THA).Methods:This study adopted a retrospective cohort study design,included to analyse 128 cases of THA patients who were received in our hospital from January 2021 to January 2024.Patients were divided into PLA group(n=61)and DAA group(n=67)according to different approach methods.Perioperative indicators,Harris hip joint function score,anteversion and abduction angles of acetabular prosthesis and incidence of complications were compared between the two groups.Results:Compared with PLA group,DAA group had longer surgical time,less intraoperative blood loss,shorter surgical incision length and shorter postoperative hospital stay(P＜0.05).Compared with the PLA group at 1 month(T2)to 6 months(T4)after surgery,DAA group had higher Harris hip joint function score(P＜0.05).Conclusion:Compared with PLA,DDA is used in THA,although the surgery time is longer,it can achieve a similar recovery effect in anteversion and abduction angles,which helps to shorten the surgical incision length and postoperative hospital stay,reduce intraoperative blood loss and achieve better hip joint function recovery.

Peritoneal dialysis (PD) is a crucial renal replacement therapy for end-stage renal disease (ESRD), offering significant advantages as high flexibility, hemodynamic stability, and high cost-effectiveness. However, prolonged exposure to intra-abdominal dialysate may predispose to the mechanical complication of abdominal external hernia. Abdominal external hernia may lead to various adverse clinical outcomes. In severe cases, it can progress to incarceration or even rupture, ultimately necessitating discontinuation of the therapy. The authors systematically review PD-associated abdominal external hernias, including their clinical landscape, risk factors, surgical treatment strategies and prognostic determinants. They also assess the effects of hernia repair on residual renal function, aiming to provide references for clinical decision-making.

Objective To investigate the prevalence of specific IgE antibodies against Alternaria alternata and Aspergillus fumigatus in serum samples from clinical allergy patients across selected provinces in China.Methods Data on specific IgE antibodies for Alternaria A.and Aspergillus F.were collected from 20 hospital laboratories in 17 cities spanning 11 provinces.The study analyzed the levels of specific IgE and their variations across different provinces and seasons.Results A total of 27 471 cases of Alternaria A.and 32 843 cases of Aspergillus F.specific IgE data were included.The national average positive rate of Alternaria A.IgE was 10.40%,with the highest rate of 22.68%in Jiangsu and the lowest rate of 2.06%in Guangxi.For Aspergillus F.specific IgE,the average positive rate was 4.24%,with Hubei province having the highest rate(7.25%)and Hunan province the lowest(1.23%).The difference in IgE levels for both Alternaria A.and Aspergillus F.among provinces were statistically significant(H=9 955,16 993,all P<0.0001).Among patients,5.85%had Alternaria A.specific IgE levels at grade 3 or above,while only 0.57%had Aspergillus F.specific IgE levels at this level.When examining seasonal variations using data from Liaoning,Hunan and Anhui provinces,significant seasonal changes were observed for both Alternaria A.and Aspergillus F.IgE antibodies(HAlternaria A=347.6,338.0,401.3,HAspergillus F=196.6,133.7,231.7,all P<0.0001).Conclusion The sensitization to Alternaria A.and Aspergillus F.exhibits distinct geographical characteristics and vary significantly with seasons.Given the relatively high IgE levels associated with Alternaria A.,it should be given adequate clinical attention.

Peritoneal dialysis (PD) is a crucial renal replacement therapy for end-stage renal disease (ESRD), offering significant advantages as high flexibility, hemodynamic stability, and high cost-effectiveness. However, prolonged exposure to intra-abdominal dialysate may predispose to the mechanical complication of abdominal external hernia. Abdominal external hernia may lead to various adverse clinical outcomes. In severe cases, it can progress to incarceration or even rupture, ultimately necessitating discontinuation of the therapy. The authors systematically review PD-associated abdominal external hernias, including their clinical landscape, risk factors, surgical treatment strategies and prognostic determinants. They also assess the effects of hernia repair on residual renal function, aiming to provide references for clinical decision-making.

Objective:To observe the relationship between serum insulin-like growth factor binding protein-3(IGFBP-3),insulin-like growth factor-1(IGF-1)and cardiac function and short-term prognosis in patients with dilated cardiomyopathy(DCM)complicated with heart failure(HF).Methods:102 patients with DCM complicated with HF were selected as study group and they were divided into good prognosis group and poor prognosis group based on prognosis,and 100 patients with simple DCM during the same period were selected as the control group.The cardiac function indicators[left ventricular end systolic volume(LVESV),left ventricular ejection fraction(LVEF),left ventricular end diastolic volume(LVEDV)]and serum IGFBP-3 and IGF-1 levels between the control group and the study group were compared.The correlation between cardiac function and IGFBP-3,IGF-1 was analyzed by pearson analysis.The serum IGFBP-3 and IGF-1 leveles between good prognosis group and poor prognosis group were compared,the correlation between prognosis and IGFBP-3,IGF-1 was analyzed by spearman.Receiver operating characteristic(ROC)curves were used to analyze the predictive value of serum levels of IGFBP-3 and IGF-1 alone and in combination for the short-term prognosis of DCM complicated with HF patients.Results:Compared with control group,study group had higher LVEDV,LVESV,IGFBP-3,IGF-1,and lower LVEF(P＜0.05).Pearson analysis results showed that,IGFBP-3 and IGF-1 were positively correlated with LVEDV and LVESV,while which was negatively correlated with LVEF(P＜0.05).Compared with good prognosis group,poor prognosis group had higher IGFBP-3,IGF-1(P＜0.05).Spearman correlation analysis results showed that,the levels of IGFBP-3 and IGF-1 were positively correlated with the poor prognosis of DCM complicated with HF patients(P＜0.05).The area under the curve(AUC)of serum IGFBP-3,IGF-1 levels,and their combined use for short-term prognosis of DCM complicated with HF patients were 0.715,0.749,and 0.831,respectively.Conclusion:Serum IGFBP-3 and IGF-1 levels are elevated in patients with DCM complicated with HF,and the changes in these two indicators are associated with poor cardiac function and prognosis in patients.The combined detection of IGFBP-3 and IGF-1 levels has a high predictive value for the short-term prognosis of DCM combined with HF.

Objective To investigate the clinical efficacy of pan-immune inflammatory value(PIV)in pre-dicting the prognosis of elderly patients with severe pneumonia(SP).Methods A total of 160 elderly patients with SP admitted to this hospital from January to June 2023 were selected as the study group,and 100 elderly patients with common pneumonia in the hospital in the same period were selected as the control group.Ac-cording to the prognosis at discharge,the patients were divided into good prognosis group(128 cases)and poor prognosis group(32 cases).Neutrophil count,platelet count,monocyte count and lymphocyte count were detected by automatic blood cell analyzer,and PIV was finally calculated.Receiver operating characteristic(ROC)curve was used to analyze the prognostic value of PIV in elderly patients with SP.Multivariate Logis-tic regression was used to analyze the prognostic factors in elderly patients with SP.Results The counts of neutrophil,monocyte and PIV in control group were lower than those in study group,and the counts of lym-phocytes,platelet in control group were higher than those in study group,the difference was statistically sig-nificant(P＜0.05).Neutrophil,monocyte count and PIV in the good prognosis group were significantly lower than those in the poor prognosis group,and platelet count and lymphocyte count in the good prognosis group were higher than those in the poor prognosis group,with statistical significance(P＜0.05).ROC curve analy-sis showed that the area under the curve of PIV in predicting poor prognosis in elderly SP patients was 0.941,which was larger than that of neutrophil,monocyte,platelet count and lymphocyte count(P＜0.001).The proportion of mechanical ventilation,C rection protein(CRP)and procalcitonin(PCT)levels in poor progno-sis group were higher than those in good prognosis group(P＜0.05).Multivariate Logistic regression analysis showed that mechanical ventilation,CRP,PCT and PIV were independent risk factors for the prognosis of eld-erly SP patients(P＜0.05).Conclusion PIV is an independent risk factor for predicting the prognosis of eld-erly patients with SP.PIV is an important prognostic factor for elderly patients with SP.

Objective To investigate the prevalence of specific IgE antibodies against Alternaria alternata and Aspergillus fumigatus in serum samples from clinical allergy patients across selected provinces in China.Methods Data on specific IgE antibodies for Alternaria A.and Aspergillus F.were collected from 20 hospital laboratories in 17 cities spanning 11 provinces.The study analyzed the levels of specific IgE and their variations across different provinces and seasons.Results A total of 27 471 cases of Alternaria A.and 32 843 cases of Aspergillus F.specific IgE data were included.The national average positive rate of Alternaria A.IgE was 10.40%,with the highest rate of 22.68%in Jiangsu and the lowest rate of 2.06%in Guangxi.For Aspergillus F.specific IgE,the average positive rate was 4.24%,with Hubei province having the highest rate(7.25%)and Hunan province the lowest(1.23%).The difference in IgE levels for both Alternaria A.and Aspergillus F.among provinces were statistically significant(H=9 955,16 993,all P<0.0001).Among patients,5.85%had Alternaria A.specific IgE levels at grade 3 or above,while only 0.57%had Aspergillus F.specific IgE levels at this level.When examining seasonal variations using data from Liaoning,Hunan and Anhui provinces,significant seasonal changes were observed for both Alternaria A.and Aspergillus F.IgE antibodies(HAlternaria A=347.6,338.0,401.3,HAspergillus F=196.6,133.7,231.7,all P<0.0001).Conclusion The sensitization to Alternaria A.and Aspergillus F.exhibits distinct geographical characteristics and vary significantly with seasons.Given the relatively high IgE levels associated with Alternaria A.,it should be given adequate clinical attention.

OBJECTIVE: Glucocorticoid-induced osteoporosis (GIOP) is a common complication of prolonged glucocorticoid therapy. Chlorogenic acid (CGA), a polyphenol with antioxidant properties that is extracted from traditional Chinese medicines such as Eucommiae Cortex, has potential anti-osteoporotic activity. This study aimed to investigate the possible effects of CGA on GIOP in mice and murine long bone osteocyte Y4 (MLO-Y4) cells and explore the underlying molecular mechanisms. METHODS: The protective effects of CGA were initially evaluated in the GIOP mouse model induced by dexamethasone (Dex). The micro-computed tomography, hematoxylin-eosin staining, silver nitrate staining, and serum detection were used to assess the efficacy of CGA for improving bone formation in vivo. Then, network pharmacology analysis was used to predict the potential targets and molecular mechanisms underlying the therapeutic efficacy of CGA against GIOP. After that, 2',7'-dichlorofluorescein diacetate staining, flow cytometry, real-time quantitative reverse transcription polymerase chain reaction, and Western blotting were used to verify the mechanisms of CGA against GIOP in vitro. RESULTS: Animal experiments showed that CGA treatment effectively attenuated Dex-induced decreases in bone mass and strength and improved disrupted osteocyte morphology in mice. The protein-protein interaction analysis highlighted erb-b2 receptor tyrosine kinase (ERBB2), which is also known as human epidermal growth factor receptor 2 (HER2), caspase-3, kinase insert domain receptor, matrix metallopeptidase 9, matrix metallopeptidase 2, proto-oncogene tyrosine-protein kinase Src, and epidermal growth factor receptor as core targets. The Kyoto Encyclopedia of Genes and Genomes analysis revealed several significantly enriched pathways (P < 0.05), including the ERBB, phosphoinositide 3 kinase-AKT serine/threonine kinase 1 (AKT), and mechanistic target of rapamycin kinase (mTOR) pathways. Cellular experiments verified that CGA enhanced bone formation and promoted autophagy while inhibiting apoptosis in MLO-Y4 cells exposed to Dex, which was associated with the upregulated expression of HER2 and activation of the HER2/AKT/mTOR signaling pathway. CONCLUSION CGA exerted anti-osteoporotic effects against GIOP, partially through targeting osteocytes and modulating the HER2/AKT/mTOR signaling pathway. Please cite this article as: Xie AN, Zhang SZY, Zhang Y, Cao JL, Wang CL, Wang LB, Wu HJ, Zhang J, Dai WW. Chlorogenic acid mitigates glucocorticoid-induced osteoporosis via modulation of HER2/AKT/mTOR signaling pathway. J Integr Med. 2025; 23(6):670-682.
Animals ; Chlorogenic Acid/therapeutic use* ; Osteoporosis/metabolism* ; Signal Transduction/drug effects* ; Proto-Oncogene Proteins c-akt/metabolism* ; TOR Serine-Threonine Kinases/metabolism* ; Mice ; Glucocorticoids/adverse effects* ; Receptor, ErbB-2/metabolism* ; Proto-Oncogene Mas ; Dexamethasone/adverse effects* ; Osteocytes/drug effects* ; Osteogenesis/drug effects* ; Male ; Cell Line ; Mice, Inbred C57BL ; Humans

Objective:To observe the relationship between serum insulin-like growth factor binding protein-3(IGFBP-3),insulin-like growth factor-1(IGF-1)and cardiac function and short-term prognosis in patients with dilated cardiomyopathy(DCM)complicated with heart failure(HF).Methods:102 patients with DCM complicated with HF were selected as study group and they were divided into good prognosis group and poor prognosis group based on prognosis,and 100 patients with simple DCM during the same period were selected as the control group.The cardiac function indicators[left ventricular end systolic volume(LVESV),left ventricular ejection fraction(LVEF),left ventricular end diastolic volume(LVEDV)]and serum IGFBP-3 and IGF-1 levels between the control group and the study group were compared.The correlation between cardiac function and IGFBP-3,IGF-1 was analyzed by pearson analysis.The serum IGFBP-3 and IGF-1 leveles between good prognosis group and poor prognosis group were compared,the correlation between prognosis and IGFBP-3,IGF-1 was analyzed by spearman.Receiver operating characteristic(ROC)curves were used to analyze the predictive value of serum levels of IGFBP-3 and IGF-1 alone and in combination for the short-term prognosis of DCM complicated with HF patients.Results:Compared with control group,study group had higher LVEDV,LVESV,IGFBP-3,IGF-1,and lower LVEF(P＜0.05).Pearson analysis results showed that,IGFBP-3 and IGF-1 were positively correlated with LVEDV and LVESV,while which was negatively correlated with LVEF(P＜0.05).Compared with good prognosis group,poor prognosis group had higher IGFBP-3,IGF-1(P＜0.05).Spearman correlation analysis results showed that,the levels of IGFBP-3 and IGF-1 were positively correlated with the poor prognosis of DCM complicated with HF patients(P＜0.05).The area under the curve(AUC)of serum IGFBP-3,IGF-1 levels,and their combined use for short-term prognosis of DCM complicated with HF patients were 0.715,0.749,and 0.831,respectively.Conclusion:Serum IGFBP-3 and IGF-1 levels are elevated in patients with DCM complicated with HF,and the changes in these two indicators are associated with poor cardiac function and prognosis in patients.The combined detection of IGFBP-3 and IGF-1 levels has a high predictive value for the short-term prognosis of DCM combined with HF.