OBJECTIVE: To investigate possible associations between physical function assessment scales, such as Short Physical Performance Battery (SPPB) and Berg Balance Scale (BBS), with all-cause mortality in acute decompensated heart failure (ADHF) patients. METHODS: A total of 108 ADHF patients were analyzed from October 2020 to October 2022, and followed up to May 2023. The association between baseline clinical characteristics and all-cause mortality was analyzed by univariate Cox regression analysis, while for SPPB and BBS, univariate Cox regression analysis was followed by receiver operating characteristic curves, in which the area under the curve represented their predictive accuracy for all-cause mortality. Incremental predictive values for both physical function assessments were measured by calculating net reclassification index and integrated discrimination improvement scores. Optimal cut-off value for BBS was then identified using restricted cubic spline plots, and survival differences below and above that cut-off were compared using Kaplan-Meier survival curves and the log-rank test. The clinical utility of BBS was measured using decision curve analysis. RESULTS: For baseline characteristics, age, female, blood urea nitrogen, as well as statins, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, or angiotensin receptor-neprilysin inhibitors, were predictive for all-cause mortality for ADHF patients. With respect to SPPB and BBS, higher scores were associated with lower all-cause mortality rates for both assessments; similar area under the curves were measured for both (0.774 for SPPB and 0.776 for BBS). Furthermore, BBS ≤ 36.5 was associated with significantly higher mortality, which was still applicable even adjusting for confounding factors; BBS was also found to have great clinical utility under decision curve analysis. CONCLUSIONS BBS or SPPB could be used as tools to assess physical function in ageing ADHF patients, as well as prognosticate on all-cause mortality. Moreover, prioritizing the improvement of balance capabilities of ADHF patients in cardiac rehabilitation regimens could aid in lowering mortality risk.

AIM To explore the clinical effects of Supplemented Buyang Huanwu Decoction on postoperative patients with lumbar vertebral fracture complicated with spinal cord injury due to Qi Deficiency and Blood Stasis Pattern.METHODS One hundred and twenty patients were randomly assigned into control group(60 cases)for 6-week intervention of conventional treatment,and observation group(60 cases)for 6-week intervention of both Supplemented Buyang Huanwu Decoction and conventional treatment.The changes in clinical effects,TCM syndrome scores,spinal cord conduction signals(SEP amplitude,MEP amplitude),serum neurotrophic factors(NGF,IGF-1,BDNF),coagulation and inflammatory indices(PT,APTT,TNF-α,IL-1 β)and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P＜0.05).After the treatment,the two groups displayed decreased TCM syndrome scores,TNF-α,IL-1β(P＜0.05),increased spinal cord conduction signals,coagulation and inflammatory indices(P＜0.05),and shortened PT,APTT(P＜0.05),especially for the observation group(P＜0.05).No significant difference in incidence of adverse reactions was found between the two groups(P＞0.05).CONCLUSION For the patients with lumbar vertebral fracture complicated with spinal cord injury due to Qi Deficiency and Blood Stasis Pattern,Supplemented Buyang Huanwu Decoction can safely and effectively promote neurological function recovery.

Aim To investigate the role of miR-130b-3p in regulating the USP47/NLRP3 inflammasome in airway remodeling associated with asthma and to explore its potential therapeutic value in asthma treat-ment.Methods An OVA-induced asthma mouse mod-el was established,and intervention with miR-130b-3p agomir was performed.Histological staining,quantita-tive real-time PCR,Western blot,immunofluorescence and flow cytometry were used to analyze the effects of miR-130b-3p on the expression of USP47,NLRP3,and related inflammatory factors,as well as the inflamma-some activity.Results miR-130b-3p was significantly downregulated in asthmatic mice,and its intervention significantly inhibited airway epithelial damage,inflam-matory cell infiltration,and collagen deposition.Addi-tionally,miR-130b-3p targeted USP47 and indirectly suppressed NLRP3 expression,leading to reduced in-flammasome activity and alleviated asthma-related in-flammatory responses.Conclusion miR-130b-3p re-duces asthma-related inflammatory responses by down-regulating USP47 expression and indirectly inhibiting NLRP3 inflammasome activity.

A method for determination and targeted screening of diflorasone components in health products using ultra performance liquid chromatography-quadrupole time of flight mass spectrometry(UPLC-Q-TOF/MS)was established.Four representative diflorasone and esters(diflorasone,diflorasone diacetate,diflorasone-17-propionate,and diflorasone-21-propionate)were selected to optimize the pretreatment conditions,and 10 mL of extraction solvent dosage,15 min of extraction time and 5 g of salting-out agent as the optimal conditions were selected by response surface methodology.The results showed that the four analytes exhibited good linearity within the concentration range of 2.0?100 μg/L with the chromatographic peak area,and the correlation coefficients(R2)were all greater than 0.9990,while the results of recovery and relative standard deviation could satisfy the requirements of determination.The common characteristic ions of diflorasone and esters werem/z121 andm/z335,and their specific structures were obtained by analyzing the cleavage pathway based on the optimized determination conditions.A targeted screening method for other esters of diflorasone based on characteristic ions guidance strategy was established.This method had many advantages such as high efficiency,high sensitivity and good reproducibility,and could be used for targeted screening of diflorasone and esters in health products.The developed characteristic ion guided strategy could be employed to construct mass spectral databases for various glucocorticoids,enabling comprehensive targeted screening across a broad range of compounds.

Objective To summarize the clinical features,treatment and prognosis of patients with primary central nervous system lymphoma(PCNSL)with clonal bone marrow B cells,and to explore the influence on clinical diagnosis and treatment.Methods PCNSL patients with clonal bone marrow B cells diagnosed by flow cytometry between Jan 2020 and Jul 2023 at Huashan Hospital of Fudan University were enrolled.The auxiliary examination data of these patients were collected,including complete blood count,routine biochemistry,bone marrow aspiration and biopsy,contrast-enhanced brain MRI,and whole-body PET-CT.Kaplan-Meier was used to draw the survival curve,and relevant literature was reviewed.Results A total of 223 newly diagnosed PCNSL patients were included,187 of whom completed bone marrow puncture and biopsy evaluation.We found clonal bone marrow B cells in 16 of 187 cases(8.56%)by flow cytometry.2 patients showed B lymphoma involving the bone marrow.All patients received a high-dose methotrexate based chemotherapy.The median progression free survival(PFS)of 16 patients with clonal bone marrow B cells was 11.1 months,and the median PFS of 171 patients with normal bone marrow was 12.6 months.There was no significant difference in the PFS between the two groups.Conclusion PCNSL with clonal bone marrow B cells had no specific clinical features,but bone marrow flow cytometry showed clonal B cells.High-dose methotrexate treatment regimen is effective.There was no significant difference in PFS for PCNSL patients with clonal B cells and normal findings in bone marrow.Clonal B cells in bone marrow may be caused by monoclonal B-cell lymphocytosis(MBL),lymphoma involves the bone marrow and the presence of common precursor cells.Bone marrow examination should be performed in the initial evaluation of suspected PCNSL.

Aim To investigate the role of miR-130b-3p in regulating the USP47/NLRP3 inflammasome in airway remodeling associated with asthma and to explore its potential therapeutic value in asthma treat-ment.Methods An OVA-induced asthma mouse mod-el was established,and intervention with miR-130b-3p agomir was performed.Histological staining,quantita-tive real-time PCR,Western blot,immunofluorescence and flow cytometry were used to analyze the effects of miR-130b-3p on the expression of USP47,NLRP3,and related inflammatory factors,as well as the inflamma-some activity.Results miR-130b-3p was significantly downregulated in asthmatic mice,and its intervention significantly inhibited airway epithelial damage,inflam-matory cell infiltration,and collagen deposition.Addi-tionally,miR-130b-3p targeted USP47 and indirectly suppressed NLRP3 expression,leading to reduced in-flammasome activity and alleviated asthma-related in-flammatory responses.Conclusion miR-130b-3p re-duces asthma-related inflammatory responses by down-regulating USP47 expression and indirectly inhibiting NLRP3 inflammasome activity.

Objective To summarize the clinical features,treatment and prognosis of patients with primary central nervous system lymphoma(PCNSL)with clonal bone marrow B cells,and to explore the influence on clinical diagnosis and treatment.Methods PCNSL patients with clonal bone marrow B cells diagnosed by flow cytometry between Jan 2020 and Jul 2023 at Huashan Hospital of Fudan University were enrolled.The auxiliary examination data of these patients were collected,including complete blood count,routine biochemistry,bone marrow aspiration and biopsy,contrast-enhanced brain MRI,and whole-body PET-CT.Kaplan-Meier was used to draw the survival curve,and relevant literature was reviewed.Results A total of 223 newly diagnosed PCNSL patients were included,187 of whom completed bone marrow puncture and biopsy evaluation.We found clonal bone marrow B cells in 16 of 187 cases(8.56%)by flow cytometry.2 patients showed B lymphoma involving the bone marrow.All patients received a high-dose methotrexate based chemotherapy.The median progression free survival(PFS)of 16 patients with clonal bone marrow B cells was 11.1 months,and the median PFS of 171 patients with normal bone marrow was 12.6 months.There was no significant difference in the PFS between the two groups.Conclusion PCNSL with clonal bone marrow B cells had no specific clinical features,but bone marrow flow cytometry showed clonal B cells.High-dose methotrexate treatment regimen is effective.There was no significant difference in PFS for PCNSL patients with clonal B cells and normal findings in bone marrow.Clonal B cells in bone marrow may be caused by monoclonal B-cell lymphocytosis(MBL),lymphoma involves the bone marrow and the presence of common precursor cells.Bone marrow examination should be performed in the initial evaluation of suspected PCNSL.

AIM To explore the clinical effects of Supplemented Buyang Huanwu Decoction on postoperative patients with lumbar vertebral fracture complicated with spinal cord injury due to Qi Deficiency and Blood Stasis Pattern.METHODS One hundred and twenty patients were randomly assigned into control group(60 cases)for 6-week intervention of conventional treatment,and observation group(60 cases)for 6-week intervention of both Supplemented Buyang Huanwu Decoction and conventional treatment.The changes in clinical effects,TCM syndrome scores,spinal cord conduction signals(SEP amplitude,MEP amplitude),serum neurotrophic factors(NGF,IGF-1,BDNF),coagulation and inflammatory indices(PT,APTT,TNF-α,IL-1 β)and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P＜0.05).After the treatment,the two groups displayed decreased TCM syndrome scores,TNF-α,IL-1β(P＜0.05),increased spinal cord conduction signals,coagulation and inflammatory indices(P＜0.05),and shortened PT,APTT(P＜0.05),especially for the observation group(P＜0.05).No significant difference in incidence of adverse reactions was found between the two groups(P＞0.05).CONCLUSION For the patients with lumbar vertebral fracture complicated with spinal cord injury due to Qi Deficiency and Blood Stasis Pattern,Supplemented Buyang Huanwu Decoction can safely and effectively promote neurological function recovery.

Objective:To retrospectively analyze the detection and diagnosis process of two cases with double rare thalassemia genotypes,explore the causes of missed diagnosis and misdiagnosis of rare thalassemia,and improve the diagnosis level of rare thalassemia.Methods:Base on the family history,hematological phenotype and hemoglobin electrophoretic analysis results,the common genotypes of α and β-thalassemia were detected by PCR+diversion hybridization.DNA sequencing technology was used for rare α and β protein genes sequencing.Results:Both subjects were combined with double rare thalassemia genotypes,and both rare thalassemia gene combinations were reported for the first time.One of them was αβ complex thalassemia with αα*53_55 del TCC/αα heterozygous merger βIVS Ⅱ2(-T)/βN heterozygous,the other was ααIVS-Ⅱ-55(T→G)in α1/αα4,2-Q double azygous heterozygous α-thalassemia,among whichαα*53_55 del TCC/αα genotype was also reported for the first time.Conclusion:The reported rare gene type αα*53_55 del TCC/αα and two cases of rare gene combinations enriches the spectrum of gene mutations in the Chinese population,and provides richer molecular information for thalassemia diagnosis and eugenics counseling.

Objective To explore the biomarkers and potential mechanisms of chronic restraint stress-induced myocardial injury in hyperlipidemia ApoE-/-mice.Methods The hyperlipidemia combined with the chronic stress model was established by restraining the ApoE-/-mice.Proteomics and bioinformatics techniques were used to describe the characteristic molecular changes and related regulatory mechanisms of chronic stress-induced myocardial injury in hyperlipidemia mice and to explore potential diagnostic biomarkers.Results Proteomic analysis showed that there were 43 significantly up-regulated and 58 sig-nificantly down-regulated differentially expressed proteins in hyperlipidemia combined with the restraint stress group compared with the hyperlipidemia group.Among them,GBP2,TAOK3,TFR1 and UCP1 were biomarkers with great diagnostic potential.KEGG pathway enrichment analysis indicated that fer-roptosis was a significant pathway that accelerated the myocardial injury in hyperlipidemia combined with restraint stress-induced model.The mmu_circ_0001567/miR-7a/Tfr-1 and mmu_circ_0001042/miR-7a/Tfr-1 might be important circRNA-miRNA-mRNA regulatory networks related to ferroptosis in this model.Conclusion Chronic restraint stress may aggravate myocardial injury in hyperlipidemia mice via ferrop-tosis.Four potential biomarkers are selected for myocardial injury diagnosis,providing a new direction for sudden cardiac death(SCD)caused by hyperlipidemia combined with the restraint stress.