Objective:To analyze the causal relationship between type 2 diabetes and lumbar bone mineral density and spinal fractures and to further explore the impact of central obesity on the diabetic bone paradox.Methods:A Mendelian randomization (MR) study was implemented. Single nucleotide polymorphisms (SNPs) associated with type 2 diabetes were selected from the data of genome-wide association studies as instrumental variables, with lumbar bone density and spinal fractures as the outcome variables. The inverse variance weighting method, weighted median method, and MR-Egger regression were applied to identify a causal relationship between type 2 diabetes and osteoporosis at the genetic level. Additionally, to analyze the impact of central obesity in the diabetic bone paradox, the waist-to-hip ratio was introduced as a new exposure variable, with type 2 diabetes and lumbar bone density as outcome variables, and the MR method was applied again to uncover the influencing factors.Results:The screening criteria were based on the three main assumptions of MR. Finally, 62 SNPs for type 2 diabetes and 241 SNPs for waist-to-hip ratio were included in the MR analysis. Using inverse variance weighting as the primary analysis, the causal association effect analysis indicated a causal relationship between type 2 diabetes and increased lumbar bone density ( OR=1.047 6, P=0.007) and spinal fractures ( OR=1.000 9, P=0.014). A causal relationship between waist-to-hip ratio and type 2 diabetes ( OR=1.638 6, P<0.001) was identified, indicating that the waist-to-hip ratio was a risk factor for type 2 diabetes and may have a causal association with increased lumbar bone density ( OR=1.096 3, P=0.044). This suggests that the waist-to-hip ratio may indirectly affect the relationship between diabetes and osteoporosis. The MR-Egger intercept test showed no horizontal pleiotropy in this study. The leave-one-out analysis indicated that no single SNP had a significant impact on the overall results. Furthermore, the MR-pleiotropy residual sum and outlier (MR-PRESSO) test results did not detect any outlier SNPs. Conclusion:MR analysis identified a causal relationship between type 2 diabetes and increased lumbar bone density as well as a higher risk of spinal fractures, a paradox that may be related to central obesity.

Objective:To analyze the causal relationship between type 2 diabetes and lumbar bone mineral density and spinal fractures and to further explore the impact of central obesity on the diabetic bone paradox.Methods:A Mendelian randomization (MR) study was implemented. Single nucleotide polymorphisms (SNPs) associated with type 2 diabetes were selected from the data of genome-wide association studies as instrumental variables, with lumbar bone density and spinal fractures as the outcome variables. The inverse variance weighting method, weighted median method, and MR-Egger regression were applied to identify a causal relationship between type 2 diabetes and osteoporosis at the genetic level. Additionally, to analyze the impact of central obesity in the diabetic bone paradox, the waist-to-hip ratio was introduced as a new exposure variable, with type 2 diabetes and lumbar bone density as outcome variables, and the MR method was applied again to uncover the influencing factors.Results:The screening criteria were based on the three main assumptions of MR. Finally, 62 SNPs for type 2 diabetes and 241 SNPs for waist-to-hip ratio were included in the MR analysis. Using inverse variance weighting as the primary analysis, the causal association effect analysis indicated a causal relationship between type 2 diabetes and increased lumbar bone density ( OR=1.047 6, P=0.007) and spinal fractures ( OR=1.000 9, P=0.014). A causal relationship between waist-to-hip ratio and type 2 diabetes ( OR=1.638 6, P<0.001) was identified, indicating that the waist-to-hip ratio was a risk factor for type 2 diabetes and may have a causal association with increased lumbar bone density ( OR=1.096 3, P=0.044). This suggests that the waist-to-hip ratio may indirectly affect the relationship between diabetes and osteoporosis. The MR-Egger intercept test showed no horizontal pleiotropy in this study. The leave-one-out analysis indicated that no single SNP had a significant impact on the overall results. Furthermore, the MR-pleiotropy residual sum and outlier (MR-PRESSO) test results did not detect any outlier SNPs. Conclusion:MR analysis identified a causal relationship between type 2 diabetes and increased lumbar bone density as well as a higher risk of spinal fractures, a paradox that may be related to central obesity.

Objective Analyze and compare the therapeutic value of contrast-enhanced ultrasound (CEUS) and enhanced spiral CT in patients with primary hepatocellular carcinoma (PHC) undergoing transcatheter arterial chemoembolization (TACE). Methods A retrospective analysis was conducted on 108 PHC patients (122 lesions) treated at Beijing Shijitan Hospital affiliated with Capital Medical University from July 2021 to June 2023. All patients were treated with TACE. After treatment, CEUS and contrast-enhanced spiral CT examinations were performed to evaluate the inactivation status of tumor lesions, with pathological results as the gold standard. The receiver operating characteristic curve and decision tree model were used to comprehensively evaluate the diagnostic value of CEUS, contrast-enhanced spiral CT, and their combination in PHC. Results The pathological results showed that 79 lesions remained active (positive) and 43 lesions were completely inactivated (negative). The areas under the receiver operating characteristic curve for evaluating PHC treatment efficacy by CEUS, contrast-enhanced spiral CT, and their combination were 0.975, 0.918, and 0.994, respectively. The sensitivity, positive predictive value, and actual application accuracy of CEUS and the combined method were higher than those of contrast-enhanced spiral CT (P < 0.05). A decision tree diagnostic model for PHC treatment efficacy was constructed using CEUS, contrast-enhanced spiral CT, and their combination as independent variables and PHC treatment efficacy as the dependent variable. The misjudgment rates were 3.3%, 10.7%, and 0.8%, respectively, and the prediction accuracy was 96.7%, 89.3%, and 99.2%, respectively. Conclusions CEUS and the combination of CEUS and contrast-enhanced spiral CT have high evaluation value for PHC treatment efficiency.

Objective Analyze and compare the therapeutic value of contrast-enhanced ultrasound (CEUS) and enhanced spiral CT in patients with primary hepatocellular carcinoma (PHC) undergoing transcatheter arterial chemoembolization (TACE). Methods A retrospective analysis was conducted on 108 PHC patients (122 lesions) treated at Beijing Shijitan Hospital affiliated with Capital Medical University from July 2021 to June 2023. All patients were treated with TACE. After treatment, CEUS and contrast-enhanced spiral CT examinations were performed to evaluate the inactivation status of tumor lesions, with pathological results as the gold standard. The receiver operating characteristic curve and decision tree model were used to comprehensively evaluate the diagnostic value of CEUS, contrast-enhanced spiral CT, and their combination in PHC. Results The pathological results showed that 79 lesions remained active (positive) and 43 lesions were completely inactivated (negative). The areas under the receiver operating characteristic curve for evaluating PHC treatment efficacy by CEUS, contrast-enhanced spiral CT, and their combination were 0.975, 0.918, and 0.994, respectively. The sensitivity, positive predictive value, and actual application accuracy of CEUS and the combined method were higher than those of contrast-enhanced spiral CT (P < 0.05). A decision tree diagnostic model for PHC treatment efficacy was constructed using CEUS, contrast-enhanced spiral CT, and their combination as independent variables and PHC treatment efficacy as the dependent variable. The misjudgment rates were 3.3%, 10.7%, and 0.8%, respectively, and the prediction accuracy was 96.7%, 89.3%, and 99.2%, respectively. Conclusions CEUS and the combination of CEUS and contrast-enhanced spiral CT have high evaluation value for PHC treatment efficiency.

ObjectiveTo investigate the mechanism of anti-inflammatory effect of diallyl sulfide (DAS) in protection against acute lung injury (ALI) in rats with paraquat poisoning.Methods Eighty male Wistar rats were randomly divided into four groups, namely: control group, model group, dexamethasone (DXM) treatment group, and DAS treatment group, with 20 rats in each group. The model of paraquat poisoning was reproduced by single does of 70 mg/kg given by gavage, while the same volume of normal saline (NS) was given in same manner in control group. 100 mg/kg of DAS, the same volume of NS, or 1 mg/kg DXM injection were given respectively in DAS treatment group, model group, or DXM treatment group intraperitoneally after exposure to paraquat, once a day for 14 days. Five rats in each group were sacrificed at 1, 3, 7, 14 days, respectively. The inferior lobe of right lung was harvested, and the degree of lung injury was observed with hematoxylin and eosin (HE) staining under optical microscope; the upper lobe of right lung was used to determine the lung wet/dry weight (W/D) ratio and for evaluation of the degree of pulmonary edema. The expression of nuclear factor -κB (NF-κB) in the middle lobe of right lung was assessed with immunohistochemistry. The expression of tumor necrosis factor -α (TNF-α) mRNA in the left lung was determined with the reverse transcription-polymerase chain reaction (RT-PCR).Results① The pulmonary structure in control group was found to be intact. However, in the model group there were progressive pathological changes in lung, including marked edema and thickening of alveolar walls, collapse of alveoli, infiltration of inflammatory cells, alveolar wall, and obvious bleeding in the local lung tissue, and formation of transparent membrane in alveolar space. Less infiltration of inflammatory cells and no obvious destruction were found in alveolar structure in the DAS and DXM treatment groups.② Lung W/D ratio: lung W/D ratio of model group was apparently higher than that in control group at every time point, and peaking on the 3rd day (6.15±0.54 vs. 4.15±2.10,P< 0.05), and the ratio of lung W/D of DAS and DXM treatment groups was obviously lower than that in model group at every time point, especially on the 3rd day (3.99±1.26, 4.30±0.70 vs. 6.15±0.54, bothP< 0.05), but there was no significant difference between DAS and DXM treatment groups in this regard.③ The immunocytochemistry analysis revealed minimal NF-κBp65 expression in the cell nuclei of the control group, while extensive NF-κBp65 expression was found in model group. Minimal NF-κBp65 positive expression in the cytoplasm and even less positive expression in the nucleus was found in the DAS and DXM treatment groups, and integralA value was significantly lower in the DAS and DXM treatment groups than that of the model group, especially on the 3rd day [(17.98±0.06)×107, (18.53±0.04)×107 vs. (28.85±0.61)×107, bothP< 0.01], but there was no significant difference between DAS and DXM treatment groups.④ It was shown by RT-PCR that the expression of TNF-α mRNA in lung tissue of the model group was significantly higher than that in the control group on the 3rd day (gray value: 3.63±0.62 vs. 0.51±0.13, P< 0.05). The expression of TNF-α mRNA in lung tissue was significantly decreased in DAS and DXM treatment groups compared with model group (gray value: 2.49±0.57, 2.02±0.26 vs. 3.63±0.62, bothP< 0.05), but there was no significant difference between DAS and DXM treated groups.ConclusionTreatment with an intraperitoneally injection of DAS is capable of attenuate the extent of PQ-induced ALI in rats by alleviating pulmonary edema, inhibiting the expression of NF-κB and TNF-α in lung tissue, and ameliorating pathological changes in lung tissue.