Objective To analyze the change in levels of high mobility group box 1 protein (HMGB1), interleukin-32 (IL-32), matrix metalloproteinase-9 (MMP-9)/tissue inhibitor of metalloproteinase-1 (TIMP-1) in peripheral blood of patients with lupus nephritis (LN) and their values in predicting prognosis. Methods A total of 86 patients with LN from October 2021 to June 2023 were selected and treated with induction therapy for 6 months. Based on remission status of the disease, patients were divided into remission group (n=66) and non-responder group (n=20). Baseline data, change in levels and reduction rates of HMGB1, IL-32 and MMP-9/TIMP-1, and the partial correlation of reduction rates of HMGB1, IL-32 and MMP-9/TIMP-1 levels in peripheral blood with treatment response as well as their predictive values for treatment response were compared between the two groups. Disease progression was compared between patients with different reduction rates of HMGB1, IL-32 and MMP-9/TIMP-1. Results HMGB1, IL-32 and MMP-9/TIMP-1 levels in the remission group decreased significantly at 1 and 3 months after treatment compared to before treatment (P < 0.05); the levels of HMGB1, IL-32 and MMP-9/TIMP-1 in the remission group were significantly lower than those in the non-responder group at 1 and 3 months after treatment (P < 0.05); the reduction rates of HMGB1, IL-32 and MMP-9/TIMP-1 levels in the remission group were significantly higher than those in the non-responder group at 1 and 3 months after treatment (P < 0.05). Partial correlation analysis showed that the reduction rates of HMGB1, IL-32 and MMP-9/TIMP-1 levels were independently significantly correlated with treatment response (P < 0.05). One and three months after treatment, the values of the area under the curve (AUC) for the combined prediction of remission by the reduction rates of HMGB1, IL-32 and MMP-9/TIMP-1 levels were 0.910 and 0.932 respectively, with the AUC being the largest at 3 months after treatment (P < 0.05). Patients were divided into high and low reduction rate subgroups based on theoptimal cut-off value from the ROC curve analysis at 3 months after treatment, and the disease progression rate was significantly lower in the high reduction rate subgroup than in the low reduction rate subgroup for HMGB1, IL-32 and MMP-9/TIMP-1 (P < 0.05). Conclusion The great change in levels of HMGB1, IL-32 and MMP-9/TIMP-1 in peripheral blood of LN patients is significantly correlated with treatment response and disease progression, and the combined detections of HMGB1, IL-32 and MMP-9/TIMP-1 levels at 1 and 3 months after treatment have high value in predicting the treatment response of LN patients.

Objective To analyze the dynamic changes in serum adiponectin (APN) levels after acute myocardial infarction (AMI) and its relationship with heart failure (HF) and major adverse cardiovascular events (MACE). Methods A total of 124 AMI patients who underwent percutaneous coronary intervention (PCI) in our hospital from January 2021 to December 2023 were enrolled as AMI group. Additionally, 30 patients with non-AMI coronary artery disease and 30 healthy individuals were included in non-AMI coronary artery disease group and healthy group, respectively. General information such as age, gender, smoking, alcohol consumption, hypertension, diabetes, and blood lipids were recorded for all subjects. Serum APN levels were measured using the enzyme-linked immunosorbent assay (ELISA) method; plasma brain natriuretic peptide (BNP) levels were determined by immunofluorescence; and left ventricular ejection fraction (LVEF) was assessed using echocardiography. Changes in serum APN levels and its relationship with BNP, LVEF, and MACE were recorded during a one-year follow-up period. Results AMI patients had lower serum APN levels than those in the non-AMI coronary artery disease group and the healthy group, while levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C); Lipoprotein-associated phospholipase A2 (Lp-PLA2), and the proportions of smokers and diabetics were higher(P < 0.05). A one-year follow-up of AMI patients revealed an upward trend in serum APN and BNP levels and a downward trend in LVEF levels at one week, one month, three months, six months, and one year postoperatively (P < 0.05). APN and BNP levels peaked one month after PCI, while LVEF reached its lowest level at the same time point. However, there were no statistically significant changes in these indicators in the subsequent 11 months (P>0.05). The incidence of MACE in AMI patients at one, three, six, and twelve months postoperatively was 2.8%, 3.2%, 4.6%, and 8.8%, respectively. Both preoperative and one-month postoperative serum APN levels had high predictive value for the occurrence of HF and MACE within one year in AMI patients, and the area under the curve for predicting HF and MACE one month postoperatively was larger than that preoperatively (P < 0.05). Conclusion Serum APN levels in AMI patients show an upward trend after PCI, peaking one month postoperatively. At this time point, serum APN levels have the highest predictive value for the occurrence of HF and MACE.

Objective To investigate the level of inflammation after interventional treatment in patients undergoing intracranial stent implantation by measuring the changes in the plasma levels of monocytes and high-density lipoprotein cholesterol（HDL-C） and monocyte to high-density lipoprotein cholesterol ratio （MHR） after stent implantation for intracranial atherosclerotic stenosis （ICAS） in high-altitude areas， as well as the causes of such changes and their value in predicting clinical prognosis. Methods The ICAS patients who were consecutively admitted to Qinghai Provincial People’s Hospital， from June 10， 2017 to March 1， 2022 and underwent interventional treatment were enrolled， and all patients signed the informed consent. Clinical data and the data on interventional surgery were collected， and blood samples were collected before interventional treatment， within 72 hours after interventional treatment， and at 3 months after interventional treatment to measure the levels of monocytes and HDL-C. The above indicators were compared before and after interventional treatment， and such changes were analyzed in terms of their association with the site of cerebrovascular stenosis and NIHSS score. Results A total of 123 patients with severe ICAS who underwent intracranial stent implantation and had complete data were included. Compared with the data before surgery， there was a significant increase in the plasma level of monocytes at 72 hours after stent implantation [（0.64±0.21）×109/L vs （0.53±0.17）×109/L， P<0.001]， while there was a significant reduction in the plasma level of monocytes at 3 months after stent implantation [（0.43±0.14）×109/L vs （0.53±0.17）×109/L，P<0.001]. Compared with the data before surgery， there was no significant change in HDL-C within 72 hours after surgery[（0.93±0.21）mmol/L vs （0.93±0.18）mmol/L， P>0.005]， while there was a significantly increase in HDL-C at 3 months after surgery[（1.05±0.21 mmol/L vs （0.93±0.18）mmol/L， P<0.001）. There was no significant correlation between monocytes/HDL-C/MHR and NIHSS score before surgery and at 72 hours after surgery （P>0.005）； there was no significant correlation between monocytes/HDL-C/MHR and NIHSS score before surgery and within 72 hours after surgery （P>0.005）；at 3 months after surgery， monocytes and MHR were significantly negatively correlated with NIHSS score （r=-0.271，P<0.05；r=-0.320，P<0.005），while HDL-C was significantly positively correlated with NIHSS score （r=0.213， P<0.001）. Conclusion Balloon dilatation and ischemia/reperfusion after intracranial stent implantation may cause inflammatory response in the body， thereby leading to increases in the level of monocytes and the value of MHR. Therefore， monocytes， HDL-C， and MHR may be used as predictive factors for the improvement in neurological defects in the convalescence stage after stent implantation.
Monocytes

Metabolic reprogramming is a common phenomenon in cancer, with aerobic glycolysis being one of its important characteristics. Hypoxia-inducible factor-1α (HIF1Α) is thought to play an important role in aerobic glycolysis. Meanwhile, naringin is a natural flavanone glycoside derived from grapefruits and many other citrus fruits. In this work, we identified glycolytic genes related to HIF1Α by analyzing the colon cancer database. The analysis of extracellular acidification rate and cell function verified the regulatory effects of HIF1Α overexpression on glycolysis, and the proliferation and migration of colon cancer cells. Moreover, naringin was used as an inhibitor of colon cancer cells to illustrate its effect on HIF1Α function. The results showed that the HIF1Α and enolase 2 (ENO2) levels in colon cancer tissues were highly correlated, and their high expression indicated a poor prognosis for colon cancer patients. Mechanistically, HIF1Α directly binds to the DNA promoter region and upregulates the transcription of ENO2; ectopic expression of ENO2 increased aerobic glycolysis in colon cancer cells. Most importantly, we found that the appropriate concentration of naringin inhibited the transcriptional activity of HIF1Α, which in turn decreased aerobic glycolysis in colon cancer cells. Generally, naringin reduces glycolysis in colon cancer cells by reducing the transcriptional activity of HIF1Α and the proliferation and invasion of colon cancer cells. This study helps to elucidate the relationship between colon cancer progression and glucose metabolism, and demonstrates the efficacy of naringin in the treatment of colon cancer.
Glycolysis ; Colonic Neoplasms/metabolism* ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit/metabolism* ; Phosphopyruvate Hydratase/metabolism* ; Flavanones/pharmacology* ; Cell Line, Tumor ; Databases, Genetic ; Cell Proliferation/drug effects* ; Transfection ; Warburg Effect, Oncologic

OBJECTIVE: To explore the effectiveness of arthroscopic binding fixation using suture through single bone tunnel for posterior cruciate ligament (PCL) tibial insertion fractures in adults. METHODS: Between October 2019 and October 2021, 16 patients with PCL tibial insertion fractures were treated with arthroscopic binding fixation using suture through single bone tunnel. There were 11 males and 5 females with an average age of 41.1 years (range, 26-58 years). The fractures were caused by traffic accident in 12 cases and sports in 4 cases. The time from injury to operation ranged from 2 to 10 days with an average of 6.0 days. The fractures were classified as Meyers-McKeever type Ⅱ in 4 cases and type Ⅲ in 9 cases, and Zaricznyi type Ⅳ in 3 cases. There were 2 cases of grade Ⅰ, 7 cases of grade Ⅱ, and 7 cases of grade Ⅲ in the posterior drawer test. There were 3 cases combined with lateral collateral ligament injury and 2 cases with meniscus injury. The visual analogue scale (VAS) score, Lysholm score, International Knee Documentation Committee (IKDC) score, and knee range of motion were used to evaluate knee joint function. The posterior drawer test and knee stability tester (Kneelax 3) were used to evaluate knee joint stability. The X-ray films were used to evaluate fracture reduction and healing. RESULTS: All incisions healed by first intention after operation. There was no incision infection, popliteal neurovascular injury, or deep venous thrombosis of lower limbs. All patients were followed up 6-12 months, with an average of 10 months. X-ray films at 6 months after operation showed the fractures obtained bone union. There were 11 cases of grade 0, 4 cases of gradeⅠ, and 1 case of grade Ⅱin posterior drawer test, showing significant difference when compared with preoperative results ( Z=23.167, P<0.001). The VAS score, Lysholm score, IKDC score, knee range of motion, and the results of Kneelax3 examination all significantly improved when compared with preoperative results ( P<0.05). CONCLUSION For adult patients with PCL tibial insertion fractures, the arthroscopic binding fixation using suture through single bone tunnel has the advantages of minimal trauma, good fracture reduction, reliable fixation, and fewer complications. The patient's knee joint function recovers well.
Adult ; Female ; Humans ; Male ; Anterior Cruciate Ligament Injuries/surgery* ; Arthroscopy/methods* ; Knee Joint/surgery* ; Posterior Cruciate Ligament/injuries* ; Suture Techniques ; Sutures ; Tibial Fractures/surgery* ; Treatment Outcome ; Middle Aged

The awake prone position plays an important role in the treatment of hypoxemia and the improvement of respiratory distress symptoms in non-intubated patients. It is widely used in clinical practice because of its simple operation, safety, and economy. To enable clinical medical staff to scientifically and normatively implement prone position for awake patients without intubation, the committees of consensus formulation, guided by evidence-based methodology and Delphi method, conducted literature search, literature quality evaluation and evidence synthesis around seven topics, including indications and contraindications, evaluation, implementation, monitoring and safety management, termination time, complication prevention and health education of awake prone position. After two rounds of expert letter consultation, Expert consensus on implementation strategy of awake prone positioning for non-intubated patients in China (2023) was formulated, and provide guidance for clinical medical staff.
Humans ; Consensus ; Prone Position ; Wakefulness ; China ; Dyspnea

OBJECTIVE To study the improvement effects and its mechanism of catalpol on testicular lesions in KK-Ay spontaneous diabetic mice on the basis of glycolysis process mediated by advanced glycation end products （AGEs） and their receptors （RAGE）. METHODS KK-Ay spontaneous diabetic mice fed with high-fat diet were used as diabetic model， and then randomly divided into model group， catalpol group （100 mg/kg）， aminoguanidine group （AGEs inhibitor， 100 mg/kg） and FPS- ZM1 group （RAGE inhibitor， 1 mg/kg）， and C57BL/6J mice fed in the same period were set as normal group， with 6 mice in each group. The catalpol group and aminoguanidine group mice were given relevant medicine intragastrically， normal group and model group mice were given constant volume of normal saline intragastrically， and FPS-ZM1 group mice were given relevant medicine 1 mL/g intraperitoneally， for consecutive 8 weeks. After the last administration， the body mass， fasting blood glucose， 24-hour food intake， water consumption， urine volume， testicular organ coefficient， and sperm motility of the mice were measured； pathological morphology and ultrastructural structure of testicular tissue were observed； the levels of reduced glutathione （GSH）， superoxide dismutase （SOD）， lactate dehydrogenase （LDH） and sugar metabolites in testicular tissue of mice were detected； pathway enrichment analysis was performed； the level of AGEs in serum and testicular tissue， protein expressions of RAGE， B-cell lymphoma-2 （Bcl-2） and Bcl-2-associated X protein （Bax）， and mRNA expressions of key rate-limiting enzymes [hexokinase （HK）， phosphofructose kinase （PFK）， pyruvate kinase （PK）， LDH] in testicular tissue were alldetected. RESULT S Catalpol could significantly improve the general symptoms， testicular organ coefficients and motility ofsperm in KK-Ay spontaneous diabetic mice （P＜0.05 or P＜0.01）. The morphology and ultrastructure of spermatogenic cells in each layer of the seminiferous tubules were all improved. The levels of GSH， SOD and LDH in testicular tissue，the levels of the metabolic product glucose fructose-1，6-diphosphate， 3-phosphate glycerate， 3-phosphate glyceraldehyde， lactic acid and pyruvate， the expressions of HK， PFK， PK and LDH mRNA were all significantly increased（P＜0.05 or P＜0.01）； the levels of AGEs in serum and testicular tissue， the expression of RAGE protein and the ratio of Bax to Bcl-2 in testicular tissue were significantly decreased（P＜0.05 or P＜0.01）. Aminoguanidine and FPS-ZM1 could significantly improve the levels of most of above indicators in mice（P＜0.05 or P＜0.01）. CONCLUSIONS Catalpol shows significant improvement effects on testicular lesions of KK-Ay spontaneous diabetic mice， and its mechanism of action was associated with upregulation of AGEs/RAGE signaling pathway- mediated glycolysis.

Objective: To explore the prognostic factors of extracellular NK/T cell lymphoma (ENKTL) treated with pegaspargase/L-asparaginase. Methods: The clinical data of 656 ENKTL patients diagnosed at 11 medical centers in the Huaihai Lymphoma Working Group from March 2014 to April 2021 were retrospectively analyzed. The patients were randomly divided into two groups: a training set (460 cases) and a validation set (196 cases) at 7∶3, and the prognostic factors of the patients were analyzed. A prognostic scoring system was established, and the predictive performance of different models was compared. Results: Patients' median age was 46 (34, 57) years, with 456 males (69.5% ) and 561 nasal involvement (85.5% ). 203 patients (30.9% ) received a chemotherapy regimen based on L-asparaginase combined with anthracyclines, and the 5-year overall survival rate of patients treated with P-GEMOX regimen (pegaspargase+gemcitabine+oxaliplatin) was better than those treated with SMILE regimen (methotrexate+dexamethasone+cyclophosphamide+L-asparaginase+etoposide) (85.9% vs 63.8% ; P=0.004). The results of multivariate analysis showed that gender, CA stage, the Eastern Cooperative Oncology Group performance status (ECOG PS) score, HGB, and EB virus DNA were independent influencing factors for the prognosis of ENKTL patients (P<0.05). In this study, the predictive performance of the prognostic factors is superior to the international prognostic index, Korean prognostic index, and prognostic index of natural killer lymphoma. Conclusion: Gender, CA stage, ECOG PS score, HGB, and EB virus DNA are prognostic factors for ENKTL patients treated with pegaspargase/L-asparaginase.
Male ; Humans ; Middle Aged ; Asparaginase/therapeutic use* ; Prognosis ; Retrospective Studies ; Lymphoma, Extranodal NK-T-Cell/drug therapy* ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Etoposide ; Cyclophosphamide ; Methotrexate/therapeutic use* ; DNA/therapeutic use* ; Treatment Outcome

【Objective】 To evaluate and analyze the impact of COVID-19 epidemic on inventory of red blood cells (RBCs)in local and municipal blood stations in China, and to provide reference for the management of public health emergencies. 【Methods】 Relevant data from 2018 to 2021 were collected, and the differences in the volume of qualified RBCs, the usage efficiency of inventory RBCs, the average daily distribution of RBCs,the blood distribution rate of RBCs prepared by 400 mL whole blood, the difference in the average storage days of RBCs at the time of distribution, the average daily inventory of RBCs and the time of the average daily inventory of RBCs to maintain the distribution in 24 local and municipal blood stations in China during the COVID-19 epidemic and non-epidemic periods were retrospectively analyzed. 【Results】 Compared with non-epidemic periods, the volume of qualified RBCs [(117 525.979 ±52 203.175)U] and the average daily distribution of RBCs [( 156. 468 ± 70. 186) U ] increased significantly, but the usage efficiency of inventory RBCs decreased(97.24%±0.51%) significantly (P<0.05).There was no significant difference in the blood distribution rate of RBCs prepared by 400 mL whole blood(73.88%±20.30%), the average storage days of RBCs distribution(13.040 ±3.486), the average daily stock quantity of RBCs[(2 280.542 ±1 446.538) U ] and the time of the average daily inventory of RBCs to maintain the distribution[(15.062 ±7.453) d] (P>0.5). 【Conclusion】 During the COVID-19 epidemic, the inventory management of RBCs operated well, the overall inventory remained relatively stable, the stock composition and storage period showed no significant change.

OBJECTIVE: To observe the clinical efficacy of acupoint injection combined with Vitalstim electrical stimulation for post-stroke dysphagia. METHODS: A total of 98 patients with dysphagia after first stroke were randomized into an acupoint injection group (35 cases, 2 cases dropped off), an electrical stimulation group (31 cases, 3 cases dropped off) and a combination group (32 cases, 3 cases dropped off). Injection of mecobalamin into Tunyan point, Vitalstim electrical stimulation and the combination of injection of mecobalamin into Tunyan point and Vitalstim electrical stimulation were applied respectively in the 3 groups, once a day, 10 times as one course, 2 courses were required. Before and after treatment, the tongue muscle thickness and video fluoroscopic swallowing study (VFSS) score were observed in the 3 groups. RESULTS: After treatment, the tongue muscle thickness was decreased (P<0.05), the VFSS scores were increased (P<0.05) compared with before treatment in the 3 groups, and the variation of tongue muscle thickness and VFSS score in the combination group was greater than the acupoint injection group and the electrical stimulation group (P<0.05). CONCLUSION Both acupoint injection of mecobalamin and Vitalstim electrical stimulation have therapeutic effect on dysphagia after stroke, and the two have synergistic effect.
Acupuncture Points ; Acupuncture Therapy ; Deglutition ; Deglutition Disorders/therapy* ; Electric Stimulation ; Humans ; Treatment Outcome