Objective To analyze the changes of liver and kidney function, blood glucose and lipid metabolism at different follow-up time points of different treatment regimens, and to provide reference for clinical optimization and adjustment of medication in HIV/AIDS patients. Methods The changes of liver and kidney function, blood glucose and lipid metabolism at seven follow-up time points were analyzed retrospectively. The baseline blood collection time of HIV /AIDS patients was set as the starting point, and the final follow-up time was set as the end point. The seven follow-up points were 0, 3, 6, 9, 12, 18 and 24 months respectively. Results There were statistically significant differences in the distribution of sex, age, education, marital status, WHO staging, infection route, and baseline CD4+T lymphocyte count among 605 enrolled patients based on different treatment regimens. Liver function: The level of T-Bil in group E was higher than that of baseline at 9M, 12M, 18M and 24M after treatment (P<0.01); In group F, the level of T-Bil was higher than that of baseline at 9M after treatment (P=0.001); The levels of ALT in group C at the six follow-up points after treatment were higher than the baseline (P<0.001); The level of AST in group C was higher than that of baseline after 3M and 6M treatment (P<0.05). Renal function: The level of UREA in group C was higher than that in baseline after 6M treatment (P=0.007); The level of UREA in group F was higher than that in the baseline after 12M treatment (P<0.001); The level of UA in group F was higher than that of baseline after 3M, 6M and 12M treatment (P<0.05). Blood lipid and blood glucose: The levels of Glu at some follow-up points after ART treatment in group A and group C were higher than that at baseline (P<0.05); The levels of TG at some follow-up points in group A, group E and group F after ART treatment were higher than those at baseline (P<0.05); The levels of TC at some follow-up points in group A, group B, group C, group E and group F after ART treatment were all higher than the baseline (P<0.05). Conclusion Regular monitoring of changes in laboratory indicators of different treatment regimens during ART is of great importance to the prognosis of patients. Different laboratory indicators should be monitored according to different treatment regimens to effectively prevent adverse reactions caused by different treatment regimens.

Liver fibrosis is a dynamic wound-healing response characterized by the agglutination of the extracellular matrix (ECM). Si-Wu-Tang (SWT), a traditional Chinese medicine (TCM) formula, is known for treating gynecological diseases and liver fibrosis. Our previous studies demonstrated that long non-coding RNA H19 (H19) was markedly upregulated in fibrotic livers while its deficiency markedly reversed fibrogenesis. However, the mechanisms by which SWT influences H19 remain unclear. Thus, we established a bile duct ligation (BDL)-induced liver fibrosis model to evaluate the hepatoprotective effects of SWT on various cells in the liver. Our results showed that SWT markedly improved ECM deposition and bile duct reactions in the liver. Notably, SWT relieved liver fibrosis by regulating the transcription of genes involved in the cytoskeleton remodeling, primarily in hepatic stellate cells (HSCs), and influencing cytoskeleton-related angiogenesis and hepatocellular injury. This modulation collectively led to reduced ECM deposition. Through extensive bioinformatics analyses, we determined that H19 acted as a miRNA sponge and mainly inhibited miR-200, miR-211, and let7b, thereby regulating the above cellular regulatory pathways. Meanwhile, SWT reversed H19-related miRNAs and signaling pathways, diminishing ECM deposition and liver fibrosis. However, these protective effects of SWT were diminished with the overexpression of H19 in vivo. In conclusion, our study elucidates the underlying mechanisms of SWT from the perspective of H19-related signal networks and proposes a potential SWT-based therapeutic strategy for the treatment of liver fibrosis.
Humans ; RNA, Long Noncoding/genetics* ; Liver Cirrhosis/genetics* ; Liver/metabolism* ; Hepatic Stellate Cells/pathology* ; MicroRNAs/metabolism* ; Extracellular Matrix/metabolism* ; Drugs, Chinese Herbal

OBJECTIVE To study the relationship between serum CC type chemotactic factor 2(CCL2),CC type chemotactic factor 18(CCL18) and clinicopathological parameters and prognosis of patients with glottic carcinoma. METHODS A total of 168 glottic carcinoma patients admitted to Handan Central Hospital and Hebei Engineering University Affiliated Hospital from August 2015 to December 2018 were selected as the research subjects. The receiver operating characteristic(ROC) curve was used to determine the optimal cut-off points for serum CCL2 and CCL18. Based on this,patients were divided into CCL2 high expression group and low expression group,CCL18 high expression group and low expression group. The relationship between levels of serum CCL2 and CCL18 and clinical pathological parameters of glottic carcinoma patients was analyzed. Kaplan-Meier curve and Log Rank x2 test were used to analyze the 5-year disease-free survival rate of serum CCL2 high/low expression group and CCL18 high/low expression group. Cox regression model was used to analyze the influencing factors of glottic carcinoma prognosis,and the relationship between serum CCL2,CCL18 expression and tumor recurrence/metastasis was analyzed. RESULTS The optimal cut-off points for CCL2 and CCL18 calculated based on the ROC curve were 100.81 and 218.99 pg/ml,respectively. Compared with the low expression groups of CCL2 and CCL18,the high expression groups of CCL2 and CCL18 showed a significant increase in the proportion of T3-T4a,N1-N3 stages,and tumor low differentiation(P<0.05). Of the 168 glottic carcinoma patients,there were 160 patients followed up for 5 years and 8 patients lost for follow-up. There were 67 patients experienced recurrence or metastasis,and 39 patients died due to recurrence or metastasis. The tumor recurrence or metastasis rate was 41.88％(67/160),and the disease-free survival rate was 58.13％(93/160). Kaplan-Meier survival curve analysis showed that the 5-year disease-free survival rate of the high expression group of serum CCL2 and CCL18 was significantly lower than that of the low expression group of serum CCL2 and CCL18(P<0.05). Cox regression analysis showed that elevated T staging,cervical lymph node recurrence,elevated N staging,local recurrence,high expression of CCL2 and CCL18 were risk factors for poor prognosis in glottic carcinoma(P<0.05). For analysis the relationship between serum CCL2 and CCL18 expression and tumor recurrence or metastasis,it was found that when both CCL2 and CCL18 were highly expressed,the recurrence or metastasis rate was significantly higher than when both CCL2 and CCL18 were lowly expressed,CCL2 was lowly expressed and CCL18 was highly expressed,and CCL2 was highly expressed and CCL18 was lowly expressed,and the differences were statistically significant(x2=10.450,P=0.015). CONCLUSION The high expression of serum CCL2 and CCL18 in patients with glottic carcinoma is significantly correlated with T stage,N stage,tumor low differentiation,and poor prognosis.

Objective To observe the influencing factors of early hypocalcemia after microwave ablation(MWA)for treating secondary hyperparathyroidism(SHPT).Methods Data of 82 SHPT patients who underwent MWA were retrospectively analyzed.The patients were divided into hypocalcemia group(n=36)and non-hypocalcemia group(n=46)based on presence of early hypocalcemia after MWA or not.Patients'age,gender,body mass index(BMI),dialysis method,dialysis time and number of lesions were compared between groups,so were baseline blood calcium,blood phosphorus,intact parathyroid hormone(iPTH),alkaline phosphatase(ALP),hemoglobin,albumin,creatinine,uric acid and 2 5-hydroxy vitamin D3.Logistic analysis was performed to screen the influencing factors of early hypocalcemia after MWA.Results Significant differences of dialysis methods,number of lesions,blood calcium,iPTH and ALP were found between groups(all P＜0.05).Univariate and multivariate logistic regression analysis showed that the number of lesions,iPTH and ALP were all independent influencing factors of early hypocalcemia after MWA for treating SHPT(all P＜0.05).Conclusion The number of lesions,iPTH and ALP were influencing factors of early hypocalcemia after MWA for treating SHPT.

Abstract: Objective　To understand the characteristics of drug resistance and molecular transmission network of HIV/AIDS patients aged 50 years and above in Zhaotong City, Yunnan Province, from 2020 to 2022, who have failed antiretroviral therapy (plasma viral load≥1 000 copies/mL). Methods　The demographic data of HIV/AIDS patients aged 50 years and above with failed antiviral therapy in Zhaotong City from 2020 to 2022 were collected through the antiviral therapy database of Yunnan Province. The plasma of the patients was collected, and the HIV pol gene protease and reverse transcriptase regions were amplified by reverse transcriptase chain reaction, the fragments were spliced using ContigExpress, the sequences were determined, and drug resistance mutations were analyzed using the HIVdb database of Stanford University. Pairwise genetic distances between sequences were calculated using the HyPhy 2.2.4 software with the TN93 model, and a threshold of 1.7% was used to construct the HIV molecular network. Cytoscape 3.7.0 was used to visualize the network. Results　A total of 480 HIV/AIDS cases were included, with 417 positive amplifications of plasma samples. Among these, 196 cases were drug-resistant, resulting in a total drug resistance rate of 47.0%. The highest resistance rate was observed in NNRTIs at 45.6% (190/417), followed by NRTIs at 14.4% (60/417), and PIs at a lower rate of 0.2% (1/417). In NNRTIs resistance mutation sites, K103N/E/S mutation sites were dominant, with a mutation rate of 33.3% (139/417). Among the NRTIs resistance mutation sites, M184V/I mutation site was the main one, with a mutation rate of 13.9% (58/417). The mutation rate of PIs resistance sites was relatively lower, at 0.2% (1/417). Through the construction of the molecular transmission network, 88 patients entered the molecular transmission network, with an access rate of 21.1%, forming 21 transmission clusters, among which CRF01_AE formed a large cluster including 37 individuals. Conclusions　Compared with studies in other regions of Yunnan Province, the drug resistance rate among the elderly population with antiretroviral therapy failure in this study in Zhaotong City has decreased, and URFs have become the main subtype, suggesting that the transmission relationships among the elderly in Zhaotong City are gradually complicated. Through the construction of a molecular network, it is suggested that CRF01_AE and married or partnered males have the highest network access rate. Interventions should be strengthened among key populations, and diversified efforts in HIV/AIDS prevention and treatment for the elderly should be developed.

Objective To explore the impact of different times for endovascular embolization thera-py on the prognosis of elderly patients with intracranial aneurysm(IA)rupture and bleeding.Methods Clinical data of 156 elderly patients with IA rupture and bleeding admitted to our hos-pital from January 2019 to December 2022 were collected and analyzed retrospectively.All of them underwent intravascular embolization treatment.According to the timing of intravascular emboli-zation,they were divided into super early group(within 24 h from onset,n=66)and delayed group(in 24 h after onset,n=90).The Hunt-Hess grade,aneurysm location,cerebrospinal fluid exchange,embolization situation and success rate of embolization treatment were observed and re-corded.The prognosis of the two groups were evaluated with NIHSS score and mRS score.Results In terms of prognosis,no significant differences were observed in cerebrovascular spasm,disorders of consciousness,limb movement disorder,proportion of re-bleeding,and mRS score between the two groups(P＞0.05).The ratio of hydrocephalus was obviously lower in the super early group than the delayed group(4.55％vs 15.56％,P＜0.05).Though no statistical difference was seen in the pre-operative NIHSS score between the two groups(P＞0.05),the score was declined after treatment(P＜0.05),with that of the super early group notably lower than that in the delayed group(6.62±1.25 vs 7.82±1.35,P＜0.01).Conclusion Super early endovascular embolization can effectively reduce the incidence of hydrocephalus and improve neurological function in elderly patients with IA rupture and bleeding.

【Objective】 To provide a new idea for the treatment of depression by summarizing the antidepressant effect and mechanism of active ingredients in functional food, and medicine and food homologous products. 【Methods】 The literature related to the antidepressant of functional food or medicine and food homologous products from September 25, 1996 to September 5, 2022 was collected through PubMed, Google Academic, Web of Science, and China National Knowledge Infrastructure (CNKI) databases. After that, their antidepressant active ingredients and mechanism of action were systematically summarized and analyzed. 【Results】 A total of 146 pieces of literature were involved in the study, including 67 plant-derived functional foods or medicine and food homologous products, 32 antidepressant extracts (including 8 flavonoid extracts), and 87 antidepressant active ingredients. The 87 antidepressant active ingredients include 7 terpenes, 22 saponins, 15 flavonoids, 11 phenylpropanoids, 7 phenols, 6 sugars, 8 alkaloids, and 11 others. 【Conclusion】 The study summarized and analyzed the active ingredients and mechanisms of antidepressants in functional foods and medicine and food homologous products, which provides a new vision for the development of new antidepressants and a potential alternative treatment for patients with depression.

Background Under the background of global climate change, temperature has increased dramatically. Most studies about association between temperature and human health are conducted in low-altitude areas, but rarely focus on plateau areas. Objective To examine the association between temperature and non-accidental mortality risk in Tibet Plateau, China and to identify vulnerable populations for formulating targeted policies of climate change adaptation. Methods The mortality data, meteorological data, and pollutant data of Tibet area between 2013 to 2019 were collected. Based on time-stratified case-crossover design, conditional logistic regression models were used to analyze the exposure-response relationship between temperature and cause-specific mortality, which was linearized to obtain excess risk for 1 ℃ change; attributable fraction was calculated for assessing burden attributable to temperature; and stratified analyses were further conducted by gender, age (＜65 years old, ≥65 years old), and causes of death (cardiovascular diseases, cerebrovascular diseases, and respiratory diseases). Sensitivity analyses were conducted by adjusting model parameters and variables. Results A total of 26 045 non-accidental deaths were collected in Tibet during 2013 and 2019, and the P₅₀ of temperature was 5.0 ℃. The non-accidental mortality risk increased as temperature become colder. A 1 ℃ decrease in temperature was associated with a 2.01% (95%CI: 0.94%-3.07%) increase in total non-accidental mortality, while the association changed to 2.05% (95%CI: 0.62%-3.47%) for male and 1.96% (95%CI: 0.34%-3.56%) for female, both of statistial significance; 1.45% (95%CI: −0.10%-2.98%) for the people <65 years old (not of significance) and 2.52% (95% CI : 1.04%-3.99%) for the people ≥65 years old (of significance); the excess risk for cardiovascular mortality was 2.65% (95%CI: 1.03%-4.24%), for cerebrovascular mortality was 3.70% (95%CI: 0.74%-6.57%), both of statistical significance, and for respiratory mortality was 2.18% (95%CI: −0.14%-4.44%), without significance. The total attribution number of non-accidental mortality was 5340 (95%CI: 2719-7528), and the total attributable fraction was 20.50% (95%CI: 10.44%-28.91%). The attributable fractions were higher in specific subgroups like male (20.72%), people ≥65 years (23.33%), and people with cardiovascular diseases (26.07%). Conclusion The exposure-response relationship between temperature and non-accidental mortality in Tibet showes that the non-accidental mortality risk increase as temperature become colder. The attributable burden of disease is heavy. Residents being male, ≥65 years, with cardiovascular diseases and respiratory diseases may be vulnerable to nonoptimal temperature.

Objective:To improve the quality of 18F-fluorodeoxyglucose (FDG) PET images at different acquisition times through deep learning (DL) PET image reconstruction methods. Methods:A total of 45 patients (20 males, 25 females; age (52.0±13.6) years) with malignant tumors and PET/CT scans from September 2020 to October 2020 in the Department of Nuclear Medicine of the First Hospital of Shanxi Medical University were included in this retrospective study. The short acquisition time 30 s/bed PET images from the raw list mode were selected as the input of DL model. DL image reconstruction model, based on the Unet algorithm, was trained to output imitated PET images with full dose standard acquisition time (3 min). The image quality evaluation and quantitative analysis were carried out for four groups of images: DL images, 30 s, 90 s, and 120 s images, respectively. The quality of PET images in four groups was evaluated using the five-point method. Liver background activities, lesions quantification parameters (maximum standardized uptake value (SUV max), mean standardized uptake value (SUV mean), standard deviation (SD), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR)), and first-order texture features (skewness, kurtosis, uniformity, entropy) were measured. Kappa test, χ2 test and one-way analysis of variance (least significant difference t test) were used for data analysis. Results:The image quality scores between four groups were highly consistent ( Kappa=0.799, P<0.001). The number of patients with scores≥3 in DL, 30 s, 90 s and 120 s groups were 6, 4, 7 and 8, respectively ( χ2=125.47, P<0.001). The liver SD of DL group was significantly lower than that of 30 s group (0.26±0.07 vs 0.43±0.11; F=3.58, t=-7.91, P<0.05). The liver SNR of DL group was higher than that of 30 s group (11.04±4.36 vs 5.41±1.41; F=10.22, t=5.40, P<0.05). The liver SD and SNR of DL group were similar to those of 90 s group (0.39±0.16, 8.46±3.34; t values: -0.87 and 2.17, both P>0.05). In 18 tumor lesions with high uptake, SNR and CNR of DL group were significantly higher than those of 30 s group (60.21±29.26 vs 38.38±16.54, 22.26±15.85 vs 15.41±9.51; F values: 13.09 and 7.05; t values: 5.20 and 4.04, both P<0.001). There were statistically significant differences among four groups in the first-order texture features ( F values: 4.30-9.65, all P<0.05), but there was no significant difference between DL group and 120 s group ( t values: from -1.25 to 0.15, all P>0.05). Conclusion:DL reconstruction model can improve the quality of short-frame PET images, which meets the needs of clinical diagnosis, efficacy evaluation and radiomics research.

OBJECTIVE：To syst ematically evaluate the effectiveness and safety of ticagrelor versus clopidogrel in the treatment of acute coronary syndrome （ACS）patients in East Asia ，and to provide evidence-based references for clinical drug use. METHODS：Retrieved from Cochrane Library ，PubMed，Embase，CNKI，Wanfang database ，etc.，randomized controlled trials （RCTs）about ticagrelor （trial group ）versus clopidogrel （control group ）in the treatment of ACS patients in east Asia were collected. After literature screening and data extraction ，the quality of included literatures was evaluated by using biasrisk evaluation tool recommended by Co chrane system evaluation manual 5.1.0，and Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS ：A total of 5 RCTs were included ，with a total of 4 511 cases. Meta-analysis showed that the incidence of major adverse cardiovascular events [OR ＝0.85，95％CI（0.68，1.04），P＝0.12]，the incidence of death from cardiovascular causes [OR ＝0.76，95％CI（0.57，1.03），P＝0.08] and the incidence of stroke [OR ＝0.77，95％CI（0.48，1.24），P＝0.28]， without statistical significance. The incidence of major bleeding events [OR ＝1.54，95％CI（1.19，1.99），P＝0.001] and minor bleeding events [OR ＝1.80，95％ CI（1.40，2.32），P＜0.000 01] in trial group were significantly higher than control group. CONCLUSIONS：Ticagrelor is comparable to clopidogrel in reduce the major adverse cardiovascular events，death from cardiovascular causes and stroke in ACS patients in East Asian ，but it can increase the risk of major and minor bleeding events.