Objective To establish a recurrence risk prediction model for meningioma based on HOXA9 DNA methylation.Methods Meningioma-related datasets were downloaded from GEO database for screening homeobox genes(HOXs)with prognostic values using differential methylation and ROC curve analysis and Cox regression analysis.The differentially methylated CpG sites with high predictive efficacy were selected to establish the risk prediction model using Lasso-Cox regression analysis,based on which the patients were divided into high-and low-risk groups by the cutoff value.The methylation levels of CpG sites were verified at the cell and tissue levels using methylation-specific PCR(MS-PCR).Clinical meningioma tissue samples were used to validate the predictive efficacy of the model.Results HOXA9 methylation level was significantly up-regulated in meningiomas(P<0.001)and showed a high diagnostic efficiency(AUC=0.884)as an independent risk factor for overall survival(P<0.01)positively correlated with the degree of malignancy and poor prognosis of meningioma(P<0.05).Risk stratification by HOXA9 methylation was more accurate than WHO grading for predicting recurrence and patient survival time.The AUCs of the sites cg03217995 and cg21001184 were both above 0.8 for meningioma diagnosis and above 0.6 for predicting recurrence.The patients'clinical characteristics differed significantly between the high-and low-risk groups(P<0.001),and the prediction score of the model was an independent prognostic factor for meningioma(P<0.05).MS-PCR results showed that the methylation levels of the two sites increased significantly in meningioma cells.In clinical samples,the combined model showed a high prediction efficiency(AUC=0.857),and the predicted risk of progression was highly consistent with the patients'actual condition.Conclusion High HOXA9 methylation level is a predictor for poor prognosis of meningiomas,and the combined prediction model based on its CpG sites provides a new approach to early screening of meningioma patients at risk of progression.

Objective To establish a recurrence risk prediction model for meningioma based on HOXA9 DNA methylation.Methods Meningioma-related datasets were downloaded from GEO database for screening homeobox genes(HOXs)with prognostic values using differential methylation and ROC curve analysis and Cox regression analysis.The differentially methylated CpG sites with high predictive efficacy were selected to establish the risk prediction model using Lasso-Cox regression analysis,based on which the patients were divided into high-and low-risk groups by the cutoff value.The methylation levels of CpG sites were verified at the cell and tissue levels using methylation-specific PCR(MS-PCR).Clinical meningioma tissue samples were used to validate the predictive efficacy of the model.Results HOXA9 methylation level was significantly up-regulated in meningiomas(P<0.001)and showed a high diagnostic efficiency(AUC=0.884)as an independent risk factor for overall survival(P<0.01)positively correlated with the degree of malignancy and poor prognosis of meningioma(P<0.05).Risk stratification by HOXA9 methylation was more accurate than WHO grading for predicting recurrence and patient survival time.The AUCs of the sites cg03217995 and cg21001184 were both above 0.8 for meningioma diagnosis and above 0.6 for predicting recurrence.The patients'clinical characteristics differed significantly between the high-and low-risk groups(P<0.001),and the prediction score of the model was an independent prognostic factor for meningioma(P<0.05).MS-PCR results showed that the methylation levels of the two sites increased significantly in meningioma cells.In clinical samples,the combined model showed a high prediction efficiency(AUC=0.857),and the predicted risk of progression was highly consistent with the patients'actual condition.Conclusion High HOXA9 methylation level is a predictor for poor prognosis of meningiomas,and the combined prediction model based on its CpG sites provides a new approach to early screening of meningioma patients at risk of progression.

Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) has a wide range of symptoms, and it is difficult for clinicians to make a quick and correct diagnosis. On November 11, 2021, a 36-year-old male patient with AAV was admitted to the emergency and critical care department of Yichang Central People's Hospital. He was admitted to the emergency intensive care unit (EICU) with gastrointestinal symptoms (abdominal pain, black stool) as the main physical signs, and was initially diagnosed as AAV with gastrointestinal hemorrhage (GIH). No bleeding point was found after repeated gastroscopy and colonoscopy. Abdominal emission CT (ECT) showed diffuse hemorrhage in the ileum, ascending colon and transverse colon. Multi-disciplinary consultation in the whole hospital considered the diffuse hemorrhage caused by small vascular lesions in the digestive tract caused by AAV. Pulse therapy with methylprednisolone 1 000 mg/d and immunosuppressive therapy with cyclophosphamide (CTX) 0.2 g/d were administered. The patient's symptoms quickly relieved and transferred out of the EICU. After 17 days of treatment, the patient finally died of massive gastrointestinal bleeding. A systematic review of relevant literatures combined with the case diagnosis and treatment process found that only a minority of AAV patients present with gastrointestinal symptoms as their first symptoms, and patients with GIH were very rare. Such patients had a poor prognosis. This patient delayed the use of induced remission and immunosuppressive agents due to the treatment of gastrointestinal bleeding, which may be the main cause of life-threatening GIH secondary to AAV. Gastrointestinal bleeding is a rare and fatal complication of vasculitis. Timely and effective induction and remission treatment is the key to survival. Whether patients should receive maintenance therapy, the duration of maintenance therapy, and the search for markers of disease diagnosis and treatment response are directions and challenges for further research.
Male ; Humans ; Adult ; Gastrointestinal Hemorrhage ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis ; Critical Care ; Cyclophosphamide ; Death

Objective:To explore the effects of nursing interventions based on SMART (specific, measurable, attainable, relevant, and time-based) principle in patients with chronic urticaria.Methods:From January 2021 to January 2022, convenience sampling was used to select 128 patients with chronic urticaria admitted to the allergy department of Henan Provincial People's Hospital as the study subject. The patients were divided into control group and observation group using a random number table method, with 64 cases in each group. The control group received routine nursing, while the observation group received nursing interventions based on SMART principle for three months. The Rating Scale of Health Self-management Skill for Adults, Life Event Scale, and Trait Coping Style Questionnaire were used to measure patients before and three months after intervention, and short-term efficacy was evaluated.Results:The total short-term curative effective rate of the observation group was 82.81% (53/64), while the control group was 65.63% (42/64) ; the recurrent interval time in the observation group was (30.29±7.35) days, while in the control group it was (21.63±7.46) days; and the differences were statistically significant ( P<0.05). After intervention, the scores of the self-management behavior, self-management cognition, self-management environment, and the total score of Rating Scale of Health Self-management Skill for Adults in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05). After intervention, the scores of positive event stimulus in Life Event Scale and positive coping in Trait Coping Style Questionnaire in the observation group were higher than those in the control group, while the scores of negative event stimulus and negative coping were lower than those in the control group, with statistically significant differences ( P<0.05) . Conclusions:Nursing interventions based on the SMART principle can effectively improve the short-term curative efficacy and the self-management ability of patients with chronic urticaria, and change their physiological and social stress levels and coping styles.

Objective:Taking the research field of pulmonary infection as an example, this study analyzed the core author institutions, research hotspots and burst keywords, and explored the application value of scientific knowledge graph in the first step of scientific research management-optimization of scientific research project selection.Methods:" Pulmonary infection" or " pneumonia" were used as key words in CNKI data base from 2014 to 2020, and medical science was selected as the discipline. Cite Space was used to generate the visual graph to analyze publishing institutions, keyword co-occurrence, topic clustering, and timeline burst keywords.Results:13 169 documents were retrieved, and 4 of the top 5 institutions were in Henan Province. In 2020, " Novel Coronavirus" and " Novel Coronavirus pneumonia" were the new hotspot words. " Chronic obstructive pulmonary disease " , " blood gas index" , " inflammatory factor" , and " vitamin A" were the burst keywords in 2018.Conclusions:Scientific knowledge graph is objective, scientific, and efficient in the development of science. It has certain feasibility in the optimization of project selection in scientific research work, and can also be used as a reference basis for experts to evaluate the project reasonability, so as to ensure objectivity and equity. This study also provides reference for scientific research management strategy, reduces research funding costs, and improves the efficiency and capacity of scientific research management.

Objective:To evaluate the clinical efficacy of Jianpi-Huazhuo Decoction in the treatment of complication patients with phlegm-dampness in type 2 diabetes mellitus (T2DM) and Diabetic nephropathies (DN). Methods:A total of 72 patients with with phlegm dampness T2DM and DN in Huaibei Traditional Chinese Medicine Hospital of Anhui Province from June 2018 to June 2020 were randomly divided into two groups with 36 in each group. The control group were treated with oral metformin sustained-release tablets on the basis of diabetes propaganda. The observation group was treated with Jianpi-Huazhuo Decoction on the basis of the control group. Both groups were treated for 4 weeks. The blood glucose (plasma, enzyme method), HbA1c (whole blood, high performance liquid chromatography) and fasting insulin (serum, chemiluminescence method) were measured, and homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Plasma BUN, SCR and urinary albumin excretion rate (UAER) were measured by automatic biochemical analyzer. The plasma laminin (LN), procollagen Ⅲ (PC Ⅲ) and collagen type Ⅳ (Ⅳ-c) were detected by ELISA. The adverse events during treatment were observed and the clinical efficacy was evaluated. Results:The total effective rate was 86.1% (31/36) in the observation group and 58.3% (21/36) in the control group ( χ2 =6.923, P=0.009). After treatment, the levels of FBG, 2 hPG, HbA1c, FINS and HOMA-IR in the observation group were significanlty lower than those in the control group ( t values were 4.242, 2.751, 3.565, 3.613 and 4.512, respectively, all Ps<0.05). After treatment, the plasma levels of LN, PC Ⅲ and Ⅳ-c were significanlty lower than those in the control group ( t values were 3.612, 1.864 and 2.046, respectively, all Ps<0.05). After treatment, the levels of serum creatinine and urinary albumin excretion rate in the control group were significanlty lower than those in the control group ( t values were 5.864 and 3.286, respectively, all Ps<0.05). Conclusion:The Jianpi-Huazhuo Decoction can reduce the blood glucose level and renal fibrosis related factors in patients with phlegm dampness T2DM complicated with DN, improve the clinical symptoms and improve the clinical curative effect.

Objective To study the relationship between pulsatile tinnitus and temporal bone pneumatization grade. Methods Through the in vitro experiment, the generation and transmission pathways of the venous sound were simulated. The sound signals at the position of eardrum were recorded and analyzed. Results In case of cortical plate dehiscence, the high pressure and pulse-synchronous venous sounds were received at eardrum. The highest sound pressure occurred in the normal pneumatization case. In case of cortical plate intactness, the non-pulsatile venous sounds with pressure close to the background control sound were received at eardrum. Temporal bone air cells (TBAC) with different pneumatization grades would transmit venous sound in different frequency ranges. Conclusions Normal pneumatization TBAC exhibited the highest amplification on venous sound, while hypopneumatization TBAC exhibited the lowest amplification on venous sound. The pneumatization grade of TBAC is neither the sufficient nor essential condition of pathogenic venous sound, while the cortical plate dehiscence is the sufficient or necessary condition of pathogenic venous sound.

Objective To analyze the clinical manifestation,imaging data and genetics mutation variants of late onset familial Alzheimer's disease concomitant with a novel mutation of presenilin 1.Methods The clinical manifestations and auxiliary examination recordings of the pedigree were analyzed.DNA was extracted from peripheral blood samples of the proband and her sons.Mutational analysis was performed by the next-generation sequencing technology and the mutation event was confirmed by Sanger sequencing technology.Results Two patients of the family presenting as Alzheimer's dementia were late onset.MRI of the proband showed extensive cerebral microbleeds.The gene detection showed p.S289P mutation in the exon 8 of presenilin 1 of the proband.Conclusion Mutation of p.S289P in the presenilin 1 gene may contribute to late onset Alzheimer's disease accompanied by amyloid angiopathy.

Long noncoding RNAs (lncRNAs) are involved in vital life processes of gene expression, epigenetic regulation and X-chromosome inactivation. lncRNAs are also closely associated with tumor initiation and progression. Moreover, lncRNAs may enter human circulation system in the form of microvesicle or exosome, or in combination with RNA binding protein. Interestingly, the circulating lncRNAs are widely existed in body fluids, such as blood and urine. We review the origin of circulating lncRNAs, and the detection methods as potential biomarkers. We focus on the early diagnosis value of circulating lncRNAs as tumor biomarkers in lung, breast, gastric, liver, colorectal and prostate cancers. Compared with the traditional biomarkers, the circulating lncRNAs show the unique advantages and clinical values as novel biomarkers.

Objective To investigate the value of conventional ultrasound and CEUS in diagnosis of thyroid nodules with Logistic regression models.Methods A total of 218 cases of thyroid nodules (74 cases of malignant,144 cases of benign nodules) confirmed by pathology were enrolled.The boundary,morphology,anteroposterior and transverse diameter ratio,microcalcification,internal echogenicity,blood distribution and enhanced pattern of nodules were observed and analyzed with univariate analysis.The Logistic regression model was established with parameters which were significantly different of those features,and the receiver operating characteristic curves (ROC) were constructed.Results Hypoechoic,irregular morphology,blurred boundary,anteroposterior and transverse diameter ratio≥ 1,microcalcifications,blood distribution (Ⅰ,Ⅱ),heterogeneous enhanced pattern and low enhanced were significantly prognostic factors (all P＜0.01).Irregular morphology,microcalcifications,heterogeneous enhanced and low enhanced were independent prognostic factors (all P＜0.05).The accuracy of Logistic regression model was 82.57％,and the area under ROC curve was 0.906.Conclusion The Logistic regression model of boundary,morphology,anteroposterior and transverse diameter ratio,microcalcifica tions,internal echogenicity,blood distribution and enhanced pattern can help to diagnose malignant thyroid nodules.