BACKGROUND Colorectal cancer(CRC)frequently metastasizes to the liver,significantly compromising patient survival.While surgical resection improves outcomes for resectable cases,many patients have limited therapeutic ...BACKGROUND Colorectal cancer(CRC)frequently metastasizes to the liver,significantly compromising patient survival.While surgical resection improves outcomes for resectable cases,many patients have limited therapeutic options.AIM To evaluate the role of laparoscopic ultrasound in resection and ablation of colorectal liver metastases(CRLM).METHODS Between June 2018 and June 2020,300 patients with CRC and liver metastases were admitted to our hospital.They were divided into two groups(150 cases each)based on treatment method:The control group(ethoxybenzyl diethylenetriamine penta-acetic acid enhanced magnetic resonance imaging)and the observation group[contrast-enhanced ultrasound with Sonazoid(S-CEUS)].RESULTS The study group demonstrated better efficacy(P<0.05),fewer adverse events(P<0.05),and better survival outcomes compared to the control group(1-year:80%vs 62%;3-year:54%vs 33%;5-year:32%vs 18%;median survival:48 months vs 30 months;hazard ratio=0.63,95%CI:0.48-0.83,P<0.001).Although Karnofsky Performance Status scores improved in both groups,the scores were significantly higher in the observation group(P<0.05).Multivariate analysis confirmed intraoperative S-CEUS and tumor differentiation as independent prognostic factors(P<0.05).CONCLUSION Laparoscopic ultrasound-guided resection/ablation improved outcomes in CRLM,reducing complications and enhancing survival.Intraoperative S-CEUS was an independent prognostic factor,supporting its clinical value.展开更多
BACKGROUND Anxiety,depression,and postoperative pain are common in patients with hip joint disorders and are associated with compromised functional outcomes and delayed recovery.AIM To investigate the prevalence of an...BACKGROUND Anxiety,depression,and postoperative pain are common in patients with hip joint disorders and are associated with compromised functional outcomes and delayed recovery.AIM To investigate the prevalence of anxiety and depression among geriatric patients who underwent total hip arthroplasty(THA),explored their association with postoperative pain,and identified contributing risk factors.METHODS A total of 111 geriatric patients who underwent THA between January 2021 and January 2024 were included.Standardized psychological assessment tools-including the Zung Self-Rating Anxiety Scale(SAS)and the Zung Self-Rating Depression Scale(SDS)-and the Numeric Rating Scale(NRS)for pain quantification were systematically administered.Pearson correlation analysis was utilized to explore the relationships among SAS,SDS,and NRS scores.Univariate and multivariate binary logistic regression analyses were conducted to identify risk factors for anxiety and depression in these patients.RESULTS The cohort exhibited moderate anxiety(SAS:44.23±9.03),mild depression(SDS:46.98±9.15),and moderate postoperative pain(NRS:4.93±2.37).Patients with anxiety or depression reported significantly higher NRS scores than those without these conditions.Significant positive correlations were observed between SAS and SDS scores,as well as between each of these and NRS scores.Univariate analysis revealed that gender,age,disease duration,alcohol use,diabetes history,and NRS scores were significantly associated with anxiety and depression.Multivariate analysis further identified female gender,disease duration≥2 years,alcohol use,and NRS scores≥5 as independent predictors of postoperative psychological distress.CONCLUSION Anxiety and depression are closely linked with postoperative pain in geriatric patients post-THA recovery.Early psychological screening and multimodal pain management strategies are recommended-particularly for individuals with a disease duration of≥2 years,a history of alcohol consumption,or an NRS score of≥5,as well as female patients-to effectively mitigate their negative emotional states and improve postoperative recovery.展开更多
BACKGROUND Diabetes is becoming increasingly common and has become an important global health issue.In addition to physical damage,diabetes often leads to psychological complications,such as depressive symptoms.Self-c...BACKGROUND Diabetes is becoming increasingly common and has become an important global health issue.In addition to physical damage,diabetes often leads to psychological complications,such as depressive symptoms.Self-care is considered to be the cornerstone of type 2 diabetes mellitus(T2DM)management.This research evaluated depression and explored the associations between self-care activities,self-perceived burden,and depression among T2DM patients in China.AIM To investigate the self-care activities and the association between depression and self-perceived burden among Chinese inpatients with T2DM.METHODS A cross-sectional study was conducted in participants with T2DM.The data collected encompassed basic characteristics,diabetes self-care activities,depre-ssion levels,and self-perceived burdens.Bootstrapping was utilized to assess the mediating role of diabetes self-care activities.RESULTS There were 599 T2DM patients in the survey,and 71.8%had been diagnosed with the disease for 1–10 years.There were significant correlations between self-care activities,depression,and self-perceived burden.The significant coefficients for paths a(B=-0.281,P<0.001)and b(B=-0.041,P<0.05)suggested negative associations between self-perceived burden and self-care behavior and between self-care activities and depression.The indirect effect(path a×b)of self-perceived burden on depression through self-care behaviors was significant(B=0.020,P<0.05),with a 95%bias-corrected bootstrap confidence interval of 0.007–0.036.CONCLUSION The mediating model presented here highlights the role of self-care activities in exerting both direct and indirect effects on depression in participants with T2DM.展开更多
Background:The study aimed to explore the clinical value of mitochondrial ribosomal protein L18(MRPL18)in breast cancer.Methods:Multiple databases were used to validate the expression of MRPL18.The prognostic impact a...Background:The study aimed to explore the clinical value of mitochondrial ribosomal protein L18(MRPL18)in breast cancer.Methods:Multiple databases were used to validate the expression of MRPL18.The prognostic impact and predictive value of MRPL18 were evaluated by using predictive models.Protein-protein interaction(PPI)networks were constructed by using GeneMANIA.Enrichment analysis is used to explore the signaling pathway regulated by MRPL18.Cell counting kit-8(CCK-8)assays,colony formation,migration assays,flow cytometry,and xenograft models were employed to evaluate the role of MRPL18 in tumor progression.The immune response of MRPL18 was examined using correlation analysis.Results:High levels of MRPL18 are considered a risk factor in breast cancer.In vitro and in vivo studies demonstrated that MRPL18 promotes proliferation and migration in breast cancer.Besides,results found that MRPL18 promotes tumor growth through the activation of phosphatidylinositol 3-kinase(PI3K).Furthermore,high MRPL18 expression was linked to reduced immunotherapy efficacy,as indicated by correlations with immune checkpoints and immune-infiltrating patterns.Conclusion:MRPL18 promotes the progression of breast cancer.展开更多
BACKGROUND Despite advances in the use of in vitro fertilization-embryo transfer(ET)in couples with infertility,recurrent implantation failure(RIF)after ET is still a major problem affecting women,with great psycholog...BACKGROUND Despite advances in the use of in vitro fertilization-embryo transfer(ET)in couples with infertility,recurrent implantation failure(RIF)after ET is still a major problem affecting women,with great psychological and economic burdens for the patient and his/her family.AIM To investigate the psychological burden(anxiety and depression)and evaluate the clinical benefits of endometrial receptivity testing(ERT)in patients experiencing RIF following frozen-thawed ET.METHODS A retrospective cohort study analyzed 371 patients experiencing RIF after assisted reproductive treatment at the First People’s Hospital of Changde City between January 2021 and June 2024.Demographic and clinical data were systematically collected through standardized questionnaires.Psychological assessment utilized validated instruments:The Self-Rating Depression Scale for depression evaluation and the Self-Rating Anxiety Scale for anxiety assessment.Participants were stratified by psychological status(anxiety/non-anxiety and depression/nondepression)to analyze influencing factors for anxiety and depression.The cohort was further categorized into the ERT and non-ERT groups based on ERT implementation to comparatively analyze their clinical outcomes.Additionally,they were divided into clinical and nonclinical pregnancy groups to identify factors affecting clinical pregnancy using univariate and multivariate logistic regression models.Compared with the non-ERT group,the 226 patients who underwent ERT-guided ET achieved a higher clinical pregnancy rate,thicker endometrium on transfer day,fewer embryos transferred,and a lower miscarriage rate.RESULTS The study identified a substantial psychological burden,with anxiety prevalence at 55.0%(mean Self-Rating Anxiety Scale score,50.89±9.34)and depression at 61.2%(mean Self-Rating Depression Scale score,55.55±9.48).Multivariate analysis identified annual household income>100000 yuan as protective factors against both anxiety and depression,whereas advanced maternal age(>35 years)and multiple implantation failures(≥3)served as risk factors.Additionally,anxiety-specific risk factors included prolonged infertility treatment(>5 years)and the spouse’s status as an only child.As to depression-specific risks,chronic infertility(>3 years)and higher educational attainment(college/bachelor’s degree or higher)were key determinants,whereas urban residence was a protective factor.Age>35 years was a risk factor for clinical pregnancy in patients experiencing RIF,whereas blastocyst-stage ET,a higher number of embryos transferred,and thicker endometrium were protective factors.CONCLUSION Patients experiencing RIF are particularly susceptible to anxiety and depression,and advanced maternal age and multiple implantation failures represent salient risk factors.Clinicians should implement proactive and evidencebased interventions to mitigate these psychological burdens.For patients experiencing RIF,ERT-guided ET demonstrates significant potential to improve assisted reproductive outcomes.展开更多
BACKGROUND Uncertainty in illness(UI)and fear of progression(FoP)are significant psycho-logical challenges for lung cancer patients.Coping styles and social support are critical mediators,influencing patients'abil...BACKGROUND Uncertainty in illness(UI)and fear of progression(FoP)are significant psycho-logical challenges for lung cancer patients.Coping styles and social support are critical mediators,influencing patients'ability to manage the emotional and psy-chological burden of UI and FoP.However,limited research has explored the chain mediation effect of these factors on the relationship between UI and FoP,particularly among Chinese lung cancer patients.Convenience sampling was used to recruit inpatients diagnosed with lung cancer at a tertiary hospital in Changde City between November and December 2023.A total of 320 participants completed the Mishel Uncertainty in Illness Scale,Simp-lified Coping Style Questionnaire,Mandarin Chinese Version of the Medical Outcomes Study Social Support Survey,and Fear of Progression Questionnaire-Short Form.The chain mediation analysis was performed using the PROCESS macro to examine the relationships between the variables.RESULTS The results revealed that UI had a significant direct effect on FoP(effect=0.224,95%CI:0.136-0.408).Additionally,three indirect pathways were identified:(1)Social support(effect=0.128,95%CI:0.045-0.153);(2)Coping style(effect=0.115,95%CI:0.048-0.157);and(3)Chain mediators involving social support and coping style(effect=0.072,95%CI:0.045-0.120).The total indirect effect of the three mediation paths is 31.5%.These results confirm that social support and coping style significantly mediate the relationship between UI and FoP.CONCLUSION Based on cross-sectional data and a chain mediation model,this study explored the mechanisms between UI,social support,coping style,and FOP.Patients with lung cancer have higher levels of FOP,and the results of this study revealed a correlation between these four factors.Social support and coping style partially mediated the effects of UI on FOP,and there was a chain-mediating effect between UI and FOP.Programs designed to strengthen social support networks should also incorporate training to develop adaptive coping strategies,ultimately reducing FOP and improving overall quality of life.展开更多
BACKGROUND Death anxiety(DA)is a prevalent psychological challenge among oncology nurses that affects their emotional well-being and professional competence in coping with death-related situations.Death-related attitu...BACKGROUND Death anxiety(DA)is a prevalent psychological challenge among oncology nurses that affects their emotional well-being and professional competence in coping with death-related situations.Death-related attitudes and resilience are critical factors that may mediate the relationship between DA and coping with death competence(CDC).However,few studies have examined the chain-mediating effect of these factors among Chinese oncology nurses.This study aimed to investigate the association between DA and CDC among Chinese oncology nurses,with a focus on the mediating roles of death attitude and resilience.AIM To investigate the association between DA and CDC among Chinese oncology nurses.using an electronic questionnaire distributed in Wenjuanxing,China.In total,615 valid responses were obtained.The participants completed the Templer death anxiety scale,death attitude profile-revised,Connor-Davidson resilience scale,and coping with death scale.A chain mediation analysis was performed using the PROCESS macro in SPSS to examine the relationships between these variables.RESULTS The findings indicated that DA had a significant direct effect on CDC[effect=0.201,95%confidence interval(CI):0.112-0.322].In addition to this direct effect,three significant indirect pathways were observed:(1)Death attitude(effect=0.118,95%CI:0.056-0.163);(2)Resilience(effect=0.108,95%CI:0.032-0.176);and(3)A sequential mediation pathway involving both death attitude and resilience(effect=0.071,95%CI:0.042-0.123).The total indirect effects of the three mediation paths accounted for 29.7%of the relationship between DA and CDC.CONCLUSION Using a chain mediation model,this study explored the mechanisms linking DA,death attitude,resilience,and CDC among Chinese oncology nurses.These findings highlighted the crucial role of death attitude and resilience in mediating the relationship between DA and CDC.Interventions aimed at fostering adaptive attitudes toward death and enhancing resilience may improve nurses’ability to cope with death-related stressors,ultimately benefiting their psychological well-being and professional competence.展开更多
Objective:To analyze the risk factors of anxiety in young hypertensive patients and build a prediction model to provide a scientific basis for clinical diagnosis and treatment.Methods:According to the research content...Objective:To analyze the risk factors of anxiety in young hypertensive patients and build a prediction model to provide a scientific basis for clinical diagnosis and treatment.Methods:According to the research content,young hypertensive patients admitted to the hospital from January 2022 to December 2024 were selected as the research object and at least 950 patients were included according to the sample size calculation.According to the existence of anxiety,950 patients were divided into control group(n=650)and observation group(n=300),and the clinical data of all patients were collected for univariate analysis and multivariate Logistic regression analysis to get the risk factors of hypertension patients complicated with anxiety in.All patients were randomly divided into a training set(n=665)and a test set(n=285)according to the ratio of 7:3,and the evaluation efficiency of different prediction models was obtained by using machine learning algorithm.To evaluate the clinical application effect of the prediction model.Results:(1)Univariate analysis showed that age,BMI,education background,marital status,smoking,drinking,sleep disorder,family history of hypertension,history of diabetes,history of hyperlipidemia,history of cerebral infarction,and TC were important risk factors for young hypertensive patients complicated with anxiety.(2)Multivariate Logistic regression analysis showed that hypertension history,drinking history,coronary heart disease history,diabetes history,BMI,TC,and TG are important independent risk factors for young hypertensive patients complicated with anxiety.(3)Extra Trees has the highest predictive power for young people with hypertension complicated with anxiety,while Decision-Tree has the lowest predictive power.Conclusion:Hypertension history,drinking history,coronary heart disease history,diabetes history,BMI,TC,and TG are important independent risk factors that affect the anxiety of young hypertensive patients.Extra Trees model has the best prediction efficiency among different groups of models.展开更多
AIM:To investigate the role of RNA methylation in retinal pigment epithelial(RPE)cells in age-related macular degeneration(AMD).METHODS:RNA methylation-related gene expression profiles of AMD patient and normal contro...AIM:To investigate the role of RNA methylation in retinal pigment epithelial(RPE)cells in age-related macular degeneration(AMD).METHODS:RNA methylation-related gene expression profiles of AMD patient and normal control retinal pigment epithelium were evaluated by single-cell transcriptome from 34 samples(11 from normal donors and 23 from AMD patients).The causal relationship between RNA methylation dysfunction and AMD was analyzed by summary-data-based Mendelian randomization(SMR)using AMD GWAS data and multi-omics quantitative trait loci(QTL),including expression QTLs(eQTLs),protein QTLs(pQTLs),splicing QTLs(sQTLs),and m^(6)A-QTLs(mQTLs).Additionally,machine learning models were applied to validate the causal association between RNA methylation dysfunction and AMD using Bulk RNA sequencing data from 31 normal donors and 37 AMD patients.RESULTS:The single-cell transcriptome data analysis revealed massive dysregulation of RNA methylationrelated methylationrelated gene expression in the RPE of AMD patients.SMR revealed causal associations between key RNA methylation regulators(METTL3,NSUN6,and MRM1,etc.)and AMD onset.Machine learning models further validated these findings and demonstrated a high accuracy of AMD risk prediction by using the above-identified RNA methylationrelated genes:METTL3,NSUN6,and MRM1.Furthermore,METTL3 and NSUN6 were found to have a protective effect,while MRM1 was associated with an increased risk of AMD.CONCLUSION:The results reveal the implication of dysregulation of RNA methylation-related gene expression in the RPE of AMD patients and further demonstrated a causal association between RNA methylation-related genes(METTL3,NSUN6,and MRM1)and AMD.These findings highlight the importance of RNA methylation in the pathogenesis of AMD and offer potential biomarkers and therapeutic targets for AMD management.展开更多
AIM:To assess the possibility of using different large language models(LLMs)in ocular surface diseases by selecting five different LLMS to test their accuracy in answering specialized questions related to ocular surfa...AIM:To assess the possibility of using different large language models(LLMs)in ocular surface diseases by selecting five different LLMS to test their accuracy in answering specialized questions related to ocular surface diseases:ChatGPT-4,ChatGPT-3.5,Claude 2,PaLM2,and SenseNova.METHODS:A group of experienced ophthalmology professors were asked to develop a 100-question singlechoice question on ocular surface diseases designed to assess the performance of LLMs and human participants in answering ophthalmology specialty exam questions.The exam includes questions on the following topics:keratitis disease(20 questions),keratoconus,keratomalaciac,corneal dystrophy,corneal degeneration,erosive corneal ulcers,and corneal lesions associated with systemic diseases(20 questions),conjunctivitis disease(20 questions),trachoma,pterygoid and conjunctival tumor diseases(20 questions),and dry eye disease(20 questions).Then the total score of each LLMs and compared their mean score,mean correlation,variance,and confidence were calculated.RESULTS:GPT-4 exhibited the highest performance in terms of LLMs.Comparing the average scores of the LLMs group with the four human groups,chief physician,attending physician,regular trainee,and graduate student,it was found that except for ChatGPT-4,the total score of the rest of the LLMs is lower than that of the graduate student group,which had the lowest score in the human group.Both ChatGPT-4 and PaLM2 were more likely to give exact and correct answers,giving very little chance of an incorrect answer.ChatGPT-4 showed higher credibility when answering questions,with a success rate of 59%,but gave the wrong answer to the question 28% of the time.CONCLUSION:GPT-4 model exhibits excellent performance in both answer relevance and confidence.PaLM2 shows a positive correlation(up to 0.8)in terms of answer accuracy during the exam.In terms of answer confidence,PaLM2 is second only to GPT4 and surpasses Claude 2,SenseNova,and GPT-3.5.Despite the fact that ocular surface disease is a highly specialized discipline,GPT-4 still exhibits superior performance,suggesting that its potential and ability to be applied in this field is enormous,perhaps with the potential to be a valuable resource for medical students and clinicians in the future.展开更多
Human endogenous retroviruses(HERVs)comprise approximately 8%of the human genome,integrated into the dynamic regulatory network of cellular potency during early embryonic development.In recent studies,resurgent the tr...Human endogenous retroviruses(HERVs)comprise approximately 8%of the human genome,integrated into the dynamic regulatory network of cellular potency during early embryonic development.In recent studies,resurgent the transcriptional activity of HERVs has been frequently observed in many types of human cancers,suggesting their potential functions in the occurrence and progression of malignancy.However,a dedicated web resource for querying the relationship between the activation of HERVs and cancer development is lacking.Here,we construct a database to explore the sequence information,expression profiles,survival prognosis,and genetic interactions of HERVs in diverse cancer types.Our database currently contains RNA sequencing data of 580 HERVs across 16,246 samples,including that of 6478 tumoral and 634 normal tissues,932 cancer cell lines,as well as 151 early embryonic and 8051 human adult tissues.The primary goal is to provide an easily accessible and user-friendly database for professionals in the fields of bioinformatics,pathology,pharmacology,and related areas,enabling them to efficiently screen the activity of HERVs of interest in normal and cancerous tissues and evaluate the clinical relevance.The ERVcancer database is available at http://kyuanlab.com/ervcancer/.展开更多
AIM:To evaluate alterations in conjunctival vascular density(CVD)and macular capillary density(MCD)in female patients with type 2 diabetes mellitus(T2DM)and gestational diabetes mellitus(GDM)using optical coherence to...AIM:To evaluate alterations in conjunctival vascular density(CVD)and macular capillary density(MCD)in female patients with type 2 diabetes mellitus(T2DM)and gestational diabetes mellitus(GDM)using optical coherence tomography angiography(OCTA).METHODS:A total of 60 female participants were recruited,comprising 20 patients with T2DM,20 patients with GDM,and 20 healthy age-matched controls(HCs).OCTA was used to assess superficial and deep retinal and conjunctival capillary plexuses.Subsequently,changes in MCD were analyzed using a circular segmentation method(C1-C6),a hemispheric quadrant segmentation method[superior right(SR),superior left(SL),inferior left(IL),and inferior right(IR)],and the early treatment diabetic retinopathy study(ETDRS)segmentation method(S,I,R,L).RESULTS:OCTA unequivocally demonstrated that the variations in CVD among HCs,T2DM,and GDM groups were statistically significant(P<0.001).In the superficial retinal capillary plexus(sRCP),significant differences were observed in the densities of total microvascular(TMI),microvasculature(MIR),and macrovascular(MAR)between patients with T2DM and HCs(P<0.05).Furthermore,the GDM group exhibited a more substantial reduction in MIR density compared to the T2DM group(P<0.01).In the deep retinal capillary plexus(dRCP),significant differences in the densities of TMI and MIR were identified between the T2DM group and HCs(P<0.05),with a notable difference in TMI density also observed between the GDM and T2DM groups(P<0.01).In the receiver operating characteristic(ROC)curve analysis,the area under the ROC curve(AUC)for TMI in sRCP between the T2DM group and HCs was 0.975,with a 95%confidence interval(CI)of 0.941–1.The AUC for MIR was highest in dRCP,with an AUC value of 0.914 and a 95%CI ranging from 0.847 to 0.981.In comparing the GDM and T2DM groups,the AUC for I region was maximized in sRCP,achieving a value of 0.978 with a 95%CI of 0.953–1.Additionally,the AUC for R region was maximized in dRCP,reaching a value of 0.99 with a 95%CI of 0.975 to 1.CONCLUSION:The sRCP and dRCP densities show higher diagnostic sensitivity for T2DM and GDM.OCTA holds potential as a significant instrument for the early diagnosis and differentiation of T2DM and GDM.展开更多
OBJECTIVE:To evaluate the anti-atherosclerotic potential and gut microbiota(GM)modulation effects of Xiong's Shiwei Wendan decoction(熊氏十味温胆汤,XSWD).METHODS:For in vitro study,Tsuchiya human peripheral blood ...OBJECTIVE:To evaluate the anti-atherosclerotic potential and gut microbiota(GM)modulation effects of Xiong's Shiwei Wendan decoction(熊氏十味温胆汤,XSWD).METHODS:For in vitro study,Tsuchiya human peripheral blood mononuclear cell-1(THP-1)derived foam cells were used to examine the possible anti-atherosclerotic effect of XSWD and XSWD-medicated serum.Atherosclerosis-prone apolipoprotein E-deficient(Apo E-/-)mice were utilized for in vivo analysis.After an 8-week high-fat diet(HFD)adminstration,25 male Apo E-/-mice were randomly divided into the model group,different doses of XSWD groups(1.25,2.5,5 mg/m L),and atorvastatin group(2.6 mg/kg).Following a continuous 8-week intervention,all mice underwent examination for AS lesion formation and assessment of its serum lipid profile.To investigate the effect on the gut microbiome,16S r RNA gene sequencing targeting the V3-V4 hypervariable region was performed on the colonic content of mice.RESULTS:XSWD administration attenuated lipid deposition in THP-1 cells,significantly reduced aortic plaque lesions,improved the lipid profile,and normalized GM composition in HFD-fed Apo E-/-mice.CONCLUSION:This study investigated the potential antiatherosclerotic and gut microbio-ta-restoring effects of XSWD in Apo E-/-mice,with findings suggesting that XSWD may be a promising preventive measure against atherosclerosis through its ability to reduce lipid accumula-tion in foam cells,improve lipid profile,and restore gut microbiota composition.展开更多
BACKGROUND Organizing pneumonia secondary to pulmonary tuberculosis is rare.Moreover,the temporal boundary between pulmonary tuberculosis and secondary organizing pneumonia has not been defined.We report a case of sec...BACKGROUND Organizing pneumonia secondary to pulmonary tuberculosis is rare.Moreover,the temporal boundary between pulmonary tuberculosis and secondary organizing pneumonia has not been defined.We report a case of secondary organizing pneumonia associated with pulmonary tuberculosis occurring after nine months of antituberculosis treatment.CASE SUMMARY A 54 years old man,previously diagnosed with pulmonary tuberculosis and tuberculous pleurisy,underwent nine months of antituberculosis treatment.Follow-up lung computed tomography revealed multiple new subpleural groundglass opacities in both lungs,and a lung biopsy confirmed organizing pneumonia.Treatment continued with anti-tuberculosis agents and hormone therapy,and subsequent dynamic pulmonary computed tomography exams demonstrated improvement in lesion absorption.No disease recurrence was observed after corticosteroid therapy discontinuation.CONCLUSION When treating patients with active pulmonary tuberculosis,if an increase in lesions is observed during anti-tuberculosis treatment,it is necessary to consider the possibility of tuberculosis-related secondary organizing pneumonia,timely lung biopsy is essential for early intervention.展开更多
BACKGROUND Improvements in the standard of living have led to increased attention to perianal disease.Although surgical treatments are effective,the outcomes of postoperative recovery(POR)are influenced by various fac...BACKGROUND Improvements in the standard of living have led to increased attention to perianal disease.Although surgical treatments are effective,the outcomes of postoperative recovery(POR)are influenced by various factors,including individual differences among patients,the characteristics of the disease itself,and the psychological state of the patient.Understanding these factors can help healthcare providers develop more personalized and effective post-operative care plans for patients with perianal disease.AIM To investigate the effect of illness perception(IP)and negative emotions on POR outcomes in patients with perianal disease.METHODS A total of 146 patients with perianal disease admitted to the First People's Hospital of Changde City from March to December 2023 were recruited.We employed a general information questionnaire,the Brief Illness Perception Questionnaire(B-IPQ),and the Hospital Anxiety and Depression Scale(HADS).We used the 15-item Quality of Recovery Score(QoR-15)to measure patients’recovery effects.Finally,we conducted Pearson’s correlation analysis to examine the relationship between pre-operative IP and anxiety and depression levels with POR quality.RESULTS Fifty-three(36.3%)had poor knowledge of their disease.Thirty(20.5%)were suspected of having anxiety and 99(67.8%)exhibited symptoms.Forty(27.4%)were suspected of having depression and 102(69.9%)displayed symptoms.The B-IPQ,HADS-A,HADS-D,and QoR-15 scores were 46.82±9.97,12.99±3.60,12.58±3.36,and 96.77±9.85,respectively.There was a negative correlation between pre-operative IP,anxiety,and depression with POR quality.The influence of age and disease course on post-operative rehabilitation effect are both negative.The impact of B-IPQ,HADS-A,and HADS-D on POR was negative.Collectively,these variables accounted for 72.6%of the variance in POR.CONCLUSION The quality of POR in patients with perianal disease is medium and is related to age,disease course,IP,anxiety,and depression.展开更多
BACKGROUND Traumatic brain injury(TBI)imposes a substantial societal and familial burden due to its high disability and fatality rates,rendering it a serious public health problem.Some patients with TBI have poor trea...BACKGROUND Traumatic brain injury(TBI)imposes a substantial societal and familial burden due to its high disability and fatality rates,rendering it a serious public health problem.Some patients with TBI have poor treatment outcomes and are prone to postoperative delirium(POD),which affects their quality of life.Anxiety has been linked to increased POD incidence in some studies,while others have found no correlation.AIM To investigate the correlation of POD risk factors,preoperative inflammatory factors,and mood disorders in patients with TBI.METHODS We retrospectively collected data on the treatment of 80 patients with TBI from November 2021 to September 2023.Patients were grouped as POD and non-POD,according to their POD status,and the general data of the two groups were compared.Inflammatory factor levels were detected preoperatively,and the Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA)were used to investigate the risk factors associated with POD in these patients.Logistic regression was used to identify the independent risk factors.RESULTS Twenty-one patients(26.25%)developed POD,including 7,10,and 4 cases of the excitatory,inhibitory,and mixed types,respectively.There were 59 cases(73.75%)in the non-POD group.Compared with the non-POD group,the POD group had a significantly higher proportion of patients with low Glasgow Coma Scale(GCS)scores before admission,unilateral mydriasis,preoperative hemorrhagic shock,intraventricular hemorrhage(IVH),and postoperative hyperglycemic hyperosmolar disease(P<0.05).In the POD group,interleukin-6(IL-6),human tumor necrosis factor-α(TNF-α),myeloperoxidase levels,HAMA,and HAMD scores were higher than those in the non-POD group(all P<0.05).Logistic multivariate analysis showed that GCS score at admission,IVH,IL-6,TNF-α,HAMA,and HAMD were independent risk factors for POD in patients with TBI(P<0.05).CONCLUSION Low GCS score at admission,IVH,elevated IL-6 and TNF-α,other inflammatory indicators,anxiety,and depression,can increase the risk of POD in patients with TBI after surgery.展开更多
BACKGROUND The incidence of colorectal cancer(CRC)is increasing annually.Laparoscopic radical resection of CRC is a minimally invasive procedure preferred in clinical practice.AIM To investigate the clinical effect of...BACKGROUND The incidence of colorectal cancer(CRC)is increasing annually.Laparoscopic radical resection of CRC is a minimally invasive procedure preferred in clinical practice.AIM To investigate the clinical effect of laparoscopic radical resection of CRC on the basis of propensity score matching(PSM).METHODS The clinical data of 100 patients who received inpatient treatment for CRC at Changde Hospital,Xiangya School of Medicine,Central South University(The First People’s Hospital of Changde City)were analyzed retrospectively.The control group included patients who underwent open surgery(n=43),and those who underwent laparoscopic surgery formed the observation group(n=57).The baseline information of both groups was equipoised using 1×1 PSM.Differences in the perioperative parameters,inflammatory response,immune function,degree of pain,and physical status between the groups were analyzed.RESULTS Thirty patients from both groups were successfully matched.After PSM,baseline data showed no statistically significant differences between the groups:(1)Periop-erative parameters:The observation group had a longer surgery time,less intra-operative blood loss,earlier first ambulation and first anal exhaust times,and shorter gastric tube indwelling time than the control group;(2)Inflammatory response:24 h after surgery,the levels of interleukin-6(IL-6),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α)between groups were higher than preoperatively.IL-6,CRP,and TNF-αlevels in the observation group were lower than in the control group;(3)Immune function:At 24 h after surgery,counts of CD4-positive T-lymphocytes(CD4+)and CD4+/CD8-positive T-lymphocytes(CD8+)in both groups were lower than those before surgery,whereas CD8+was higher than that before surgery.At 24 h after surgery,both CD4+counts and CD4+/CD8+in the observation group were higher than those in the control group,whereas CD8+counts were lower;(4)Degree of pain:The visual analog scale scores in the observation group were lower than those in the control group at 24 and 72 h after surgery;and(5)Physical status:One month after surgery,the Karnofsky performance score in the observation group was higher than that in the control group.CONCLUSION Laparoscopic radical resection of CRC has significant benefits,such as reducing postoperative pain and postoperative inflammatory response,avoiding excessive immune inhibition,and contributing to postoperative recovery.展开更多
BACKGROUND The incidence of chronic wounds is rising due to an aging population and lifestyle changes in our country.In addition,as the disease spectrum evolves,chronic wounds have become common clinical issues that s...BACKGROUND The incidence of chronic wounds is rising due to an aging population and lifestyle changes in our country.In addition,as the disease spectrum evolves,chronic wounds have become common clinical issues that seriously threaten health and impose significant social and economic burdens.AIM To investigate how depression,anxiety,peripheral blood inflammatory factors,and stress levels affect therapeutic outcomes in patients with chronic wounds.METHODS Retrospectively collected clinical data from 110 patients with chronic wounds treated at Changde Hospital,Xiangya School of Medicine,Central South University(The First People’s Hospital of Changde City)between January 2021 and December 2023,categorizing them into effective and ineffective groups based on treatment effects.Differences between both groups were analyzed using univariate analysis,independent risk factors identified via logistic regression,and their predictive value assessed through receiver operating characteristic analysis.RESULTS Following treatment,95 cases were classified as the effective group(cured or improved),while 15 cases with improvement formed the ineffective group.Significant differences between both groups were noted in wound area,infection status,daily bed time,Hamilton Anxiety Rating Scale(HAMA)scores,Hamilton Depression Rating Scale(HAMD)scores,and levels of interleukin-6,tumor necrosis factor-alpha,and superoxide dismutase(P<0.05).Logistic regression analysis identified a wound area≥7 cm^(2),HAMA≥9 scores,and HAMD≥8 scores were independent risk factors for ineffective treatment in patients with chronic wounds(P<0.05).The receiver operating characteristic curve analysis revealed that the area under the curve for ineffective treatment based on wound area,HAMA,and HAMD was 0.767,0.805,and 0.768 respectively.CONCLUSION Wound size,anxiety,and depression are significant factors influencing the therapeutic outcomes in patients with chronic wounds that require careful attention,alongside the development of appropriate strategies.展开更多
AIM:To investigate the protective effects,antioxidant potential,and anti-inflammatory mechanisms of eicosane on glutamate-induced cell damage and on N-methyl-Daspartate(NMDA)-induced retinal ganglion cell(RGC)injury i...AIM:To investigate the protective effects,antioxidant potential,and anti-inflammatory mechanisms of eicosane on glutamate-induced cell damage and on N-methyl-Daspartate(NMDA)-induced retinal ganglion cell(RGC)injury in a mouse model of glaucoma.METHODS:The protective effects of eicosane on the rat R28 retinal precursor cell line were assessed using cell counting kit-8 assays and Hoechst-propidium iodide staining.Intracellular reactive oxygen species(ROS)production was measured using the fluorescent probe 2'-7'-dichlorofluorescin diacetate and flow cytometry.The protective role of eicosane on NMDA-induced RGC injury in a mouse glaucoma model was determined by immunostaining of frozen sections of retina.The effects of eicosane on the metabolome of the retina in mice with NMDA-induced RGC damage were evaluated by liquid chromatographymass spectroscopy(LC-MS)and untargeted metabolomics analyses.RESULTS:Eicosane treatment significantly attenuated glutamate-induced damage to R28 cells in vitro.Eicosane also protected RGCs against NMDA-induced injury in a mouse glaucoma model.Untargeted metabolomics analyses showed that eicosane increased multiple metabolites,including L-arginine and L-carnitine,in the retina.CONCLUSION:Eicosane has protective effects,antioxidant potential,and anti-inflammatory properties in an in vitro model of glutamate-induced cell damage and in an in vivo model of NMDA-induced RGC injury in mouse glaucoma through modulation of L-arginine and/or L-carnitine metabolism.展开更多
AIM:To study functional brain abnormalities in patients with eye trauma(ET)and to discuss the pathophysiological mechanisms of ET.METHODS:Totally 31 ET patients and 31 healthy controls(HCs)were recruited.The age,gende...AIM:To study functional brain abnormalities in patients with eye trauma(ET)and to discuss the pathophysiological mechanisms of ET.METHODS:Totally 31 ET patients and 31 healthy controls(HCs)were recruited.The age,gender,and educational background characteristics of the two groups were similar.After functional magnetic resonance imaging(fMRI)scanning,the subjects’spontaneous brain activity was evaluated with the functional connectivity(FC)method.Receiver operating characteristic(ROC)curve analysis was used to classify the data.Pearson’s correlation analysis was used to explore the relationship between FC values in specific brain regions and clinical behaviors in patients with ET.RESULTS:Significantly increased FC between several regions was identified including the medial prefrontal cortex(MPFC)and left hippocampus formations(HF),the MPFC and left inferior parietal lobule(IPL),the left IPL and left medial temporal lobe(MTL),the left IPL and right MTL,and the right IPL and left MTL.No decreased region-to-region connectivity was detected in default mode network(DMN)sub-regions in patients with ET.Compared with HCs,ET patients exhibited significantly increased FC between several paired DMN regions,as follows:posterior cingulate cortex(PCC)and right HF(HF.R,t=2.196,P=0.032),right inferior parietal cortices(IPC.R)and left MTL(MTL.L,t=2.243,P=0.029),and right MTL(MTL.R)and HF.R(t=2.236,P=0.029).CONCLUSION:FC values in multiple brain regions of ET patients are abnormal,suggesting that these brain regions in ET patients may be dysfunctional,which may help to reveal the pathophysiological mechanisms of ET.展开更多
基金Supported by National Clinical Key Specialty Major Research Project of Hunan Provincial Health Commission in 2023,No.Z2023165.
文摘BACKGROUND Colorectal cancer(CRC)frequently metastasizes to the liver,significantly compromising patient survival.While surgical resection improves outcomes for resectable cases,many patients have limited therapeutic options.AIM To evaluate the role of laparoscopic ultrasound in resection and ablation of colorectal liver metastases(CRLM).METHODS Between June 2018 and June 2020,300 patients with CRC and liver metastases were admitted to our hospital.They were divided into two groups(150 cases each)based on treatment method:The control group(ethoxybenzyl diethylenetriamine penta-acetic acid enhanced magnetic resonance imaging)and the observation group[contrast-enhanced ultrasound with Sonazoid(S-CEUS)].RESULTS The study group demonstrated better efficacy(P<0.05),fewer adverse events(P<0.05),and better survival outcomes compared to the control group(1-year:80%vs 62%;3-year:54%vs 33%;5-year:32%vs 18%;median survival:48 months vs 30 months;hazard ratio=0.63,95%CI:0.48-0.83,P<0.001).Although Karnofsky Performance Status scores improved in both groups,the scores were significantly higher in the observation group(P<0.05).Multivariate analysis confirmed intraoperative S-CEUS and tumor differentiation as independent prognostic factors(P<0.05).CONCLUSION Laparoscopic ultrasound-guided resection/ablation improved outcomes in CRLM,reducing complications and enhancing survival.Intraoperative S-CEUS was an independent prognostic factor,supporting its clinical value.
文摘BACKGROUND Anxiety,depression,and postoperative pain are common in patients with hip joint disorders and are associated with compromised functional outcomes and delayed recovery.AIM To investigate the prevalence of anxiety and depression among geriatric patients who underwent total hip arthroplasty(THA),explored their association with postoperative pain,and identified contributing risk factors.METHODS A total of 111 geriatric patients who underwent THA between January 2021 and January 2024 were included.Standardized psychological assessment tools-including the Zung Self-Rating Anxiety Scale(SAS)and the Zung Self-Rating Depression Scale(SDS)-and the Numeric Rating Scale(NRS)for pain quantification were systematically administered.Pearson correlation analysis was utilized to explore the relationships among SAS,SDS,and NRS scores.Univariate and multivariate binary logistic regression analyses were conducted to identify risk factors for anxiety and depression in these patients.RESULTS The cohort exhibited moderate anxiety(SAS:44.23±9.03),mild depression(SDS:46.98±9.15),and moderate postoperative pain(NRS:4.93±2.37).Patients with anxiety or depression reported significantly higher NRS scores than those without these conditions.Significant positive correlations were observed between SAS and SDS scores,as well as between each of these and NRS scores.Univariate analysis revealed that gender,age,disease duration,alcohol use,diabetes history,and NRS scores were significantly associated with anxiety and depression.Multivariate analysis further identified female gender,disease duration≥2 years,alcohol use,and NRS scores≥5 as independent predictors of postoperative psychological distress.CONCLUSION Anxiety and depression are closely linked with postoperative pain in geriatric patients post-THA recovery.Early psychological screening and multimodal pain management strategies are recommended-particularly for individuals with a disease duration of≥2 years,a history of alcohol consumption,or an NRS score of≥5,as well as female patients-to effectively mitigate their negative emotional states and improve postoperative recovery.
基金Supported by the Hunan Provincial Natural Science Foundation of China,No.2025JJ80413.
文摘BACKGROUND Diabetes is becoming increasingly common and has become an important global health issue.In addition to physical damage,diabetes often leads to psychological complications,such as depressive symptoms.Self-care is considered to be the cornerstone of type 2 diabetes mellitus(T2DM)management.This research evaluated depression and explored the associations between self-care activities,self-perceived burden,and depression among T2DM patients in China.AIM To investigate the self-care activities and the association between depression and self-perceived burden among Chinese inpatients with T2DM.METHODS A cross-sectional study was conducted in participants with T2DM.The data collected encompassed basic characteristics,diabetes self-care activities,depre-ssion levels,and self-perceived burdens.Bootstrapping was utilized to assess the mediating role of diabetes self-care activities.RESULTS There were 599 T2DM patients in the survey,and 71.8%had been diagnosed with the disease for 1–10 years.There were significant correlations between self-care activities,depression,and self-perceived burden.The significant coefficients for paths a(B=-0.281,P<0.001)and b(B=-0.041,P<0.05)suggested negative associations between self-perceived burden and self-care behavior and between self-care activities and depression.The indirect effect(path a×b)of self-perceived burden on depression through self-care behaviors was significant(B=0.020,P<0.05),with a 95%bias-corrected bootstrap confidence interval of 0.007–0.036.CONCLUSION The mediating model presented here highlights the role of self-care activities in exerting both direct and indirect effects on depression in participants with T2DM.
基金supported by grants from the Key Project of Scientific Research Plan of Hunan Provincial Health Commission(C202301047982,Wei Du)Changde City Science and Technology Innovation Guidance Plan Project(2022ZD39,Wei Du)+1 种基金the Wings Scientific and Technological Foundation of The First People’s Hospital of Changde City(2022ZZ05,Wei Du,2024ZC02,Rong Xu,Z2025ZC04,Hailong Li)The Science and Technology Innovation Program of Changde City(2024ZD248,Rong Xu,2024ZD200,Yun Peng).
文摘Background:The study aimed to explore the clinical value of mitochondrial ribosomal protein L18(MRPL18)in breast cancer.Methods:Multiple databases were used to validate the expression of MRPL18.The prognostic impact and predictive value of MRPL18 were evaluated by using predictive models.Protein-protein interaction(PPI)networks were constructed by using GeneMANIA.Enrichment analysis is used to explore the signaling pathway regulated by MRPL18.Cell counting kit-8(CCK-8)assays,colony formation,migration assays,flow cytometry,and xenograft models were employed to evaluate the role of MRPL18 in tumor progression.The immune response of MRPL18 was examined using correlation analysis.Results:High levels of MRPL18 are considered a risk factor in breast cancer.In vitro and in vivo studies demonstrated that MRPL18 promotes proliferation and migration in breast cancer.Besides,results found that MRPL18 promotes tumor growth through the activation of phosphatidylinositol 3-kinase(PI3K).Furthermore,high MRPL18 expression was linked to reduced immunotherapy efficacy,as indicated by correlations with immune checkpoints and immune-infiltrating patterns.Conclusion:MRPL18 promotes the progression of breast cancer.
文摘BACKGROUND Despite advances in the use of in vitro fertilization-embryo transfer(ET)in couples with infertility,recurrent implantation failure(RIF)after ET is still a major problem affecting women,with great psychological and economic burdens for the patient and his/her family.AIM To investigate the psychological burden(anxiety and depression)and evaluate the clinical benefits of endometrial receptivity testing(ERT)in patients experiencing RIF following frozen-thawed ET.METHODS A retrospective cohort study analyzed 371 patients experiencing RIF after assisted reproductive treatment at the First People’s Hospital of Changde City between January 2021 and June 2024.Demographic and clinical data were systematically collected through standardized questionnaires.Psychological assessment utilized validated instruments:The Self-Rating Depression Scale for depression evaluation and the Self-Rating Anxiety Scale for anxiety assessment.Participants were stratified by psychological status(anxiety/non-anxiety and depression/nondepression)to analyze influencing factors for anxiety and depression.The cohort was further categorized into the ERT and non-ERT groups based on ERT implementation to comparatively analyze their clinical outcomes.Additionally,they were divided into clinical and nonclinical pregnancy groups to identify factors affecting clinical pregnancy using univariate and multivariate logistic regression models.Compared with the non-ERT group,the 226 patients who underwent ERT-guided ET achieved a higher clinical pregnancy rate,thicker endometrium on transfer day,fewer embryos transferred,and a lower miscarriage rate.RESULTS The study identified a substantial psychological burden,with anxiety prevalence at 55.0%(mean Self-Rating Anxiety Scale score,50.89±9.34)and depression at 61.2%(mean Self-Rating Depression Scale score,55.55±9.48).Multivariate analysis identified annual household income>100000 yuan as protective factors against both anxiety and depression,whereas advanced maternal age(>35 years)and multiple implantation failures(≥3)served as risk factors.Additionally,anxiety-specific risk factors included prolonged infertility treatment(>5 years)and the spouse’s status as an only child.As to depression-specific risks,chronic infertility(>3 years)and higher educational attainment(college/bachelor’s degree or higher)were key determinants,whereas urban residence was a protective factor.Age>35 years was a risk factor for clinical pregnancy in patients experiencing RIF,whereas blastocyst-stage ET,a higher number of embryos transferred,and thicker endometrium were protective factors.CONCLUSION Patients experiencing RIF are particularly susceptible to anxiety and depression,and advanced maternal age and multiple implantation failures represent salient risk factors.Clinicians should implement proactive and evidencebased interventions to mitigate these psychological burdens.For patients experiencing RIF,ERT-guided ET demonstrates significant potential to improve assisted reproductive outcomes.
基金Supported by Hunan Provincial Natural Science Foundation of China,No.2024JJ9579 and No.2025JJ80410The Science and Technology Innovation Program of Changde City,No.2023YD23.
文摘BACKGROUND Uncertainty in illness(UI)and fear of progression(FoP)are significant psycho-logical challenges for lung cancer patients.Coping styles and social support are critical mediators,influencing patients'ability to manage the emotional and psy-chological burden of UI and FoP.However,limited research has explored the chain mediation effect of these factors on the relationship between UI and FoP,particularly among Chinese lung cancer patients.Convenience sampling was used to recruit inpatients diagnosed with lung cancer at a tertiary hospital in Changde City between November and December 2023.A total of 320 participants completed the Mishel Uncertainty in Illness Scale,Simp-lified Coping Style Questionnaire,Mandarin Chinese Version of the Medical Outcomes Study Social Support Survey,and Fear of Progression Questionnaire-Short Form.The chain mediation analysis was performed using the PROCESS macro to examine the relationships between the variables.RESULTS The results revealed that UI had a significant direct effect on FoP(effect=0.224,95%CI:0.136-0.408).Additionally,three indirect pathways were identified:(1)Social support(effect=0.128,95%CI:0.045-0.153);(2)Coping style(effect=0.115,95%CI:0.048-0.157);and(3)Chain mediators involving social support and coping style(effect=0.072,95%CI:0.045-0.120).The total indirect effect of the three mediation paths is 31.5%.These results confirm that social support and coping style significantly mediate the relationship between UI and FoP.CONCLUSION Based on cross-sectional data and a chain mediation model,this study explored the mechanisms between UI,social support,coping style,and FOP.Patients with lung cancer have higher levels of FOP,and the results of this study revealed a correlation between these four factors.Social support and coping style partially mediated the effects of UI on FOP,and there was a chain-mediating effect between UI and FOP.Programs designed to strengthen social support networks should also incorporate training to develop adaptive coping strategies,ultimately reducing FOP and improving overall quality of life.
基金Supported by the Hunan Provincial Natural Science Foundation of China,No.2025JJ80410.
文摘BACKGROUND Death anxiety(DA)is a prevalent psychological challenge among oncology nurses that affects their emotional well-being and professional competence in coping with death-related situations.Death-related attitudes and resilience are critical factors that may mediate the relationship between DA and coping with death competence(CDC).However,few studies have examined the chain-mediating effect of these factors among Chinese oncology nurses.This study aimed to investigate the association between DA and CDC among Chinese oncology nurses,with a focus on the mediating roles of death attitude and resilience.AIM To investigate the association between DA and CDC among Chinese oncology nurses.using an electronic questionnaire distributed in Wenjuanxing,China.In total,615 valid responses were obtained.The participants completed the Templer death anxiety scale,death attitude profile-revised,Connor-Davidson resilience scale,and coping with death scale.A chain mediation analysis was performed using the PROCESS macro in SPSS to examine the relationships between these variables.RESULTS The findings indicated that DA had a significant direct effect on CDC[effect=0.201,95%confidence interval(CI):0.112-0.322].In addition to this direct effect,three significant indirect pathways were observed:(1)Death attitude(effect=0.118,95%CI:0.056-0.163);(2)Resilience(effect=0.108,95%CI:0.032-0.176);and(3)A sequential mediation pathway involving both death attitude and resilience(effect=0.071,95%CI:0.042-0.123).The total indirect effects of the three mediation paths accounted for 29.7%of the relationship between DA and CDC.CONCLUSION Using a chain mediation model,this study explored the mechanisms linking DA,death attitude,resilience,and CDC among Chinese oncology nurses.These findings highlighted the crucial role of death attitude and resilience in mediating the relationship between DA and CDC.Interventions aimed at fostering adaptive attitudes toward death and enhancing resilience may improve nurses’ability to cope with death-related stressors,ultimately benefiting their psychological well-being and professional competence.
文摘Objective:To analyze the risk factors of anxiety in young hypertensive patients and build a prediction model to provide a scientific basis for clinical diagnosis and treatment.Methods:According to the research content,young hypertensive patients admitted to the hospital from January 2022 to December 2024 were selected as the research object and at least 950 patients were included according to the sample size calculation.According to the existence of anxiety,950 patients were divided into control group(n=650)and observation group(n=300),and the clinical data of all patients were collected for univariate analysis and multivariate Logistic regression analysis to get the risk factors of hypertension patients complicated with anxiety in.All patients were randomly divided into a training set(n=665)and a test set(n=285)according to the ratio of 7:3,and the evaluation efficiency of different prediction models was obtained by using machine learning algorithm.To evaluate the clinical application effect of the prediction model.Results:(1)Univariate analysis showed that age,BMI,education background,marital status,smoking,drinking,sleep disorder,family history of hypertension,history of diabetes,history of hyperlipidemia,history of cerebral infarction,and TC were important risk factors for young hypertensive patients complicated with anxiety.(2)Multivariate Logistic regression analysis showed that hypertension history,drinking history,coronary heart disease history,diabetes history,BMI,TC,and TG are important independent risk factors for young hypertensive patients complicated with anxiety.(3)Extra Trees has the highest predictive power for young people with hypertension complicated with anxiety,while Decision-Tree has the lowest predictive power.Conclusion:Hypertension history,drinking history,coronary heart disease history,diabetes history,BMI,TC,and TG are important independent risk factors that affect the anxiety of young hypertensive patients.Extra Trees model has the best prediction efficiency among different groups of models.
基金Supported by the Key Research and Development Program of the Ministry of Science and Technology(No.2022YFF1202901)the National Natural Science Foundation of China(No.82171404)+6 种基金the Natural Science Foundation of Guangdong Province of China(No.2023A1515011529)the Science and Technology Planning Project of Guangzhou City(No.2023A03J0181No.2024A04J6481)the Fundamental Research Funds for the Central Universities(No.22yklj04)the Research Start-up Founds of Sun Yat-sen University(No.[2020]18)the Scientific Research Project of Hunan Provincial Health Commission(No.w20243051)Hunan Provincial Natural Science Foundation of China(No.2024JJ7003).
文摘AIM:To investigate the role of RNA methylation in retinal pigment epithelial(RPE)cells in age-related macular degeneration(AMD).METHODS:RNA methylation-related gene expression profiles of AMD patient and normal control retinal pigment epithelium were evaluated by single-cell transcriptome from 34 samples(11 from normal donors and 23 from AMD patients).The causal relationship between RNA methylation dysfunction and AMD was analyzed by summary-data-based Mendelian randomization(SMR)using AMD GWAS data and multi-omics quantitative trait loci(QTL),including expression QTLs(eQTLs),protein QTLs(pQTLs),splicing QTLs(sQTLs),and m^(6)A-QTLs(mQTLs).Additionally,machine learning models were applied to validate the causal association between RNA methylation dysfunction and AMD using Bulk RNA sequencing data from 31 normal donors and 37 AMD patients.RESULTS:The single-cell transcriptome data analysis revealed massive dysregulation of RNA methylationrelated methylationrelated gene expression in the RPE of AMD patients.SMR revealed causal associations between key RNA methylation regulators(METTL3,NSUN6,and MRM1,etc.)and AMD onset.Machine learning models further validated these findings and demonstrated a high accuracy of AMD risk prediction by using the above-identified RNA methylationrelated genes:METTL3,NSUN6,and MRM1.Furthermore,METTL3 and NSUN6 were found to have a protective effect,while MRM1 was associated with an increased risk of AMD.CONCLUSION:The results reveal the implication of dysregulation of RNA methylation-related gene expression in the RPE of AMD patients and further demonstrated a causal association between RNA methylation-related genes(METTL3,NSUN6,and MRM1)and AMD.These findings highlight the importance of RNA methylation in the pathogenesis of AMD and offer potential biomarkers and therapeutic targets for AMD management.
基金Supported by National Natural Science Foundation of China(No.82160195,No.82460203)Degree and Postgraduate Education Teaching Reform Project of Jiangxi Province(No.JXYJG-2020-026).
文摘AIM:To assess the possibility of using different large language models(LLMs)in ocular surface diseases by selecting five different LLMS to test their accuracy in answering specialized questions related to ocular surface diseases:ChatGPT-4,ChatGPT-3.5,Claude 2,PaLM2,and SenseNova.METHODS:A group of experienced ophthalmology professors were asked to develop a 100-question singlechoice question on ocular surface diseases designed to assess the performance of LLMs and human participants in answering ophthalmology specialty exam questions.The exam includes questions on the following topics:keratitis disease(20 questions),keratoconus,keratomalaciac,corneal dystrophy,corneal degeneration,erosive corneal ulcers,and corneal lesions associated with systemic diseases(20 questions),conjunctivitis disease(20 questions),trachoma,pterygoid and conjunctival tumor diseases(20 questions),and dry eye disease(20 questions).Then the total score of each LLMs and compared their mean score,mean correlation,variance,and confidence were calculated.RESULTS:GPT-4 exhibited the highest performance in terms of LLMs.Comparing the average scores of the LLMs group with the four human groups,chief physician,attending physician,regular trainee,and graduate student,it was found that except for ChatGPT-4,the total score of the rest of the LLMs is lower than that of the graduate student group,which had the lowest score in the human group.Both ChatGPT-4 and PaLM2 were more likely to give exact and correct answers,giving very little chance of an incorrect answer.ChatGPT-4 showed higher credibility when answering questions,with a success rate of 59%,but gave the wrong answer to the question 28% of the time.CONCLUSION:GPT-4 model exhibits excellent performance in both answer relevance and confidence.PaLM2 shows a positive correlation(up to 0.8)in terms of answer accuracy during the exam.In terms of answer confidence,PaLM2 is second only to GPT4 and surpasses Claude 2,SenseNova,and GPT-3.5.Despite the fact that ocular surface disease is a highly specialized discipline,GPT-4 still exhibits superior performance,suggesting that its potential and ability to be applied in this field is enormous,perhaps with the potential to be a valuable resource for medical students and clinicians in the future.
基金supported by the National Natural Science Foundation of China(32370821,32170821,and 92153301 to K.Y)National Key Research and Development Program of China(2021YFC2701200)+2 种基金Department of Science&Technology of Hunan Province(2023RC1028,and 2023SK2091 to K.Y)Middle/Young aged Teachers'Research Ability Improvement Project of Guangxi Higher Education(2024KY0111 to X.L)Joint Project on Regional High-lncidence Diseases Research of Guangxi Natural Science Foundation(2023JJB140356 to X.L).
文摘Human endogenous retroviruses(HERVs)comprise approximately 8%of the human genome,integrated into the dynamic regulatory network of cellular potency during early embryonic development.In recent studies,resurgent the transcriptional activity of HERVs has been frequently observed in many types of human cancers,suggesting their potential functions in the occurrence and progression of malignancy.However,a dedicated web resource for querying the relationship between the activation of HERVs and cancer development is lacking.Here,we construct a database to explore the sequence information,expression profiles,survival prognosis,and genetic interactions of HERVs in diverse cancer types.Our database currently contains RNA sequencing data of 580 HERVs across 16,246 samples,including that of 6478 tumoral and 634 normal tissues,932 cancer cell lines,as well as 151 early embryonic and 8051 human adult tissues.The primary goal is to provide an easily accessible and user-friendly database for professionals in the fields of bioinformatics,pathology,pharmacology,and related areas,enabling them to efficiently screen the activity of HERVs of interest in normal and cancerous tissues and evaluate the clinical relevance.The ERVcancer database is available at http://kyuanlab.com/ervcancer/.
基金Supported by National Natural Science Foundation of China(No.82160195,No.82460203)The Science and Technology Innovation Program of Changde City(No.2023YD25).
文摘AIM:To evaluate alterations in conjunctival vascular density(CVD)and macular capillary density(MCD)in female patients with type 2 diabetes mellitus(T2DM)and gestational diabetes mellitus(GDM)using optical coherence tomography angiography(OCTA).METHODS:A total of 60 female participants were recruited,comprising 20 patients with T2DM,20 patients with GDM,and 20 healthy age-matched controls(HCs).OCTA was used to assess superficial and deep retinal and conjunctival capillary plexuses.Subsequently,changes in MCD were analyzed using a circular segmentation method(C1-C6),a hemispheric quadrant segmentation method[superior right(SR),superior left(SL),inferior left(IL),and inferior right(IR)],and the early treatment diabetic retinopathy study(ETDRS)segmentation method(S,I,R,L).RESULTS:OCTA unequivocally demonstrated that the variations in CVD among HCs,T2DM,and GDM groups were statistically significant(P<0.001).In the superficial retinal capillary plexus(sRCP),significant differences were observed in the densities of total microvascular(TMI),microvasculature(MIR),and macrovascular(MAR)between patients with T2DM and HCs(P<0.05).Furthermore,the GDM group exhibited a more substantial reduction in MIR density compared to the T2DM group(P<0.01).In the deep retinal capillary plexus(dRCP),significant differences in the densities of TMI and MIR were identified between the T2DM group and HCs(P<0.05),with a notable difference in TMI density also observed between the GDM and T2DM groups(P<0.01).In the receiver operating characteristic(ROC)curve analysis,the area under the ROC curve(AUC)for TMI in sRCP between the T2DM group and HCs was 0.975,with a 95%confidence interval(CI)of 0.941–1.The AUC for MIR was highest in dRCP,with an AUC value of 0.914 and a 95%CI ranging from 0.847 to 0.981.In comparing the GDM and T2DM groups,the AUC for I region was maximized in sRCP,achieving a value of 0.978 with a 95%CI of 0.953–1.Additionally,the AUC for R region was maximized in dRCP,reaching a value of 0.99 with a 95%CI of 0.975 to 1.CONCLUSION:The sRCP and dRCP densities show higher diagnostic sensitivity for T2DM and GDM.OCTA holds potential as a significant instrument for the early diagnosis and differentiation of T2DM and GDM.
基金National Natural Science Foundation of China:the AntiAtherosclerotic Mechanism of Xiong’s Shiwei Wendan decoction based on the Regulation of Reverse Cholesterol Transport via the Micro RNA-33A Adenosine Triphosphate-binding Cassette Subfamily A Member 1/Adenosine Triphosphate-binding Cassette Subfamily A Member 1 Pathway(No.81603600)the Natural Science Foundation of Hunan Province of China:the Anti-Atherosclerotic Mechanism of Xiong's Shiwei Wendan Decoction based on the Activation of Lipophagy Mediated by the AMP-activated Protein Kinase/Mechanistic Target of Rapamycin Pathway(No.2021JJ30510)the Health Research Project of Hunan Provincial Health Commission:the An-ti-Atherosclerotic Mechanism of Xiong's Shiwei Wendan Decoction based on Lipophagy Mediated by the Micro RNA-499a-3p/Autophagy-related 5 Pathway(No.D202303018265)。
文摘OBJECTIVE:To evaluate the anti-atherosclerotic potential and gut microbiota(GM)modulation effects of Xiong's Shiwei Wendan decoction(熊氏十味温胆汤,XSWD).METHODS:For in vitro study,Tsuchiya human peripheral blood mononuclear cell-1(THP-1)derived foam cells were used to examine the possible anti-atherosclerotic effect of XSWD and XSWD-medicated serum.Atherosclerosis-prone apolipoprotein E-deficient(Apo E-/-)mice were utilized for in vivo analysis.After an 8-week high-fat diet(HFD)adminstration,25 male Apo E-/-mice were randomly divided into the model group,different doses of XSWD groups(1.25,2.5,5 mg/m L),and atorvastatin group(2.6 mg/kg).Following a continuous 8-week intervention,all mice underwent examination for AS lesion formation and assessment of its serum lipid profile.To investigate the effect on the gut microbiome,16S r RNA gene sequencing targeting the V3-V4 hypervariable region was performed on the colonic content of mice.RESULTS:XSWD administration attenuated lipid deposition in THP-1 cells,significantly reduced aortic plaque lesions,improved the lipid profile,and normalized GM composition in HFD-fed Apo E-/-mice.CONCLUSION:This study investigated the potential antiatherosclerotic and gut microbio-ta-restoring effects of XSWD in Apo E-/-mice,with findings suggesting that XSWD may be a promising preventive measure against atherosclerosis through its ability to reduce lipid accumula-tion in foam cells,improve lipid profile,and restore gut microbiota composition.
基金Supported by The Science and Technology Innovation Program of Changde City.
文摘BACKGROUND Organizing pneumonia secondary to pulmonary tuberculosis is rare.Moreover,the temporal boundary between pulmonary tuberculosis and secondary organizing pneumonia has not been defined.We report a case of secondary organizing pneumonia associated with pulmonary tuberculosis occurring after nine months of antituberculosis treatment.CASE SUMMARY A 54 years old man,previously diagnosed with pulmonary tuberculosis and tuberculous pleurisy,underwent nine months of antituberculosis treatment.Follow-up lung computed tomography revealed multiple new subpleural groundglass opacities in both lungs,and a lung biopsy confirmed organizing pneumonia.Treatment continued with anti-tuberculosis agents and hormone therapy,and subsequent dynamic pulmonary computed tomography exams demonstrated improvement in lesion absorption.No disease recurrence was observed after corticosteroid therapy discontinuation.CONCLUSION When treating patients with active pulmonary tuberculosis,if an increase in lesions is observed during anti-tuberculosis treatment,it is necessary to consider the possibility of tuberculosis-related secondary organizing pneumonia,timely lung biopsy is essential for early intervention.
文摘BACKGROUND Improvements in the standard of living have led to increased attention to perianal disease.Although surgical treatments are effective,the outcomes of postoperative recovery(POR)are influenced by various factors,including individual differences among patients,the characteristics of the disease itself,and the psychological state of the patient.Understanding these factors can help healthcare providers develop more personalized and effective post-operative care plans for patients with perianal disease.AIM To investigate the effect of illness perception(IP)and negative emotions on POR outcomes in patients with perianal disease.METHODS A total of 146 patients with perianal disease admitted to the First People's Hospital of Changde City from March to December 2023 were recruited.We employed a general information questionnaire,the Brief Illness Perception Questionnaire(B-IPQ),and the Hospital Anxiety and Depression Scale(HADS).We used the 15-item Quality of Recovery Score(QoR-15)to measure patients’recovery effects.Finally,we conducted Pearson’s correlation analysis to examine the relationship between pre-operative IP and anxiety and depression levels with POR quality.RESULTS Fifty-three(36.3%)had poor knowledge of their disease.Thirty(20.5%)were suspected of having anxiety and 99(67.8%)exhibited symptoms.Forty(27.4%)were suspected of having depression and 102(69.9%)displayed symptoms.The B-IPQ,HADS-A,HADS-D,and QoR-15 scores were 46.82±9.97,12.99±3.60,12.58±3.36,and 96.77±9.85,respectively.There was a negative correlation between pre-operative IP,anxiety,and depression with POR quality.The influence of age and disease course on post-operative rehabilitation effect are both negative.The impact of B-IPQ,HADS-A,and HADS-D on POR was negative.Collectively,these variables accounted for 72.6%of the variance in POR.CONCLUSION The quality of POR in patients with perianal disease is medium and is related to age,disease course,IP,anxiety,and depression.
基金Supported by Hunan Provincial Natural Science Foundation of China,No.2021JJ70001.
文摘BACKGROUND Traumatic brain injury(TBI)imposes a substantial societal and familial burden due to its high disability and fatality rates,rendering it a serious public health problem.Some patients with TBI have poor treatment outcomes and are prone to postoperative delirium(POD),which affects their quality of life.Anxiety has been linked to increased POD incidence in some studies,while others have found no correlation.AIM To investigate the correlation of POD risk factors,preoperative inflammatory factors,and mood disorders in patients with TBI.METHODS We retrospectively collected data on the treatment of 80 patients with TBI from November 2021 to September 2023.Patients were grouped as POD and non-POD,according to their POD status,and the general data of the two groups were compared.Inflammatory factor levels were detected preoperatively,and the Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA)were used to investigate the risk factors associated with POD in these patients.Logistic regression was used to identify the independent risk factors.RESULTS Twenty-one patients(26.25%)developed POD,including 7,10,and 4 cases of the excitatory,inhibitory,and mixed types,respectively.There were 59 cases(73.75%)in the non-POD group.Compared with the non-POD group,the POD group had a significantly higher proportion of patients with low Glasgow Coma Scale(GCS)scores before admission,unilateral mydriasis,preoperative hemorrhagic shock,intraventricular hemorrhage(IVH),and postoperative hyperglycemic hyperosmolar disease(P<0.05).In the POD group,interleukin-6(IL-6),human tumor necrosis factor-α(TNF-α),myeloperoxidase levels,HAMA,and HAMD scores were higher than those in the non-POD group(all P<0.05).Logistic multivariate analysis showed that GCS score at admission,IVH,IL-6,TNF-α,HAMA,and HAMD were independent risk factors for POD in patients with TBI(P<0.05).CONCLUSION Low GCS score at admission,IVH,elevated IL-6 and TNF-α,other inflammatory indicators,anxiety,and depression,can increase the risk of POD in patients with TBI after surgery.
基金Supported by Scientific Research Project of Hunan Provincial Health Commission,No.202204114103.
文摘BACKGROUND The incidence of colorectal cancer(CRC)is increasing annually.Laparoscopic radical resection of CRC is a minimally invasive procedure preferred in clinical practice.AIM To investigate the clinical effect of laparoscopic radical resection of CRC on the basis of propensity score matching(PSM).METHODS The clinical data of 100 patients who received inpatient treatment for CRC at Changde Hospital,Xiangya School of Medicine,Central South University(The First People’s Hospital of Changde City)were analyzed retrospectively.The control group included patients who underwent open surgery(n=43),and those who underwent laparoscopic surgery formed the observation group(n=57).The baseline information of both groups was equipoised using 1×1 PSM.Differences in the perioperative parameters,inflammatory response,immune function,degree of pain,and physical status between the groups were analyzed.RESULTS Thirty patients from both groups were successfully matched.After PSM,baseline data showed no statistically significant differences between the groups:(1)Periop-erative parameters:The observation group had a longer surgery time,less intra-operative blood loss,earlier first ambulation and first anal exhaust times,and shorter gastric tube indwelling time than the control group;(2)Inflammatory response:24 h after surgery,the levels of interleukin-6(IL-6),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α)between groups were higher than preoperatively.IL-6,CRP,and TNF-αlevels in the observation group were lower than in the control group;(3)Immune function:At 24 h after surgery,counts of CD4-positive T-lymphocytes(CD4+)and CD4+/CD8-positive T-lymphocytes(CD8+)in both groups were lower than those before surgery,whereas CD8+was higher than that before surgery.At 24 h after surgery,both CD4+counts and CD4+/CD8+in the observation group were higher than those in the control group,whereas CD8+counts were lower;(4)Degree of pain:The visual analog scale scores in the observation group were lower than those in the control group at 24 and 72 h after surgery;and(5)Physical status:One month after surgery,the Karnofsky performance score in the observation group was higher than that in the control group.CONCLUSION Laparoscopic radical resection of CRC has significant benefits,such as reducing postoperative pain and postoperative inflammatory response,avoiding excessive immune inhibition,and contributing to postoperative recovery.
文摘BACKGROUND The incidence of chronic wounds is rising due to an aging population and lifestyle changes in our country.In addition,as the disease spectrum evolves,chronic wounds have become common clinical issues that seriously threaten health and impose significant social and economic burdens.AIM To investigate how depression,anxiety,peripheral blood inflammatory factors,and stress levels affect therapeutic outcomes in patients with chronic wounds.METHODS Retrospectively collected clinical data from 110 patients with chronic wounds treated at Changde Hospital,Xiangya School of Medicine,Central South University(The First People’s Hospital of Changde City)between January 2021 and December 2023,categorizing them into effective and ineffective groups based on treatment effects.Differences between both groups were analyzed using univariate analysis,independent risk factors identified via logistic regression,and their predictive value assessed through receiver operating characteristic analysis.RESULTS Following treatment,95 cases were classified as the effective group(cured or improved),while 15 cases with improvement formed the ineffective group.Significant differences between both groups were noted in wound area,infection status,daily bed time,Hamilton Anxiety Rating Scale(HAMA)scores,Hamilton Depression Rating Scale(HAMD)scores,and levels of interleukin-6,tumor necrosis factor-alpha,and superoxide dismutase(P<0.05).Logistic regression analysis identified a wound area≥7 cm^(2),HAMA≥9 scores,and HAMD≥8 scores were independent risk factors for ineffective treatment in patients with chronic wounds(P<0.05).The receiver operating characteristic curve analysis revealed that the area under the curve for ineffective treatment based on wound area,HAMA,and HAMD was 0.767,0.805,and 0.768 respectively.CONCLUSION Wound size,anxiety,and depression are significant factors influencing the therapeutic outcomes in patients with chronic wounds that require careful attention,alongside the development of appropriate strategies.
基金Supported by the Science and Technology Innovation Program of Hunan Province(No.2018SK50208).
文摘AIM:To investigate the protective effects,antioxidant potential,and anti-inflammatory mechanisms of eicosane on glutamate-induced cell damage and on N-methyl-Daspartate(NMDA)-induced retinal ganglion cell(RGC)injury in a mouse model of glaucoma.METHODS:The protective effects of eicosane on the rat R28 retinal precursor cell line were assessed using cell counting kit-8 assays and Hoechst-propidium iodide staining.Intracellular reactive oxygen species(ROS)production was measured using the fluorescent probe 2'-7'-dichlorofluorescin diacetate and flow cytometry.The protective role of eicosane on NMDA-induced RGC injury in a mouse glaucoma model was determined by immunostaining of frozen sections of retina.The effects of eicosane on the metabolome of the retina in mice with NMDA-induced RGC damage were evaluated by liquid chromatographymass spectroscopy(LC-MS)and untargeted metabolomics analyses.RESULTS:Eicosane treatment significantly attenuated glutamate-induced damage to R28 cells in vitro.Eicosane also protected RGCs against NMDA-induced injury in a mouse glaucoma model.Untargeted metabolomics analyses showed that eicosane increased multiple metabolites,including L-arginine and L-carnitine,in the retina.CONCLUSION:Eicosane has protective effects,antioxidant potential,and anti-inflammatory properties in an in vitro model of glutamate-induced cell damage and in an in vivo model of NMDA-induced RGC injury in mouse glaucoma through modulation of L-arginine and/or L-carnitine metabolism.
基金Supported by National Natural Science Foundation of China(No.82160195,No.82460203)Key R&D Program of Jiangxi Province(No.20223BBH80014)+1 种基金Science and Technology Project of Jiangxi Province Health Commission of Traditional Chinese Medicine(No.2022B258)Science and Technology Project of Jiangxi Health Commission(No.202210017).
文摘AIM:To study functional brain abnormalities in patients with eye trauma(ET)and to discuss the pathophysiological mechanisms of ET.METHODS:Totally 31 ET patients and 31 healthy controls(HCs)were recruited.The age,gender,and educational background characteristics of the two groups were similar.After functional magnetic resonance imaging(fMRI)scanning,the subjects’spontaneous brain activity was evaluated with the functional connectivity(FC)method.Receiver operating characteristic(ROC)curve analysis was used to classify the data.Pearson’s correlation analysis was used to explore the relationship between FC values in specific brain regions and clinical behaviors in patients with ET.RESULTS:Significantly increased FC between several regions was identified including the medial prefrontal cortex(MPFC)and left hippocampus formations(HF),the MPFC and left inferior parietal lobule(IPL),the left IPL and left medial temporal lobe(MTL),the left IPL and right MTL,and the right IPL and left MTL.No decreased region-to-region connectivity was detected in default mode network(DMN)sub-regions in patients with ET.Compared with HCs,ET patients exhibited significantly increased FC between several paired DMN regions,as follows:posterior cingulate cortex(PCC)and right HF(HF.R,t=2.196,P=0.032),right inferior parietal cortices(IPC.R)and left MTL(MTL.L,t=2.243,P=0.029),and right MTL(MTL.R)and HF.R(t=2.236,P=0.029).CONCLUSION:FC values in multiple brain regions of ET patients are abnormal,suggesting that these brain regions in ET patients may be dysfunctional,which may help to reveal the pathophysiological mechanisms of ET.
