In order to strengthen the prevention and management in the geriatric department during the pandemic of COVID‑19 and to explore how to implement nursing measures to control the spread of COVID‑19 to elderly patients,o...In order to strengthen the prevention and management in the geriatric department during the pandemic of COVID‑19 and to explore how to implement nursing measures to control the spread of COVID‑19 to elderly patients,our geriatric department established a leading group for epidemic prevention to train the medical staffs,the patients and caregivers and implemented a set of measures such as controlling the source of infection,cutting off the transmission route,and rehabilitation nursing of Chinese medicine,thus achieved zero infection of medical staff and elderly patients.展开更多
Background Frailty is common and significantly impacts prognosis in heart failure(HF). The Vulnerable Elders Survey-13(VES-13), widely used in oncogeriatrics and public health, remains unexplored as a frailty screenin...Background Frailty is common and significantly impacts prognosis in heart failure(HF). The Vulnerable Elders Survey-13(VES-13), widely used in oncogeriatrics and public health, remains unexplored as a frailty screening tool in HF outpatients. In this study, we prospectively evaluated VES-13 against a multimodal screening assessment in detecting frailty and predicting individual risk of adverse prognosis.Methods Frailty was assessed at the initial visit using both a multimodal approach, incorporating Barthel Index, Older American Resources and Services scale, Pfeiffer Test, abbreviated Geriatric Depression Scale, age > 85 years, lacking support systems,and VES-13. Patients scoring ≥ 3 on VES-13 or meeting at least one multimodal criterion were classified as frail. Endpoints included all-cause mortality, a composite of death or HF hospitalization, and recurrent HF hospitalizations.Results A total of 301 patients were evaluated. VES-13 identified 40.2% as frail and the multimodal assessment 33.2%. In Cox regression analyses, frailty identified by VES-13 showed greater prognostic significance than the multimodal assessment for allcause mortality(HR = 3.70 [2.15–6.33], P < 0.001 vs. 2.40 [1.46–4.0], P = 0.001) and the composite endpoint(HR = 3.13 [2.02–4.84], P< 0.001 vs. 1.96 [1.28–2.99], P = 0.002). Recurrent HF hospitalizations were four times more frequent in VES-13 frail patients while two times in those identified as frail by the multimodal assessment. Additionally, stratifying patients by VES-13 tertiles provided robust risk differentiation.Conclusions VES-13, a simple frailty tool, outperformed a comprehensive multimodal assessment and could be easily integrated into routine HF care, highlighting its clinical utility in identifying patients at risk for poor outcomes.展开更多
Alterations in RNA methylation may affect the initiation and development of Alzheimer’s disease.However,the exact nature of the relationship between RNA methylation and Alzheimer’s disease remains unclear.In this st...Alterations in RNA methylation may affect the initiation and development of Alzheimer’s disease.However,the exact nature of the relationship between RNA methylation and Alzheimer’s disease remains unclear.In this study,RNA methylation levels were analyzed by bulk transcriptomic and single-cell RNA sequencing.The expression levels of RNA methylation regulators were confirmed using molecular biology techniques.Co-expression network analysis was used to identify relevant long non-coding RNAs.Molecular subtypes related to RNA methylation were classified,and variations in clinical characteristics,biological behavior,and immune signatures between subtypes were assessed.Machine learning approaches were applied to identify methylation-associated long non-coding RNAs,which were used to construct a risk model and nomogram for Alzheimer’s disease.Potential therapeutic agents for different risk groups were predicted,and in vitro experiments were conducted to identify key RNA methylation events.Single-cell analysis demonstrated enhanced RNA methylation in patients with Alzheimer’s disease,particularly within T cells,B cells,and NK cells.Quantitative reverse transcription-polymerase chain reaction and western blot confirmed alterations in RNA methylation regulators in neurons treated with amyloid-βoligomers in vitro.This evidence supported the classification of patients with Alzheimer’s disease into heterogeneous subtypes.Specifically,subtype 1 was identified as the immune-active subtype,while subtype 2 was characterized by a metabolic phenotype.Machine learning algorithms identified five significant methylation-associated long non-coding RNAs-LINC01007,MAP4K3-DT,MIR302CHG,VAC14-AS1,and TGFB2-OT1-that accurately predict clinical outcomes for patients with Alzheimer’s disease.These patients were classified into low-and high-risk categories;the latter group displayed higher immune infiltration,upregulated immune regulatory gene expression,and elevated immune scores and responded better to treatment with arachidonic-trifluoroethane.These findings suggest that dysregulated RNA methylation alters the immune microenvironment in Alzheimer’s disease and is closely associated with its progression.This phenomenon provides novel insights into potential therapeutic strategies for Alzheimer’s disease that target RNA methylation.展开更多
Objective Frailty is becoming increasingly common among aging adults.Frailty transitionis shaped by biological,social,psychological,and environmental factors.This study investigated combined effects of protective fact...Objective Frailty is becoming increasingly common among aging adults.Frailty transitionis shaped by biological,social,psychological,and environmental factors.This study investigated combined effects of protective factors on frailty transition by constructing a Protection Index(PI)to guide targeted interventions.Methods Data were extracted from the 4th Sample Survey of the Aged Population in Urban and Rural China,including baseline(2017)and follow-up(2019)surveys.Frailty was assessed using the Frailty Index(FI),whereas the PI measured protective factors.Frailty transitions over 2 years were analyzed prospectively.Pearson’s correlation examined the relationship between FI and PI,and logistic regression assessed the effects of PI on frailty transitions.Results This study included 9,093 older adults.FI values increased with age and were higher in women,whereas PI values decreased with age and were higher in men.Over 2 years,56.2%of the participants showed a stable frailty status,14.2%improved,and 29.6%worsened.Negative transitions were more common than positive transitions,with transitions occurring most frequently between adjacent states.The PI was moderately negatively correlated with the FI(r=−0.349,P<0.001).A higher PI was associated with a lower risk of negative transitions among robust and prefrail individuals(OR=0.989,0.981,both P<0.05),but showed no significant effect among those with existing frailty.Conclusion Negative frailty transitions were more common with advancing age.Enhancing PI may help prevent negative frailty transitions among robust and pre-frail older adults,underscoring the value of early interventions.展开更多
Alzheimer’s disease (AD) is the most common neurodegenerative disease causing an alteration of life quality in the terminal stage. The purpose was to report 14 years of experience about the early impact on the qualit...Alzheimer’s disease (AD) is the most common neurodegenerative disease causing an alteration of life quality in the terminal stage. The purpose was to report 14 years of experience about the early impact on the quality of life of patients with AD. Methodology: Descriptive retrospective study over 14 years in the geriatric department of Pitié Salpêtrière Hospital, using the activity of daily living, Instrumental activity of daily living, neuropsychological inventory and Hoen Yahr scale evaluated at the time of diagnosis of AD according to the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer Disease’s and Related Disorders Association diagnostic criteria. Results: A total of 214 exploitable files had been listed. At the moment of diagnosis, the mean age was 82.1 years with extremes 68 to 95 with sex ratio 1.6 in women’s favor. The mean socio-cultural level was 4.9 with extremes about 0 to 7. There was poly pathology with a mean Cumulative Illness Rate Scale = 4.6 with extremes 0 to 16. the mean cognitive status was moderate = 22.5 with extremes 0 to 30. Quality life showed moderate impairment of IADL = 9.2 with extreme 3 to 11 compared to activity of daily living. The activity of daily living was more affected in 68 - 80-year-olds, while poly pathology impacted more on IADL in men. The cognitive impairment was more deficient in IADL when the MMSE test was low. The common disorders at the NPI were psychological, behavioral and psychotic. Conclusion: At the early diagnosis of Alzheimer’s Disease cognitive deficiencies were predominant and influenced on global Instrumental activity and psychological, behavioral disorders.展开更多
Background: Lewy body disease (LBD) is a neurodegenerative affection responsible for impaired quality of life. The objective was to share the data experience of 14 years concerning the functional, neuropsychological a...Background: Lewy body disease (LBD) is a neurodegenerative affection responsible for impaired quality of life. The objective was to share the data experience of 14 years concerning the functional, neuropsychological and behaviors effects on geriatrics patients. Methodology: Descriptive retrospective study over 14 years (2005 to 2019) in the geriatrics department of Pitié Salpétrière Hospital, using the instrumentals activity of daily living (IADL) sheets and the neuropsychological inventory (NPI) assessed at the moment diagnosis according to the diagnostic criteria of 2017 and 1996. Results: A total of 70 patients including 55 exploitable files had been listed with a mean age 82.6 years [70 - 91], a sex ratio 1.2 in men favor, a mean socio-cultural level 5.2 [1 - 7], a mean Cumulating Illness Scale (CIRS52) = 10 [1 - 22]. The mean IADL and NPI were respectively 9.3 [3 - 11] and 25.1 [0 - 79]. We found an early global impairment of IADL activities frequent in transport (65%), medication management (49%), and displacement (42%) for basic activities without significant statistical difference between the age and sex groups but statistically significant early involvement with polypathology after adjustment for displacement (45%) and transport (65%). The IADL impairment is significant as soon as the MMS-BREF decreases. Hoen Yahr (HY) scale increase could influences shopping (22%), displacement (27%) after adjustment. NPI disorders frequently found were apathy-depression (31.8% - 25%), anxiety (28%), irritability (25.6%) and sleep disturbance (22.9%) after 80 years old independently of gender and poly-pathology. Also, the best mental status was associated of less disturbance of NPI items. Conclusion: Polypathology, motor disorders and cognitive decline seem to influence IADL while with advanced age, cognitive decline appears to be worsened early in LBD.展开更多
Tooth developmental anomalies are a group of disorders caused by unfavorable factors affecting the tooth development process,resulting in abnormalities in tooth number,structure,and morphology.These anomalies typicall...Tooth developmental anomalies are a group of disorders caused by unfavorable factors affecting the tooth development process,resulting in abnormalities in tooth number,structure,and morphology.These anomalies typically manifest during childhood,impairing dental function,maxillofacial development,and facial aesthetics,while also potentially impacting overall physical and mental health.The complex etiology and diverse clinical phenotypes of these anomalies pose significant challenges for prevention,early diagnosis,and treatment.As they usually emerge early in life,long-term management and multidisciplinary collaboration in dental care are essential.However,there is currently a lack of systematic clinical guidelines for the diagnosis and treatment of these conditions,adding to the difficulties in clinical practice.In response to this need,this expert consensus summarizes the classifications,etiology,typical clinical manifestations,and diagnostic criteria of tooth developmental anomalies based on current clinical evidence.It also provides prevention strategies and stage-specific clinical management recommendations to guide clinicians in diagnosis and treatment,promoting early intervention and standardized care for these anomalies.展开更多
Aim： To compare the results of bladder tumor associated antigen （BTA TRAK）, nuclear matrix protein 22 （NMP 22） and voided urine cytology （VUC） in detecting bladder cancer. Methods： A total of 135 elderly male ...Aim： To compare the results of bladder tumor associated antigen （BTA TRAK）, nuclear matrix protein 22 （NMP 22） and voided urine cytology （VUC） in detecting bladder cancer. Methods： A total of 135 elderly male and 50 healthy volunteers enrolled in this study were classified into three groups： （i） 93 patients with bladder cancer; （ii） 42 patients with urinary benign conditions; and （iii） 50 healthy volunteers. BTA TRAK and NMP 22 kits were used to detect bladder cancer. Voided urine cytology was used to compare the sensitivity and specificity of the screening tests. Results： The sensitivity and specificity of cytology, BTA TRAK and NMP 22 were 24% and 97%, 51% and 73%, 78% and 73%, respectively. The level of NMP 22 increased with tumor grading. The BTA TRAK kit has the lowest sensitivity among the screening tests. The NMP 22 with the best sensitivity can be an adjunct to cytology for evaluating bladder cancer. Conclusion： The NMP 22 test has a better correlation with the grading of the bladder cancer than BTA TRAK. As cytology units are typically not available in hospitals or in outpatient clinics, NMP 22 might be a promising tool for screening bladder cancer.展开更多
Periodontal disease is a risk factor for many systemic diseases such as Alzheimer’s disease and adverse pregnancy outcomes.Cleft palate(CP),the most common congenital craniofacial defect,has a multifaceted etiology i...Periodontal disease is a risk factor for many systemic diseases such as Alzheimer’s disease and adverse pregnancy outcomes.Cleft palate(CP),the most common congenital craniofacial defect,has a multifaceted etiology influenced by complex genetic and environmental risk factors such as maternal bacterial or virus infection.A prior case-control study revealed a surprisingly strong association between maternal periodontal disease and CP in offspring.However,the precise relationship remains unclear.In this study,the relationship between maternal oral pathogen and CP in offspring was studied by sonicated P.gingivalis injected intravenously and orally into pregnant mice.We investigated an obvious increasing CP(12.5%)in sonicated P.gingivalis group which had inhibited osteogenesis in mesenchyme and blocked efferocytosis in epithelium.Then glycolysis and H4K12 lactylation(H4K12la)were detected to elevate in both mouse embryonic palatal mesenchyme(MEPM)cells and macrophages under P.gingivalis exposure which further promoted the transcription of metallopeptidase domain17(ADAM17),subsequently mediated the shedding of transforming growth factor-beta receptor 1(TGFBR1)in MEPM cells and mer tyrosine kinase(MerTK)in macrophages and resulted in the suppression of efferocytosis and osteogenesis in palate,eventually caused abnormalities in palate fusion and ossification.The abnormal efferocytosis also led to a predominance of M1 macrophages,which indirectly inhibited palatal osteogenesis via extracellular vesicles.Furthermore,pharmacological ADAM17 inhibition could ameliorate the abnormality of P.gingivalis-induced abnormal palate development.Therefore,our study extends the knowledge of how maternal oral pathogen affects fetal palate development and provides a novel perspective to understand the pathogenesis of CP.展开更多
Early correction of childhood malocclusion is timely managing morphological,structural,and functional abnormalities at different dentomaxillofacial developmental stages.The selection of appropriate imaging examination...Early correction of childhood malocclusion is timely managing morphological,structural,and functional abnormalities at different dentomaxillofacial developmental stages.The selection of appropriate imaging examination and comprehensive radiological diagnosis and analysis play an important role in early correction of childhood malocclusion.This expert consensus is a collaborative effort by multidisciplinary experts in dentistry across the nation based on the current clinical evidence,aiming to provide general guidance on appropriate imaging examination selection,comprehensive and accurate imaging assessment for early orthodontic treatment patients.展开更多
Background Elevated N-terminal pro-brain natriuretic peptide(NT-pro-BNP)is a recognized predictor of poor prognosis in heart failure and infectious diseases.We aimed to investigate its predictive value for short-term ...Background Elevated N-terminal pro-brain natriuretic peptide(NT-pro-BNP)is a recognized predictor of poor prognosis in heart failure and infectious diseases.We aimed to investigate its predictive value for short-term mortality in patients with infective endocarditis(IE)complicated by sepsis.Methods A total of 416 consecutive patients diagnosed with IE and sepsis at Guangdong Provincial People's Hospital were enrolled.The patients were divided into three groups according to the tertiles of NT-pro-BNP level of the first blood collection within 24 hours after admission:<2000 pg/mL(n=138),2000-7167 pg/mL(n=140),and>7167 pg/mL(n=138).Univariate and multivariate regression analysis were used to explore the predictive value of NT-pro-BNP for short-term mortality,and the best cut-off value was determined by receiver operating characteristic(ROC)curve.Results In-hospital and 6-month death occurred in 65 and 94 patients,respectively.Higher in-hospital mortality was found in patients with higher serum NT-pro-BNP levels(9.4%vs.13.6%vs.23.9%,P=0.003).ROC curve analysis identified an optimal NT-pro-BNP cutoff level of 1357 pg/mL[area under curve(AUC):0.652,95%CI:0.588-0.717,P<0.001].Multivariate regression analysis showed that both log-transformed NT-pro-BNP(in-hospital mortality:OR:1.987,95%CI:1.045-3.778,P=0.036;6-month mortality:HR:1.714,95%CI:1.072-2.7400,P=0.025)and NT-pro-BNP>1357 pg/mL(in-hospital mortality:OR:8.059,95%CI:1.813-35.818,P=0.006;6-month mortality:HR:5.193,95%CI:1.806-14.938,P=0.002)were both independent risk factors for in-hospital and 6-month mortality.Conclusions Serum NT-pro-BNP could serve as an independent predictor of in-hospital and 6-month mortality in patients with IE complicated with sepsis.展开更多
Background Renal and liver dysfunction,which are common complications in infectious diseases,are associated with poor clinical outcomes.This study aimed to evaluate the prognostic value of the Model for End-Stage Live...Background Renal and liver dysfunction,which are common complications in infectious diseases,are associated with poor clinical outcomes.This study aimed to evaluate the prognostic value of the Model for End-Stage Liver Disease Excluding International Normalized Ratio(MELD-XI)score for predicting short-term mortality in patients with infective endocarditis(IE)complicated by sepsis.Methods A total of 496 consecutive IE patients complicated with sepsis at Guangdong Provincial People's Hospital were enrolled and divided into three groups according to the tertiles of MELD-XI score:<7.9(n=164),7.9-14.6(n=168),and>14.6(n=164).Major adverse clinical events(MACE)were composite endpoints that included acute heart failure,renal dialysis,stroke,and death during hospitalization.Multivariate analysis was used to explore the prognostic value of MELD-XI score.Results In-hospital and 6-month mortality were 14.3%and 21.5%,respectively.In-hospital mortality and the incidence of MACE rose significantly with higher MELD-XI scores(mortality:8.5%vs.12.5%vs.14.3%,P=0.002;Incidence of MACE:24.4%vs.31%vs.51.2%,P<0.001).Receiver operating characteristic(ROC)curve analysis showed that the optimal cutoff value of MELD-XI score was 15.7[area under the curve(AUC):0.648,95%CI:0.578-0.718,P<0.001].Multivariate regression analysis revealed that MELD-XI score>15.7 was a significantly independent risk factor for both in-hospital[adjusted odds ratio(OR):2.27,95%CI:1.28-4.05,P=0.005]and 6-month mortality[adjusted hazard ratio(HR):1.69,95%CI:1.13-2.53,P=0.011].Conclusions MELD-XI score>15.7 was independently associated with short-term mortality in IE patients complicated with sepsis,suggesting its potential value as a prognostic biomarker for risk stratification in this population.展开更多
Background Elderly patients(age≥60 years)with ST-segment elevation myocardial infarction(STEMI)are at an elevated risk of mortality.This study aimed to investigate the association of the creatinine to ejection fracti...Background Elderly patients(age≥60 years)with ST-segment elevation myocardial infarction(STEMI)are at an elevated risk of mortality.This study aimed to investigate the association of the creatinine to ejection fraction ratio(CER)with in-hospital and 1-year death in elderly patients with STEMI.Methods A total of 753 consecutive elderly patients(age≥60 years)with STEMI undergoing percutaneous coronary intervention(PCI)were enrolled and divided into three groups according to the tertiles of CER at admission:<1.5(n=250),1.5-2.2(n=249)and>2.2(n=254).Multivariate analyses were performed to evaluate the prognostic value of CRE for short-term death in this population.Results The in-hospital and 1-year mortality reached 6.0%and 13.3%,respectively.Patients with higher CER exhibited a higher in-hospital mortality(0.8%vs.2.8%vs.14.2%,P<0.001).An optimal cut-off value of 2.5 for CER was identified for predicting in-hospital death by receiver operating characteristic curve analysis,yielding a sensitivity of 77.8%and a specificity of 76.1%[area under curve(AUC):0.791,95%confidence interval(CI):0.734-0.847,P<0.001].Multivariate regression analyses revealed that CER>2.5 was an independent risk factor for both in-hospital[adjusted odds ratio(OR):9.006,95%CI:2.707-29.967,P<0.001]and 1-year mortality[adjusted hazard ratio(HR):5.082,95%CI:2.462-10.490,P<0.001].Conclusions Elevated CER is associated with adverse short-term mortality in elderly STEMI patients undergone PCI,offering valuable insights for the early identification and management of high-risk individuals in clinical practice.展开更多
Background Although the age,creatinine,and ejection fraction(ACEF)score effectively predicts risk in general populations with ST segment elevation myocardial infarction(STEMI),its performance specifically in elderly p...Background Although the age,creatinine,and ejection fraction(ACEF)score effectively predicts risk in general populations with ST segment elevation myocardial infarction(STEMI),its performance specifically in elderly patients-who are often underrepresented in validation studies and present with unique pathophysiology-is not well established.This study was designed to directly evaluate and compare the predictive value of the ACEF score for short-term mortality in elderly versus non-elderly STEMI patients,addressing a critical gap in its clinical application.Methods We enrolled 934 consecutive STEMI patients undergoing percutaneous coronary intervention,categorized into a non elderly group(<65 years,n=534)and an elderly group(≥65 years,n=400).The ACEF score was calculated as age/left ventricular ejection fraction+1(if serum creatinine>2 mg/dL).Its predictive ability for in hospital and one year mortality was assessed.Results Overall,in hospital and one year mortality rates were 4.4%and 8.2%,respectively.Elderly patients had significantly worse in hospital outcomes,including higher all cause mortality(6.5%vs.2.8%,P=0.006)and major adverse cardiovascular events(16.0%vs.9.2%,P=0.002).The predictive performance of the ACEF score for in hospital mortality was lower in the elderly group than in the non elderly group(area under the curve:0.753 vs.0.828,P=0.047).The optimal cut off value for ACEF was 1.65 in both groups.In multivariate analysis,an ACEF score>1.65 independently predicted in hospital mortality[adjusted odds ratio(OR):11.58,P=0.001]and one year mortality[adjusted hazard ratio(HR):7.12,P<0.001]in non elderly patients.Similar associations were observed in elderly patients(in hospital mortality:adjusted OR:3.26,P=0.027;one year mortality:adjusted HR:2.79,P=0.003).Conclusions Despite a relatively lower discriminatory ability for short-term mortality in elderly STEMI patients,the ACEF score still demonstrated significant predictive value and might serve as a practical,initial tool for identifying high-risk individuals in clinical settings.展开更多
Coronary artery disease and aortic valve stenosis are highly prevalent cardio-vascular diseases worldwide,resulting in substantial morbidity and mortality.Surgical interventions,such as coronary artery bypass grafting...Coronary artery disease and aortic valve stenosis are highly prevalent cardio-vascular diseases worldwide,resulting in substantial morbidity and mortality.Surgical interventions,such as coronary artery bypass grafting and surgical aortic valve replacement,offer significant therapeutic benefits,including enhanced postoperative quality of life(QoL)and functional capacity,which are key indi-cators of surgical success.This editorial reviews recent studies on postoperative QoL and functional outcomes in patients undergoing cardiac surgery.Factors such as preoperative health,age,intensive care unit stay duration,surgical risk,and perioperative complications could influence these outcomes.Cardiac rehabil-itation is pivotal in enhancing patient function,reducing frailty and improving long-term QoL.展开更多
BACKGROUND It is critical to explore effective therapeutic targets for improving the survival rate of patients with hepatocellular carcinoma(HCC).Although many studies have focused on flotillin-1(FLOT1)as a lipid raft...BACKGROUND It is critical to explore effective therapeutic targets for improving the survival rate of patients with hepatocellular carcinoma(HCC).Although many studies have focused on flotillin-1(FLOT1)as a lipid raft-associated protein that regulates the activation of some proteins or kinases to promote tumor cell survival and proliferation,few studies have explored the regulation of Golgi apparatus function.AIM To investigate the molecular mechanism through which FLOT1 activates the Golgi stress response downstream of transcription factor E3(TFE3),thereby promoting the progression of HCC.METHODS FLOT1 expression in HCC tissue,HCC cell lines,and nude mouse tumor models was assessed.The impact of FLOT1 silencing or its overexpression on the proliferation of HCC cells was studied.CCK-8,flow cytometry,and transwell assays were used to assess the proliferation,cell cycle,migration,and invasion abilities of HCC cells.A dual-luciferase reporter assay was used to study the effect of FLOT1 on the transcriptional activity of the downstream Golgi apparatus stress element promoter of TFE3.Western blotting,co-immunoprecipitation,and immunofluorescence staining were employed to detect relevant proteins.RESULTS High FLOT1 expression was correlated with a poor prognosis in patients with HCC.The knockdown of FLOT1 suppressed the proliferation,migration,and invasion of HCC cells and promoted their apoptosis.Xenograft assays revealed that FLOT1 knockdown inhibited HCC tumorigenesis in vivo.Mechanistically,FLOT1 inhibited the expression of mechanistic target of rapamycin complex 1/2 proteins through ubiquitination and downstream effector p-S6 kinase-T389,leading to the dephosphorylation and nuclear translocation of TFE3 and promotion of Golgi stress-mediated responses,ultimately resulting in HCC progression.CONCLUSION FLOT1 recruits and inhibits mechanistic target of rapamycin complex 1/2,causing dephosphorylation and TFE3 nuclear translocation,thereby activating the Golgi stress response and further promoting the proliferation,migration,and invasion capabilities of HCC cells.These results underscore the potential of FLOT1 as a promising therapeutic target for HCC.展开更多
BACKGROUND Depression is a disease with a significant global social burden.Single nucleotide polymorphisms(SNPs)are correlated with the development of depression.This study investigates the relationship between polymo...BACKGROUND Depression is a disease with a significant global social burden.Single nucleotide polymorphisms(SNPs)are correlated with the development of depression.This study investigates the relationship between polymorphisms in the GPHN and ATP6V1D gene promoter regions and susceptibility to depression in the Chinese population.AIM To provide new insights into identifying SNPs for predicting depression in the Chinese population.METHODS We conducted a case-control study involving 555 individuals with depression and 509 healthy controls.GPHN rs8020095 and ATP6V1D rs3759755,rs10144417,rs2031564,and rs8016024 in the promoter region were genotyped using nextgeneration sequencing.Dual luciferase reporter genes were employed to assess the transcriptional activity of promoter regions for each SNP genotype,with transcription factors binding to each site predicted using the JASPAR database.RESULTS Compared to healthy controls,the ATP6V1D promoter rs10144417 AG genotype (P = 0.015), rs3759755 AC/CC genotype (P = 0.036), and GPHN gene rs8020095 GA and AA genotypes (GA: P =0.028, GG: P = 0.025) were significantly associated with a lower prevalence of depression. Linked disequilibria werepresent in five SNPs, with the AGATA haplotype frequency in patients significantly lower than in healthy subjects(P = 0.023). Luciferase activity of the rs3759755-A recombinant plasmid was significantly higher than that of thers3759755-C recombinant plasmid (P = 0.026), and the rs8020095-A recombinant plasmid activity was significantlyhigher than that of the rs8020095-G recombinant plasmid (P = 0.001). Transcription factors orthodenticle homeobox2, orthodenticle homeobox 1, forkhead box L1, NK homeobox 3-1, and nuclear factor, interleukin 3 regulateddemonstrated binding affinity with rs3759755A > C and rs8020095A > G.CONCLUSIONThis study demonstrates that SNPs (rs3759755 and rs10144417) in the promoter region of the ATP6V1D and SNP(rs8020095) of GPHN are indeed associated with susceptibility to depression.展开更多
BACKGROUND Recurrence of common bile duct(CBD)calculi within 30 days following T-tube cholangiography is exceedingly rare.CASE SUMMARY This article details an instance of choledocholithiasis involving a 1.2 cm×0....BACKGROUND Recurrence of common bile duct(CBD)calculi within 30 days following T-tube cholangiography is exceedingly rare.CASE SUMMARY This article details an instance of choledocholithiasis involving a 1.2 cm×0.9 cm stone located in the lower and middle segments of the CBD,identified 30 days after T-tube cholangiography,accompanied by multiple microstones.Magnetic resonance cholangiopancreatography revealed dilation of both intrahepatic and extrahepatic bile ducts,with the widest segment of the CBD measuring approximately 2 cm.The patient underwent laparoscopic choledochal exploration followed by choledochojejunostomy using the Roux-en-Y technique.CONCLUSION Although recurrence of choledocholithiasis within such a short postoperative period is exceedingly uncommon,this case underscores the necessity for clinicians to remain vigilant regarding the potential for early postoperative recurrence.展开更多
BACKGROUND Bipolar disorder(BD),marked by recurring manic and depressive episodes,often coexists with anxiety disorder(AD),which increases treatment complexity and morbidity.Although quetiapine,an atypical antipsychot...BACKGROUND Bipolar disorder(BD),marked by recurring manic and depressive episodes,often coexists with anxiety disorder(AD),which increases treatment complexity and morbidity.Although quetiapine,an atypical antipsychotic,has demonstrated efficacy in treating BD and AD,further investigation is needed regarding its effectiveness and safety in patients with AD at high-risk factors for BD.AIM To explore the application and efficacy of quetiapine in combination therapy for patients with AD at high-risk factors for BD.METHODS This study included 67 patients,with two excluded,leaving 65 divided into Group A(sertraline treatment)and Group B(combination treatment).All patients received sertraline,with Group B additionally receiving quetiapine.Efficacy was assessed using the Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),and Bech-Rafaelsen Mania sale(BRMS)throughout the treatment period.Side effects and physiological indicators were also monitored.RESULTS No significant baseline differences existed between the two groups at treatment onset.Over the treatment course,Group B exhibited significantly lower HAMA scores than Group A at the end of weeks 1 and 24.HAMD scores gradually decreased over time,with Group B consistently showing lower scores than Group A.BRMS scores decreased significantly from baseline by week 8.In Group A,27.27%of patients received zolpidem treatment compared to 10.53%in Group B,which was a significant difference.Incidence of adverse reactions did not differ significantly between groups at treatment onset,but most patients experienced relief from adverse reactions within 4 weeks.CONCLUSION Combination of quetiapine and sertraline can more rapidly alleviate anxiety and depressive symptoms in patients with AD at high-risk factors for BD,improving treatment outcomes.展开更多
BACKGROUND The characteristics of cerebral hemodynamic indexes of patients with different types of auditory verbal hallucinations(AVHs)was not clear.AIM To explore the characteristics of cerebral hemodynamic indexes o...BACKGROUND The characteristics of cerebral hemodynamic indexes of patients with different types of auditory verbal hallucinations(AVHs)was not clear.AIM To explore the characteristics of cerebral hemodynamic indexes of patients with different types of AVHs and construct the risk nomogram prediction model of patients with different types of AVHs.METHODS Patients with different types of verbal hallucinations who visited Wenzhou Seventh People’s Hospital were retrospectively selected from March 2021 to March 2023,and these patients were classified into 117 cases of schizophrenia(SCZ)with AVHs,108 cases of post-traumatic stress disorder(PTSD)with AVHs,and 105 cases of recurrent depressive disorder with AVHs according to type.Transcranial doppler was performed to measure the hemodynamic parameters of the anterior cerebral artery(ACA),middle cerebral artery(MCA),posterior cerebral artery(PCA),basilar artery(BA)and vertebral artery(VA).Logistic regression modelling was used to explore the factors affecting patients with different types of AVHs and odds ratio,95%confidence interval(CI).A clinical prediction model was constructed,and the efficacy of the clinical prediction model was evaluated by using receiver operating characteristic,Hosmer-Lemeshow Goodness-of-Fit test,calibration curves and decision curve analysis.RESULTS The differences between the three groups of patients in mean velocity(Vm)-MCA,end-diastolic velocity(Vd)-MCA,Vm-ACA,pulsatility index(PI)-ACA,Vm-PCA,peak systolic velocity(Vs)-PCA,Vd-PCA,Vm-BA,Vs-BA,Vd-BA,PI-BA,resistance index(RI)-BA,Vm-VA,Vs-VA,Vd-VA,PI-VA,and RI-VA indexes were statistically significant.Rising Vm-ACA is an independent risk factor for SCZ with AVHs,and falling Vm-VA,Vd-MCA,and Vd-VA are independent risk factors for SCZ with AVHs.Rising Vm-ACA,Vm-PCA,Vs-PCA,Vd-PCA,Vm-BA,and Vs-BA are independent risk factors for PTSD with AVHs,and Vm-MCA,Vs-MCA,Vd-MCA,PI-PCA,and RIBA are independent protective factors for PTSD with AVHs.Elevated Vm-MCA,Vd-MCA,RI-BA,Vm-VA,and Vd-VA were independent risk factors,and elevated Vm-ACA,Vs-ACA,Vm-PCA,Vs-PCA,and Vd-PCA were independent protective factors.The areas under the curve of the three models were 0.82(95%CI:0.76-0.87),0.88(95%CI:0.83-0.92),and 0.81(95%CI:0.77-0.86),respectively;the Hosmer-Lemeshow Goodness-of-Fit test of the calibration curves of the three models suggests that P>0.05.CONCLUSION Monitoring the cerebral hemodynamic indexes of patients with AVHs is of practical significance in determining the type of mental disorder,which helps clinicians identify the type of AVHs and adopt more efficient treatment strategies to help patients recover.展开更多
文摘In order to strengthen the prevention and management in the geriatric department during the pandemic of COVID‑19 and to explore how to implement nursing measures to control the spread of COVID‑19 to elderly patients,our geriatric department established a leading group for epidemic prevention to train the medical staffs,the patients and caregivers and implemented a set of measures such as controlling the source of infection,cutting off the transmission route,and rehabilitation nursing of Chinese medicine,thus achieved zero infection of medical staff and elderly patients.
文摘Background Frailty is common and significantly impacts prognosis in heart failure(HF). The Vulnerable Elders Survey-13(VES-13), widely used in oncogeriatrics and public health, remains unexplored as a frailty screening tool in HF outpatients. In this study, we prospectively evaluated VES-13 against a multimodal screening assessment in detecting frailty and predicting individual risk of adverse prognosis.Methods Frailty was assessed at the initial visit using both a multimodal approach, incorporating Barthel Index, Older American Resources and Services scale, Pfeiffer Test, abbreviated Geriatric Depression Scale, age > 85 years, lacking support systems,and VES-13. Patients scoring ≥ 3 on VES-13 or meeting at least one multimodal criterion were classified as frail. Endpoints included all-cause mortality, a composite of death or HF hospitalization, and recurrent HF hospitalizations.Results A total of 301 patients were evaluated. VES-13 identified 40.2% as frail and the multimodal assessment 33.2%. In Cox regression analyses, frailty identified by VES-13 showed greater prognostic significance than the multimodal assessment for allcause mortality(HR = 3.70 [2.15–6.33], P < 0.001 vs. 2.40 [1.46–4.0], P = 0.001) and the composite endpoint(HR = 3.13 [2.02–4.84], P< 0.001 vs. 1.96 [1.28–2.99], P = 0.002). Recurrent HF hospitalizations were four times more frequent in VES-13 frail patients while two times in those identified as frail by the multimodal assessment. Additionally, stratifying patients by VES-13 tertiles provided robust risk differentiation.Conclusions VES-13, a simple frailty tool, outperformed a comprehensive multimodal assessment and could be easily integrated into routine HF care, highlighting its clinical utility in identifying patients at risk for poor outcomes.
基金supported by the Elderly Health Research Project of Jiangsu Province,No.LKM2023043(to XZ).
文摘Alterations in RNA methylation may affect the initiation and development of Alzheimer’s disease.However,the exact nature of the relationship between RNA methylation and Alzheimer’s disease remains unclear.In this study,RNA methylation levels were analyzed by bulk transcriptomic and single-cell RNA sequencing.The expression levels of RNA methylation regulators were confirmed using molecular biology techniques.Co-expression network analysis was used to identify relevant long non-coding RNAs.Molecular subtypes related to RNA methylation were classified,and variations in clinical characteristics,biological behavior,and immune signatures between subtypes were assessed.Machine learning approaches were applied to identify methylation-associated long non-coding RNAs,which were used to construct a risk model and nomogram for Alzheimer’s disease.Potential therapeutic agents for different risk groups were predicted,and in vitro experiments were conducted to identify key RNA methylation events.Single-cell analysis demonstrated enhanced RNA methylation in patients with Alzheimer’s disease,particularly within T cells,B cells,and NK cells.Quantitative reverse transcription-polymerase chain reaction and western blot confirmed alterations in RNA methylation regulators in neurons treated with amyloid-βoligomers in vitro.This evidence supported the classification of patients with Alzheimer’s disease into heterogeneous subtypes.Specifically,subtype 1 was identified as the immune-active subtype,while subtype 2 was characterized by a metabolic phenotype.Machine learning algorithms identified five significant methylation-associated long non-coding RNAs-LINC01007,MAP4K3-DT,MIR302CHG,VAC14-AS1,and TGFB2-OT1-that accurately predict clinical outcomes for patients with Alzheimer’s disease.These patients were classified into low-and high-risk categories;the latter group displayed higher immune infiltration,upregulated immune regulatory gene expression,and elevated immune scores and responded better to treatment with arachidonic-trifluoroethane.These findings suggest that dysregulated RNA methylation alters the immune microenvironment in Alzheimer’s disease and is closely associated with its progression.This phenomenon provides novel insights into potential therapeutic strategies for Alzheimer’s disease that target RNA methylation.
基金supported by grants from the National Key R&D Program of China[Grant Nos.2020YFC2003000 and 2020YFC2003001]the National High Level Hospital Clinical Research Funding(BJ-2023-074 and BJ-2023-018)+1 种基金Beijing Municipal Science&Technology Commission“AI+Health Collaborative Innovation Cultivation”Project(Z221100003522015)the Non-Profit Central Research Institute Fund of the Chinese Academy of Medical Sciences(2021-JKCS-024).
文摘Objective Frailty is becoming increasingly common among aging adults.Frailty transitionis shaped by biological,social,psychological,and environmental factors.This study investigated combined effects of protective factors on frailty transition by constructing a Protection Index(PI)to guide targeted interventions.Methods Data were extracted from the 4th Sample Survey of the Aged Population in Urban and Rural China,including baseline(2017)and follow-up(2019)surveys.Frailty was assessed using the Frailty Index(FI),whereas the PI measured protective factors.Frailty transitions over 2 years were analyzed prospectively.Pearson’s correlation examined the relationship between FI and PI,and logistic regression assessed the effects of PI on frailty transitions.Results This study included 9,093 older adults.FI values increased with age and were higher in women,whereas PI values decreased with age and were higher in men.Over 2 years,56.2%of the participants showed a stable frailty status,14.2%improved,and 29.6%worsened.Negative transitions were more common than positive transitions,with transitions occurring most frequently between adjacent states.The PI was moderately negatively correlated with the FI(r=−0.349,P<0.001).A higher PI was associated with a lower risk of negative transitions among robust and prefrail individuals(OR=0.989,0.981,both P<0.05),but showed no significant effect among those with existing frailty.Conclusion Negative frailty transitions were more common with advancing age.Enhancing PI may help prevent negative frailty transitions among robust and pre-frail older adults,underscoring the value of early interventions.
文摘Alzheimer’s disease (AD) is the most common neurodegenerative disease causing an alteration of life quality in the terminal stage. The purpose was to report 14 years of experience about the early impact on the quality of life of patients with AD. Methodology: Descriptive retrospective study over 14 years in the geriatric department of Pitié Salpêtrière Hospital, using the activity of daily living, Instrumental activity of daily living, neuropsychological inventory and Hoen Yahr scale evaluated at the time of diagnosis of AD according to the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer Disease’s and Related Disorders Association diagnostic criteria. Results: A total of 214 exploitable files had been listed. At the moment of diagnosis, the mean age was 82.1 years with extremes 68 to 95 with sex ratio 1.6 in women’s favor. The mean socio-cultural level was 4.9 with extremes about 0 to 7. There was poly pathology with a mean Cumulative Illness Rate Scale = 4.6 with extremes 0 to 16. the mean cognitive status was moderate = 22.5 with extremes 0 to 30. Quality life showed moderate impairment of IADL = 9.2 with extreme 3 to 11 compared to activity of daily living. The activity of daily living was more affected in 68 - 80-year-olds, while poly pathology impacted more on IADL in men. The cognitive impairment was more deficient in IADL when the MMSE test was low. The common disorders at the NPI were psychological, behavioral and psychotic. Conclusion: At the early diagnosis of Alzheimer’s Disease cognitive deficiencies were predominant and influenced on global Instrumental activity and psychological, behavioral disorders.
文摘Background: Lewy body disease (LBD) is a neurodegenerative affection responsible for impaired quality of life. The objective was to share the data experience of 14 years concerning the functional, neuropsychological and behaviors effects on geriatrics patients. Methodology: Descriptive retrospective study over 14 years (2005 to 2019) in the geriatrics department of Pitié Salpétrière Hospital, using the instrumentals activity of daily living (IADL) sheets and the neuropsychological inventory (NPI) assessed at the moment diagnosis according to the diagnostic criteria of 2017 and 1996. Results: A total of 70 patients including 55 exploitable files had been listed with a mean age 82.6 years [70 - 91], a sex ratio 1.2 in men favor, a mean socio-cultural level 5.2 [1 - 7], a mean Cumulating Illness Scale (CIRS52) = 10 [1 - 22]. The mean IADL and NPI were respectively 9.3 [3 - 11] and 25.1 [0 - 79]. We found an early global impairment of IADL activities frequent in transport (65%), medication management (49%), and displacement (42%) for basic activities without significant statistical difference between the age and sex groups but statistically significant early involvement with polypathology after adjustment for displacement (45%) and transport (65%). The IADL impairment is significant as soon as the MMS-BREF decreases. Hoen Yahr (HY) scale increase could influences shopping (22%), displacement (27%) after adjustment. NPI disorders frequently found were apathy-depression (31.8% - 25%), anxiety (28%), irritability (25.6%) and sleep disturbance (22.9%) after 80 years old independently of gender and poly-pathology. Also, the best mental status was associated of less disturbance of NPI items. Conclusion: Polypathology, motor disorders and cognitive decline seem to influence IADL while with advanced age, cognitive decline appears to be worsened early in LBD.
基金supported by the grants No.82370912 from the National Natural Science Foundation of ChinaNo.2022020801010499 from the Bureau of Science and Technology of Wuhan,ChinaNo.2042023kf0231 from the Fundamental Research Funds for the Central Universities,China。
文摘Tooth developmental anomalies are a group of disorders caused by unfavorable factors affecting the tooth development process,resulting in abnormalities in tooth number,structure,and morphology.These anomalies typically manifest during childhood,impairing dental function,maxillofacial development,and facial aesthetics,while also potentially impacting overall physical and mental health.The complex etiology and diverse clinical phenotypes of these anomalies pose significant challenges for prevention,early diagnosis,and treatment.As they usually emerge early in life,long-term management and multidisciplinary collaboration in dental care are essential.However,there is currently a lack of systematic clinical guidelines for the diagnosis and treatment of these conditions,adding to the difficulties in clinical practice.In response to this need,this expert consensus summarizes the classifications,etiology,typical clinical manifestations,and diagnostic criteria of tooth developmental anomalies based on current clinical evidence.It also provides prevention strategies and stage-specific clinical management recommendations to guide clinicians in diagnosis and treatment,promoting early intervention and standardized care for these anomalies.
文摘Aim： To compare the results of bladder tumor associated antigen （BTA TRAK）, nuclear matrix protein 22 （NMP 22） and voided urine cytology （VUC） in detecting bladder cancer. Methods： A total of 135 elderly male and 50 healthy volunteers enrolled in this study were classified into three groups： （i） 93 patients with bladder cancer; （ii） 42 patients with urinary benign conditions; and （iii） 50 healthy volunteers. BTA TRAK and NMP 22 kits were used to detect bladder cancer. Voided urine cytology was used to compare the sensitivity and specificity of the screening tests. Results： The sensitivity and specificity of cytology, BTA TRAK and NMP 22 were 24% and 97%, 51% and 73%, 78% and 73%, respectively. The level of NMP 22 increased with tumor grading. The BTA TRAK kit has the lowest sensitivity among the screening tests. The NMP 22 with the best sensitivity can be an adjunct to cytology for evaluating bladder cancer. Conclusion： The NMP 22 test has a better correlation with the grading of the bladder cancer than BTA TRAK. As cytology units are typically not available in hospitals or in outpatient clinics, NMP 22 might be a promising tool for screening bladder cancer.
基金funded by grants from the National Natural Science Foundation of China(grant numbers 82170912 and 82370910)the Beijing Stomatological Hospital,Capital Medical University Young Scientist Program(No.YSP202404).
文摘Periodontal disease is a risk factor for many systemic diseases such as Alzheimer’s disease and adverse pregnancy outcomes.Cleft palate(CP),the most common congenital craniofacial defect,has a multifaceted etiology influenced by complex genetic and environmental risk factors such as maternal bacterial or virus infection.A prior case-control study revealed a surprisingly strong association between maternal periodontal disease and CP in offspring.However,the precise relationship remains unclear.In this study,the relationship between maternal oral pathogen and CP in offspring was studied by sonicated P.gingivalis injected intravenously and orally into pregnant mice.We investigated an obvious increasing CP(12.5%)in sonicated P.gingivalis group which had inhibited osteogenesis in mesenchyme and blocked efferocytosis in epithelium.Then glycolysis and H4K12 lactylation(H4K12la)were detected to elevate in both mouse embryonic palatal mesenchyme(MEPM)cells and macrophages under P.gingivalis exposure which further promoted the transcription of metallopeptidase domain17(ADAM17),subsequently mediated the shedding of transforming growth factor-beta receptor 1(TGFBR1)in MEPM cells and mer tyrosine kinase(MerTK)in macrophages and resulted in the suppression of efferocytosis and osteogenesis in palate,eventually caused abnormalities in palate fusion and ossification.The abnormal efferocytosis also led to a predominance of M1 macrophages,which indirectly inhibited palatal osteogenesis via extracellular vesicles.Furthermore,pharmacological ADAM17 inhibition could ameliorate the abnormality of P.gingivalis-induced abnormal palate development.Therefore,our study extends the knowledge of how maternal oral pathogen affects fetal palate development and provides a novel perspective to understand the pathogenesis of CP.
基金supports by the National Natural Science Foundation of China(Nos.82201135)"2015"Cultivation Program for Reserve Talents for Academic Leaders of Nanjing Stomatological School,Medical School of Nanjing University(No.0223A204).
文摘Early correction of childhood malocclusion is timely managing morphological,structural,and functional abnormalities at different dentomaxillofacial developmental stages.The selection of appropriate imaging examination and comprehensive radiological diagnosis and analysis play an important role in early correction of childhood malocclusion.This expert consensus is a collaborative effort by multidisciplinary experts in dentistry across the nation based on the current clinical evidence,aiming to provide general guidance on appropriate imaging examination selection,comprehensive and accurate imaging assessment for early orthodontic treatment patients.
文摘Background Elevated N-terminal pro-brain natriuretic peptide(NT-pro-BNP)is a recognized predictor of poor prognosis in heart failure and infectious diseases.We aimed to investigate its predictive value for short-term mortality in patients with infective endocarditis(IE)complicated by sepsis.Methods A total of 416 consecutive patients diagnosed with IE and sepsis at Guangdong Provincial People's Hospital were enrolled.The patients were divided into three groups according to the tertiles of NT-pro-BNP level of the first blood collection within 24 hours after admission:<2000 pg/mL(n=138),2000-7167 pg/mL(n=140),and>7167 pg/mL(n=138).Univariate and multivariate regression analysis were used to explore the predictive value of NT-pro-BNP for short-term mortality,and the best cut-off value was determined by receiver operating characteristic(ROC)curve.Results In-hospital and 6-month death occurred in 65 and 94 patients,respectively.Higher in-hospital mortality was found in patients with higher serum NT-pro-BNP levels(9.4%vs.13.6%vs.23.9%,P=0.003).ROC curve analysis identified an optimal NT-pro-BNP cutoff level of 1357 pg/mL[area under curve(AUC):0.652,95%CI:0.588-0.717,P<0.001].Multivariate regression analysis showed that both log-transformed NT-pro-BNP(in-hospital mortality:OR:1.987,95%CI:1.045-3.778,P=0.036;6-month mortality:HR:1.714,95%CI:1.072-2.7400,P=0.025)and NT-pro-BNP>1357 pg/mL(in-hospital mortality:OR:8.059,95%CI:1.813-35.818,P=0.006;6-month mortality:HR:5.193,95%CI:1.806-14.938,P=0.002)were both independent risk factors for in-hospital and 6-month mortality.Conclusions Serum NT-pro-BNP could serve as an independent predictor of in-hospital and 6-month mortality in patients with IE complicated with sepsis.
文摘Background Renal and liver dysfunction,which are common complications in infectious diseases,are associated with poor clinical outcomes.This study aimed to evaluate the prognostic value of the Model for End-Stage Liver Disease Excluding International Normalized Ratio(MELD-XI)score for predicting short-term mortality in patients with infective endocarditis(IE)complicated by sepsis.Methods A total of 496 consecutive IE patients complicated with sepsis at Guangdong Provincial People's Hospital were enrolled and divided into three groups according to the tertiles of MELD-XI score:<7.9(n=164),7.9-14.6(n=168),and>14.6(n=164).Major adverse clinical events(MACE)were composite endpoints that included acute heart failure,renal dialysis,stroke,and death during hospitalization.Multivariate analysis was used to explore the prognostic value of MELD-XI score.Results In-hospital and 6-month mortality were 14.3%and 21.5%,respectively.In-hospital mortality and the incidence of MACE rose significantly with higher MELD-XI scores(mortality:8.5%vs.12.5%vs.14.3%,P=0.002;Incidence of MACE:24.4%vs.31%vs.51.2%,P<0.001).Receiver operating characteristic(ROC)curve analysis showed that the optimal cutoff value of MELD-XI score was 15.7[area under the curve(AUC):0.648,95%CI:0.578-0.718,P<0.001].Multivariate regression analysis revealed that MELD-XI score>15.7 was a significantly independent risk factor for both in-hospital[adjusted odds ratio(OR):2.27,95%CI:1.28-4.05,P=0.005]and 6-month mortality[adjusted hazard ratio(HR):1.69,95%CI:1.13-2.53,P=0.011].Conclusions MELD-XI score>15.7 was independently associated with short-term mortality in IE patients complicated with sepsis,suggesting its potential value as a prognostic biomarker for risk stratification in this population.
文摘Background Elderly patients(age≥60 years)with ST-segment elevation myocardial infarction(STEMI)are at an elevated risk of mortality.This study aimed to investigate the association of the creatinine to ejection fraction ratio(CER)with in-hospital and 1-year death in elderly patients with STEMI.Methods A total of 753 consecutive elderly patients(age≥60 years)with STEMI undergoing percutaneous coronary intervention(PCI)were enrolled and divided into three groups according to the tertiles of CER at admission:<1.5(n=250),1.5-2.2(n=249)and>2.2(n=254).Multivariate analyses were performed to evaluate the prognostic value of CRE for short-term death in this population.Results The in-hospital and 1-year mortality reached 6.0%and 13.3%,respectively.Patients with higher CER exhibited a higher in-hospital mortality(0.8%vs.2.8%vs.14.2%,P<0.001).An optimal cut-off value of 2.5 for CER was identified for predicting in-hospital death by receiver operating characteristic curve analysis,yielding a sensitivity of 77.8%and a specificity of 76.1%[area under curve(AUC):0.791,95%confidence interval(CI):0.734-0.847,P<0.001].Multivariate regression analyses revealed that CER>2.5 was an independent risk factor for both in-hospital[adjusted odds ratio(OR):9.006,95%CI:2.707-29.967,P<0.001]and 1-year mortality[adjusted hazard ratio(HR):5.082,95%CI:2.462-10.490,P<0.001].Conclusions Elevated CER is associated with adverse short-term mortality in elderly STEMI patients undergone PCI,offering valuable insights for the early identification and management of high-risk individuals in clinical practice.
文摘Background Although the age,creatinine,and ejection fraction(ACEF)score effectively predicts risk in general populations with ST segment elevation myocardial infarction(STEMI),its performance specifically in elderly patients-who are often underrepresented in validation studies and present with unique pathophysiology-is not well established.This study was designed to directly evaluate and compare the predictive value of the ACEF score for short-term mortality in elderly versus non-elderly STEMI patients,addressing a critical gap in its clinical application.Methods We enrolled 934 consecutive STEMI patients undergoing percutaneous coronary intervention,categorized into a non elderly group(<65 years,n=534)and an elderly group(≥65 years,n=400).The ACEF score was calculated as age/left ventricular ejection fraction+1(if serum creatinine>2 mg/dL).Its predictive ability for in hospital and one year mortality was assessed.Results Overall,in hospital and one year mortality rates were 4.4%and 8.2%,respectively.Elderly patients had significantly worse in hospital outcomes,including higher all cause mortality(6.5%vs.2.8%,P=0.006)and major adverse cardiovascular events(16.0%vs.9.2%,P=0.002).The predictive performance of the ACEF score for in hospital mortality was lower in the elderly group than in the non elderly group(area under the curve:0.753 vs.0.828,P=0.047).The optimal cut off value for ACEF was 1.65 in both groups.In multivariate analysis,an ACEF score>1.65 independently predicted in hospital mortality[adjusted odds ratio(OR):11.58,P=0.001]and one year mortality[adjusted hazard ratio(HR):7.12,P<0.001]in non elderly patients.Similar associations were observed in elderly patients(in hospital mortality:adjusted OR:3.26,P=0.027;one year mortality:adjusted HR:2.79,P=0.003).Conclusions Despite a relatively lower discriminatory ability for short-term mortality in elderly STEMI patients,the ACEF score still demonstrated significant predictive value and might serve as a practical,initial tool for identifying high-risk individuals in clinical settings.
基金Supported by National High Level Hospital Clinical Research Funding Project,No.BJ-2023-206.
文摘Coronary artery disease and aortic valve stenosis are highly prevalent cardio-vascular diseases worldwide,resulting in substantial morbidity and mortality.Surgical interventions,such as coronary artery bypass grafting and surgical aortic valve replacement,offer significant therapeutic benefits,including enhanced postoperative quality of life(QoL)and functional capacity,which are key indi-cators of surgical success.This editorial reviews recent studies on postoperative QoL and functional outcomes in patients undergoing cardiac surgery.Factors such as preoperative health,age,intensive care unit stay duration,surgical risk,and perioperative complications could influence these outcomes.Cardiac rehabil-itation is pivotal in enhancing patient function,reducing frailty and improving long-term QoL.
基金Supported by the National Natural Science Foundation of China,No.82203806the General Hospital of Western Theater Command Project Funding,No.2024-YGJC-B10.
文摘BACKGROUND It is critical to explore effective therapeutic targets for improving the survival rate of patients with hepatocellular carcinoma(HCC).Although many studies have focused on flotillin-1(FLOT1)as a lipid raft-associated protein that regulates the activation of some proteins or kinases to promote tumor cell survival and proliferation,few studies have explored the regulation of Golgi apparatus function.AIM To investigate the molecular mechanism through which FLOT1 activates the Golgi stress response downstream of transcription factor E3(TFE3),thereby promoting the progression of HCC.METHODS FLOT1 expression in HCC tissue,HCC cell lines,and nude mouse tumor models was assessed.The impact of FLOT1 silencing or its overexpression on the proliferation of HCC cells was studied.CCK-8,flow cytometry,and transwell assays were used to assess the proliferation,cell cycle,migration,and invasion abilities of HCC cells.A dual-luciferase reporter assay was used to study the effect of FLOT1 on the transcriptional activity of the downstream Golgi apparatus stress element promoter of TFE3.Western blotting,co-immunoprecipitation,and immunofluorescence staining were employed to detect relevant proteins.RESULTS High FLOT1 expression was correlated with a poor prognosis in patients with HCC.The knockdown of FLOT1 suppressed the proliferation,migration,and invasion of HCC cells and promoted their apoptosis.Xenograft assays revealed that FLOT1 knockdown inhibited HCC tumorigenesis in vivo.Mechanistically,FLOT1 inhibited the expression of mechanistic target of rapamycin complex 1/2 proteins through ubiquitination and downstream effector p-S6 kinase-T389,leading to the dephosphorylation and nuclear translocation of TFE3 and promotion of Golgi stress-mediated responses,ultimately resulting in HCC progression.CONCLUSION FLOT1 recruits and inhibits mechanistic target of rapamycin complex 1/2,causing dephosphorylation and TFE3 nuclear translocation,thereby activating the Golgi stress response and further promoting the proliferation,migration,and invasion capabilities of HCC cells.These results underscore the potential of FLOT1 as a promising therapeutic target for HCC.
基金Supported by the Natural Science Foundation of Sichuan,China,No.2022NSFSC0778Research Project Foundation of Sichuan Applied Psychology Research Center,No.CSXL-24202+1 种基金Foundation of Sichuan Clinical Research Center for Geriatrics,No.24LHLNYX1-04 and No.24LHLNYX1-06and the Key Laboratory Foundation for Development and Regeneration of Sichuan Province,No.24LHFYSZ1-25.
文摘BACKGROUND Depression is a disease with a significant global social burden.Single nucleotide polymorphisms(SNPs)are correlated with the development of depression.This study investigates the relationship between polymorphisms in the GPHN and ATP6V1D gene promoter regions and susceptibility to depression in the Chinese population.AIM To provide new insights into identifying SNPs for predicting depression in the Chinese population.METHODS We conducted a case-control study involving 555 individuals with depression and 509 healthy controls.GPHN rs8020095 and ATP6V1D rs3759755,rs10144417,rs2031564,and rs8016024 in the promoter region were genotyped using nextgeneration sequencing.Dual luciferase reporter genes were employed to assess the transcriptional activity of promoter regions for each SNP genotype,with transcription factors binding to each site predicted using the JASPAR database.RESULTS Compared to healthy controls,the ATP6V1D promoter rs10144417 AG genotype (P = 0.015), rs3759755 AC/CC genotype (P = 0.036), and GPHN gene rs8020095 GA and AA genotypes (GA: P =0.028, GG: P = 0.025) were significantly associated with a lower prevalence of depression. Linked disequilibria werepresent in five SNPs, with the AGATA haplotype frequency in patients significantly lower than in healthy subjects(P = 0.023). Luciferase activity of the rs3759755-A recombinant plasmid was significantly higher than that of thers3759755-C recombinant plasmid (P = 0.026), and the rs8020095-A recombinant plasmid activity was significantlyhigher than that of the rs8020095-G recombinant plasmid (P = 0.001). Transcription factors orthodenticle homeobox2, orthodenticle homeobox 1, forkhead box L1, NK homeobox 3-1, and nuclear factor, interleukin 3 regulateddemonstrated binding affinity with rs3759755A > C and rs8020095A > G.CONCLUSIONThis study demonstrates that SNPs (rs3759755 and rs10144417) in the promoter region of the ATP6V1D and SNP(rs8020095) of GPHN are indeed associated with susceptibility to depression.
基金Supported by the Key Research and Development Program of Shaanxi Province,China,No.2021GXLH-Z-100.
文摘BACKGROUND Recurrence of common bile duct(CBD)calculi within 30 days following T-tube cholangiography is exceedingly rare.CASE SUMMARY This article details an instance of choledocholithiasis involving a 1.2 cm×0.9 cm stone located in the lower and middle segments of the CBD,identified 30 days after T-tube cholangiography,accompanied by multiple microstones.Magnetic resonance cholangiopancreatography revealed dilation of both intrahepatic and extrahepatic bile ducts,with the widest segment of the CBD measuring approximately 2 cm.The patient underwent laparoscopic choledochal exploration followed by choledochojejunostomy using the Roux-en-Y technique.CONCLUSION Although recurrence of choledocholithiasis within such a short postoperative period is exceedingly uncommon,this case underscores the necessity for clinicians to remain vigilant regarding the potential for early postoperative recurrence.
基金Supported by Huzhou City Science and Technology Plan Public Welfare Technology Application Research Project[Key Project],No.2020GZ42.
文摘BACKGROUND Bipolar disorder(BD),marked by recurring manic and depressive episodes,often coexists with anxiety disorder(AD),which increases treatment complexity and morbidity.Although quetiapine,an atypical antipsychotic,has demonstrated efficacy in treating BD and AD,further investigation is needed regarding its effectiveness and safety in patients with AD at high-risk factors for BD.AIM To explore the application and efficacy of quetiapine in combination therapy for patients with AD at high-risk factors for BD.METHODS This study included 67 patients,with two excluded,leaving 65 divided into Group A(sertraline treatment)and Group B(combination treatment).All patients received sertraline,with Group B additionally receiving quetiapine.Efficacy was assessed using the Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),and Bech-Rafaelsen Mania sale(BRMS)throughout the treatment period.Side effects and physiological indicators were also monitored.RESULTS No significant baseline differences existed between the two groups at treatment onset.Over the treatment course,Group B exhibited significantly lower HAMA scores than Group A at the end of weeks 1 and 24.HAMD scores gradually decreased over time,with Group B consistently showing lower scores than Group A.BRMS scores decreased significantly from baseline by week 8.In Group A,27.27%of patients received zolpidem treatment compared to 10.53%in Group B,which was a significant difference.Incidence of adverse reactions did not differ significantly between groups at treatment onset,but most patients experienced relief from adverse reactions within 4 weeks.CONCLUSION Combination of quetiapine and sertraline can more rapidly alleviate anxiety and depressive symptoms in patients with AD at high-risk factors for BD,improving treatment outcomes.
文摘BACKGROUND The characteristics of cerebral hemodynamic indexes of patients with different types of auditory verbal hallucinations(AVHs)was not clear.AIM To explore the characteristics of cerebral hemodynamic indexes of patients with different types of AVHs and construct the risk nomogram prediction model of patients with different types of AVHs.METHODS Patients with different types of verbal hallucinations who visited Wenzhou Seventh People’s Hospital were retrospectively selected from March 2021 to March 2023,and these patients were classified into 117 cases of schizophrenia(SCZ)with AVHs,108 cases of post-traumatic stress disorder(PTSD)with AVHs,and 105 cases of recurrent depressive disorder with AVHs according to type.Transcranial doppler was performed to measure the hemodynamic parameters of the anterior cerebral artery(ACA),middle cerebral artery(MCA),posterior cerebral artery(PCA),basilar artery(BA)and vertebral artery(VA).Logistic regression modelling was used to explore the factors affecting patients with different types of AVHs and odds ratio,95%confidence interval(CI).A clinical prediction model was constructed,and the efficacy of the clinical prediction model was evaluated by using receiver operating characteristic,Hosmer-Lemeshow Goodness-of-Fit test,calibration curves and decision curve analysis.RESULTS The differences between the three groups of patients in mean velocity(Vm)-MCA,end-diastolic velocity(Vd)-MCA,Vm-ACA,pulsatility index(PI)-ACA,Vm-PCA,peak systolic velocity(Vs)-PCA,Vd-PCA,Vm-BA,Vs-BA,Vd-BA,PI-BA,resistance index(RI)-BA,Vm-VA,Vs-VA,Vd-VA,PI-VA,and RI-VA indexes were statistically significant.Rising Vm-ACA is an independent risk factor for SCZ with AVHs,and falling Vm-VA,Vd-MCA,and Vd-VA are independent risk factors for SCZ with AVHs.Rising Vm-ACA,Vm-PCA,Vs-PCA,Vd-PCA,Vm-BA,and Vs-BA are independent risk factors for PTSD with AVHs,and Vm-MCA,Vs-MCA,Vd-MCA,PI-PCA,and RIBA are independent protective factors for PTSD with AVHs.Elevated Vm-MCA,Vd-MCA,RI-BA,Vm-VA,and Vd-VA were independent risk factors,and elevated Vm-ACA,Vs-ACA,Vm-PCA,Vs-PCA,and Vd-PCA were independent protective factors.The areas under the curve of the three models were 0.82(95%CI:0.76-0.87),0.88(95%CI:0.83-0.92),and 0.81(95%CI:0.77-0.86),respectively;the Hosmer-Lemeshow Goodness-of-Fit test of the calibration curves of the three models suggests that P>0.05.CONCLUSION Monitoring the cerebral hemodynamic indexes of patients with AVHs is of practical significance in determining the type of mental disorder,which helps clinicians identify the type of AVHs and adopt more efficient treatment strategies to help patients recover.
