OBJECTIVE:To investigate the protective effects of dihydroquercetin (DHQ) on mitochondrial function in primary hepatocytes from patients with chronic liver failure (CLF) and discuss the underlying molecular mechanism. METHODS:Blood samples from 15 CLF patients and 15 healthy subjects were retrospectively analyzed. Primary hepatocytes were isolated using a modified two-step collagenase perfusion method. The optimal concentration of DHQ (20 μmol/L) was determined using the Cell Counting Kit-8 (CCK-8) assay. Cells were divided into a control group, a plasma group, and a DHQ intervention group. The assessed indicators included cell viability (CCK-8), apoptosis rate (flow cytometry), inflammatory factors (IL-1β, IL-6, TNF-α; ELISA), oxidative stress markers (MDA, SOD, GSH-Px), mitochondrial function (JC-1 staining, mtDNA/nDNA ratio) and related protein expression (Western blot). RESULTS:DHQ adjunctive therapy reduced serum circulating mitochondrial DNA levels in patients with CLF, increased serum SOD2 and Humanin expression, inhibited activation of the NLRP3-mediated pyroptotic pathway, improved remission rates of decompensated complications, and showed favorable safety and tolerability in patients with end-stage liver diseases. In vitro, hepatocyte viability was markedly decreased in the CLF group, with increased apoptosis, elevated IL-1β, IL-6, TNF-α, and MDA levels, as well as declined SOD and GSH-Px activities. DHQ reduced apoptosis, up-regulated mitochondrial functional markers (SOD2, Humanin), restored JC-1 red/green fluorescence ratios, inhibited NLR family pyrin domain-containing 3 (NLRP3) inflammasome activation, and suppressed the caspase-1/IL-1β axis. CONCLUSION:DHQ exerts multidimensional protective effects on hepatocytes, providing a novel strategy and clinical evidence for mitochondria-targeted CLF therapy.
OBJECTIVE:To evaluate the use of circulating free DNA (cfDNA) epigenetic characteristics in cardiac function stratification and risk prediction in patients with cardiovascular disease (CVD). METHODS:This retrospective study included 624 CVD patients diagnosed from January 2023 to January 2025. Patients were grouped according to the New York Heart Association (NYHA) classification into mild (I-II) and severe (III-IV) cardiac insufficiency groups. Genome-wide methylation level, hypermethylation proportion, and "risk-type cfDNA" (defined by hypermethylation of cardioprotective gene promoters and hypomethylation of injury-promoting gene promoters) were assessed. Logistic regression, Random Forest, and XGBoost models were constructed to identify predictors of severe cardiac dysfunction. RESULTS:Severe cardiac dysfunction was significantly associated with higher genome-wide methylation levels, hypermethylation proportion, and risk-type cfDNA (all P < 0.05). cfDNA concentration was an independent protective factor for endpoint events (OR = 0.946, 95% CI: 0.893-0.997, P = 0.0443). The combined model (cfDNA + left ventricular ejection fraction [LVEF] + N-terminal pro-brain natriuretic peptide [NT-proBNP] + age) achieved an area under the ROC curve (AUC) of 0.994. Machine learning models identified age, cfDNA concentration, and LVEF as the top three predictors of severe cardiac dysfunction. CONCLUSION:Epigenetic characteristics of cfDNA are closely associated with the severity of cardiac dysfunction in CVD patients and may serve as effective noninvasive molecular markers for cardiac function stratification. Integrating cfDNA epigenetic features with traditional clinical indicators significantly improves risk prediction accuracy.
OBJECTIVE:To evaluate the effects of Hegu (LI4) induced by two acupuncture stimulation techniques in healthy females using Shear Wave Elastography (SWE). METHODS:Forty-five right-handed healthy females were recruited in this study. Participants first received "Lifting-Thrusting" acupuncture stimulation (LT AS) at the right LI4 acupoint, followed by "Shaoshanhuo" acupuncture stimulation (SSH AS) at the left LI4 two weeks later. De-qi responses were measured using a professional data collection platform (Wenjuanxing). Muscle and fascia stiffness at the Hegu acupoint were assessed using SWE, and blood flow of the first dorsal metacarpal arteries (FDMA) was measured using Color Doppler Flow Imaging (CDFI) at three time points: before intervention (T0), 1 minute after intervention (T1), and 5 minutes after intervention (T2). Quality of life was evaluated using the 36-Item Short Form Health Survey (SF-36). RESULTS:Compared with the LT AS, SSH AS induced stronger acupuncture sensation and greater expansiveness. SWE measurements demonstrated significant differences between the two acupuncture techniques in muscle and fascia stiffness, although these differences were not time-dependent. CDFI showed a transient increase in peak systolic velocity (PSV) and resistance index (RI) of the FDMA, which then recovered; end-diastolic velocity (EDV) and S/D ratio did not show significant changes. Infrared thermal imaging showed a decrease in the initial temperature, followed by acupuncture-induced elevation, with significant differences over time and between groups. Both acupuncture stimulation methods contributed to comparable SF-36 scores. CONCLUSION:Although the two acupuncture stimulation methods (LT AS and SSH AS) differ in terms of acupuncture sensation and de-qi spread, they show similar temporal patterns regarding their effects on muscle/fascia stiffness, FDMA hemodynamics, and quality of life. However, the integrated effects differ significantly between the two techniques.
Postoperative cognitive dysfunction (POCD) is associated with neuroinflammation and oxidative stress, but the underlying mechanisms remain unclear. Resveratrol (RES), a natural polyphenol, has shown neuroprotective potential; however, its effects on microglial injury related to postoperative neuroinflammation have not been fully characterized. In this study, potential shared targets of RES and POCD were first explored using network pharmacology, followed by experimental validation using an LPS-stimulated HMC3 microglial cell model. HMC3 cells were treated with LPS (1000 ng/mL) and RES (50 µM), either with or without the NRF2 inhibitor ML385 (1 µM). Cell viability, proliferation, apoptosis, ROS production, and NRF2-related markers were assessed using CCK-8, EdU staining, flow cytometry, qPCR, Western blotting, and immunofluorescence. Network pharmacology suggested that apoptosis- and NRF2-related antioxidant pathways may be involved in the effects of RES. LPS reduced cell viability and proliferation and increased apoptosis, ROS production, BAX expression, and Caspase-3-related expression. RES partially reversed these changes, increased NRF2, HO-1, and SOD2 expression, and decreased KEAP1 expression under LPS-stimulated conditions. These RES-associated effects were partly weakened by ML385. Overall, RES may attenuate LPS-induced oxidative stress and apoptosis in HMC3 microglial cells, partly involving NRF2-related signaling. This study provides in vitro evidence supporting the potential protective role of RES in microglial injury related to postoperative neuroinflammation.
OBJECTIVES:To compare perioperative outcomes, complications, aesthetic results, and patient-reported satisfaction among breast-conserving surgery (BCS), endoscopic nipple-sparing (ENS) mastectomy with immediate implant-based reconstruction, and open nipple-sparing (ONS) mastectomy, and to identify factors independently associated with aesthetic outcome. METHODS:This retrospective study included 160 early-stage breast cancer patients (BCS=100, ENS=30, ONS=30). Perioperative outcomes, complications classified according to the Clavien-Dindo system, oncologic safety, aesthetic scores, and BREAST-Q domains were analyzed. Multivariable regression analysis was performed to identify predictors of aesthetic outcomes. A 1:1 propensity score-matched sensitivity analysis (30 pairs) was conducted, which confirmed significantly reduced blood loss in the ENS group (P<0.001), and showed a numerical but non-significant difference in aesthetic scores (P=0.088). RESULTS:The ENS group had the longest operative time (159.2 min), whereas the ONS group experienced the greatest intraoperative blood loss (72.5 ml). Patients in the BCS group had the shortest drainage and hospital stay (both P<0.001). The overall complication rates were 7.0% in BCS group, 20.0% in the ENS group, and 16.7% in the ONS group. Aesthetic scores were highest in the BCS group (84.9), followed by the ENS group (79.2) and the ONS group (75.8) (all P<0.001). BREAST-Q scores demonstrated a similar pattern. No significant differences were observed among groups regarding margin positivity or short-term recurrence. Multivariable analysis identified surgical approach, complications, and tumor location as independent predictors of aesthetic outcomes. CONCLUSION:BCS remains the preferred option for eligible patients with early-stage breast cancer. For patients unsuited to BCS, ENS is associated with significantly lower intraoperative blood loss than ONS. While aesthetic scores showed a favorable trend in the ENS group, this difference did not reach statistical significance in the propensity score-matched analysis.
OBJECTIVE:To investigate the clinical value of image-guided radiotherapy (IGRT) in reducing setup errors and acute radiation-induced adverse reactions in patients with head and neck tumors. METHODS:A retrospective analysis was conducted on 87 patients who underwent radiotherapy for head and neck tumors. Patients were divided into an IGRT group (n = 45) and a control group (n = 42). Setup errors, acute adverse reactions, and treatment completion rates were compared between the two groups. RESULTS:Compared with the control group, the IGRT group demonstrated significantly smaller setup errors in all directions (P < 0.001) and lower incidences of ≥ Grade 2 dermatitis (24.4% vs. 45.2%, P = 0.041), ≥ Grade 3 mucositis (20.0% vs. 40.5%, P = 0.036), and ≥ Grade 2 xerostomia (17.8% vs. 38.1%, P = 0.033). The treatment completion rate was higher in the IGRT group (P = 0.045). CONCLUSION:IGRT effectively reduces setup errors, decreases the incidence of moderate to severe acute adverse reactions, and improves treatment completion rates in radiotherapy for head and neck cancers, demonstrating favorable clinical practicality.
OBJECTIVE:To evaluate serum C-reactive protein (CRP) and blood lactate levels in elderly patients with Chronic Obstructive Pulmonary Disease (COPD) complicated by acute lower respiratory tract infection (ALRTI). METHODS:A total of 265 elderly COPD patients (age ≥ 65 years) were retrospectively analyzed. According to the presence of ALRTI, patients were divided into an ALRTI group (n = 160) and a non-ALRTI group (n = 105). Serum CRP and blood lactate levels were measured within 24 hours of admission. RESULTS:Compared with the non-ALRTI group, the serum CRP and lactate levels were significantly higher in the ALRTI group (both P < 0.01). Elevated CRP (OR = 3.22) and blood lactate (OR = 2.78) were independent risk factors for ALRTI. Both markers were positively correlated with Confusion, Urea, Respiratory rate, Blood pressure, Age ≥ 65 years (CURB-65) score (r = 0.452 and r = 0.387, both P < 0.001). The area under the receiver operating characteristic (ROC) curve (AUC) for the combination of CRP and lactate in predicting intensive care unit (ICU) admission was 0.835 [95% confidence interval (CI): 0.782-0.888], which was superior to either marker alone. CONCLUSION:Serum CRP and lactate levels are significantly elevated in elderly COPD patients complicated with ALRTI and are associated with disease severity. Their combined detection may improve the identification of high-risk patients and prediction of ICU admission.
OBJECTIVE:To investigate the predictive value of uterine artery hemodynamic parameters for missed abortion and to develop and validate a multimodal prediction model for clinical use. METHODS:This retrospective study included 162 women with missed abortion and 812 women with normal early pregnancy from January 2023 to May 2024. Baseline clinical characteristics, including age, body mass index (BMI), and history of miscarriage, together with uterine artery Doppler parameters, including pulsatility index (PI), resistance index (RI), peak systolic velocity (PSV), and end-diastolic velocity (EDV), were collected from medical records. Group differences were analyzed using the t-test, Mann-Whitney U test, and chi-square test. Logistic regression was used to identify independent risk factors. A nomogram was constructed and evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). The cohort was randomly divided into training and validation sets at a ratio of 7:3. RESULTS:The missed abortion group had significantly higher PI, RI, PSV, and EDV values than the normal pregnancy group (all P < 0.001). Among the four hemodynamic parameters, PI showed the best predictive performance, with an area under the curve (AUC) of 0.838. Multivariate logistic regression identified age, BMI, history of miscarriage, PI, RI, PSV, and EDV as independent predictors of missed abortion (all P < 0.05), with PI showing the strongest predictive value (odds ratio [OR] = 13.784). The nomogram achieved an AUC of 0.908 (95% confidence interval [CI]: 0.882-0.935) in the training set and 0.873 (95% CI: 0.819-0.927) in the validation set, with good calibration and clinical utility. CONCLUSIONS:Uterine artery hemodynamic parameters, particularly PI, are valuable predictors of missed abortion. The multimodal nomogram demonstrated good predictive performance and may assist in early risk stratification and individualized clinical management.
BACKGROUND:To investigate the predictive value of Endothelial Activation and Stress Index (EASIX) for acute kidney injury (AKI) in hospitalized patients with multiple myeloma (MM). METHODS:This retrospective study included 352 MM patients admitted to our hospital between January 2020 and December 2024. Patients were divided into a training set (n = 248) and a validation set (n = 104) using a time-based split. Patients were further classified into AKI (training n = 52, validation n = 22) and non-AKI groups (training n = 196, validation n = 82) according to occurrence of AKI during hospitalization. Factors associated with the development of AKI in MM patients were identified using logistic regression analysis. The predictive performance of EASIX for AKI was assessed by receiver operating characteristic (ROC) curve analysis. RESULTS:In the training set, binary logistic regression analysis revealed that EASIX, International Staging System (ISS) stage, and bortezomib-lenalidomide-dexamethasone (VRD) chemotherapy regimen were independent factors influencing the development of AKI in MM patients during hospitalization (all P < 0.05). The area under the ROC curve (AUC) for EASIX predicting AKI was 0.897 (95% CI: 0.852-0.942). All 248 patients were followed up without loss to follow-up. The mortality rate was significantly different between the group with EASIX ≤ 3.16 (18.54%) and the group with EASIX > 3.16 (34.29%) (P < 0.05). Temporal validation in the time-split validation set confirmed higher EASIX in the AKI group (P < 0.001) and robust predictive performance (AUC = 0.893, 95% CI: 0.830-0.956), with consistent mortality differences between EASIX subgroups (P = 0.016). CONCLUSION:EASIX holds promise in predicting AKI in hospitalized MM patients, supporting its potential use in risk stratification and clinical decision-making.
OBJECTIVE:To explore whether the favorable association between weight loss and glycemic improvement in patients with obesity and type 2 diabetes mellitus (T2DM) is partially mediated by weight loss-induced changes in the hypothalamic-pituitary-thyroid (HPT) axis, including alterations in thyroid-stimulating hormone (ΔTSH), free triiodothyronine (ΔFT3), and free thyroxine (ΔFT4). METHODS:A total of 364 patients with obesity and T2DM who underwent bariatric surgery, glucagon-like peptide-1 receptor agonist (GLP-1RA) therapy, or standardized lifestyle intervention were enrolled in this retrospective real-world cohort study. Anthropometric, glycemic, and thyroid function indicators were measured at baseline and after a median follow-up of approximately 12 months. RESULTS:Weight loss interventions led to significant reductions in body weight, glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), and homeostatic model assessment for insulin resistance (HOMA-IR), as well as a significant increase in homeostatic model assessment for β-cell function (HOMA-β) (all P < 0.001). Serum TSH and FT3 levels decreased markedly after intervention (both P < 0.001), whereas FT4 levels remained stable (P = 0.542). Changes in TSH and FT3 were significantly correlated with changes in HbA1c (ΔTSH: r = 0.319, P < 0.001; ΔFT3: r = 0.135, P = 0.010). The HPT axis exerted a significant total indirect mediating effect of 10.7% on the association between weight loss and HbA1c improvement (P = 0.032), with ΔTSH contributing 5.5% and ΔFT3 contributing 5.2% of the total effect. Subgroup analysis showed that the indirect mediating effect was more prominent in patients with higher baseline TSH levels. CONCLUSION:Changes in thyroid axis markers, specifically reductions in TSH and FT3, significantly and indirectly mediate the improvement in glycemic control following weight loss interventions in T2DM patients. Although this mediating effect is modest in overall magnitude, it is augmented in individuals with elevated baseline TSH levels. These findings suggest a novel auxiliary mechanism underlying the metabolic benefits of weight loss mediated by HPT axis remodeling.
OBJECTIVES:Sex differences in propofol sensitivity have been reported, but their characterization remains inconsistent, particularly regarding their electroencephalographic (EEG) correlates. This study aims to elucidate sex-specific responses to propofol-induced loss of consciousness and to identify associated pharmacodynamic and EEG biomarkers for informing individualized clinical dosing. METHODS:Fifty-four surgical patients (28 males/26 females) undergoing elective procedures were enrolled in this prospective cohort study. Using the Schnider pharmacokinetic model, we administered target-controlled infusion of propofol with precise effector compartment targeting. Synchronized recordings of effect-site concentration (Ce) and prefrontal EEG activity were obtained at loss of consciousness (LOC) thresholds. RESULTS:Pharmacodynamic analysis revealed a significant reduction in Ce of propofol at LOC in females compared with males (3.1 vs 4.0 μg·ml-1). EEG analyses revealed sex-specific differences in neural oscillatory dynamics. Female participants exhibited enhanced alpha and delta oscillations. Sex-dependent coherence patterns were observed: male-predominant focal synchronization in the δ-θ band contrasting with female-biased distributed coherence across the θ-γ range. Both sexes exhibited comparable burst suppression indices (P > 0.05). CONCLUSION:Our findings demonstrate that females exhibit greater sensitivity to propofol-induced unconsciousness, as evidenced by a lower effect-site concentration, distinct enhancements in alpha and delta oscillations, and modified high-frequency coherence. These biomarkers offer robust evidence for sex-specific propofol dosing strategies, improving precision in anesthesia depth management and potentially mitigating overdose and awareness risks in female populations.
OBJECTIVE:To evaluate the combined use of Clopidogrel (CLO) and Atorvastatin (ATO) in patients with angina pectoris caused by coronary heart disease (CHD-AP), focusing on clinical effectiveness, safety, and contributing factors. METHODS:A total of 178 CHD-AP patients admitted to Shaanxi Provincial People's Hospital between October 2022 and October 2025 were retrospectively analyzed. Based on their medication regimens, patients were categorized int an ATO+Acetylsalicylic Acid (ASA) group (n=88), receiving ATO plus ASA therapy, and an ATO+CLO group (n=90), receiving ATO+CLO treatment. Inter-group comparative assessments included clinical efficacy, safety, cardiac function measurements, serum myocardial injury markers, lipid profile (high-/low-density lipoprotein cholesterol [HDL-C/LDL-C], triacylglycerol [TG], total cholesterol [TG]), and hemorheology indices (e.g., plasma viscosity, whole blood viscosity). Factors influencing therapeutic outcomes were further explored using multivariate analysis. RESULTS:The ATO+CLO group demonstrated higher overall clinical efficacy and comparable adverse reaction rates compared to the ATO+ASA group. Moreover, the ATO+CLO group showed greater improvement in cardiac function indices and HDL-C levels after treatment, as well as lower levels of various serum myocardial markers, LDL-C, TG, TC, and hemorheology indices compared to the ATO+ASA group. Multivariate analysis identified Canadian Cardiovascular Society (CCS) angina grading, cardiac index [CI], and medication regimen as independent predictors of therapeutic effects. CONCLUSION:The combination of CLO and ATO is effective and safe for CHD-AP patients, providing superior clinical benefits without increasing the risk of adverse reactions.
OBJECTIVE:To explore the predictive value of intraoperative oxygen delivery (DO2) and renal regional oxygen saturation (rSO2) during cardiopulmonary bypass (CPB) for cardiac surgery-associated acute kidney injury (CS-AKI) in neonates with congenital heart disease (CHD). METHODS:A total of 235 neonates who underwent CPB-assisted cardiac surgery were enrolled and divided into CS-AKI and non-CS-AKI groups according to the occurrence of postoperative CS-AKI. Perioperative clinical data, intraoperative DO2 and renal rSO2 as well as postoperative recovery indicators were collected. Binary logistic regression analysis was performed to screen independent risk factors for CS-AKI. Based on the independent predictors, a predictive nomogram was constructed and validated internally and externally. The predictive value of DO2 and rSO2 for CS-AKI was assessed. RESULTS:Aortic cross-clamp (ACC) time, DO2 at 5 minutes post-ACC (T2), DO2 at 5 minutes after aortic opening (T3), the minimum renal rSO2 during CPB (R_min), and renal rSO2 at CPB termination (R_post) were independent influencing factors for CS-AKI. The combined application of the above four DO2 and rSO2 indicators yielded the optimal predictive efficacy for CS-AKI, with an (AUC) of 0.924. The constructed nomogram exhibited good discriminatory power, and external validation confirmed its excellent predictive efficiency. CONCLUSION:ACC time, DO2 (T2, T3) and renal rSO2 (R_min, R_post) were independent determinants of CS-AKI in CHD neonates. The nomogram established based on these intraoperative oxygenation indices achieved superior predictive performance for postoperative CS-AKI.
Background: An imbalance in autophagy leads to persistent pulmonary vascular remodeling, resulting from impaired phenotypes of dysfunctional vascular smooth muscle cells in chronic thromboembolic pulmonary hypertension (CTEPH). Long non-coding RNA autophagy-promoting factor (APF) is an essential regulator of the miR188-3p/autophagy-related gene 7 (ATG7)/autophagy pathway in cardiomyocytes, but its role in CTEPH was uncertain. Methods: In paired vascular specimens from CTEPH patients, APF/miR-188-3p/ATG7 expression changes were explored. Primary human pulmonary artery smooth muscle cells (HPASMCs) freshly isolated from CTEPH lesion sites were used for biological validation We investigated the effect of APF on the growth, migration, invasion ability, and autophagy of HPASMCs. Regulatory interactions along this axis were also verified. Rescue assays a using miR-1883p inhibitor, ATG7 over-expression plasmids, and the autophagy inducer rapamycin were conducted to establish mechanistic connection. Results: APF and ATG7 were downregulated in CTEPH tissues, while miR-188-3p was upregulated. APF overexpression inhibited HPASMC proliferation, migration, and invasion but increased autophagy; APF knockdown showed the opposite effects. The pro-proliferative and pro-migratory behaviors induced by APF silencing or miR-188-3p upregulation were abrogated by inhibiting miR-188-3p or restoring ATG7, respectively. Reactivation of autophagy with rapamycin reversed the effects of APF silencing. Conclusion: The downregulation of APF in CTEPH promoted excessive proliferation, migration, and invasion in HPASMCs by inhibiting autophagy through the miR-188-3p/ATG7 axis. We highlight the APF/miR-188-3p/ATG7-autophagy pathway as a potential therapeutic target for CTEPH.
OBJECTIVES:Nutraceutical formulations with adaptogenic and androgen-supportive properties are increasingly being explored for improving endurance, muscle strength, and reproductive health. NS2128E03, a proprietary herbal blend, was evaluated through pre-clinical and clinical studies to establish its safety and efficacy. METHODS:Pre-clinical studies in Sprague Dawley rats assessed toxicity, sexual behavior, and hormonal modulation following oral administration of NS2128E03 at low and high doses for 50 days. A randomized, double-blind, placebo-controlled clinical trial was conducted in healthy adult males receiving NS2128E03 or placebo for 60 days alongside resistance training. Outcomes included muscle performance (cable pulldown, Mid Upper Arm Circumference [MUAC]), treadmill endurance, serum testosterone, and safety considerations. RESULTS:Pre-clinical findings showed that NS2128E03 significantly increased total and free testosterone in male rats, improved sexual behavior indices (mount frequency, intromission latency, ejaculatory latency), and enhanced physical endurance without adverse effects. Histopathologic examination of reproductive organs confirmed normal architecture, supporting safety. In the clinical trial, NS2128E03 supplementation produced statistically significant improvements in muscle strength (bench press, leg press, handgrip), treadmill endurance, and both total and free testosterone levels compared to placebo. Significant changes (P < 0.01) were also observed in recovery biomarkers [increased mechanistic Target of Rapamycin (mTOR), reduced lactate dehydrogenase (LDH), and Creatine kinase (CK)]. No adverse events or clinically meaningful laboratory abnormalities were reported. CONCLUSION:NS2128E03 is a safe and effective nutraceutical that enhances testosterone, improves reproductive indices in animals, and translates into improved strength, endurance, and recovery in humans.
OBJECTIVE:To investigate the variation in serum secreted frizzled-related protein 5 (SFRP5) levels among individuals with essential hypertension and its association with carotid atherosclerosis. METHODS:297 subjects were included: 77 with stage 1 hypertension, 73 with stage 2, 67 with stage 3, and 80 normotensive controls. Logistic regression analyses alongside receiver operating characteristic (ROC) curve examinations were used to determine the independent relationship and predictive significance of SFRP5 in relation to carotid atherosclerosis. The primary outcome measure was serum SFRP5 level. Secondary outcome measures included levels of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6), carotid intima-media thickness (CIMT), and incidence of carotid plaque. RESULTS:Serum SFRP5 levels decreased significantly with increasing hypertension severity and were lower in patients with carotid atherosclerosis (P<0.001). A strong inverse relationship was found between SFRP5 levels and carotid atherosclerosis (r = -0.67, P<0.001). Regression analysis revealed SFRP5 was an independent protective factor (adjusted OR = 0.673, 95% CI: 0.585-0.774, P<0.001) after adjusting for age, sex, body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), and hypertension grade. SFRP5's predictive capability for carotid atherosclerosis was indicated by an area under ROC curve of 0.902. CONCLUSION:Lower serum SFRP5 levels are associated with hypertension severity and heightened risk of carotid atherosclerosis in hypertensive patients. SFRP5 may be a biomarker for risk assessment and may also represent a promising therapeutic target. Additional studies are required to validate these results and unravel the underlying mechanisms.
OBJECTIVE:This study aims to investigate the mechanisms underlying reserpine-induced hypotension. METHODS:A rat model of hypotension was established by reserpine administration, followed by levodopa (L-DOPA) intervention. Arterial blood pressure, histopathologic changes in the heart and kidneys, the levels of norepinephrine (NE), the renin-angiotensin-aldosterone system (RAAS), and endothelial function markers were systematically evaluated. RESULTS:Reserpine significantly lowered blood pressure and caused myofibrillar disarray, tubular epithelial degeneration, and elevated biomarkers of cardiac and renal injury. These pathologic changes were attributable primarily to depletion of NE and dysregulation of vasoactive regulatory systems. L-DOPA treatment restored NE and vasoactive mediator levels and markedly ameliorated hypotension and cardiorenal injury. CONCLUSION:Reserpine induces hypotension and cardiorenal injury through suppression of the catecholamine system, accompanied by dysregulation of the RAAS and nitric oxide/endothelin (NO/ET) system, whereas L-DOPA attenuates these pathologic changes.
OBJECTIVE:To clarify the effects of flexible ureterorenoscopy (FURS) combined with holmium laser lithotripsy on surgical outcomes, postoperative pain (POP), and renal function (RF) for the treatment of ureteral calculi (UC) complicated by hydronephrosis (HN). METHODS:A total of 128 patients diagnosed with UC complicated with HN treated between February 2024 and December 2025 were enrolled in this retrospective study and divided according to surgical approach. Among them, 65 patients underwent FURS combined with holmium laser lithotripsy (FURS group), and 63 patients received conventional ureteroscopy (URS) combined with laser lithotripsy (URS group). The two groups were compared in terms of clinical efficacy, surgical metrics (intraoperative blood loss, operative time, one-time stone clearance success rate), hospitalization indicators (hospitalization duration and medical expenses), POP, renal function, routine urine test results, serum inflammatory markers, and postoperative complications. RESULTS:The FURS group exhibited a significantly higher overall treatment efficacy rate (P=0.035). Additionally, the FURS group had less intraoperative blood loss, a shorter operative time, and a shorter hospital stay (all P<0.001). In terms of postoperative recovery, patients in the FURS group experienced milder pain on postoperative days 1 (P=0.032) and 3 (P<0.001), with better preserved postoperative renal function (P<0.05), improved routine urine test indicators (P<0.05), lower serum inflammatory levels (P<0.05), and fewer total complications (P<0.001). No significant differences were observed between the two groups in the one-time stone clearance success rate and hospitalization expenses (all P>0.05). CONCLUSION:FURS demonstrated significantly superior clinical efficacy to conventional URS for the treatment of UC complicated by HN, with better surgical outcome and more safety.
Objective: To evaluate the predictive value of a thromboinflammatory signature integrating the Systemic Immune-Inflammation Index (SII) and routine coagulation markers for Hospital-Acquired Pneumonia (HAP) in patients with Traumatic Brain Injury (TBI). Methods: This retrospective study included two cohorts of patients with imaging-confirmed TBI: a development cohort (n=204) and an external validation cohort (n=80). Candidate predictors included demographic characteristics, Glasgow Coma Scale score, mechanical ventilation (MV), SII, and all routine coagulation markers, including prothrombin time (PT), activated partial thromboplastin time (APTT), international normalized ratio (INR), fibrinogen (FIB), and thrombin time (TT). Multivariable logistic regression was used to identify factors associated with HAP. Among patients who developed HAP, ventilator-associated pneumonia (VAP) was analyzed descriptively as an exploratory subgroup only. Results: In the development cohort, 76 of 204 patients (37.3%) developed HAP. Patients with HAP exhibited significant coagulation abnormalities, including elevated FIB. Multivariable logistic regression with collinearity diagnostics (VIF analysis) identified SII, FIB, and MV as independent predictors. The combined model demonstrated good discrimination (AUC=0.824) and maintained moderate performance in the external validation cohort (AUC=0.675). Conclusions: Admission SII, FIB, and MV are independently associated with HAP in patients with TBI. A combined model based on these variables retained original discrimination and nomogram performance for HAP. VAP-related observations are presented only as exploratory subgroup findings.
