Objective To investigate the effects of transcription factor AP-2α (TFAP2A) on the proliferation, migration, and invasion of endometrial cancer Ishikawa cells through the regulation of coactivator-associated arginine methyltransferase 1 (CARM1). Methods Bioinformatics analysis: The expression, correlation, and prognostic value of TFAP2A and CARM1 in endometrial cancer were analyzed based on TCGA and GTEx databases. The STRING database was used to predict their potential interactions. Clinical validation: RT-qPCR and Western blot were performed to detect the mRNA and protein expression of TFAP2A and CARM1 in human endometrial cancer tissues and normal endometrial tissues. Cell functional assays: Ishikawa cells were used as an in vitro model. RNA interference was employed to knock down TFAP2A or CARM1 expression. Cell proliferation, migration, and invasion were evaluated using CCK-8 assay, wound healing assay, and Transwell assay, respectively. Mechanistic validation: Chromatin immunoprecipitation (ChIP)-qPCR was conducted to verify the direct binding of TFAP2A to the promoter region of the CARM1 gene. Results Bioinformatics analysis showed that TFAP2A and CARM1 were both highly expressed in endometrial cancer tissues and exhibited a significant positive correlation. High expression of these genes were associated with shorter overall survival. Clinical sample validation further confirmed that the mRNA and protein expression of TFAP2A and CARM1 were significantly upregulated in endometrial cancer tissues compared with normal endometrial tissues. In vitro experiments demonstrated that knockdown of TFAP2A or CARM1 significantly inhibited the proliferation, migration, and invasion of Ishikawa cells. ChIP-qPCR results confirmed that TFAP2A directly binds to the promoter region of the CARM1 gene. Conclusions TFAP2A promotes the proliferation, migration, and invasion of endometrial cancer Ishikawa cells by binding to the promoter region of the CARM1 gene and activating its transcription. The TFAP2A-CARM1 axis may serve as a potential molecular target for understanding the pathogenesis of endometrial cancer and developing targeted therapeutic strategies.
Objective To analyze the clinical characteristics of patients receiving extracorporeal membrane oxygena-tion(ECMO)support and to investigate the pathogen distribution,composition,and risk factors of nosocomial infections during ECMO support.Methods A retrospective study was conducted on 144 patients who received ECMO support(du-ration≥48 h)at the Affiliated Hospital of Xuzhou Medical University from January 2022 to December 2025.According to whether nosocomial infection occurred during ECMO support,the patients were divided into an infection group(n=59)and a non-infection group(n=85).Clinical characteristics were compared between the two groups.Pathogen distri-bution and composition in the infection group were analyzed.Binary logistic regression was used to identify risk factors for nosocomial infection.Results The incidence of nosocomial infection during ECMO support was 40.97%(59/144).A total of 133 infection cases were reported in 59 infected patients,including 110 cases of lower respiratory tract infection(82.7%),18 cases of bloodstream infection(13.5%),and 5 cases of urinary tract infection(3.8%).Gram-negative bacteria were the predominant pathogens(110/133,82.7%),with Acinetobacter baumannii being the most frequently i-solated organism(46/133,34.6%).Binary logistic regression analysis showed that ECMO duration(OR=1.188,95%CI:1.075-1.314,P<0.001)was an independent risk factor for nosocomial infection during ECMO support.The length of ICU stay[22.0(10.5-29.5)days]and total length of hospitalization stay[25.0(14.0-37.0)days]were significantly longer in the infection group than the non-infection group[7.0(4.0-10.0)days and 15.0(9.0-19.0)days,respectively](P<0.05).However,there was no significant difference in 28-day mortality between the two groups(30.51%vs 31.74%,P>0.05).Conclusions Nosocomial infections are common during ECMO support,with lower respiratory tract infections being the most frequent.Acinetobacter baumannii is the predominant pathogen.ECMO duration is an independent risk factor for nosocomial infection.Although infection significantly prolongs ICU and overall hospital stay,it does not appear to affect 28-day mortality.
Objective To investigate the association between the axial length/corneal curvature radius (AL/CR) ratio and the risk of myopia in children and adolescents of different age groups, and to determine the critical values and diagnostic efficacy of AL/CR for myopia screening in these populations. Methods This was a cross-sectional study. A total of 213 children and adolescents aged 5-16 years who were admitted to Optometry Center, the Affiliated Hospital of Xuzhou Medical University from May 30, 2025 to September 30, 2025. After full cycloplegia, all participants underwent computerized refraction to record spherical equivalent (SE) values. Axial length (AL) and horizontal and vertical corneal curvatures (K1, K2) were measured using a biometer, and AL/CR values were calculated. Receiver operating characteristic (ROC) curves were plotted to determine the optimal AL/CR cutoff for myopia diagnosis and its screening performance. Pearson and Spearman correlation analyses were used to assess the association between AL/CR and SE. Results Among the participants, 99 were male and 114 were female, with no significant differences in sex distribution. Overall ROC analysis demonstrated good diagnostic value of AL/CR for myopia (AUC=0.925, 95%CI: 0.891-0.960). For the 5-7 years group (n=63), the optimal AL/CR cutoff was 3.004, with a sensitivity of 0.714, a specificity of 0.929, AUC=0.887, and correlation coefficient r=-0.837. In the 8-11 years group (n=90), the optimal cutoff was 3.082, with a sensitivity of 0.726, a specificity of 0.964, AUC=0.930, r=-0.836. For the 12-16 years group (n=60), the optimal cutoff was 3.181, a sensitivity of 0.800, a specificity of 0.900, AUC = 0.936, r=-0.846. In hyperopic eyes, AL/CR was highly correlated with SE (r=-0.782); in low-and moderate-myopic eyes, correlations were moderate (r=-0.538, -0.517); in emmetropic eyes, the correlation was weak (r=-0.112). Conclusions AL/CR has high diagnostic value for myopia screening in children and adolescents, outperforming AL alone. The optimal cutoff for diagnosing myopia increases with age. Across different ages and refractive statuses, the correlation between AL/CR and SE is stronger than that between AL and SE.
Objective To investigate the correlation between postoperative prostate specimen density and positive surgical margins in patients undergoing radical prostatectomy for prostate cancer, and to provide reference for clinical assessment of postoperative recurrence risk and optimization of subsequent treatment strategies. Methods A total of 153 patients who underwent robot-assisted radical prostatectomy for prostate cancer at Northern Jiangsu People's Hospital from November 2023 to August 2025 were retrospectively selected. Clinical baseline data were collected, including age, postoperative prostate specimen weight and volume, postoperative Gleason score, operation duration, intraoperative blood loss, prostate-specific antigen (PSA), clinical T stage, and extracapsular extension. Postoperative specimen weight (with seminal vesicles removed) was measured using an electronic balance (precision: 0.01 g). Specimen volume was determined using the water displacement method (the specimen was fully submerged in a graduated cylinder filled with normal saline, and the increase in liquid volume was recorded). Specimen density was calculated as weight/volume (g/cm3). Positive surgical margin status was determined based on pathological examination of the surgical specimen (defined as cancer cells observed at the inked resection margin under microscopy). Spearman correlation analysis was used to assess the relationship between prostate specimen density and positive surgical margins. Multivariate logistic regression was performed to identify independent risk factors for positive surgical margins. Results Among the 153 patients, 37 (24.2%) had positive surgical margins and 116 (75.8%) had negative margins. A statistically significant difference in prostate specimen density was observed between the positive and negative margin groups (t=-6.96, P<0.001). Spearman correlation analysis showed that prostate specimen density was positively correlated with positive surgical margin rate (r=0.462, P<0.001). Multivariate logistic regression analysis indicated that Gleason score and specimen density were independent risk factors for positive surgical margins after radical prostatectomy. Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for prostate specimen density (AUC=0.812) was slightly higher than that of the Gleason score (AUC=0.801). The optimal cutoff values were 1.111 g/cm3 and 2.50, respectively (corresponding to ISUP grade≥3). Conclusions Prostate specimen density after radical prostatectomy is significantly positively correlated with positive surgical margins and serves as an independent risk factor. In clinical practice, postoperative prostate specimen density combined with Gleason score and other indicators may help predict the risk of positive surgical margins in patients after radical prostatectomy.
Objective To investigate the effect of epidural labor analgesia(ELA)on postpartum pelvic floor func-tion in primiparous women undergoing vaginal delivery.Methods A total of 100 primiparous women who delivered at Nanjing First Hospital,Nanjing Medical University between January 2023 and February 2025,and underwent pelvic floor assessment at postpartum 6-8 weeks were selected and their clinical data were retrospectively analyzed.According to the administration of ELA during delivery,the participants were divided into two groups:an analgesia group(n=50)and a non-analgesia group(n=50).Their general maternal characteristics,delivery-related indicators,and postpartum pelvic floor function parameters were compared between the two groups.Results ①There were no statistical differences between the two groups in terms of age,gestational weeks,pre-pregnancy body mass index(BMI),gestational weight gain,and newborn birth weight(P>0.05).②Compared with the non-analgesia group,the first stage,second stage,and total du-ration of labor were significantly prolonged in the analgesia group(P<0.05).③There were no statistically significant differences between the two groups in terms of episiotomy rate and artificial rupture of membranes,fetal distress,meconi-um-stained amniotic fluid,and postpartum hemorrhage rate(P>0.05).④Postpartum pelvic floor electromyography showed that the electrical activity values of both type I and type II muscle fibers decreased compared with prepartum val-ues in both groups,with a more pronounced reduction observed in the analgesia group;however,the difference was not statistically significant(P>0.05).Pelvic floor ultrasonography revealed no pelvic floor muscle injury in either group.Nevertheless,increased bladder neck mobility,opening of the posterior vesicourethral angle during the Valsalva maneu-ver,and enlargement of the levator hiatus area were commonly observed in both groups,with no statistical differences(P=0.078).The incidences of urinary incontinence and uterine prolapse were lower in the non-analgesia group than in the analgesia group,with no statistical differences(P>0.05).Conclusions Although epidural labor analgesia prolongs labor duration and increases oxytocin use,the overall labor process remains within the normal range.ELA does not in-crease the risk of adverse maternal and neonatal outcomes or postpartum pelvic floor dysfunction.Vaginal delivery is asso-ciated with a decline in postpartum pelvic floor muscle contractile function.Therefore,early pelvic floor rehabilitation training is essential to protect and restore maternal pelvic floor function.
Objective To investigate the association between neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) and cardiovascular autonomic neuropathy (CAN) in patients with type 2 diabetes mellitus (T2DM), and to evaluate their predictive value. Methods A total of 728 T2DM patients who were hospitalized in the Affiliated Suqian Hospital of Xuzhou Medical University between January 2023 and April 2025 were enrolled. All participants were assessed for CAN using cardiovascular autonomic reflex tests (CARTs) and then divided into a CAN group (n=352) and a non-CAN group (n=376). Clinical characteristics and laboratory parameters were compared between the two groups. Spearman correlation analysis was used to assess the relationships between NLR, PLR, MLR, and CART parameters. Logistic regression analysis was performed to identify independent risk factors for CAN. Receiver operating characteristic (ROC) curve analysis and area under the curve (AUC) were used to evaluate the predictive performance of NLR and PLR for CAN in T2DM patients. Results Compared with the non-CAN group, patients in the CAN group had significantly higher age, duration of T2DM, glycated hemoglobin (HbA1c), NLR, PLR, and MLR levels, as well as higher prevalence of hypertension, coronary heart disease, diabetic nephropathy, diabetic retinopathy, and diabetic peripheral neuropathy (all P<0.05). In contrast, alanine aminotransferase levels were significantly lower in the CAN group (P<0.05). Spearman correlation analysis showed that NLR, PLR, and MLR were negatively correlated with deep breathing heart rate variability, Valsalva ratio, and 30∶15 R-R interval ratio (r<0, all P<0.05). Logistic regression analysis demonstrated that NLR, PLR, age, duration of T2DM, HbA1c, and diabetic retinopathy were independent risk factors for CAN in T2DM patients. ROC curve analysis showed that the AUCs of NLR, PLR, and their combination for predicting CAN were 0.775, 0.720, and 0.783, respectively. Conclusions NLR and PLR are closely associated with the occurrence of CAN in T2DM patients and have potential predictive value. Their combined assessment further improves predictive performance.
Objective To compare the prognostic performance of cystatin C(Cys C)cut-off values determined by seven different methods-mean,mode,median,tertiles,upper limit of normal reference range,receiver operating charac-teristic(ROC)curve,and X-tile software-in patients with clear cell renal cell carcinoma(ccRCC).Methods It was a retrospective study.ccRCC patients who underwent surgery at Department of Urology,the Affiliated Hospital of Xuzhou Medical University,from 2013 to 2021 were enrolled and their clinical,pathological,and follow-up data were collected.The above seven methods were applied to determine the corresponding prognostic cut-off values of preoperative serum Cys C,and the patients were grouped into high and low levels based on these cut-off values.Then,Kaplan-Meier,Log-rank,and Cox proportional hazards regression models were used to assess the impact of each cut-off value and other clinical variables on overall survival(OS).Model performance and stability were evaluated by concordance index(C-index),ROC curves,calibration curves,and decision curve analysis,and internal validation was performed by the Bootstrap method.Results A total of 820 patients were included,including 541 males(65.98%)and 279 females(34.02%).The Cys C cut-off values determined by the seven methods were:mean 0.87 mg/L,mode 0.77 mg/L,me-dian 0.83 mg/L,tertiles 0.77 mg/L(P33.3)and 0.91 mg/L(P66.7),upper limit of normal reference range 1.15 mg/L,ROC 0.88 mg/L,and X-tile 1.07 mg/L.Multivariate Cox analysis indicated that high serum Cys C defined by the upper limit of normal reference range,ROC curve,and X-tile methods were independent risk factors for OS in ccRCC patients[upper limit of normal reference range:HR=2.87(95%CI:1.50-5.47),P=0.001;ROC curve:HR=1.78(95%CI:1.10-2.88),P=0.020;X-tile:HR=2.47(95%CI:1.41-4.33),P=0.002].Model performance testing showed that Cox proportional hazards models based on these three methods had high predictive performance and low over-fitting after internal validation using Bootstrap.Conclusions Cys C is an effective prognostic biomarker for patients with ccRCC,but its predictive performance depends on the method used to determine the cut-off value.Cut-off values deter-mined by the upper limit of normal reference range,X-tile,and ROC curve methods are preferred strategies.
Objective To investigate the effects of initiating esmolol after fluid resuscitation on physiological parameters and clinical outcomes in patients with sepsis-associated tachyarrhythmia. Methods A total of 76 septic patients with tachyarrhythmia who received esmolol treatment in the Intensive Care Unit (ICU) of the Affiliated Hospital of Xuzhou Medical University from January 2023 to June 2025 were selected and their clinical data were collected for retrospective analysis. According to whether fluid resuscitation had been achieved at the time of esmolol initiation [defined as mean arterial pressure (MAP) ≥65 mmHg, lactate reduction ≥10% from peak value, and urine output ≥0.5 mL·kg-1·h-1 sustained for ≥2 h], patients were divided into two groups: a completed resuscitation group (n=39) and an incompleted resuscitation group (n=37). Their eart rate, MAP, blood lactate, oxygenation index, cardiac biomarkers (N-terminal pro-B-type natriuretic peptide and high-sensitivity troponin T), and norepinephrine equivalent doses were compared before and after treatment at different time points. The length of ICU stay, total length of hospitalization stay, and 28-day mortality were also analyzed. A subgroup analysis based on left atrial volume index was performed to assess cardiac function. Results After treatment, heart rate in both groups decreased significantly and reached target levels (HR ≤ 100 beats/min, MAP ≥ 65 mmHg), with no intergroup difference. Compared with the incompleted resuscitation group, the completed resuscitation group showed lower lactate levels and better improvement in oxygenation index, but lower MAP (all P<0.05). Norepinephrine equivalent doses in the completed resuscitation group were lower than those in the incompleted resuscitation group from 12 h onward (P<0.05), and the median dose decreased to 0.00 after 24 h, accompanied by a shorter length of ICU stay (P<0.05). No statistically significant differences were observed in cardiac biomarkers or 28-day mortality between the two groups. In the subgroup with cardiac dysfunction, the completed resuscitation group had significantly lower lactate and N-terminal pro-B-type natriuretic peptide levels (P<0.05). Conclusions Initiating esmolol after completion of fluid resuscitation in septic patients with tachyarrhythmia improves short-term physiological outcomes, including lactate clearance, oxygenation, and vasopressor reduction, and shortens length of ICU stay. However, its impact on long-term prognosis, particularly 28-day mortality, requires further investigation.
Objective To investigate the clinical value of immunotherapy in patients with limited-stage small cell lung cancer(LS-SCLC)undergoing prophylactic cranial irradiation(PCI)and to identify risk factors associated with brain metastasis and survival outcomes.Methods A total of 103 LS-SCLC patients who received PCI at the Affiliated Hospital of Xuzhou Medical University between February 2016 and July 2024 were enrolled and their clinical data were retrospectively analyzed.According to whether they received immune checkpoint inhibitors(ICIs),patients were divided into a PCI+ICI group(n=42)and a PCI group(n=61).Survival outcomes and the occurrence of brain metastasis were analyzed using the Kaplan-Meier method,and prognostic factors were evaluated using Cox proportional hazards regression models.Results The median follow-up duration for the entire cohort was 35.0 months(95%CI:30.5-39.5 months),and the median overall survival(mOS)was 28.0 months(95%CI:24.9-31.1 months).The median intracranial pro-gression-free survival(miPFS)in the PCI+ICI group was 28.0 months(95%CI:21.2-34.8 months),which was sig-nificantly longer than the 16.0 months(95%CI:12.9-19.1 months)observed in the PCI group(P=0.002).Com-pared with the PCI group,the PCI+ICI group achieved significantly prolonged mOS(34.0 vs.25.0 months,P<0.001)and median progression-free survival(mPFS)(23.0 vs.13.0 months,P=0.020).Cox multivariate analysis revealed that smoking history(HR=3.21,95%CI:1.04-9.90,P=0.042)and immunotherapy(HR=0.21,95%CI:0.06-0.75,P=0.016)were independent predictors of brain metastasis risk.Furthermore,smoking history(HR=2.36,95%CI:1.35-4.13,P=0.003)and immunotherapy(HR=0.33,95%CI:0.18-0.60,P<0.001)were identified as independent prognostic factors for overall survival.Conclusions For patients with LS-SCLC receiving PCI,the combina-tion of immunotherapy can reduce the risk of brain metastasis and significantly prolong iPFS,OS,and PFS.Smoking is an important adverse prognostic factor,emphasizing the need for strengthened smoking cessation interventions and long-term follow-up in clinical practice.
Objective To investigate the clinical manifestations, laboratory findings, electrophysiological characteristics, and magnetic resonance imaging (MRI) features of neurological disorders induced by nitrous oxide (N2O) abuse. Methods A retrospective analysis was conducted on the clinical data of 52 patients with neurological disorders caused by nitrous oxide abuse. Demographic characteristics, clinical manifestations, laboratory examination results, nerve conduction studies, and spinal cord and brain MRI findings were collected and analyzed. Results The mean age of patients with nitrous oxide abuse-related neurological disorders was 22 years. The average duration of nitrous oxide abuse was 11 months, and the mean interval between the last exposure to nitrous oxide and the onset of symptoms was (13.8±2.1) days. The most common clinical manifestations included limb numbness and weakness, gait abnormalities, and cognitive decline. Laboratory examinations revealed decreased serum vitamin B12 levels in 13 patients, elevated homocysteine levels in 42 patients, and megaloblastic anemia in 3 patients. Nerve conduction studies indicated sensorimotor neuropathy, predominantly affecting the lower extremities. Spinal cord MRI demonstrated bilateral hyperintense signals in the posterior columns on T2-weighted images in 28 patients, while brain MRI revealed white matter lesions in 6 patients. Conclusions Long-term nitrous oxide abuse can result in severe neurological disorders, particularly among young individuals. In neurological disorders associated with nitrous oxide abuse, homocysteine appears to be a more sensitive biomarker than serum vitamin B12. Nitrous oxide can cause severe sensorimotor neuropathy, predominantly involving the lower limbs. In addition to inducing lesions in the posterior columns of the spinal cord, nitrous oxide may also lead to cerebral white matter damage.
Objective To investigate the therapeutic effects of Mahuang Shengma Decoction on ulcerative colitis(UC)and its influence on gut microbiota through integrated network pharmacology prediction and animal experimental validation.Methods Network pharmacology was used to identify common targets between Mahuang Shengma Decoction and UC,followed by pathway enrichment analysis.Kunming mice were randomly divided into five groups:a control group,a model group,a low-dose Mahuang Shengma Decoction group,a high-dose group,and a 5-aminosalicylic acid(5-ASA)positive control group.Except for the control group,UC was induced in mice by rectal administration of 5%acetic acid.After modeling,each group received corresponding decoction or an equal volume of normal saline via gavage once daily for eight consecutive days.During the experiment,phenotypic changes in mice were recorded daily.After the final administration,mice were sacrificed;colon length was measured and histopathological damage of the colonic mucosa was evaluated.Gut microbiota composition in colonic contents was analyzed using 16S rRNA sequencing.Results Net-work pharmacology identified 111 common targets,mainly enriched in signaling pathways such as the mitogen-activated protein kinase(MAPK)pathway.Animal experiments showed that Mahuang Shengma Decoction effectively alleviated body weight loss and colon shortening in UC mice and significantly reduced colonic mucosal injury.Microbiota analysis indicated that the high-dose group exhibited significantly increased microbial diversity,with the overall community struc-ture approaching that of the control group.In terms of composition,the formula restored the imbalance between the phyla Bacteroidetes and Firmicutes,and significantly increased the abundance of beneficial genera such as Akkermansia and Ligilactobacillus.Conclusions Mahuang Shengma Decoction exerts therapeutic effects on UC mice by modulating inflam-mation-and immunity-related signaling pathways to restore gut microbiota balance.
Objective To investigate the predictive value of the neutrophil-to-lymphocyte ratio (NLR) for the prognosis of acute respiratory distress syndrome (ARDS). Methods We conducted a retrospective analysis of 159 ARDS patients admitted to the intensive care unit (ICU) from January 2021 to December 2023. Patients were categorized into a survival group (n=102) and a non-survival group (n=57) based on 28-day outcomes. Data collected included demographic characteristics, imaging features (focal or non-focal), neutrophil and lymphocyte counts and ratios, and 28-day mortality. NLR was calculated using neutrophil and lymphocyte counts obtained within 24 hours of ICU admission. Results NLR was significantly higher in non-survivors than in survivors (35.4 vs. 21.7, P<0.05). Receiver operating characteristic (ROC) curve analysis showed that NLR predicted 28-day mortality with an area under the curve (AUC) of 0.665 (95%CI:0.58-0.75). The optimal cutoff value was 15.84, corresponding to a sensitivity of 0.67 and a specificity of 0.64. When SOFA and APACHE Ⅱ scores were comined the predictive model's AUC increased to 0.701 (95%CI:0.620-0.782). Subgroup analysis revealed no significant difference in NLR between patients with focal and non-focal ARDS (P>0.05). Conclusions NLR is significantly elevated in ARDS non-survivors, while no significant difference was observed between different imaging subtypes. Combining NLR with SOFA and APACHE II scores improves the predictive value for 28-day mortality, providing practical reference for clinical prognosis assessment.
Objective To investigate the molecular mechanism by which securinine inhibits the proliferation and in-vasion of glioblastoma.Methods Network pharmacology was used to screen the common target genes between glioblasto-ma and securinine.Through in vitro cell experiments and an orthotopic xenograft model in nude mice,combined with cel-lular biological functional assays and molecular-level analyses,the effects and mechanisms of securinine on glioblastoma were evaluated.Results In vitro experiments demonstrated that securinine significantly inhibited the proliferation of glio-blastoma cells and induced apoptosis,while reducing the phosphorylation levels of phosphatidylinositol 3-kinase(PI3K),protein kinase B(AKT),and mammalian target of rapamycin(mTOR),thereby suppressing the activity of the PI3K/AKT/mTOR signaling pathway.In vivo experiments showed that securinine effectively slowed glioblastoma growth and prolonged the survival of tumor-bearing nude mice.Conclusions Securinine may inhibit glioblastoma growth through the PI3K/AKT/mTOR signaling pathway,providing experimental evidence for its potential development as a no-vel natural anti-glioblastoma agent and offering a new strategy for clinical treatment of glioblastoma.
Objective To analyze the epidemiological characteristics of high-risk human papillomavirus(HR-HPV)infection among women undergoing physical examinations in Xuzhou from 2018 to 2025.Methods HR-HPV gen-otyping results from 37 503 women undergoing physical examinations in Xuzhou were retrospectively collected.Partici-pants were grouped by age(20-29,30-39,40-49,50-59,≥60 years)and by year(2018-2019,2020-2022,2023-2025).Overall infection rates,proportions of single versus multiple infections,type distribution and ranking were calculated.Differences between groups were compared using the χ2 test.Results The overall HR-HPV infection rate was 9.18%;single infections accounted for 82.0%of positive cases,while multiple infections accounted for 18.0%.The predominant types were HPV52(1.845%),HPV58(1.248%),and HPV16(1.192%).Infection rates differed sig-nificantly among age groups(χ2=78.566,P<0.001),with the highest rate in women aged≥60 years(12.34%)and the lowest in those aged 30-39 years(8.02%).Infection rates over the different year groups first increased and then de-creased,with significant differences(χ2=28.146,P<0.001):9.46%in 2018-2019,10.18%in 2020-2022,and 8.53%in 2023-2025.Conclusions HR-HPV infection among women undergoing physical examinations in Xuzhou is at a moderate level domestically.Older women represent a high-risk group,and HPV52,HPV58,and HPV16 are the main prevalent types.Targeted optimization of screening strategies and vaccination programs is recommended.
Objective To investigate the relationship between eye,ear,nose,and throat(EENT)related neuro-logical signs and 90-day functional outcomes in stroke patients,and to construct and validate a prognostic prediction model integrating EENT signs.Methods A total of 575 patients with acute ischemic stroke who were admitted to the Second Affiliated Hospital of Xuzhou Medical University between January 2022 and June 2025 were enrolled for retrospec-tive analysis.Their demographic characteristics,routine clinical indicators,and EENT-related neurological signs at ad-mission were collected.The 90-day modified Rankin Scale(mRS)score was used as the outcome measure.Prediction variables were identified by logistic regression to construct a conventional prediction model,an EENT model,and a com-bined model.Four machine learning models were trained on a fixed training set and validated in the test set.Shapley ad-ditive explanations(SHAP)were used for interpretability analysis.Results Multivariate analysis showed that 24-hour post-thrombolysis NIH Stroke Scale(NIHSS)score,mRS score at admission,and aspiration pneumonia were independ-ent risk factors for poor 90-day outcomes(all P<0.05).The combined model demonstrated superior predictive perform-ance compared to individual models,with an area under the receiver operating characteristic curve(AUC)of 0.868.A-mong the machine learning models,the elastic net model based on combined features achieved the optimal predictive per-formance(AUC=0.842).SHAP analysis indicated that,in addition to conventional clinical indicators such as 24-hour post-thrombolysis NIHSS and mRS scores at admission,EENT-related indicators including 72-hour feeding method,oc-ular motility disorders,and vertigo also provided predictive value.Conclusions Integrating EENT-related neurological signs significantly improves the prediction performance of 90-day functional outcomes in stroke patients and offers a po-tential tool for assisting early risk stratification and individualized interventions.
Objective To investigate the correlation between prognostic nutritional index (PNI) and disease severity in patients with preeclampsia (PE). Methods A total of 646 pregnant women who were admitted to Department of Obstetrics, Xuzhou Maternal and Child Health Care Hospital between January 2021 and December 2023 were retrospectively enrolled. Among them, 395 patients had PE, including 125 cases of non-severe PE and 270 cases of severe PE according to disease severity; 97 patients had gestational hypertension, and 154 were healthy pregnant women. Baseline characteristics and clinical data were compared among the groups. Spearman correlation analysis was used to assess the correlation between PNI and disease severity in patients with PE. Multivariate logistic regression analysis was performed to identify factors associated with disease severity in PE patients. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of PNI for disease severity in PE. Results The pre-pregnancy body mass index (BMI) in the gestational hypertension group, non-severe PE group, and severe PE group was significantly higher than that in the healthy pregnancy group (all P<0.05). Compared with the gestational hypertension group and the non-severe PE group, patients in the severe PE group had a lower gestational age, lower serum albumin levels, and lower PNI values (all P<0.05). Spearman correlation analysis demonstrated that PNI was negatively correlated with disease severity in PE patients (r=-0.468, P<0.01). After adjustment for potential confounding factors, PNI remained negatively correlated with disease severity (r=-0.399, P<0.05). Multivariate logistic regression analysis revealed that maternal age was a risk factor for severe PE (OR=1.057, P<0.05), whereas gestational age and PNI were independent protective factors against disease severity (OR=0.647 and 0.769, respectively; both P<0.05). The area under the ROC curve (AUC) of PNI for predicting disease severity in PE was 0.790, with a sensitivity of 0.741, specificity of 0.752, and an optimal cut-off value of 40.475. Conclusions PNI is closely associated with disease severity in patients with preeclampsia and may serve as a useful indicator for predicting disease severity in PE.
Objective To investigate the molecular mechanism by which the deubiquitinase USP13 promotes the mi-gration and invasion of hepatocellular carcinoma(HCC)cells through stabilization of fibronectin 1(FN1).Methods The interaction between USP13 and FN1 and the regulatory effect of USP13 on FN1 protein stability were evaluated by co-immunoprecipitation(Co-IP),Western blot,ubiquitination assay,wound-healing assay,and Transwell migration/invasion assay.Rescue experiments were further conducted to verify the functional role of the USP13-FN1 axis in HCC cell migration and invasion.Results Co-IP assays demonstrated that USP13 interacts with FN1 in HCC cells.Function-al assays showed that USP13 overexpression significantly enhanced the migratory and invasive capacities of Huh7 and MHCC97H cells,whereas USP13 knockdown produced the opposite effects.Mechanistic studies revealed that USP13 re-duced the level of FN1 polyubiquitination and increased FN1 protein expression.In contrast,the catalytically inactive mutant USP13-C345A lost these regulatory effects.Further analysis indicated that USP13 primarily decreased K48-linked and K63-linked polyubiquitination of FN1.Rescue experiments showed that FN1 silencing under USP13-overex-pressing conditions significantly reversed the USP13-mediated enhancement of HCC cell migration and invasion.Conclu-sions USP13 promotes HCC cell migration and invasion by deubiquitinating and stabilizing FN1 protein.The USP13-FN1 axis may represent an important molecular mechanism underlying HCC invasion and metastasis and may serve as a potential therapeutic target.
Objective To investigate the expression of chaperonin-containing TCP1 subunit 7 (CCT7) in lung adenocarcinoma tissues and its effects on the proliferation, migration, and invasion of lung adenocarcinoma cells. Methods Immunohistochemistry (IHC) was performed to detect the expression of CCT7 in lung adenocarcinoma tissues and adjacent non-tumorous tissues. The human lung adenocarcinoma cell line H1299 was used as the experimental model. Stable CCT7-knockdown (sh-CCT7) and CCT7-overexpressing (OE-CCT7) cell lines were established through lentiviral transduction. Cell proliferation was assessed using CCK-8 and EdU assays. Cell migration and invasion abilities were evaluated using Transwell assays. In addition, Western blot analysis was conducted to determine the expression levels of epithelial-mesenchymal transition (EMT)-related proteins, including E-cadherin, Vimentin, and N-cadherin. Results The levels of CCT7 were significantly higher in lung adenocarcinoma tissues than in adjacent non-tumorous tissues. Knockdown of CCT7 in H1299 cells markedly inhibited cell proliferation, migration, and invasion, accompanied by increased expression of E-cadherin and decreased expression of Vimentin and N-cadherin. In contrast, overexpression of CCT7 produced the opposite effects. Conclusions CCT7 is highly expressed in lung adenocarcinoma tissues and promotes the proliferation, migration, and invasion of lung adenocarcinoma cells. Its underlying mechanism may be associated with the regulation of the epithelial-mesenchymal transition process.
Objective To investigate the correlation between serum neurotransmitter metabolites and glial cell line-derived neurotrophic factor (GDNF) in a Parkinson disease (PD) mouse model. Methods Subacute PD mouse models were established by intraperitoneal injection of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) in C57BL/6J mice (MPTP group), while control mice received equal volumes of normal saline (control group). Motor function was assessed using behavioral tests (rotarod test, pole test). The expression and distribution of tyrosine hydroxylase (TH) in the substantia nigra was observed by immunofluorescence. Serum GDNF levels were measured by ELISA. The relationship between GDNF levels and motor performance was evaluated by Pearson correlation analysis. Targeted neurotransmitter metabolites were analyzed by LC-MS/MS. Principal component analysis (PCA), partial least squares discriminant analysis (PLS-DA), and orthogonal PLS-DA (OPLS-DA) were used to analyze intergroup metabolic differences and identify differential metabolites. Metabolic pathways were analyzed based on SMPDB and other databases, and Pearson correlation analysis was used to evaluate the correlation between GDNF levels and differential metabolites. Results Compared with the control group, mice in the MPTP group showed decreased motor function, reduced TH distribution in the substantia nigra, and decreased serum GDNF levels. Pearson correlation analysis indicated that serum GDNF levels were positively correlated with time on the rotarod and negatively correlated with time to descend the pole. Serum neurotransmitter metabolite profiles were clearly separated between groups, and eight differential metabolites were identified: glutamate, glutamine, L-tryptophan, 5-hydroxyindole-3-acetic acid, kynurenic acid, γ-aminobutyric acid (GABA), L-tyrosine, and dopamine. In the MPTP group, glutamate, glutamine, L-tryptophan, 5-hydroxyindole-3-acetic acid, and kynurenic acid were upregulated, whereas GABA, L-tyrosine, and dopamine were downregulated. Pathway enrichment analysis revealed central roles for glutamate metabolism, the urea cycle, and ammonia recycling pathways (associated with eight or more pathways). Further Pearson correlation analysis showed that serum GDNF levels were significantly positively correlated with L-tyrosine and dopamine levels, and significantly negatively correlated with glutamate levels in both groups. In the MPTP group specifically, GDNF levels were significantly positively correlated with GABA and glutamine. Conclusions Serum GDNF levels in PD mice are positively correlated with motor function and with glutamine and GABA, but negatively correlated with glutamate. GDNF may improve motor symptoms in PD mice by regulating the glutamine-glutamate-GABA metabolic cycle.
Objective To investigate the effects of an exercise-nutrition-psychological-sleep multimodal interven-tion on perioperative skeletal muscle function and clinical outcomes in patients undergoing surgery for gastrointestinal tumors.Methods A total of 100 patients who were scheduled for laparoscopic resection of gastrointestinal tumors in De-partment of Gastrointestinal Surgery,the Affiliated Hospital of Xuzhou Medical University,between November 2024 and October 2025 were enrolled.According to the sequential random allocation method,patients were divided into two groups(n=50):an intervention group and a control group.After exclusion of 15 dropout cases,85 patients were ultimately se-lected,including 43 patients in the intervention group and 42 patients in the control group.The control group received routine perioperative management,whereas the intervention group received an additional 35-day multimodal intervention.Changes in skeletal muscle index(SMI)and function(handgrip strength,five-times sit-to-stand test,and 6-minute walking distance)before and after surgery were compared between the two groups.Postoperative gastrointestinal recover-y,nutritional and inflammatory indicators,complication rates,length and cost of hospitalization,Self-Rating Anxiety Scale(SAS)scores,Pittsburgh Sleep Quality Index(PSQI)scores,and Global Health Status(GHS)scores were also evaluated.Results There were no significant differences in baseline characteristics between the two groups(P>0.05).Compared with the control group,the intervention group showed significantly smaller declines in postoperative SMI,hand-grip strength,and 6-minute walking distance,as well as a smaller increase in five-times sit-to-stand time(P<0.05).The intervention group also had shorter times to first postoperative flatus and defecation(P<0.05).Furthermore,decrea-ses in nutritional indicators and increases in inflammatory markers were significantly less pronounced in the intervention group than in the control group(P<0.05).The intervention group exhibited lower complication rates,shorter length of hospital stays,less hospitalization costs,and greater improvements in SAS,PSQI,and GHS scores than the control group(P<0.05).Conclusions The exercise-nutrition-psychological-sleep multimodal intervention effectively attenuates postoperative skeletal muscle loss in patients with gastrointestinal tumors,accelerates gastrointestinal functional recovery,reduces excessive inflammatory responses and nutritional depletion,comprehensively improves clinical outcomes,and en-hances long-term quality of life.
