BACKGROUND:The uc003pes.1 has been identified as a potential diagnostic biomarker for coronary artery disease (CAD) and is associated with the risk of CAD. However, the precise function and intricate mechanism of uc003pes.1 in CAD remain elusive. METHODS:To elucidate the underlying mechanism we employed various techniques including RNA pull-down assays coupled with mass spectrometry analysis, RIP, RNA MeRIP, as well as luciferase reporter gene analysis. RESULTS:Overexpression of uc003pes.1 suppressed the proliferation and migration of HCASMCs. The upregulation of uc003pes.1 can be attributed to m6A modification mediated by the methylase RBM15. In terms of downstream mechanisms, uc003pes.1 acts as a molecular scaffold facilitating the interaction between STAT1 and the USP10, thereby impeding ubiquitination degradation of STAT1 and promoting phosphorylation levels at Tyr701 and Ser727, ultimately influencing HCASMCs' proliferation and migration. CONCLUSION:Our study has discovered, for the first time, that uc003pes.1, regulated by m6A modification, functions as a molecular scaffold for STAT1 and USP10. This interaction plays a crucial role in regulating the proliferation and migration of HCASMCs, thereby offering novel insights into the diagnosis and treatment of CAD.

Arctigenin belongs to a major bioactive component of Fructus arctii and has been found with cardioprotective effects on rats with ischemia‒reperfusion (I/R) injury. The application of arctigenin is limited due to poor water solubility and low bioavailability. Hydrogel drug delivery systems can improve the efficacy and safety of drugs, increase drug utilization, and reduce side effects. We hypothesized that hydrogels containing arctigenin would facilitate the effect of arctigenin and alleviate I/R injury in the rat heart. Presently, adult Sprague-Dawley (SD) rats were subjected to 1 h of I/R injury, then hydrogels comprising arctigenin were implanted into the myocardium of rats. Triphenyl tetrazolium chloride staining, hematoxylin-eosin staining, and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling staining and Western blot were performed for evaluating the infarct size, histopathological, and vital protein alterations of hearts. It was discovered that the hydrogel combined with arctigenin abated apoptosis and reduced infarct size. In addition, the results of echocardiography and Masson staining suggested that the hydrogel with arctigenin improved cardiac function, restrained myocardial fibrosis, and activated AMP-activated protein kinase (AMPK) and sirtuin 1 (SIRT1). Collectively, the injectable hydrogel delivery system enhances the effect of arctigenin, which may play a protective role in I/R injury by activating AMPK and SIRT1.

N6-methyladenosine (m6A) is the most prevalent internal RNA modification in mammals. However, limited research has been conducted on the role of m6A in coronary artery disease (CAD). We conducted methylated RNA immunoprecipitation sequencing and RNA sequencing to obtain a genome-wide profile of m6A-modified long noncoding RNAs (lncRNAs) in human coronary artery smooth muscle cells either exposed to oxidized low-density lipoprotein treatment or not, and the characteristics of the expression profiles were explored using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses. The predictive effects of seven selected lncRNAs on CAD were evaluated in peripheral blood mononuclear cells (PBMCs). The differentially m6A-modified and expressed lncRNAs related genes were predominantly enriched in small GTPase-mediated signal transduction, ErbB signaling, and Rap1 signaling. Additionally, the expression levels of uc003pes.1, ENST00000422847, and NR_110155 were significantly associated with CAD, with uc003pes.1 identified as an independent risk factor and NR_110155 as an independent protective factor for CAD. NR_110155 and uc003pes.1 in PBMCs have the potential to serve as biomarkers for predicting CAD.

Abstract OBJECTIVE: To investigate the correlation between fatty liver index (FLI) and estimated glomerular filtration rate (eGFR). METHODS: We analyzed the correlation between fatty liver index (FLI) and estimated glomerular filtration rate (eGFR) in a cohort of elderly people who underwent physical examination at the Medical Examination Center of the Affiliated Hospital of Yangzhou University from 01/01/2020 to 12/31/2020, collected relevant data, and calculated the fatty liver index and estimated glomerular filtration rate. RESULTS: A total of 7879 individuals were included in the analysis, and the results suggested that the probability of abnormal estimated glomerular filtration rate increased in the FLI≥30 group compared to the FLI<30 group, with abnormal estimated glomerular filtration rate of 66.37% and 62.19% in the two groups, respectively (P<0.001). Logistic regression analysis showed that the probability of abnormal estimated glomerular filtration rate increased by 0.7% for every 1 increase in FLI (OR=1.007, 95% CI 1.005-1.010, P<0.001). CONCLUSION: Elevated FLI is associated with an increased risk of abnormalities in their estimated glomerular filtration rate in an elderly population in Yangzhou.

OBJECTIVE:Disease-related skeletal muscle loss is highly prevalent among patients with Crohn's disease. Low skeletal muscle mass lead to disability and interventions to prevent skeletal mass loss as an effective strategy to prevent disability. The aim of this article was to identify the factor associated with skeletal muscle loss of Crohn's disease and seek for management target for the prevention of sarcopenia-related disability.METHODS:Patients with Crohn's disease were divided into low and normal skeletal muscle mass groups based on L3 skeletal muscle index using abdominal CT scans. The clinical and laboratory parameters and colonoscopy were compared between the two groups. Univariate and multivariate regression logistic models were built to identify the prognostic markers of Crohn's disease-associated muscle loss.RESULTS:A total of 191 Crohn's disease patients were enrolled in this study, of whom 116 (60.73%) were detected to have low L3 skeletal muscle index, including 71 (68.26%) males. The multivariate logistic regression analysis showed that age (OR: 1.031, 95%CI: 1.006-1.057), female gender (OR: 2.939, 95%CI: 1.386-6.233), disease duration (OR: 0.988, 95%CI: 0.980-0.996), endoscopic disease activity (simple endoscopic score for Crohn's disease) (OR: 0.923, 95%CI: 0.855-0.996), serum albumin (OR: 1.079, 95%CI: 1.009-1.154), and serum creatinine (OR: 1.037, 95%CI: 1.011-1.063) were associated with L3 skeletal muscle index among Crohn's disease patients.CONCLUSION:The gender, age, and duration of disease were uncontrollable factors associated with muscle loss of Crohn's disease. The treatment target of mucosal healing and improved nutritional status may be beneficial for maintaining muscle mass among Crohn's disease patients.

炎症性肠病(IBD)是一种慢性、复发性的非特异性肠道炎症疾病,肌少症是IBD的并发症之一,可降低患者的治疗效果和生活质量,导致骨折、身体功能下降等不良结局.肌少症的发生、发展与IBD在进程上一致,且两者相互影响、相互作用.肌少症在IBD患者中有较高的发病率,但在临床上很容易被忽视,且目前发病机制尚不明确.基于此,现针对IBD合并肌少症的流行病学与诊断、发病机制、干预和治疗方法展开综述,为临床预防IBD合并肌少症的发生提供有价值的理论参考.

目的 探讨胸部CT单一层面影像上测量的骨骼肌指数对慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)因呼吸衰竭需要机械通气患者预后的预测价值.方法 回顾性分析2013年2月至2018年12月扬州大学附属医院收治的386例因呼吸衰竭需机械通气的AECOPD患者的临床及影像学资料.所有患者随访至2019年10月31日.根据30d预后情况分为存活组(279例)和死亡组(107例),比较两组患者的年龄、性别、临床资料及第8胸椎水平骨骼肌指数(skeletal muscle index at the 8th thoracic vertebra level,T8SMI)、第12胸椎水平背部肌群骨骼肌指数(the dorsal muscle index at the 8th thoracic vertebra level,T12DMI)等影像学指标.通过logistic回归及Cox风险比例模型分析AECOPD机械通气患者30d及长期预后的预测因子.结果 存活组与死亡组患者的年龄、格拉斯哥评分、急性生理与慢性健康评分Ⅱ评分、有创机械通气、白细胞计数、中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值、C反应蛋白、T8SMI、T12DMI组间差异均有显著性.Logistic多因素回归分析显示,T8SMI、T12DMI均可独立预测AECOPD机械通气患者的30d预后.Cox风险比例模型多因素分析显示,校正年龄、性别等因素后,T8SMI、T12DMI仍可独立预测AECOPD机械通气患者的长期预后.结论 通过胸部CT测量的骨骼肌指数T8SMI、T12DMI可独立预测AECOPD机械通气患者的30d及长期预后.

Background: Many studies have been done regarding perforation after colonoscopy, but few studies analyzed the risk factors of endoscopic treatment failure after colonoscopy perforation. This study aimed to analyze the clinical characteristics and treatment plan of those patients with perforation after colonoscopy diagnosis and the treatment and risk factors of failure to endoscopic treatment. Method: This was a retrospective observational study of patients who underwent colonoscopy examination and treatment at the Affiliated Hospital of Yangzhou University, from 04/2009 to 03/2020. The patients were grouped as perforation, treatment success, or failure (required laparoscopy or laparotomy). Results: From April 2009 to March 2020, 43,470 patients were examined and treated with colonoscopy. There were 35 cases of intestinal perforation, for an incidence of 0.081%. Four patients had immediate surgical intervention (two patients with laparoscopic surgery and two with laparotomy surgery). Thirty-one (88.57%) patients underwent endoscopic treatment. Endoscopic treatment was successful in 20 patients and failed in 11. Compared with the failure group, the perforation size in the success group was smaller (7.60±4.85 vs. 14.4±7.03 mm, P=0.004), hospital stay was shorter (26.6±13.1 vs. 14.2±3.0, P=0.011), and hospitalization costs were lower (30,208±9506 vs. 23,053±6227 RMB, P=0.002). Multivariable logistic stepwise analysis showed that the absence of abdominal pain after therapeutic colonoscopy was independently associated with the success of endoscopic treatment. Conclusions: Endoscopic treatment is logically the preferred modality for perforation management, leading to good recovery, shorter hospital stay, and lower costs of treatment. Postoperative abdominal pain is significantly related to the failure of endoscopic treatment.

AbstractN6-methyladenosine (m6A) is the most common internal RNA modification in mammalian cells. Lots of previous studies have shown that m6A is strongly linked to the occurrence and development of diseases. However, studies on the role of m6A modifications in atherosclerosis are limited and the possible mechanism needs to be elucidated. In this study, we used MeRIP-seq and RNA-seq to obtain a genome-wide profiling of m6A-modified lncRNAs in the model of coronary atherosclerosis. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to verify the reliability of the data. Functional enrichment analysis uncovered that the associated genes of lncRNAs with different m6A levels were mostly enriched in the regulation of many crucial cell biological processes, including cytoskeletal rearrangement, cell cycle, and Rap1 signaling pathway which can affect the proliferation and migration of vascular smooth muscle cells (VSMCs). In summary, our study provided an expressed profile of lncRNA m6A in Human Coronary Artery Smooth Muscle Cells(HCASMCs), and we can infer that the methylation state of lncRNA may be essential for their function and offer a new direction for the treatment ofcoronary artery disease(CAD).

目的 探讨预后营养指数(PNI)预测老年重症COPD病人预后的价值. 方法 回顾性分析2016年1月至2019年12月扬州大学附属医院收治的132例老年重症COPD病人的临床资料,采用ROC曲线判断PNI与病人预后相关性并计算最佳截断值,通过电话回访病人入院6个月后是否生存,分为死亡组和存活组,比较2组病人临床指标.采用COX回归模型和Kalan-Meier曲线探究PNI与老年COPD重症病人生存不良预后的关系. 结果 最终纳入132例病人,死亡组72例,存活组60例,PNI的最佳截断值为37.32.多因素COX回归分析提示,年龄、PNI<37.32、住院总时间是老年重症COPD病人死亡的独立影响因素,当PNI<37.32时,老年重症COPD病人死亡风险为对照组的2.281倍. 结论 PNI对老年重症COPD病人预后有预测价值,PNI<37.32预示预后不良.

慢性阻塞性肺疾病(COPD)是一种复杂的、具有高度异质性的全身性疾病.肌少症作为COPD多种合并症中之一,能够加速疾病进程,增加致残率和全因死亡率.近年来研究发现,COPD合并肌少症的危险因素为活动受限、营养不良、脂肪沉积等.结合肺功能相关指标与肌肉测量技术能够较精确的预测住院患者生存率和死亡率,在此基础上进行个性化干预,对疾病转归和预后改善具有重大的临床意义.本文对COPD与肌少症的危险因素、诊断、干预治疗等方面进行综述.

目的 探讨miR-25 调控SERCA2a抗心肌缺血再灌注损伤的作用机制.方法 在H9c2 细胞系中转染miR-25 的mimic及inhibitor,运用Real-Time PCR、Western Blotting检测miR-25 和SERCA2a的变化趋势及细胞凋亡相关蛋白caspase-3 的表达水平,通过JC-1 线粒体膜电位测定、Annexin V APC／7AAD检测细胞凋亡情况,再通过双荧光素酶报告基因验证miR-25 与SERCA2a的靶向关系.结果 与I／R组相比,miR-25minic+I／R组中细胞活力明显下降,线粒体膜电位变化显著,凋亡明显增多,同时SERCA2a蛋白表达下调、Caspase-3蛋白表达上调(n＝6,P＜0.01);而在下调miR-25 的I／R组中凋亡蛋白Caspase-3较前减少,SERCA2a活性表达上调(n＝6,P＜0.01 ),流式细胞提示细胞凋亡减少(P＜0.01 ).双荧光素报告基因显示,转染miR-25mimic可以抑制SERCA2a报告基因的荧光素酶活性(P＜0.01 ).结论 miR-25 表达下调对抗H9c2心肌细胞系缺血再灌注损伤,其作用机制可能与靶向调控SERCA2a表达有关.

目的:探讨全结肠靛胭脂染色内镜在大肠癌高风险人群肠镜检查中的应用价值。方法:纳入500例准备接受结肠镜检查的大肠癌高危患者作为研究对象，采用随机数字表法将患者随机分为2组，对照组行常规肠镜检查，试验组行全结肠0.2%靛胭脂喷洒染色肠镜检查，主要对比分析2组间息肉、腺瘤患者的发现率。结果:研究期间72例因肠道准备差、肠镜检查失败、炎症性肠病、缺血性肠病等原因被剔除，最终共428例纳入数据分析，其中试验组209例、对照组219例，2组基线资料具有可比性。与对照组比较，试验组息肉发现率更高[61.2%(128/209)比43.8%(96/219)， P<0.001]，腺瘤发现率更高[35.9%(75/209)比26.0%(57/219)， P＝0.027]；且直径<5 mm息肉发现率试验组明显高于对照组[27.8%(58/209)比15.5%(34/219)， P＝0.002]，直径<5 mm腺瘤发现率试验组明显高于对照组[24.9%(52/209)比12.8%(28/219)， P＝0.001]。 结论:全结肠靛胭脂染色内镜用于大肠癌高风险人群的肠镜检查具有较好的应用价值，有助于提高结肠息肉、腺瘤的检出，尤其是小的结肠病变。

目的 探讨慢性阻塞性肺疾病急性加重期因呼吸衰竭入住ICU行有创机械通气治疗患者的预后影响因素.方法 纳入2013年2月至2019年5月扬州大学附属医院收治的因慢性阻塞性肺疾病急性加重导致呼吸衰竭入住ICU行有创机械通气治疗的患者167例,根据预后情况分为存活组和死亡组.比较两组患者的临床特点,探索影响预后的危险因素.将单因素分析差异有显著性的指标进行多因素logistic逐步回归分析,确定独立危险因素,通过受试者工作特征曲线确定连续性独立危险因素的最佳截断值.根据各个危险因素最佳预测值分组,并通过绘制Kaplan-Meier曲线观察危险因素对患者长期预后的影响,Log-rank检验分析生存曲线差异是否有显著性.结果 单因素分析显示,两组中性粒细胞/淋巴细胞比值(Z=-2.233,P=0.020)、血小板/淋巴细胞比值(Z=-1.987,P=0.047)、D-二聚体(Z=-2.989,P=0.003)差异有显著性.多因素分析显示,中性粒细胞/淋巴细胞比值(OR=1.029,P=0.008),D-二聚体(OR=1.212,P=0.027)为影响患者预后独立危险因素.中性粒细胞/淋巴细胞比值、D-二聚体预测死亡的最佳预测值分别为5.550、1.175mg/L.Log-rank检验显示,中性粒细胞/淋巴细胞比值(χ2=8.511,P=0.004)对患者长期生存有预测价值.结论 入住ICU 24h内中性粒细胞/淋巴细胞比值及D-二聚体是慢性阻塞性肺疾病急性加重期行机械通气患者ICU住院死亡的独立危险因素,而中性粒细胞/淋巴细胞比值对患者长期生存具有预测价值.

Low L3 skeletal muscle area (SMA), which is assessed on computed tomography (CT) images, has been reported to indicate poor clinical outcomes of patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). The dorsal muscle group area at the T12 vertebral level (T12DMA) was used as an alternative to L3 SMA. This study aimed to investigate whether T12DMA could be used as a predictor of in-hospital mortality and long-term survival in elderly patients with COPD admitted to the intensive care unit (ICU). This single-center retrospective case-control study was performed by analyzing the clinical information and measuring T12DMA on chest CT images of elderly patients with COPD admitted to the ICU between May 2013 and May 2018. This study included 136 patients. The multivariate logistic regression analysis showed that T12DMA, neutrophil-lymphocyte ratio, invasive mechanical ventilation, and systemic steroid therapy were independent risk factors for predicting the hospital mortality. The median survival was significantly higher in the high-T12DMA group (214 days) than in the low-T12DMA group (32 days).

目的 观察肥胖与非肥胖2型糖尿病患者血清几丁质酶-3样蛋白-1(YKL-40)水平差异及与胰岛素抵抗的相关性.方法 回顾性分析扬州大学附属医院2016年10月 ～2018年11月就诊的286例2型糖尿病患者的临床资料.按体质量指数(BMI)的不同分为2组,肥胖组患者144例(BMI≥28 kg/m2);非肥胖组患者142例(BMI 18.5～23.0 kg/m2),其中非肥胖组患者为经本院互联网慢病管理后减重为标准体质量的2型糖尿病患者.比较各组患者的血清YKL-40水平的差异,观察其与胰岛素抵抗指数(HOMA-IR)及其他相关指标的相关性.结果 肥胖组的YKL-40、糖化血红蛋白、HOMA-IR指数及脂肪细胞脂肪酸结合蛋白(A-FABP)明显高于非肥胖组(P<0.05).Pearson直线相关分析显示,BMI、腰围、HOMA-IR及A-FABP和血清YKL-40水平呈正相关关系(r=0.504,0.589,0.320,0.389,P<0.05).多重线性回归分析结果显示,在调整了相关变量因素后,BMI、腰围、HOMA-IR、A-FABP是影响血清YKL-40水平的独立相关因素(P<0.05).结论 与非肥胖2型糖尿病患者相比,肥胖糖尿病患者具有较高的血清YKL-40水平,而YKL-40水平也与胰岛素抵抗密切相关.

报道1例高龄患者的胆石性肠梗阻内科治疗的经过.

Objective. This study aims to investigate the effects of reporting colonoscopy findings and the regular review of outcomes on adenoma detection rates. Methods. Patients who underwent colonoscopy from August 2013 to February 2014 were selected as the intervention group. The preintervention group included patients who underwent colonoscopy from January 2013 to July 2013, in which the procedure sheet for this group of patients was not accomplished. The primary outcome was adenoma detection rate (ADR), and secondary outcomes included the success rate of intubation and withdrawal time. Results. This study included 2,467 cases: 1,302 cases in the intervention group and 1,165 cases in the preintervention group. There was no significant difference in demographic characteristics between the two groups. In the intervention group, withdrawal time of colonoscopy was longer (P < 0.01), and the success rate of intubation (92.5% versus 89.1%, p < 0.05) and detection rate of polyps (32.6% versus 27.6%, p < 0.05) and adenomas (20.0% versus 16.1%, p < 0.05) were higher. Significantly high detection rates for proximal adenomas, flat adenomas, and adenomas with a diameter < 5 mm were observed in the intervention group (all p < 0.01). Conclusion. The reporting and review of procedure details help to improve quality indicators of colonoscopy.

目的:探讨中西医结合治疗急性重度有机磷农药中毒的临床疗效,为相关临床治疗提供参考依据.方法:选取我院收治的90例急性重度有机磷农药中毒患者,随机分成研究组和对照组,对照组采用常规西医手段进行抢救治疗,研究组在对照组治疗基础上采用中西医结合的模式进行治疗,对比两组患者治疗后的临床疗效、卫生经济学指标及并发症情况.结果:研究组和对照组的治疗总有效率分别为95.6％和80.0％,两组差异具有统计学意义(P＜0.05);研究组在阿托品用量、患者住院时间、胆碱酯酶活性恢复时间等卫生经济学指标,以及并发症发生情况,均显著优于对照组(P＜0.05).结论:中西医结合治疗急性重度有机磷农药中毒疗效显著,有助于胆碱酯酶活性恢复,促进患者早日康复,减少并发症,值得临床推广使用.