Objective To investigate the effect and mechanism of adenovirus-mediated overexpression of Sprouty RTK signaling antagonist 1 (SPRY1) on proliferation, apoptosis and autophagy in human hepatocellular carcinoma (HCC) cells. Methods The recombinant adenovirus vector Ad5-SPRY1 was constructed and used to infect human HCC cell lines Huh7 and Hep3B. Cells were divided into the control group (infected with Ad5-GFP) and the SPRY1 overexpression group (infected with Ad5-SPRY1). SPRY1 mRNA expression was detected by qPCR. Western blot assay was used to analyze the protein levels of SPRY1, c-MYC, BCL2 and autophagy-related proteins LC3Ⅰ/Ⅱ. Cell apoptosis was measured by flow cytometry with Annexin V-PE/7-AAD double staining. Autophagosome formation was observed by transmission electron microscopy (TEM), and autophagic flux was assessed using the Ad-mCherry-GFP-LC3B reporter system. Results After 48 hours of Ad5-SPRY1 infection in Huh7 and Hep3B cells, the expression levels of SPRY1 mRNA and protein were higher than those in the control group and the Ad5-GFP group (P<0.05). Flow cytometry analysis showed that after 24 hours of infection in Huh7 and Hep3B cells, the apoptosis rate in the Ad5-SPRY1 group was lower than that in the control group and the Ad5-GFP group (P<0.05). Western blot results showed that the expression levels of c-MYC and BCL2 proteins in the Ad5-SPRY1 group were higher than those in the control group and the Ad5-GFP group (P<0.05). Transmission electron microscopy observation revealed a large number of double-membrane autophagosome structures in the cytoplasm of the Ad5-SPRY1 group. Western blot results indicated that the expression level of LC3Ⅱ protein in the Ad5-SPRY1 group was higher than that in the control group and the Ad5-GFP group (P<0.05). Ad-mCherry-GFP-LC3B fluorescence assay showed that the number of yellow spots in the Ad5-SPRY1 group was higher than that in the control group and pcDNA3.1 group (P<0.05). Conclusion Adenovirus-mediated SPRY1 overexpression inhibits apoptosis and promotes autophagy in HCC cells, possibly through upregulation of c-MYC and BCL2 and enhancement of LC3-mediated autophagic flux. SPRY1 may represent a novel therapeutic target for hepatocellular carcinoma.

Objective To investigate the impact of miR-493-3p on high glucose-induced cardiomyocyte injury and apoptosis by regulating long noncoding RNA (lncCCAT2)/transcription factor 7-like 2 (TCF7L2) axis. Methods Diabetic cardiomyopathy (DCM) cell model (AC16) was established in vitro with high glucose (HG, 55 mmol/L glucose). Experimental grouping:the control group, the HG group, the si-RNA negative control group, the si-CCAT2 group, the RNA mimics negative control group, the miR-493-3p-mimics group, the miR-493-3p-mimics +Lentivirus negative control group and the miR-493-3p-mimics +LV-CCAT2 group. Cell viability and apoptosis rate were detected by CCK8 assay and flow cytometry. The levels of lactate dehydrogenase (LDH) and aspartate aminotransferase (AST) in cell culture medium and superoxide dismutase (SOD) in cells were detected by the kit methods. Dual luciferase reporter gene assay was used to verify the targeting relationship between miR-493-3p and lncRNA CCAT2. The expression of miR-493-3p, lncRNA CCAT2, β?catenin, TCF7L2, Caspase-3 and CyclinD1 genes were detected by RT-PCR. Western blot assay was used to detect the expressions of β-catenin (nuclear), β-catenin (Cytoplasm), TCF7L2, Caspase-3 and CyclinD1 proteins. Results Compared with the control group, miR-493-3p, OD₄₅₀ and SOD were decreased in the HG group, and levels of lncRNA CCAT2, LDH, AST, apoptosis rate, the expression levels of TCF7L2 mRNA and protein increased. Up-regulating miR-493-3p or knocking down the expression of lncRNA CCAT2 can antagonize the above changes (P<0.05). The double luciferase reporter gene experiment verified the relationship between miR-493-3p and CCAT2 and TCF7L2. Compared with the HG+miR-493-3p-mimics group, the TCF7L2, β-catenin (nuclear), downstream Caspase-3 and CyclinD1 mRNA and protein expression were increased in the HG+miR-493-3p-mimics+LV-CCAT2 group (P<0.05). Conclusion miR-493-3p can alleviate myocardial cell injury and apoptosis under high glucose condition by inhibiting lncRNA CCAT2 expression, and there is a competitive relationship between the two regulation of TCF7L2.

Objective To explore the role of cyclooxygenase-2 (COX-2) in the proliferation, migration, invasion and tumorigenesis in vivo of oral squamous cell carcinoma (OSCC) cells. Methods Tissue samples, including five cases of normal oral mucosa and five cases of OSCC, were collected postoperatively from the Department of Stomatology, Hainan Cancer Hospital. Immunohistochemistry was performed to detect the expression of COX-2 in both groups. Celecoxib and COX-2 shRNA were used to inhibit the expression of COX-2 in SCC9 cells, and the inhibition efficiency was verified by Western blot assay. The proliferation ability of cells was evaluated by CCK-8 and colony formation assays. The migration and invasion abilities of cells were detected by scratch and invasion assays. A subcutaneous xenograft tumor model of SCC9 cells in nude mice was established to observe the effect of COX-2 silencing on tumor growth. Results Immunohistochemistry showed that COX-2 was mostly negative or weakly positive in normal oral mucosa tissue, but strongly positive in OSCC tissue. Compared with the control group, both Celecoxib treatment and COX-2 shRNA transfection could down-regulate the expression of COX-2 protein in SCC9 cells (P<0.05), and reduce the OD₄₅₀ value of cells, the number of clones, the scratch healing rate and the number of transmembrane cells. The xenograft tumor experiment in nude mice showed that with the extension of tumor formation time, the tumor volume in the COX-2 silencing group decreased, and the final measured body weight was lower than that in the empty vector group (P<0.05). Conclusion COX-2 is highly expressed in OSCC and participates in the proliferation, migration, invasion and in vivo growth of tumors. The inhibition of COX-2 can weaken the malignant biological behavior of OSCC cells.

Objective To investigate the effect of grape seed proanthocyanidin extract (GSPE) on doxorubicin-induced chronic cardiotoxicity by regulating the nuclear factor E2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) signaling pathway. Methods Thirty-six 6-week-old SD rats were randomly divided into six groups (n=6 for each group): the control group (control), the doxorubicin group (DOX), the doxorubicin+low-dose GSPE group (L-GSPE), the doxorubicin+medium-dose GSPE group (M-GSPE), the doxorubicin+ high-dose GSPE group (H-GSPE) and the doxorubicin+tert-butylhydroquinone group (TBHQ). Except for the control group, rats in the other groups were injected intraperitoneally with doxorubicin (2.5 mg/kg) once weekly for 6 consecutive weeks to establish the chronic cardiotoxicity model. The control group received equal volume of intraperitoneal injection of 0.9% NaCl solution (1 mL/kg). Starting from the first day of doxorubicin injection, the L-GSPE, M-GSPE and H-GSPE groups were administered GSPE solutions at doses of 100 mg/kg, 200 mg/kg and 400 mg/kg, respectively, via oral gavage. The TBHQ group was given 25 mg/kg TBHQ solution, while the control group and the DOX group were given an equal volume of ddH₂O. Cardiac structure and function were evaluated using echocardiography. Cardiac tissue morphology and fibrosis were observed via HE and Masson staining. Serum levels of superoxide dismutase (SOD), malondialdehyde (MDA), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), cardiac troponin T (cTnT) and brain natriuretic peptide (BNP) were measured using commercial kits and ELISA. Western blot assay and qRT-PCR were employed to assess protein and mRNA expression levels of Nrf2, NAD(P)H quinone oxidoreductase 1 (NQO1) and HO-1 in cardiac tissue. Results Compared with the DOX group, the cardiac structure and function, myocardial injury and fibrosis were all improved in the GSPE-treated groups, serum levels of TNF-α, IL-6, MDA, cTnT and BNP decreased, and serum SOD activity, protein and mRNA expression levels of Nrf2, HO-1 and NQO1 increased. Notably, the H-GSPE group demonstrated more significant improvement compared to the L-GSPE group (P<0.05). Conclusion GSPE may exert preventive and therapeutic effects against doxorubicin-induced chronic cardiotoxicity by activating the Nrf2/HO-1 signaling pathway.

Objective To explore the interaction between the time of intrapartum fever and the peak of fever in parturients with epidural analgesia and adverse neonatal outcome. Methods A total of 118 parturients with fever during labor who received epidural analgesia were included. A statistical analysis was conducted to investigate the occurrence of neonatal adverse outcomes. Logistic regression modeling was utilized to assess the independent association of intrapartum fever onset timing and peak fever magnitude with neonatal adverse outcomes, along with their potential interaction effects. Threshold effect analyse for intrapartum fever timing and peak temperature were performed using restricted cubic splines through the rms package in R version 3.6.1, generating smoothed fitting curves to visualize these relationships. Results The incidence of adverse neonatal outcome in parturients with fever during labor due to epidural analgesia was 36.44%. Older age, gestational diabetes and peak fever were all independent risk factors for adverse neonatal outcome, while later timing of intrapartum fever was a protective factor (P < 0.05). When the duration of fever during labor was shorter than 7.9 hours, the incidence of adverse neonatal outcome decreased with the delay of the duration of fever during labor. When the peak fever was higher than 38 ℃, the incidence of adverse neonatal outcome increased with the increase of the peak fever. There was a negative additive interaction between the moment of fever during labor and the peak of fever on adverse neonatal outcome. Among the adverse neonatal outcomes where the moment of fever during labor and the peak of fever coexist, 39.8% was caused by the interaction between the two. Conclusion The time and peak of fever during labor in parturients with epidural analgesia have a negative additive interaction effect on adverse neonatal outcome.

Objective To construct a clinical prediction model for severe pneumonia caused by mycoplasma pneumoniae (MP) and adenovirus (ADV) in children based on the backpropagation method (BP) neural network. Methods A retrospective analysis was conducted on the clinical, laboratory and imaging data of 138 children with severe pneumonia caused by MP mixed with ADV infection. The research subjects were randomly divided into the training set and the test set (7:3), and a BP neural network prediction model was constructed. The contribution of clinical features in the training set was quantified by shapley additive explanations (SHAP). The predictors of severe pneumonia for MP mixed with ADV were screened out. It is verified through the accuracy rate, loss value and confusion matrix in the test set. Results In the severe group, the duration of fever, the highest body temperature, neutrophil percentage (N%), aspartate transaminase (AST), lactate dehydrogenase (LDH), interleukin-6 (IL-6), extensive inflammatory consolidation and length of hospital stay were higher than those in the non-severe group, while lymphocyte percentage (L%) and albumin levels were lower than those in the non-severe group（P<0.05）. Further research results through BP neural network showed that the duration of fever, AST, N%, maximum body temperature, large areas of inflammatory consolidation, IL-6, L% and LDH were the key predictors of severe pneumonia caused by MP and ADV infection. In constructing the clinical prediction model of severe MP mixed with ADV in children, the test set showed an accuracy rate of 90.48% and a loss value of 0.233 2. Conclusion The prediction model for severe pneumonia caused by mixed MP-ADV infections is successfully constructed in children using a BP neural network. The eight key predictors are identified from the model that can serve as a reference for early clinical identification of severe cases.

Objective To investigate changes of serum levels of leucine-rich α-2 glycoprotein 1 (LRG1) and soluble urokinase-type plasminogen activator receptor (suPAR) in sepsis patients and their predictive value for concurrent acute kidney injury (AKI). Methods A total of 120 sepsis patients were included and divided into the AKI group and the non AKI group according to whether AKI occurred within one week after admission. Another 120 cases of healthy individuals who underwent physical examinations in the same period were included as the health group. The serum levels of LRG1 and suPAR were detected by enzyme-linked immunosorbent assay (ELISA). Receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of serum LRG1 and suPAR for sepsis-associated AKI. Decision curve analysis (DCA) was used to analyze the clinical utility of serum LRG1 and suPAR in predicting sepsis complicated with AKI. Logistic regression was used to analyze the influencing factors of sepsis complicated with AKI. Results The serum expression levels of LRG1 and suPAR in patients were significantly higher in the disease group than those in the healthy control group (P<0.05). The proportion of vasoactive drug application, sequential organ failure assessment score, acute physiology and chronic health evaluation Ⅱ score, procalcitonin, blood lactate (Lac), LRG1 and suPAR levels were higher in the AKI group than those in the non-AKI group (P<0.05). The area under the curve (AUC) of combined prediction of sepsis complicated with AKI was 0.850 (95%CI: 0.773-0.909), which was better than that of LRG1 or suPAR alone (Z=2.185, 2.464, both P<0.05). When the high risk threshold was 0.0-1.0, the net benefit rate of combined detection of the two tests in predicting sepsis complicated with AKI was better than that of single detection. Increased LRG1 level, increased suPAR level, increased Lac level and the use of vasoactive drugs were independent risk factors for sepsis complicated with AKI. Conclusion Serum LRG1 and suPAR levels are increased in sepsis patients and are related factors affecting AKI. The combination of the two has a higher predictive value.

Objective To investigate the distribution of pathogenic bacteria in postoperative incision infection following closed lower limb fracture and the effects of different pathogens on the expression of microRNA-15b-5p (miR-15b-5p)/inhibitor of nuclear factor kappa-B kinase subunit beta (IKBKB) signaling pathway-related molecules. Methods A total of 2 318 patients with closed lower limb fracture were analyzed for postoperative incision infection, with 120 patients diagnosed with incision infection. These patients were divided into the methicillin-resistant Staphylococcus aureus (MRSA) group (group A), the methicillin-sensitive S. aureus (MSSA) group (group B), the coagulase-negative staphylococci (CNS) group (group C) and the other bacterial groups (group D) based on the pathogens. The sensitivity of these pathogens to commonly used antibiotics in each group was analyzed. Infected incision tissue specimens were collected, and the expression levels of miR-15b-5p, IKBKB mRNA and protein were detected using qRT-PCR and Western blot assay to analyze the expression differences between the groups. Results The incidence of incision infection in this group was 5.18%. Among the 120 infected patients, Staphylococcus aureus infection was identified in 84 cases (70.00%). There were no statistically significant differences in the sensitivity of the pathogens to cefazolin sodium and cefuroxime sodium between the groups (P > 0.05). There were significant differences in the sensitivity differences of pathogens to cefazolin sodium, cefuroxime sodium and cefuroxime sodium between different groups (P < 0.01). Compared to the group A, the differences in the sensitivity to cefazolin sodium and cefuroxime sodium were statistically significant in the groups B, C and D (P < 0.01). Compared to the group B, the differences in the sensitivity to cefazolin sodium and cefuroxime sodium were also statistically significant in the groups C and D (P < 0.01). The expression levels of miR-15b-5p were lower in the group C and the group D than those of the group A and the group B (P < 0.01). The expression levels of IKBKB mRNA and protein were higher in the group C and the group D than those in the group A and the group B (P < 0.01). Conclusion Staphylococcus aureus is the most common bacterium causing postoperative incision infections following closed lower limb fracture. It can induce the increased expression of miR-15b-5p in tissue and may promote inflammatory progression by regulating the expression of IKBKB.

Objective To observe the efficacy and safety of intra-articular injection of platelet-rich plasma (PRP) combined with intermittent hypoxic training in the treatment of early knee osteoarthritis (KOA). Methods A total of 220 patients with early KOA were enrolled and equally divided into four groups using a random number table. The low oxygen group received intermittent hypoxic training alone, the sodium hyaluronate+low oxygen group received intra-articular injection of sodium hyaluronate combined with intermittent hypoxic training, the PRP group received intra-articular injection of PRP alone and the PRP+low oxygen group received intra-articular injection of PRP combined with intermittent hypoxic training. Patients of all groups were treated continuously for 6 weeks. The numerical pain rating scale (NPRS) score, inflammatory pain mediators [C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-17 (IL-17), 5-hydroxytryptamine (5-HT) and substance P], oxidative stress indicators [superoxide dismutase (SOD), malondialdehyde (MDA)], the knee injury and osteoarthritis outcome scores (KOOS), timed up and go test (TUG) results, and adverse reactions were compared between the four groups. Results After treatment, NPRS scores, CRP, TNF-α, IL-17, 5-HT, substance P and MDA levels were decreased in order in the low oxygen group, the PRP group, the sodium hyaluronate+low oxygen group and the PRP+low oxygen group. SOD levels, the scores for pain, knee-related quality of life, symptoms, exercise and recreation, activities of daily living and total KOOS scores were increased in order in these groups, while the TUG time decreased in order (all P<0.05). There was no significant difference in the incidence of adverse reactions between the four groups (P>0.05). Conclusion Applying intra-articular injection of PRP combined with intermittent hypoxic training to treat early KOA can effectively improve the expression levels of inflammatory pain mediators and oxidative stress level, alleviate pain and enhance knee function and balance ability of patients, with high safety.

Objective To explore the pathogenic characteristics and drug resistance of Staphylococcus aureus (SA) in patients with skin and soft tissue infections (SSTIs), and to analyze the risk factors for methicillin-resistant Staphylococcus aureus (MRSA) infection. Methods A total of 110 patients who were hospitalized due to SSTIs and whose secretions or drainage fluid were cultured as SA were selected. The clinical data of the patients were collected, and the status of patients with SA infection, the antibiotics sensitivity of the SA strains and the carrying rate of drug-resistant genes were statistically analyzed. Multivariate Logistic regression was used to analyze the influencing factors of MRSA infection in SSTIs patients. Results A total of 110 SSTIs-related SA isolates were isolated, among which 27 isolates (24.5%) were MRSA. Compared with the methicillin-sensitive Staphylococcus aureus (MSSA) group, the MRSA group had a higher proportion of outpatient antibiotic treatment before admission and mecA gene carriage rate (P<0.05). The resistance rate of SA to penicillin was the highest (94.5%), followed by erythromycin (58.2%), and the resistance rate to rifampicin was the lowest (0.9%). Resistance to linezolid, tigecycline, vancomycin, daptomycin and teicoplanin was not observed. Compared with the MSSA group, the MRSA group had a higher resistance rate to oxacillin, tetracycline, minocycline and levofloxacin (P<0.05). Logistic regression analysis showed that outpatient antibiotic treatment before admission and fever were risk factors for MRSA infection in SSTIs patients (P<0.05). Conclusion The drug resistance spectrum of SA in SSTIs is different, and MRSA strains show extensive multi-drug resistance. SSTIs patients with outpatient antibiotic treatment and fever before admission are more likely to have MRSA infection.

Objective To investigate the effects of Tongguan decoction retention enema combined with heat-sensitive moxibustion on inflammatory factors, hysterosalpingography (HSG) recanalization rate and natural pregnancy rate in patients with qi-stagnation and blood-stasis type tubal factor infertility (TFI). Methods A total of 170 patients with qi-stagnation and blood-stasis type TFI were enrolled and randomly assigned to either the surgery group (85 cases) or the combination group (85 cases) using a random number table. All patients had proximal tubal obstructive lesions and underwent hysteroscopic tubal catheterization recanalization. The combination group additionally received Tongguan decoction retention enema and heat-sensitive moxibustion for three menstrual cycles after surgery. Changes in traditional Chinese medicine (TCM) syndrome scores and uterine fluid inflammatory cytokine levels [interleukin (IL)-6, IL-1β, tumor necrosis factor-α (TNF?α)] were compared before and after the intervention between groups. Secondary outcomes including HSG recanalization rates, natural pregnancy rates, ectopic pregnancy rate and complication rate were analyzed. Results After intervention, both groups showed reduced TCM syndrome scores (including lower abdominal stabbing pain, menstrual blood stasis, hypochondriac and breast distension pain, lumbosacral soreness, emotional distress and menstrual obstruction) and inflammatory cytokine levels (IL-6, IL-1β and TNF-α) compared with those before intervention, and the combination group was lower than those of the surgery group (P<0.05). The combination group demonstrated significantly higher HSG recanalization rate and natural pregnancy rate than those of the surgery group after intervention (P<0.05). There were no significant differences in ectopic pregnancy rate and total complication rate between the two groups (P>0.05). Conclusion As an adjunct to hysteroscopic tubal recanalization, Tongguan decoction retention enema combined with heat-sensitive moxibustion significantly improves TCM syndromes, reduces inflammatory cytokines and enhances HSG recanalization and natural pregnancy rate in qi-stagnation and blood-stasis type TFI patients.

Objective To explore the expression levels of serum neuropilin-1 (NRP-1) and C-X-C motif chemokine receptor 4 (CXCR4) in patients with ovarian endometriosis cysts (OEC) and their predictive value for pregnancy outcome. Methods A total of 136 OEC patients were included as the study group and were divided into the pregnancy group (84 cases) and the non-pregnancy group (52 cases) based on whether they were pregnant during follow-up period. Additionally, 136 healthy married women of reproductive age undergoing physical examinations at our hospital during the same period were selected as the control group. Multivariate Logistic regression analysis was used to identify factors influencing non-pregnancy in OEC patients. Receiver operating characteristic (ROC) curves were used to evaluate the predictive value of serum NRP-1 and CXCR4 for pregnancy outcome. Decision curve analysis (DCA) was performed to determine the predictive performance of combined detection for non-pregnancy, and calibration curves were drawn to assess the consistency of the model. Results The serum levels of vascular endothelial growth factor (VEGF), NRP-1 and CXCR4 were higher in the study group compared to those of the control group (P<0.05). In the non-pregnant group, age and serum levels of VEGF, NRP-1 and CXCR4 were higher compared to those of the pregnant group (P<0.05). The elevated levels of NRP-1, CXCR4 and VEGF were risk factors for non-pregnancy in patients aged ≥35 years (P<0.05). The area under the curve (AUC) of serum NRP-1 and CXCR4 alone and in combination for predicting pregnancy outcome was 0.764, 0.776 and 0.870, respectively. The combination of the two was superior to their individual predictions (P<0.05). The DCA results showed that when the high-risk threshold was between 0.14 and 0.91, the net benefit rate of joint prediction of pregnancy outcome was better than that of individual prediction. In addition, H-L test showed χ²=7.032, P=0.714, indicating good consistency. Conclusion OEC patients have elevated serum levels of NRP-1 and CXCR4, which are related to pregnancy outcome. Early detection can assist in clinically predicting patient pregnancy outcome, and the predictive value is higher when tested in combination.

Objective To observe the effect and restenosis rate of ultrasound-guided balloon dilatation in the treatment of arteriovenous fistula stenosis. Methods The clinical data of 78 patients with arteriovenous fistula stenosis were retrospectively analyzed. The above patients were grouped by different surgical methods. Thirty-eight patients who received balloon dilatation under digital subtraction angiography (DSA) were included in the DSA group, and 40 cases who adopted ultrasound-guided balloon dilatation were enrolled as the ultrasound-guided group. The surgical conditions (success rate of one-time puncture, surgical time, intraoperative blood loss and postoperative fistula starting time) were observed in the two groups of patients. The postoperative clinical indicators, postoperative restenosis and occurrence of postoperative complications were compared. Results Compared with the DSA group, the success rate of one-time puncture, was higher, and the surgical time was shorter in the ultrasound-guided group (P<0.05), but there were no significant differences in the intraoperative blood loss and postoperative fistula starting time between the two groups (P>0.05). The internal diameter, dialysis blood flow volume, internal fistula natural blood flow and cross-sectional area of the arteriovenous fistula stenosis were increased at 7 days after surgery compared with those before surgery in the two groups (P<0.05). The internal diameter, dialysis blood flow volume and internal fistula natural blood flow in the ultrasound-guided group at 7 days after surgery were significantly higher than those in the DSA group (P<0.05). There was no significant difference in postoperative cross-sectional area between the two groups of patients (P>0.05). No restenosis occurred within 1 month after surgery in the two groups, and there was no significant difference in the restenosis rate at 3 months after surgery between the two groups of patients (P>0.05). The restenosis rates at 6 and 9 months after surgery were lower in the ultrasound-guided group than those in the DSA group (P<0.05). There was no statistical difference in total incidence rate of postoperative complications between the two groups of patients (P>0.05). Conclusion Ultrasound-guided balloon dilatation in the treatment of arteriovenous fistula stenosis can effectively improve the inner diameter of the stenosis, exhibit quick surgery and increase the dialysis blood flow volume. In addition, it has low risk of restenosis and few postoperative complications.

Objective To explore the expression of cytochrome P450 1B1 (CYP1B1) and proteasome 26 S subunit non-ATpase 14 (PSMD14) in colorectal cancer tissue and their impact on the prognosis of colorectal cancer. Methods A total of 107 colorectal cancer patients who underwent surgery in our hostpital from January 2021 to June 2022 were selected in this study. Cancer tissue and adjacent tissue samples were obtained during surgery, and the mRNA levels of CYP1B1 and PSMD14 in cancer tissue and adjacent tissue were detected by qRT-PCR. The relationship between levels of CYP1B1 and PSMD14 and pathological characteristics of colorectal cancer was analyzed. The Cox regression model was used to analyze the influencing factors of survival prognosis. The diagnostic value of CYP1B1 and PSMD14 levels in colorectal cancer was analyzed using ROC curves. Results In colorectal cancer tissue, the mRNA expressions of CYP1B1 and PSMD14 were significantly higher than those in paracancerous tissue (P<0.01). The area under the curve (AUC) and sensitivity of the combined diagnosis of CYP1B1 and PSMD14 were significantly higher than those of the individual detection of CYP1B1 and PSMD14. The proportion of high CYP1B1 and PSMD14 mRNA expression in cancer tissue of patients with tumor diameter ≥5 cm, TNM stage Ⅲ+Ⅳ, low differentiation and lymph node metastasis were relatively high (P<0.05). The 3-year overall survival rate of patients with high mRNA expression of CYP1B1 (40.82%) was significantly lower than that of patients with low mRNA expression of CYP1B1 (89.09%). The 3-year overall survival rate of those with high expression of PSMD14 mRNA (34.04%) was significantly lower than that of patients with low expression of PSMD14 mRNA (92.98%), Log-rank χ² were 26.070 and 43.060 respectively, both P<0.01. TNM stage Ⅲ+Ⅳ, low differentiation degree, lymph node metastasis, high expression of CYP1B1 mRNA and high expression of PSMD14 mRNA were independent risk factors for the survival prognosis of colorectal cancer patients (P<0.05). Conclusion CYP1B1 and PSMD14 mRNA are highly expressed in colorectal cancer tissue and are closely related to disease progression and survival prognosis. They have good diagnostic value for colorectal cancer, and may become important biomarkers for assessing treatment and prognosis in colorectal cancer patients.

Objective To investigate the clinical efficacy of a proprietary formula for clearing pancreas and lowering lipids combined with abdominal acupoint application in treating hyperlipidaemic acute pancreatitis (HLAP). Methods Seventy patients with HLAP admitted between May 2024 to August 2025 were selected as study subjects, and patients were randomly divided into the observation group (n=35) and the control group (n=35). The control group received conventional Western medical treatment, while the observation group received a proprietary formula for clearing pancreas and lowering lipids combined with acupoint plaster therapy on the basis of the control group. Both groups were treated for 10 days. The clinical efficacy and incidence of adverse reactions were compared between the two groups. The levels of amylase, blood lipids and inflammatory factors in patients of two groups were measured before treatment, 3 days after treatment and 10 days after treatment. The modified CT severity index (MCTSI) was used for evaluation. Results The clinical total effective rate was significantly higher in the observation group than that of the control group (P<0.05). The results of repeated measurement analysis showed that there were statistically significant differences in levels of serum amylase, urine amylase, triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), serum C-reactive protein (CRP), white blood cell (WBC) and MCTSI score in terms of inter group effects, time effects and interaction effects (P<0.05). After 3 days and 10 days of treatment, the scores of serum amylase, urine amylase, TG, TC, LDL-C, CRP, WBC and MCTSI were decreased in both groups, while HDL-C increased. Moreover, after 3 days and 10 days of treatment the scores of serum amylase, urine amylase, TG, TC, LDL-C, CRP, WBC and MCTSI were lower in the observation group than those of the control group (P<0.05), and HDL-C level was higher than that of the control group. There were no significant differences in adverse reactions between the two groups (P>0.05). Conclusion The combination of a proprietary formula for clearing pancreas and lowering lipids with abdominal acupoint plaster application in the treatment of hyperlipidaemic acute pancreatitis enhances therapeutic efficacy, reduces blood lipid levels, alleviates inflammatory states, regulates microcirculation, accelerates symptom improvement and demonstrates safety.

Objective To explore the predictive value of prognostic nutritional index (PNI) combined with urea nitrogen/creatinine, D-dimer/fibrinogen (DFR) and red blood cell distribution width (RDW) for poor prognosis in patients with acute cerebral infarction. Methods A total of 280 patients with acute cerebral infarction were selected as the research subjects by convenience sampling. According to the modified Rankin scale, they were divided into the good prognosis group (177 cases) and the poor prognosis group (103 cases). Clinical data of patients were collected, including their age, gender, body mass index (BMI) and history of underlying diseases (diabetes, coronary heart disease and hypertension). The fully automatic blood cell analyzer, fully automatic biochemical analyzer, whole blood C-reactive protein analyzer and the corresponding reagents were used to obtain serum homocysteine (Hcy), total lymphocyte count (TLC), serum albumin (ALB), hemoglobin (Hb), total cholesterol (TC), total serum protein (TP) and C-reactive protein (CRP). The levels of indicators such as high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), uric acid (UA), urea nitrogen, creatinine, D-dimer, fibrinogen and RDW were also collected. PNI and DFR were calculated. Spearman assay was used to analyze the correlation between PNI, urea nitrogen/creatinine, DFR, RDW and prognosis. Univariate and multivariate Logistic regression were used to analyze the influencing factors of poor prognosis in patients with acute cerebral infarction. The receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) was compared. Results The RDW, urea nitrogen/creatinine ratio and DFR were higher in the poor prognosis group than those in the good prognosis group (all P<0.05). The PNI index level was lower in the poor prognosis group than that in the good prognosis group (P<0.05). The results of univariate Logistic regression analysis showed that elevated PNI was a protective factor for poor prognosis in patients with acute cerebral infarction, while elevated urea nitrogen/creatinine ratio, elevated DFR and widened red blood cell distribution (RDW) were risk factors (all P<0.05). The PNI of patients with acute cerebral infarction was negatively correlated with poor prognosis (P<0.01). Urea nitrogen/creatinine, DFR and RDW were positively correlated with poor prognosis (all P<0.01). The results of Logistic multivariate regression analysis showed that elevated PNI was a protective factor for poor prognosis in patients with acute cerebral infarction, while elevated urea nitrogen/creatinine ratio, elevated DFR and widened RDW were risk factors. The results of ROC curve analysis showed that the AUC of the combination of the four was 0.986 (95%CI: 0.974-0.999), and the sensitivity and specificity were 84.50% and 99.40% respectively, both of which were superior to the individual detection. Conclusion Compared with patients with a good prognosis, those with a poor prognosis of acute cerebral infarction have a lower PNI, while levels of urea nitrogen/creatinine, DFR and RDW are higher. The combined detection of the four indicators has a high predictive value for the prognosis of patients with acute cerebral infarction.

Objective To explore the clinical effect of disitamab vedotin combined with toripalimab in the neoadjuvant therapy of muscle-invasive bladder cancer (MIBC). Methods A total of 87 MIBC patients were divided into the control group (treated with gemcitabine+cisplatin combined with toripalimab, n=47) and the study group (treated with disitamab vedotin combined with toripalimab, n=40) based on the different neoadjuvant treatment regimens. Every 3 weeks was one course of treatment, for a total of 3 courses of treatment. The clinical objective response rate (ORR) and disease control rate (DCR) after three treatment courses were calculated in two groups, and the ORR and DCR of human epidermal growth factor receptor 2 (HER-2) in positive patients were also caculated. Immunohistochemical staining was used to detect the positive expression levels of cytokeratin 20 (CK20), GATA-binding protein 3 (GATA-3) and Ki-67 before and after treatment in the two groups. Serum vascular endothelial growth factor (VEGF) and urinary bladder tumor antigen (BTA) levels were detected by enzyme-linked immunosorbent assay. The incidence of grade 3 adverse reactions during the treatment process was compared between the two groups. Results After 3 courses of treatment, the ORR (75.0% vs. 51.1%) and DCR (95.0% vs. 80.9%) were higher in the study group than those of the control group (all P<0.05). After three courses of treatment, the ORR of HER-2 positive patients in the study group was higher than that in the control group (81.25% vs. 55.17%, P<0.05). There was no significant difference in DCR between the two groups (100.00% vs. 89.66%，P>0.05). After treatment, the proportions of patients with positive CK20, GATA-3 and Ki-67, urinary BTA, and serum VEGF expression levels were lower in the study group than those in the control group (all P<0.05). The incidence of grade 3 adverse reactions of leukopenia was lower in the research group than that in the control group (0.00% vs. 19.15%, P<0.05). There were no significant differences in the incidence of other grade 3 adverse reactions such as neutropenia, itching and rash between the two groups (all P>0.05). Conclusion Disitamab vedotin combined with toripalimab has high ORR and DCR in the neoadjuvant therapy of MIBC. Moreover, the ORR is higher in HER-2 positive patients, with controllable safety and good overall efficacy.

Chest wall sarcoma is a malignant tumor that originates in chest wall, and its treatment is mainly based on surgical resection. Large chest wall defects following the excision of extensive tumors necessitate structural reconstruction to preserve thoracic stability and prevent paradoxical respiration. This report presents a complex case of a patient with recurrent giant chest wall sarcoma treated in our department. The patient had previously underwent treatment such as chemotherapy, radiotherapy and anti-angiogenic targeted therapy. This year, the tumor had recurred. Our department, in collaboration with the orthopedic department, performed a chest wall tumor resection accompanied by carbon fiber artificial rib reconstruction and latissimus dorsi myocutaneous flap transplantation. The patient exhibited stable thoracic architecture postoperatively, and the latissimus dorsi myocutaneous flap healed well. This case is presented to provide insights and a potential reference for the management of complex chest wall tumors.

Cholera toxin is an AB5-type toxin secreted by vibrio cholerae and has the ability to regulate immunity. Research has found that cholera toxin has potential anti-cancer effects. It not only inhibits cell proliferation by suppressing growth factor signaling or triggering apoptosis, but also acts as an immunomodulator by mediating inflammatory responses and regulating the immune system to inhibit tumor occurrence and development. Additionally, cholera toxin can also indirectly exert anti-tumor effects by assisting in targeted drug delivery and serving as an adjuvant in vaccines. This article reviews the role of cholera toxin in tumors, providing new ideas for cancer prevention and treatment.

In recent years, rapid advances in multi-omics technologies have substantially promoted metabolomic, proteomic and transcriptomic investigations of follicular fluid (FF), providing novel insights into the molecular mechanism underlying oocyte quality deterioration. During the process of ovarian function decline and reproductive aging, hormone levels, energy metabolism and lipid metabolism characteristics in FF have undergone significant changes. It is accompanied by the imbalance in inflammatory and immune-related pathways. A variety of key proteins in FF not only participate in ovulation, tissue remodeling and signal transduction, but are also closely related to the quality of oocytes and the outcome of embryonic development. This review systematically summarizes recent progress in FF-based multi-omics research and discusses its potential applications in oocyte quality assessment and precision decision-making in assisted reproductive technologies.