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Phytoene and astaxanthin are 2 important carotenoids in the green alga Haematococcus pluvialis. Under environmental stress, the synthesis of phytoene in H. pluvialis increases significantly, and phytoene is converted to astaxanthin through enzymatic catalysis. This paper analyzes the relationship between astaxanthin and phytoene accumulation in carotenoid synthesis pathways under different concentrations of sodium acetate (NaAc) by high-performance liquid chromatography. The highest concentrations of phytoene and astaxanthin were observed at the NaAc concentration of 6 g l-1 on the 12th day of induction. The highest astaxanthin concentration achieved was 2.26 ± 0.28%. Therefore, we concluded that 6 g l-1 NaAc and induction for 12 d provided the optimal inducing conditions for astaxanthin accumulation in H. pluvialis. psy, pds, lcyB, β-carotene ketolase crtw, and crtz, which are genes related to phytoene and astaxanthin synthesis, were cloned and studied at the transcriptional level. crtw and crtz were continuously up-regulated since the first day of induction, while psy, pds, and lcyB were continuously up-regulated starting on the 3rd day of induction. These findings are important for enhancing our understanding of the mechanism of accumulation of phytoene and astaxanthin in H. pluvialis and provide a foundation for identifying the induction conditions necessary for optimizing astaxanthin production and increasing astaxanthin yields.

Ling Hou,1,2,* Ke Su,1,* Jinbo Zhao,1 Ting He,2 Yuanhong Li1 1Cardiovascular Disease Center, Central Hospital of Tujia and Miao Autonomous Prefecture, Enshi, Hubei Province, People’s Republic of China; 2Department of Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Shiyan, Hubei, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yuanhong Li, Email lyh0101@vip.163.comBackground: Coronary heart disease (CHD) is a leading cause of mortality worldwide, with atrial fibrillation (AF) being a common complication. Chronic inflammatory responses play a significant role in the relationship between coronary artery disease and AF. This study aims to investigate the value of the multi-inflammatory index (MII) in predicting the occurrence of atrial fibrillation in patients with coronary heart disease.Methods: A retrospective analysis was conducted on patients who visited our hospital from January 1, 2020, to December 31, 2023, including a total of 1392 patients. Clinical data and laboratory results were collected. Feature selection was performed using the Boruta algorithm. Five machine learning models were constructed: Logistic Regression, Decision Tree, Elastic Net, Light Gradient Boosting Machine (LightGBM), and Multilayer Perceptron. Model performance was evaluated using five-fold cross-validation. SHAP values were utilized to analyze feature importance and model interpretability.Results: The study included 1302 patients without AF and 90 patients with AF. Patients with AF had significantly higher MII compared to those without AF (10.02 vs 4.79). Thirteen variables most related to AF occurrence were selected using the Boruta algorithm. The LightGBM model outperformed others, showing the highest accuracy and calibration in both training and test sets. In the training set, LightGBM achieved an AUC of 0.958, accuracy of 0.851, and sensitivity of 0.943, while in the testing set, it achieved an AUC of 0.757 and accuracy of 0.821. SHAP analysis indicated that age, heart rate, and MII were the primary predictors of AF occurrence.Conclusion: The LightGBM model demonstrated adequate sensitivity and accuracy. The multi-inflammatory index plays a crucial role in predicting atrial fibrillation in patients with coronary heart disease.Keywords: atrial fibrillation, coronary heart disease, multi-inflammatory index, machine learning models, light gradient boosting machine

Ling Hou,1,2,* Ke Su,1,* Ting He,1 Jinbo Zhao,1 Yuanhong Li1 1Cardiovascular Disease Center, Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Enshi, Hubei Province, People’s Republic of China; 2Department of Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Shiyan, Hubei Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yuanhong Li, Email lyh0101@vip.163.comBackground: Percutaneous coronary intervention (PCI) is the primary treatment for acute myocardial infarction (AMI). However, in-stent restenosis (ISR) remains a significant limitation to the efficacy of PCI. The cholesterol-to-lymphocyte ratio (CLR), a novel biomarker associated with inflammation and dyslipidemia, may have predictive value for ISR. Deep learning-based models, such as the multilayer perceptron (MLP), can aid in establishing predictive models for ISR using CLR.Methods: A retrospective analysis was conducted on clinical and laboratory data from 1967 patients. The Boruta algorithm was employed to identify key features associated with ISR. An MLP model was developed and divided into training and validation sets. Model performance was evaluated using ROC curves and calibration plots.Results: Patients in the ISR group exhibited significantly higher levels of CLR and low-density lipoprotein (LDL) compared to the non-ISR group. The Boruta algorithm identified 21 important features for subsequent modeling. The MLP model achieved an AUC of 0.95 on the validation set and 0.63 on the test set, indicating good predictive performance. Calibration plots demonstrated good agreement between predicted and observed outcomes. Feature importance analysis revealed that the number of initial stent implants, hemoglobin levels, Gensini score, CLR, and white blood cell count were significant predictors of ISR. Partial dependence plots (PDP) confirmed CLR as a key predictor for ISR.Conclusion: The CLR, as a biomarker that integrates lipid metabolism and inflammation, shows significant potential in predicting coronary ISR. The MLP model, based on deep learning, demonstrated robust predictive capabilities, offering new insights and strategies for clinical decision-making.Keywords: cholesterol-to-lymphocyte ratio, deep learning, multilayer perceptron, Boruta algorithm, in-stent restenosis

Ling Hou,1,* Jinbo Zhao,2,* Ting He,1,* Yinhua Luo,3 Ke Su,2 Yuanhong Li,2 Ruiyang Zhu3 1Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Shiyan, People’s Republic of China; 2Cardiovascular Disease Center, Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Enshi, Hubei Province, People’s Republic of China; 3Center for Gene Diagnosis and Department of Clinical Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yuanhong Li, Cardiovascular Disease Center, Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Enshi, 445400, People’s Republic of China, Email lyh0101@vip.163.com Ruiyang Zhu, Center for Gene Diagnosis and Department of Clinical Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, People’s Republic of China, Email zhuruiyang@whu.edu.cnAbstract: Granulomatosis with polyangiitis (GPA) is a necrotizing granulomatous vasculitis classified as an autoimmune small-vessel vasculitis. Clinically, approximately 80% of affected organs in GPA involve the upper/lower respiratory tract and kidneys, with cardiovascular system involvement being rare. Here, we report a case of a 50-year-old female patient who presented with sudden-onset chest pain lasting for 1 hour. The patient had normal body temperature, and markers of infection such as C-reactive protein and erythrocyte sedimentation rate were within normal limits. Electrocardiography revealed ST-segment elevation in inferior, precordial, and posterior leads. Emergency coronary angiography showed no significant obstructive disease, prompting consideration of vasospastic angina given the patient’s recurrent chest pain symptoms and findings on laboratory and imaging studies. The patient underwent treatment including coronary vasospasm antagonists and immunomodulation, resulting in clinical improvement and subsequent discharge. During a 7-month follow-up period, the patient did not experience any further adverse cardiovascular events.Keywords: granulomatosis with polyangiitis, vasospastic angina, case report

Ling Hou,1,* Ke Su,2,* Ting He,1 Jinbo Zhao,2 Yuanhong Li2 1Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Shiyan, Hubei Province, People’s Republic of China; 2Cardiovascular Disease Center, Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Enshi, Hubei Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yuanhong Li, Email lyh0101@vip.163.comObjective: This study aims to investigate their correlation and predictive utility for in-stent restenosis (ISR) in patients with acute coronary syndrome (ACS) following percutaneous coronary intervention (PCI).Methods: We collected medical records of 668 patients who underwent PCI treatment from January 2022 to December 2022. Based on follow-up results (ISR defined as luminal narrowing ≥ 50% on angiography), all participants were divided into ISR and non-ISR groups. The XGBoost machine learning (ML) model was employed to identify the optimal predictive variables from a set of 31 variables. Discriminatory ability was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC), while calibration and performance of the prediction models were assessed using the Hosmer-Lemeshow (HL) test and calibration plots. Clinical utility of each model was evaluated using decision curve analysis (DCA).Results: In the XGBoost importance ranking of predictive factors, LMR and RC ranked first and fourth, respectively. The AUC of the entire XGBoost ML model was 0.8098, whereas the model using traditional stepwise backward regression, comprising five predictive factors, had an AUC of 0.706. The XGBoost model showed superior predictive performance with a higher AUC, indicating better discrimination and predictive accuracy for ISR compared to traditional methods.Conclusion: LMR and RC are identified as cost-effective and reliable biomarkers for predicting ISR risk in ACS patients following drug-eluting stent (DES) implantation. LMR and RC represent cost-effective and reliable biomarkers for predicting ISR risk in ACS patients following drug-eluting stent implantation. Enhances the accuracy and clinical utility of ISR prediction models, offering clinicians a robust tool for risk stratification and personalized patient management.Keywords: Lymphocyte-to-monocyte ratio, residual cholesterol, XGBoost, machine learning, in-stent restenosis, drug-eluting stent

Zhiyuan Wu,1,* Lili Hou,2,* Cheng Li,1,* Xiaohua Li,2 Ying Li1 1Department of Radio-Oncology, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, People’s Republic of China; 2Department of Breast Surgery, Suzhou Wuzhong People’s Hospital, Suzhou, People’s Republic of China*These authors contributed equally to this worksCorrespondence: Ying Li; Xiaohua Li, Email lisalee198812@163.com; xq810@163.comPurpose: Breast cancer is the leading cause of cancer mortality among women. Radiotherapy can reduce recurrence and prolong survival of patients accepting breast-conserving surgery (BCS). This study aims to compare acute skin reactions in patients receiving hypofractionated versus conventional radiotherapy at a single institution and to summarize the relevant influencing factors.Methods: This study analyzed 152 patients who underwent either hypofractionated or conventional whole-breast irradiation (WBI) after BCS. Acute skin toxicity was assessed according to the Radiation Therapy Oncology Group (RTOG) criteria. Predictive factors for acute skin toxicity were identified using multivariate analysis and visualized using a forest spot.Results: Grade 0 reactions occurred in 75.34% vs 70.89%, grade 1 in 16.44% vs 15.19%, grade 2 in 8.22% vs 12.66%, and grade 3 in 0% vs 1.27% of patients receiving hypofractionated and conventional WBI, respectively. There was no statistically significant difference in acute skin reaction in patients treated with hypofractionated radiation compared with conventional radiation (P = 0.62). Multivariate analysis revealed that metastatic lymph nodes (P = 0.021), whole-breast planning target volume (PTV-WB) (P

Ling Hou,1,* Jinbo Zhao,2,* Ting He,2 Ke Su,2 Yuanhong Li2 1Department of Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Shiyan, Hubei Province, People’s Republic of China; 2Cardiovascular Disease Center, Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Enshi, Hubei Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yuanhong Li, Email lyh0101@vip.163.comIntroduction: Coronary artery disease (CAD) remains a significant global health challenge, with percutaneous coronary intervention (PCI) being a primary revascularization method. In-stent restenosis (ISR) post-PCI, although reduced, continues to impact patient outcomes. Inflammation and platelet activation play key roles in ISR development, emphasizing the need for accurate risk assessment tools. The systemic inflammation aggregation index (AISI) has shown promise in predicting adverse outcomes in various conditions but has not been studied in relation to ISR.Methods: A retrospective observational study included 1712 patients post-drug-eluting stent (DES) implantation. Data collected encompassed demographics, medical history, medication use, laboratory parameters, and angiographic details. AISI, calculated from specific blood cell counts, was evaluated alongside other variables using machine learning models, including random forest, Xgboost, elastic networks, logistic regression, and multilayer perceptron. The optimal model was selected based on performance metrics and further interpreted using variable importance analysis and the SHAP method.Results: Our study revealed that ISR occurred in 25.8% of patients, with a range of demographic and clinical factors influencing the risk of its development. The random forest model emerged as the most adept in predicting ISR, and AISI featured prominently among the top variables affecting ISR prediction. Notably, higher AISI values were positively correlated with an elevated probability of ISR occurrence. Comparative evaluation and visual analysis of model performance, the random forest model demonstrates high reliability in predicting ISR, with specific metrics including an AUC of 0.9569, accuracy of 0.911, sensitivity of 0.855, PPV of 0.81, and NPV of 0.948.Conclusion: AISI demonstrated itself as a significant independent risk factor for ISR following DES implantation, with an escalation in AISI levels indicating a heightened risk of ISR occurrence.Keywords: coronary artery disease, percutaneous coronary intervention, Systemic inflammation aggregation index, machine learning models, In-stent restenosis

Lin Wang,1,2 Fulan Wang,1,2 Hong Qin,2 Li Hou,2 Shiqiong Zhu,3 Fang He,2 Chao Zeng2 1Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China; 2Gynecology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China; 3Gynecology Department, Sichuan Provincial People’s Hospital, Chengdu, Sichuan, 610031, People’s Republic of ChinaCorrespondence: Fulan Wang, Department of Nursing, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China, Tel +86-13012370558, Email WFL3076@163.comBackground: Bladder dysfunction is a common complication following radical hysterectomy, affecting patients’ QOL. Exploring interventions, particularly IC continuity care, is crucial for identifying strategies to enhance postoperative outcomes. This study aimed to assess the impact of continuous intermittent catheterization (IC) care on bladder function recovery and quality of life (QOL) in patients undergoing radical hysterectomy for cervical cancer.Methods: The primary outcome measured was the time to bladder function recovery, with secondary outcomes comprising EORTC QLQ-C30 assessments at 3 and 6 months post-surgery, as well as EORTC QLQ-CX24 evaluations. Meanwhile, urinary complications, readmissions, and outpatient follow-up were also compared.Results: Among the 128 participants, with 64 in each group, indwelling catheterization durations were similar. However, the IC continuity care group exhibited significantly shorter IC duration and bladder recovery time. This group demonstrated superior QOL, lower occurrence rates post-IC, reduced urethral injuries, and higher readmission and outpatient follow-up rates.Conclusion: This study underscores continuous IC care emerges as a beneficial intervention, facilitating accelerated bladder function recovery and improved QOL in patients following radical hysterectomy for cervical cancer.Keywords: intermittent urethral catheterization, cervical cancer, urinary bladder neurogenic dysfunction, continuity of patient care, rehabilitation

Kunjie Zheng,1– 3 Xiaolong Li,1– 3 Yihua Rong,2 Xuejing Wang,4 Liping Hou,2 Wei Gu,2 Xiaoyu Hou,3 Yunpeng Guan,5 Lifang Liu,6 Jianlin Geng,2 Guangyao Song1,3 1Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China; 2Department of Endocrinology, Hengshui People’s Hospital, Hengshui, Hebei, People’s Republic of China; 3Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China; 4Hengshui People’s Hospital Statistical Office, Hengshui, Hebei, People’s Republic of China; 5Department of Endocrinology, Shijiazhuang People’s Hospital, Shijiazhuang, Hebei Province, People’s Republic of China; 6Department of Endocrinology, Baoding First Central Hospital, Baoding, Hebei, People’s Republic of ChinaCorrespondence: Guangyao Song, Department of Endocrinology, Hebei General Hospital, 348 Heping West Road, Shijiazhuang, Hebei, 050051, People’s Republic of China, Email sguangyao2@163.comPurpose: Elevated serum gamma-glutamyltranspeptidase (GGT) is an independent marker of the activation of systemic inflammation, while conditions associated with elevated triglyceride (TG) levels, such as type 2 diabetes, non-alcoholic fatty liver disease, obesity, and metabolic syndrome, are associated with an increased inflammatory burden. Moreover, serum liver enzymes (GGT, alanine aminotransferase [ALT], aspartate aminotransferase [AST], and alkaline phosphatase [ALP]) are associated with metabolic syndrome and its components, including hypertriglyceridemia. However, the relationship between liver enzymes and postprandial hypertriglyceridemia (PHTG) remains unclear. Therefore, in this study we conducted oral fat tolerance tests (OFTTs) to understand the differences in serum liver enzyme levels among individuals with different lipid tolerance levels and their correlation with PHTG.Patients and Methods: For the OFTT, we enrolled 202 non-diabetic volunteers whose fasting triglyceride (TG) levels were less than 1.7 mmol/L in this case-control study. The participants were categorized into two groups according to the TG levels at the 0- and 4-h OFTT: a postprandial normal TG (PNTG) group and a PHTG group. Routine fasting serum biochemical indices, liver enzyme (GGT, ALT, AST, and ALP) levels, and 0- and 4-h OFTT lipid levels were assessed.Results: The PHTG group had significantly higher serum GGT and ALT levels and a lower AST/ALT ratio than those in the PNTG group. However, no significant difference was observed in AST and ALP levels compared with the PNTG group. After adjusting for major confounders, logistic regression analysis indicated a significant correlation between serum GGT and PHTG (odds ratio = 1.168, P < 0.001), but not with ALT level, AST level, AST/ALT ratio, and ALP level. The receiver operating characteristic curve analysis demonstrated that the serum GGT level was an effective predictor of PHTG.Conclusion: Serum GGT levels are significantly associated with PHTG risk and serve as an effective biomarker for early identification.Keywords: gamma-glutamyl transferase, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, inflammation, triglyceride, oral fat tolerance test

Lu Hou,1,&ast; Jing Zhang,2,&ast; Jing Liu,3 Chang Chen,1 Xuezheng Gao,4 Limin Chen,4 Zhenhe Zhou,1,3 Hongliang Zhou5 1Department of Psychiatry, The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi City, 214151, People’s Republic of China; 2Department of Psychiatry, Huaian Third People’s Hospital, Huaian City, 223021, People’s Republic of China; 3School of Humanities and Management Science, Wannan Medical College, Wuhu City, 241000, People’s Republic of China; 4Department of Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi City, 214151, People’s Republic of China; 5Department of Psychology, The Affiliated Hospital of Jiangnan University, Wuxi City, 214151, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhenhe Zhou, Department of Psychiatry, The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi City, 214151, People’s Republic of China, Tel +86-1-335-811-8986, Fax +86-510-83219366, Email zhouzh@njmu.edu.cn Hongliang Zhou, Department of Psychology, the Affiliated Hospital of Jiangnan University, Wuxi City, 214151, People’s Republic of China, Tel +86-1-536-525-1126, Fax +86-510-85808820, Email Hongliangzh2022@hotmail.comPurpose: Nicotine withdrawal is a multifaceted physiological and psychological process that can induce a spectrum of mood disturbances. Gaining a more nuanced understanding of how pure nicotine withdrawal influences cognitive control functions may provide valuable insights for the enhancement of smoking cessation programs. This study investigated changes in inhibitory control function in smokers after 2-hour nicotine withdrawal using the event-related potential (ERP) technique.Participants and Methods: 28 nicotine dependence (ND) patients and 28 health controls (HCs) completed a smoking-cued Go/No-go task containing two different types of picture stimuli, smoking-cued and neutral picture stimuli. We analyzed the behavioral and ERP data using a mixed model Repeated Measure Analysis of Variance (ANOVA).Results: No-go trials accuracy rate (ACC) at baseline (time 1) was lower in the ND group compared to HCs with smoking-cued stimuli, and No-go trials ACC after 2-hour nicotine withdrawal (time 2) was not lower in the ND group compared to HCs. When confronted with smoking-cued stimuli, the No-go trials ACC was higher in time 2 than in time 1 in the ND group. For the ERP component, the No-go N2 amplitudes in the ND group with smoking-cued stimuli were lower than that of HCs, whereas after 2-hour nicotine withdrawal, the ND group’s No-go N2 amplitudes higher than that at time 1, and did not differ from that of HCs. No-go P3 amplitudes were not significantly different between the two groups.Conclusion: Evidenced from ERP data, ND patients have an inhibitory control dysfunction in the face of smoking cues, which is mainly manifested in the early stage of response inhibition rather than in the late stage. Two-hour nicotine withdrawal improves inhibitory control dysfunction in ND patients. The No-go N2 component is an important and sensitive neuroelectrophysiological indicator of inhibitory control function in ND patients.Keywords: nicotine dependence, inhibitory control, 2-hour nicotine withdrawal, event-related potentials, Go/No-go task

Hao Zou,1 Jianrong Liu,1 Dongxu Jiang,2 Linlin Hou,3 Weiliang Wang,4 Linlin Zhang5 1Nursing Department, The Second Affiliated Hospital of Xi’an Medical University, Shanxi, People’s Republic of China; 2Department of Nursing, Harbin Medical University, Heilongjiang, People’s Republic of China; 3Nursing Department, The second Affiliated Hospital of Xi’an Jiaotong University, Shanxi, People’s Republic of China; 4Nursing Department, Xuzhou Medical university, Jiangsu, People’s Republic of China; 5Department of Nursing, School of Pharmacy, Changzhou University, Jiangsu, People’s Republic of ChinaCorrespondence: Jianrong Liu; Linlin Zhang, Email 1548708192@qq.com; zhanglinlin1971@163.comPurpose: To test a hypothetical pathway model to estimate the links between health literacy, social support, illness perception, and disease management self-efficacy.Methods: This cross-sectional study, conducted from June to October 2022, involved the recruitment of 210 patients with chronic diseases at two primary care facilities. Participants completed the Health Literacy Management Scale, Self-Efficacy for Managing Chronic Disease 6-Item Scale, Social Support Rating Scale and Brief Illness Perception Questionnaire. We used the PROCESS macro for R to determine the hypothetical pathway model.Results: The direct effect of health literacy on self-efficacy was significant (β=0.1792, 95% CI: 0.0940– 0.2644), and social support played a partial mediating role between health literacy and self-efficacy (ES=0.0761, 95% CI: 0.0398– 0.1204). Illness perception moderated the relationship between social support and self-efficacy (β=− 0.0153, 95% CI: − 0.0268- − 0.0039).Conclusion: Proposed a conceptual model including the mediating effect of social support and the moderating effect of illness perception, which helps to clarify the underlying mechanisms between health literacy and self-efficacy.Keywords: health literacy, self efficacy, moderated mediation analysis

Chang Chen,1 Qian Mei,2 Qi Liu,3 Meichen Lu,4 Lu Hou,1 Xiaohong Liu,3 Xuezheng Gao,3 Limin Chen,3 Zhenhe Zhou,1– 4 Hongliang Zhou5 1Department of Psychiatry, The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi City, People’s Republic of China; 2School of Humanities and Management Science, Wannan Medical College, Wuhu City, People’s Republic of China; 3Grade 2021 Class 3, First Clinical Medical College of Jinzhou Medical University, Jinzhou City, People’s Republic of China; 4Department of Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi City, People’s Republic of China; 5Department of Psychology, The Affiliated Hospital of Jiangnan University, Wuxi City, People’s Republic of ChinaCorrespondence: Zhenhe Zhou, Wuxi Mental Health Center, No. 156, Qianrong Road, Binhu District, Wuxi City, Jiangsu Province, People’s Republic of China, Tel +86-1-335-811-8986, Fax +86-510-83219366, Email zhouzh@njmu.edu.cn Hongliang Zhou, The Affiliated Hospital of Jiangnan University, No. 200, Huihe Road, Binhu District, Wuxi City, Jiangsu Province, People’s Republic of China, Tel +86-1-536-525-1126, Fax +86-510-85808820, Email Hongliangzh2022@hotmail.comPurpose: Schizophrenia patients show impaired conditional reasoning. This study was to investigate event-related potential (ERP) characteristics of the conditional reasoning in schizophrenia.Patients and methods: Participants included 24 schizophrenia patients and 30 normal controls (NCs), and the measurements of ERPs were conducted during the Wason selection task.Results: Results showed that NCs consistently outperformed schizophrenia patients in terms of accuracy. Among the different rule types of the task, the precautionary type experiment yielded the highest accuracy rates. In contrast, both the descriptive and abstract type experiments resulted in lower accuracy. The RTs of the abstract type experiment were the shortest among the four experiments. In the abstract type of the Wason selection task, the NCs exhibited higher amplitudes for both the N1 and P2 components compared to the schizophrenia patients. At the parietal lobe, the N2 amplitudes were higher for the social contract type of the task compared to the precautionary version. At the frontal lobe, the N2 amplitudes were highest for the abstract type of the task. In the abstract type, the N2 amplitude at the parietal lobe was higher than that at the central lobe. The NCs displayed lower amplitudes for both the P3 and slow wave compared to the schizophrenia patients. Differences were observed between the NC and schizophrenia groups in terms of the latencies for N1, P2, N2, P3 and slow wave components across different experiment types and regions of interest.Conclusion: In conclusion, the observed ERP patterns provide valuable insights into the neural mechanisms underlying the Wason selection task, highlighting the differences between NCs and patients with schizophrenia.Keywords: event-related potential, wason selection task, schizophrenia, conditional reasoning, neural mechanism

Liang Zhang,1,&ast; Jun Wang,1,&ast; Yang Li,2 Leina Hou,3 Jianguo Xia,4,&ast; Jialin Shen1,&ast; 1Department of Interventional Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 2Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 3Department of Anesthesiology, Shaanxi Provincial Cancer Hospital, Xi’an, Shaanxi, People’s Republic of China; 4Department of Ultrasound, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jianguo Xia, Department of Ultrasound, Renji Hospital, Shanghai Jiao Tong University School of Medicine, NO. 160 Pujian Road, Shanghai, People’s Republic of China, Tel +86-13671807078, Fax +86-21-34506514, Email xiajianguo@renji.com Jialin Shen, Department of Interventional Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, NO. 160 Pujian Road, Shanghai, People’s Republic of China, Tel +86-13501794493, Fax +86-21-34506368, Email jialinshen123@163.comPurpose: To investigate the feasibility and efficacy of implanting an iodine-125 (125I) seed strand inside a portal vein stent (PVS) in the treatment of patients with hepatocellular carcinoma (HCC) and main portal vein tumor thrombus (mPVTT).Patients and Methods: Twenty-three patients who diagnosed with HCC and mPVTT and underwent endovascular implantation 125I seed strands and portal vein stenting were included in this study. Patients were divided into two groups. For patients in group A (n = 12), the 125I seed strand was placed outside the PVS, and for those in group B (n = 11), the strand was placed inside the PVS. Technical success, pain intensity during the procedure (numeric rating scale), procedure-related complications, changes in liver function, stent patency, and survival rates were recorded and analyzed.Results: The procedures were successful in all patients, and no serious procedure-related complications occurred in either group. Pain intensity during the procedure was significantly lower in group B than in group A (2.64 ± 1.50 vs 4.08 ± 1.78, p = 0.048), and there were no significant differences between pre- and post-procedure liver function in either group. The median duration of stent patency was 9 months (95% CI 2.21– 15.79 months) in group A and 12 months (95% CI 3.63– 18.37 months) in group B (p = 0.670). Median survival was 12 months (95% CI 10.30– 13.70 months) in group A and 13 months (95% CI 10.03– 15.97 months) in group B (p = 0.822). The cumulative stent patency and survival rates at 3, 6, and 12 months were 75%, 50%, and 41.7%, and 83.3%, 75%, and 50% in group A and 72.7%, 62.3%, and 31.2%, and 90.9%, 80.8%, and 50.5%, respectively.Conclusion: Implantation of 125I seed strand inside the PVS is effective and feasible for treating patients with HCC and mPVTT.Keywords: portal vein tumor thrombus, 125I seed, portal vein stent, endovascular brachytherapy, hepatocellular carcinoma

Ling Hou,1 Ke Su,2 Jinbo Zhao,2 Yuanhong Li2 1Department of Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Shiyan, Hubei Province, People’s Republic of China; 2Cardiovascular Disease Center, Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Enshi, Hubei Province, People’s Republic of ChinaCorrespondence: Yuanhong Li, Email lyh0101@vip.comObjective: Chronic obstructive pulmonary disease (COPD) is a prevalent chronic respiratory disease that poses a significant health risk to individuals. Patients with COPD are predisposed to a higher incidence of coronary artery disease (CAD) than the general population. This study aims to investigate the correlation between COPD and the incidence of in-stent restenosis (ISR) after percutaneous coronary intervention (PCI).Methods: This study retrospectively analyzed the clinical data and laboratory test results of patients who underwent PCI at our hospital between January 2018 and December 2021 to investigate the relationship between COPD and drug-Eluting Stents (DES) postoperative ISR. We employed the best subset method to select the most suitable combination of predictive factors, utilizing the data, and verified the precision of the model by means of internal validation. We ultimately assessed the performance of the prediction model using an ROC curve.Results: The research indicates that COPD is an independent risk factor for ISR after PCI (OR=2.437, 95% CI [1.336, 4.495], P=0.004). The analysis revealed an area under the receiver operating characteristic (ROC) curve of 0.783 for the training group and 0.705 for the testing group, indicating a model fitting for both groups (both > 0.5).Conclusion: COPD history is a dependable predictor of stent restenosis post percutaneous coronary intervention.Keywords: percutaneous coronary intervention, PCI, chronic obstructive pulmonary disease, COPD, in-stent restenosis, ISR, drug-eluting stents, DES, optimal subset regression

Shaoxing Zhang,1 Yuxin Zhang,1 Ruijie Liu,1 Shuying Yuan,2 Yanwen Chen,1 Wenjie Li,1 Xinrong Lu,3 Yongliang Tong,3 Linlin Hou,4 Li Chen,3 Guiqin Sun1 1School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China; 2Clinical Laboratory Department, Jiaxing Maternity and Child Health Care Hospital, Jiaxing, Zhejiang, People’s Republic of China; 3Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Fudan University, Shanghai, People’s Republic of China; 4College of Veterinary Medicine, Qingdao Agricultural University, Qingdao, Shandong, People’s Republic of ChinaCorrespondence: Guiqin Sun, School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, Zhejiang, People’s Republic of China, Tel +86 13868118601, Fax +86 571-86633307, Email sunguiqin2001@163.com Li Chen, Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Fudan University, 131 Dongan Road, Xuhui District, Shanghai, People’s Republic of China, Tel +86 15821138980, Fax +86 21-54237381, Email lichen_bk@fudan.edu.cnPurpose: Elizabethkingia meningoseptica (EM) is a multi-drug-resistant bacterium of global concern for its role in nosocomial infection and is generally resistant to aminoglycoside antibiotics. In the whole genome of an EM strain (FMS-007), an aminoglycoside-6-adenyl transferase gene (ant(6)FMS-007) was predicted. This study aimed to characterize the biochemical function of ANT(6)FMS-007 and analyze the relationship between genotype and phenotype of ant(6) in clinical EM isolates, so as to provide evidence for clinical precision drug use. This study could establish a method for the verification of known or unknown functionally resistant genes.Methods: A total of 42 EM clinical isolates were collected from clinical departments during 2015– 2023. The phenotype of aminoglycoside antibiotics was analyzed by broth microdilution (BMD) and Kirby-Bauer (K-B) methods. The whole-length ant(6) from EM clinical isolates was analyzed by polymerase chain reaction (PCR) and sequencing. The biochemical function of predictive ANT(6)FMS-007 from the FMS-007 whole genome was identified by 3D plate experiment and mass spectrometry analysis. Candidate active sites were predicted by multi-species sequence alignment and molecular docking, and other important sites were identified in the comparison of ant(6) genotypes and phenotypes of EM clinical isolates. Drug susceptibility test was used to verify the function of these sites.Results: The predictive ANT(6)FMS-007 protein could inactivate STR by modifying STR with ATP to form STR-AMP. Four active sites (Asp-38, Asp-42, Lys-95, and Lys-213) of ANT(6)FMS-007 were identified. Thirty-one EM clinical isolates (74%) carried the ant(6) gene. Eight EM clinical isolates containing the ant(6) gene had MIC values (

Kaikai Yang, Shanru Yang, Yang Chen, Guihua Cao, Rong Xu, Xin Jia, Liming Hou, Jinke Li, Chenting Bi, Xiaoming Wang Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of ChinaCorrespondence: Xiaoming Wang, Department of Geriatrics, Xijing Hospital, Air Force Medical University, 127 Changle West Road, Xi’an, 710032, People’s Republic of China, Tel +86-29-84775543, Email xmwang@fmmu.edu.cnPurpose: Fall is a common geriatric syndrome leading to various adverse outcomes in the elderly. Gait and balance disorders and decreased lower extremity muscle function are the major intrinsic risk factors of falls, and studies suggested that they were closely related to the underlying chronic conditions. This study aimed to explore the patterns of multimorbidity and determine the associations of these multimorbidity patterns with gait, balance and lower extremity muscle function.Patients and Methods: A cross-sectional survey of 4803 participants aged ≥ 60 years in Shaanxi Province, China was conducted and the self-reported chronic conditions were investigated. The 6-m walk test, timed-up-and-go test (TUG) and 5-sit-to-stand test (5-STS) were conducted to evaluate gait, balance, and lower extremity muscle function respectively. Latent class analysis was used to explore patterns of multimorbidity, and multivariate regression analysis was used to determine the associations of multimorbidity patterns with gait, balance, and lower extremity muscle function.Results: Five multimorbidity patterns were identified: Degenerative Disease Class, Cardio-metabolic Class, Stroke-Respiratory-Depression Class, Gastrointestinal Class, and Very sick Class, and they were differently associated with gait and balance disorders and decreased lower extremity muscle function. In particular, the multimorbidity patterns of Degenerative Disease Class and Stroke-Respiratory-Depression Class were closely associated with all the three risk factors of falls.Conclusion: There are significant differences in the impact of different multimorbidity patterns on the major intrinsic risk factors of falls in the elderly population, and appropriate multimorbidity patterns are closely related to the prediction of falls and can help to develop fall prevention strategies in the elderly.Keywords: elderly, multimorbidity, gait, balance, falls

Xiaolong Li,1– 3 Kunjie Zheng,1– 3 Wei Gu,1– 3 Xiaoyu Hou,1,3 Yunpeng Guan,1 Lifang Liu,1,3,4 Liping Hou,2 Jianlin Geng,2 Guangyao Song1,3 1Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China; 2Department of Endocrinology, Harrison International Peace Hospital, Hengshui, Hebei, People’s Republic of China; 3Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China; 4Department of Endocrinology, Baoding First Central Hospital, Baoding, Hebei, People’s Republic of ChinaCorrespondence: Guangyao Song, Tel +86-0311-8598-8556, Email sguangyao2@163.comPurpose: The relationship between blood lipids and fibroblast growth factor (FGF) 21 in the postprandial period remains unclear. To investigate this, we observed the changes in blood lipid levels after an oral fat tolerance test (OFTT) and examined the short-term effects on FGF21.Patients and Methods: A total of 158 non-diabetic adult volunteers who underwent OFTT were randomly recruited from the Hebei General Hospital. Participants were stratified into three groups according to fasting and 4-h postprandial triglyceride levels: normal fat tolerance (NFT), impaired fat tolerance (IFT), and hypertriglyceridemia (HTG). Blood samples were collected at 2-h intervals for 6 h. Circulating total cholesterol levels, triglycerides, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, free fatty acids (FFA), and FGF21 were assessed.Results: Fasting FGF21 levels increased progressively in the NFT, IFT, and HTG groups and were strongly correlated with FFA levels (r = 0.531, P < 0.001). During the OFTT, the FFA and FGF21 levels decreased and then increased after reaching a nadir at 2 and 4 h, respectively. After adjusting for potential risk factors, the FFA incremental area under the curve (iAUC) was an independent influencing factor of FGF21 iAUC (P = 0.005).Conclusion: Fasting FGF21 levels showed a strong positive correlation with FFA. During OFTT, changes in FGF21 levels were closely associated with alterations in FFA exogenously changed by OFTT. Moreover, they were linearly related to each other. Therefore, the serum FGF21 level is positively correlated to the FFA level in the postprandial period.Keywords: fibroblast growth factor 21, free fatty acid, lipids, dyslipidemia, postprandial state, oral fat tolerance test

Yinhua Luo,1,&ast; Jinbo Zhao,2,&ast; Xueru Chen,3,&ast; Rui Huang,2 Ling Hou,2 Ke Su,2 Yuhua Lei,2 Yuanhong Li1,2 1Department of Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Shiyan, Hubei Province, 442000, People’s Republic of China; 2Cardiovascular Disease Center, Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Enshi Prefecture, Hubei Province, 445000, People’s Republic of China; 3Department of General Practice, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, 510120, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yuanhong Li, Cardiovascular Disease Center, Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Enshi Prefecture, People’s Republic of China, Email shaoyiju75482@163.comBackground: Ischemic cardiomyopathy (ICM) with high mobility and mortality is closely linked to immunology, oxidative stress, inflammatory response and so on. Early diagnosis counts for the effective treatment of ICM. However, there are still no distinctive diagnostic signatures. This research aims to investigate effective signatures and build the diagnostic model for ICM.Methods: The Gene Expression Omnibus was used to retrieve the microarray data of GSE9800 and GSE580, which were obtained from tissue biopsy samples. Differentially expressed genes (DEGs), GO, and KEGG analyses were then carried out on the microarray data. The PPI network was constructed via STRING database.Following that, CIBERSORT techniques in conjunction with the LM22 feature matrix were used to assess the immune infiltration of the samples.The expression of a few chosen genes served as the predictor variable, and the occurrence of ICM served as the responder variable, in the construction of the best subset stepwise regression model.Results: A total of 28 DEGs were found. And according to the GO and KEGG studies, numerous biological processes were enriched. Patients with ICM and their normal counterparts had considerably distinct immune cell types infiltrating. For the construction of the PPI network, the top 20 most significant DEGs were selected and were used to build the original regression model. The optimal subset screened using stepwise regression analysis contained three pivotal genes (SCD, SNX25, WNT7B) and the area under the curve (AUC) values in this model was 0.891.Conclusion: We identified several possible hub genes, including SCD, SNX25, and WNT7B, which may be strongly related to the development of ICM. Based on the three genes, the logistic regression model could be used to accurately diagnose ICM patients.Keywords: ischemic cardiomyopathy, ICM, immunology, inflammatory responses, diagnosis, differently expressed genes, bioinformatic analysis, the optimal subset stepwise regression

Jinbo Zhao,1,&ast; Ling Hou,2,&ast; Ni Zhu,3,&ast; Rui Huang,1 Ke Su,1 Yuhua Lei,1 Yuanhong Li1 1Cardiovascular Disease Center, Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Enshi Prefecture, Hubei Province, 445000, People’s Republic of China; 2Department of Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Shiyan, Hubei Province, 442000, People’s Republic of China; 3Department of Pathology, Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Enshi Prefecture, Hubei Province, 445000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yuanhong Li, Email lyh0101@vip.comObjective: The CHA2DS2-VASc score, a system which has been initially recommended for the assessment of thromboembolic risk in patients with atrial fibrillation (AF), arouses attention in the field of adverse coronary events. The purpose of this study was to explore the predictive value of preprocedural CHA2DS2-VASc score on ISR in patients after drug-eluting stent (DES) implantation.Methods: To further investigate the relationship between CHA2DS2-VASc scores and ISR after DES, a retrospective study of DES was carried on. Additionally, the preoperative variables for the ISR and control groups were contrasted. Predictive factors were chosen using the optimal subset regression. We validate the model using internal validation. The prediction model was evaluated using the receiver operator characteristic (ROC) analysis.Results: We used a 3:7 ratio to create an experimental group and a validation group, and then ran a stepwise regression with the data from each of the two groups. The results showed that CHA2DS2-VASc score was an independent risk factor for ISR in both the experimental (p = 0.0139) and validation groups (p = 0.0014), and both had significant predictive value for ISR. The area of the ROC curve was greater than 0.5 in both groups (AUC = 0.78, 0.719, respectively) indicating that the model fit was good in both groups.Conclusion: The CHA2DS2-VASc score is a reliable predictor of in-stent restenosis (ISR) after DES implantation.Keywords: CHA2DS2-VASc score, drug-eluting stents, DES, percutaneous coronary intervention, PCI, in-stent restenosis, ISR

Peipei Han,1– 3,&ast; Lin Hou,3,4,&ast; Zhenwen Liang,2 Wuxiong Chen,5 Junxue Li,5 Yazhou Cheng,5 Wenjing Zhou,2 Siya Zeng,2 Jiangtao Pan,2 Lanshan Xu,2 Yi Wang,2 Yangyi Chen,2 Qi Guo1– 3 1Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, People’s Republic of China; 2College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, People’s Republic of China; 3Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, People’s Republic of China; 4Child Mental Health and Rehabilitation Center, Shenzhen Maternity & Child Health Care Hospital, Shenzhen, People’s Republic of China; 5Department of Rehabilitation Medicine, Shanghai Health Rehabilitation Hospital, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Qi Guo, College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, 279 Zhouzhu Highway, Pudong New Area, Shanghai, 201318, People’s Republic of China, Tel/Fax +86-22-8333-6977, Email guoqijp@gmail.comBackground: Few longitudinal studies have explored exploring the relationship between sleep duration and sarcopenia. Evidence concerning the relationship between sleep duration and sarcopenia is limited and inconsistent. The purpose of this 3-year prospective study was to explore whether sleep duration was associated with sarcopenia onset in suburb-dwelling older Chinese individuals.Methods: This was a prospective study that included 754 Chinese suburb-dwelling men and women aged ≥ 60 years (men n=327, mean age 65.24± 4.87 years) who were not initially diagnosed with sarcopenia. We defined sarcopenia using the diagnostic algorithm recommended by the Asian Working Group for Sarcopenia. Self-reported sleep duration was a component of the interview measured by trained interviewers. Subjects were categorized into 3 groups at baseline [short: < 6 h, medium: 6– 8 h, and long: > 8 h].Results: The incidence of sarcopenia during the 3-year follow-up was 12.2%. Multivariate logistic regression analyses showed that after adjustments for potential confounders long sleep duration was independently associated with sarcopenia incidence from baseline through the 3-year follow-up: when using the 6– 8 h sleep duration group as a reference, the adjusted ORs for sarcopenia of the groups who slept < 6 and > 8 hours were 2.74 (95% CI 1.05– 7.13) and 1.84 (95% CI 1.07– 3.14).Conclusion: Both short and long sleep durations were associated with a greater incidence of sarcopenia. Thus, sleep duration should be considered when developing prevention and management strategies for sarcopenia.Keywords: longitudinal study, older, sarcopenia, sleep duration, suburb-dwelling

This review assesses interventions to reduce loneliness in Chinese older adults, analyzing 36 studies involving 3965 participants. Focusing on individuals aged 50 and over, the meta-analysis reveals a significant overall effect size (Hedges' g = 0.937, 95% CI [0.71,1.16], p<0.001), highlighting the effectiveness of psychological and mixed-method approaches. Despite promising results, methodological concerns suggest cautious interpretation. Future research should aim to refine intervention quality and examine the impact of technology-supported methods on loneliness. [ABSTRACT FROM AUTHOR]