Tangshan Gongren Hospital

The developmental trajectory of exercise self-efficacy refers to the course of change in an individual's belief in their capability to successfully perform exercise-related behaviors over time. This study aims to explore the developmental trajectory of exercise self-efficacy in patients with multivessel coronary artery disease, and analyze the predictors of various trajectory subgroups. Between September 2023 to October 2024, 297 patients with multivessel coronary artery disease were recruited from three tertiary hospitals in Tangshan, China. Exercise self-efficacy was measured using the Multidimensional Self-Efficacy for Exercise Scale on the third day of admission (T1), one month after discharge (T2), three months after discharge (T3), and six months after discharge (T4). The latent class growth model was employed to identify the developmental trajectory of exercise self-efficacy in patients with multivessel coronary artery disease. Multinomial logistic regression was adopted to determine the predictors of trajectory subgroups. Three distinct trajectories of exercise self-efficacy were identified: the "Low-Efficacy Decline Group" (22%), the "High-Efficacy Ascending-Stable Group" (34%), and the "Moderate-Efficacy Continuous Increase Group" (44%). Multinomial logistic regression analysis revealed significant determinants of distinct exercise self-efficacy trajectories, when compared with the moderate-efficacy continuous increase group, the predictors for the low-efficacy decline group included having diabetes, a lack of exercise habits, low social support, and anxiety. In contrast, the predictors for the high-efficacy ascending-stable group were high average monthly household income, established exercise habits, and strong social support. The study revealed heterogeneous trajectories of exercise self-efficacy among patients with multivessel coronary artery disease, highlighting the necessity for personalized intervention strategies. These findings offer a valuable opportunity for early prevention and targeted interventions aimed at enhancing exercise self-efficacy.

Abstract Objective: To evaluate the procedural safety, short-term efficacy, and hemodynamic impact of the low-profile visualized intraluminal support (LVIS) stent in treating intracranial wide-necked aneurysms. Methods: A retrospective analysis was conducted on 61 consecutive patients with intracranial wide-necked aneurysms undergoing LVIS stent-assisted coiling between January and December 2022. The cohort comprised 35 patients with ruptured aneurysms and 26 with unruptured aneurysms. The Raymond-Roy Occlusion Classification (RROC) was employed to assess the immediate angiographic results. Clinical outcomes were evaluated at 3-6 months using the modified Rankin Scale (mRS), with parent artery patency and aneurysm recurrence evaluated using follow-up digital subtraction angiography (DSA). Additionally, computational fluid dynamics (CFD) analysis was adopted in a subset of patients to quantify hemodynamic alterations by measuring changes in wall shear stress (WSS) and intra-aneurysmal mean flow velocity. Results: Embolization Efficacy: Immediate postprocedural angiography revealed RROCclass I in 28 (80.0%) and class II in 7 (20.0%) ruptured aneurysms; as well as class I in 22 (84.6%) and class II in 4 (15.4%) unruptured aneurysms. Complications and Outcomes: Intraprocedural thrombosis occurred in 2 patients with ruptured aneurysms; patency was restored following intra-arterial tirofiban administration, though one patient sustained residual neurological deficits. The results of mRS at 3–6 months in the ruptured group showed 0 (n=21), 1 (n=6), 2 (n=3), 3 (n=2), and 5 (n=3). In the unruptured group, one case exhibited suboptimal stent expansion. One patient developed postoperative neurological deterioration and died after discontinuing dual antiplatelet therapy, without stent thrombosis or parent vessel occlusion via subsequent angiography. Imaging Follow-up: Fourteen patients with ruptured and 13 with unruptured aneurysms were followed up by DSA at 6 months. It was observed with patent parent arteries without stenosis, thrombosis, or aneurysm recurrence. Hemodynamic Analysis: CFD analysis indicated a significant immediate reduction in intra-aneurysmal WSS postoperatively (P<0.001), which remained significant at 6 months (P<0.001). In addition, there was significantly decreased intra-aneurysmal flow velocity (P=0.021), albeit with substantial interindividual variability. Conclusion: LVIS stent-assisted coiling demonstrates a favorable safety profile, technical feasibility, and reliable short-term efficacy for treating intracranial wide-necked aneurysms, including those in the acute rupture phase, with concurrent improvement in intra-aneurysmal hemodynamic environment.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a prevalent urological condition affecting men's health. This study aims to investigate the clinical efficacy of Qianlie Shutong (QLST) capsule in the treatment of CP/CPPS. The medical records of patients with CP/CPPS who were admitted to our hospital from January 2023 to January 2024 were retrospectively analysed. They were divided into observation and control groups according to treatment modality received. The control group received levofloxacin (0.5 g, qd) in combination with tamsulosin hydrochloride (0.2 mg, qd). The observation group received an additional supplementation of QLST capsule (0.4 g, tid) alongside the treatment administered to the control group. Both groups underwent treatment for 28 days. Baseline data and clinical outcomes were compared between the groups, including the National Institute of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), maximum urine flow rate (Qmax), urine volume (UV), prostate-specific extracellular vesicle protein (PSEP) and International Index of Erectile Function-15 (IIEF-15). A total of 117 patients were enrolled in this study, comprising 60 in the observation group and 57 in the control group. No significant differences in baseline characteristics were found between the two groups (p > 0.05). Before intervention, no significant differences in NIH-CPSI, Qmax, UV, PSEP and IIEF-15 were found between the two groups (p > 0.05). Following intervention, both groups exhibited significant reductions in NIH-CPSI and PSEP, and the levels in the observation group were lower than those in the control group (p < 0.05). Qmax, UV and IIEF-15 increased in both groups, and the levels in the observation group were higher than those in the control group (p < 0.05). This study demonstrates that QLST effectively alleviates the clinical symptoms in patients with CP/CPPS, reduces PSEP levels and improves erectile function, supporting its clinical application.

Diabetic foot ulcer (DFU) is a common and serious complication of diabetes mellitus (DM) and one of the main causes of disability or mortality in diabetic patients. Astragaloside IV (AS-IV) is a naturally occurring plant product that can be used to treat DM and its complications. N6-methyladenosine (m6A) modification participates in the progression of DM. This study aimed to explore the potential molecular mechanisms of m6A modification induced by AS-IV treatment of DFU. The biological behaviours of cells were assessed by cell counting kit-8, EdU incorporation, wound healing, and transwell assays. The levels of m6A modification and relative genes mRNA were detected by dot blot assay and quantitative real-time PCR. The interactions between molecules were evaluated by methylated RNA immunoprecipitation (MeRIP), RIP, fluorescence insitu hybridisation, and dual-luciferase reporter analysis. The results suggested AS-IV facilitated cell proliferation and migration of AGE-induced HaCaT cells and accelerated wound healing, thereby alleviating DFU progression. Mechanically, AS-IV promoted the m6A modification levels of SIRT1 invivo and invitro which was associated with increased METTL3. Besides, SIRT1 was the target of METTL3-mediated m6A modification. Silencing of SIRT1 abrogated the biological effects of METTL3. The mitigation effect of AS-IV on DFU is achieved by promoting m6A modification of SIRT1 to enhance SIRT1 stability. This study not only reveals the novel molecular mechanisms of AS-IV in the treatment of DFU but also provides new insights for the treatment of diabetes and its complications.

Abstract Background Gasdermin D (GSDMD)-mediated pyroptosis, a critical component of the innate immune response, is triggered by pathogenic microbial infections and plays a key role in host defense mechanisms. This process involves the cleavage of GSDMD by inflammatory caspases, releasing carboxy-terminal fragments (GSDMD-CT). Monitoring GSDMD-CT levels represents a promising approach for inflammatory diseases, including sepsis and systemic inflammatory response syndrome (SIRS). Methods We developed an immunoassay to measure plasma GSDMD-CT concentrations in 109 healthy individuals, 137 patients with SIRS, and 100 patients with sepsis. The diagnostic utility of GSDMD-CT in distinguishing sepsis from SIRS or healthy controls was assessed using receiver operating characteristic (ROC) analysis, alongside correlations with procalcitonin (PCT), and C-reactive protein (CRP). Results Plasma GSDMD-CT levels were significantly elevated in patients with sepsis compared to healthy control and SIRS groups. ROC analysis demonstrated an area under the curve (AUC) of 0.8701, with a sensitivity of 91.00% and specificity of 60.55% for differentiating sepsis from HC. Comparable performance was observed in distinguishing SIRS from HC. Diagnostic accuracy was further enhanced when GSDMD-CT was combined with PCT. Strikingly, GSDMD-CT mirrored the kinetic profile of PCT in antibiotic-treated patients with bacterial infections. Conclusion The GSDMD-CT assay demonstrates high sensitivity as a biomarker, offering potential for early and differential diagnosis of sepsis across diverse pathogens.

Background Few studies have been conducted to investigate the association between the triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio and major adverse cardiac and cerebrovascular events (MACCEs) in a predominantly male cohort from China. Methods A prospective cohort study was conducted on a total 95,837 individuals (males account for 79.67) extracted from the Kailuan study. All individuals were grouped according to the TG/HDL-C ratio quartile. The endpoints of this study were composite MACCEs and its subtypes [non-fatal myocardial (MI), non-fatal stroke and all-cause mortality]. The Kaplan-Meier method was employed to illustrate the cumulative incidence curve. The incidence rate was reported as per 1000 person-years. To explore the impact of varying quartiles of the TG/HDL-C ratio on the risk of MACCEs, Cox proportional hazard regression analysis was conducted. Furthermore, multivariate adjusted spline regression models were applied to examine the relationship between the TG/HDL-C ratio and the risk of MACCEs. Results A total of 18,430 cases of composite MACCEs occurred during a 13.97-year follow-up. In brief, 1762 cases of MI, 6653 cases of stroke, and 12,524 cases of all-cause mortality were reported, respectively. The cumulative incidence and incidence rate of composite MACCEs, MI, and stroke increased with increment in the TG/HDL-C ratio (p < 0.001). In comparison to quartile 1, the hazard ratios of quartile 4 for composite MACCEs, MI, stroke, and all-cause mortality were 1.13 (95% CI 1.07–1.19), 1.55 (95% CI 1.30–1.84), 1.21 (95% CI 1.12–1.31), and 1.12 (95% CI 1.05–1.20), respectively. Multivariate adjusted spline regression models showed a nonlinear relationship between baseline TG/HDL-C ratio and risk of composite MACCEs (p for non-linearity < 0.01), MI (p for non-linearity < 0.01), stroke (p for non-linearity < 0.01), and all-cause mortality (p for non-linearity = 0.029). Conclusions The TG/HDL-C ratio is significantly associated with an increased risk of MACCEs in a predominantly male cohort from northern China.

Hepatocellular carcinoma (HCC) remains one of the most lethal cancers globally. Despite advancements in immunotherapy, the prognosis for patients with HCC continues to be poor. As oxidative stress plays a significant role in the onset and progression of various diseases, including metabolism-related HCC, comprehending its mechanism in HCC is critical for effective diagnosis and treatment. This study utilized the TCGA dataset and a collection of oxidative stress genes to identify the expression of oxidative stress-related genes in HCC and their association with overall survival using diverse bioinformatics methods. A novel prognostic risk model was developed, and the TCGA cohort was divided into high-risk and low-risk groups based on each tumor sample's risk score. Levels of immune cell infiltration and the expression of immune checkpoint-related genes in different risk subgroups were analyzed to investigate the potential link between tumor immunity and oxidative stress-related features. The expression of model genes in actual samples was validated through immunohistochemistry, and their mRNA and protein expression levels were measured in cell cultures. Four oxidative stress-related genes (EZH2, ANKZF1, G6PD, and HMOX1) were identified and utilized to create a predictive risk model for HCC patient overall survival, which was subsequently validated in an independent cohort. A correlation was found between the expression of these prognostic genes and the infiltration of tumor immune cells. Elevated expression of EZH2, ANKZF1, G6PD, and HMOX1 was observed in both HCC tissues and cell lines. The combined assessment of EZH2, ANKZF1, G6PD, and HMOX1 gene expression can serve as an oxidative stress risk model for assessing HCC prognosis. Furthermore, there is a correlation between the expression of these risk model genes and tumor immunity.

Background: This Pseudoangiomatous stromal hyperplasia (PASH), a rare benign breast tumor, manifests as a fissured pseudovascular cavity formed by interstitial hyperplasia. Imaging often presents it as a nodular or non-mass-type lesion associated with other benign lesions. Clinical detection of PASH generally reveals a rare mass type. Materials and Methods: We report a case of a 13-year-old girl with a rapidly growing circumscribed mass in her unilateral breast. Mammography of the breast revealed a high-density mass without calcification; color Doppler ultrasound showed a low echo with arterial blood flow; magnetic resonance imaging (MRI) suggested that the mass was heterogeneous; diffusion-weighted imaging (DWI) results indicated a slightly high signal; T2-weighted imaging (T2WI) high-signal components showed a fissure without enhancement; and the time-signal intensity curve of solid components displayed a type I curve. Patient underwent surgical treatment, whereupon pathological results indicated PASH. Conclusion: PASH presents as a rapidly growing borderline mass without calcification in a unilateral breast. Comparative analyses of the imaging characteristics of multiple MR sequences show significant enhancement of the low-signal area in T2WI results.