The classification of diabetes is undergoing a significant transformation. As advancements in medical technology and a deeper understanding of its etiology， traditional classification methods based on clinical characteristics and insulin dependency are increasingly revealing their limitations. In recent years， the integration of genomic， epigenetic， and metabolomic technologies， combined with the application of big data analytics and machine learning in disease classification， has propelled diabetes classification towards enhanced precision and personalization. These cutting-edge technologies elucidate the intricate pathophysiological mechanisms and extensive heterogeneity inherent in diabetes， offering novel methodologies for early diagnosis， individualized treatment， and prognostic evaluation. This paradigm shift not only deepens the comprehension of diabetes complexity but also holds the potential to provide more precise and efficacious therapeutic interventions for patients. Consequently， this marks a historic transition from simplistic， clinically-based classification systems to sophisticated， molecular mechanism-based paradigms in diabetes classification.

In the early stages of type 2 diabetes， inducing remission of hyperglycemia has become a global hotspot in the field of diabetes management. In recent years， scholars from both domestic and international communities have established several remission intervention methods， including short-term intensive insulin therapy， lifestyle intervention， and metabolic surgery. They have also proposed theories such as beta-cell dedifferentiation and liver-pancreas “twin cycle” hypothesis， which have accelerated the growth of clinical and research information in this field. This review summarizes the clinical evidence， basic mechanisms， applicable populations， and exacutive principle points in the field of diabetes remission， with the aim of deepening the understanding of clinical practitioners about diabetes remission and laying the foundation for better practice and research in related fields.

This paper discusses the entry point of traditional Chinese medicine in the field of diabetes treatment， and puts forward several directions as the entry point， including unique understanding of diabetes and its complications in TCM， treatment of diabetes at the early stage， improvement in clinical symptoms of diabetes patients， treatment of diabetes complications， improvement in adverse drug reactions， intensive research of classic prescriptions and effective drugs in successive dynasties， and diversity of TCM treatment methods. It can complement the advantages of modern medicine while make best use of the advantages and avoid the disadvantages. Traditional Chinese medicine has the characteristics of general regulation and multi?target effects， and its advantages are more obvious in improving symptoms and treating complications and accompanying diseases.

With the improvement of people's living standards， the number of patients with obesity and diabetes in China has been surging， causing a great disease burden. In recent years， evidence-based guidelines has increasingly emphasized the importance of weight management in the prevention and treatment of diabetes. Although there are many issues in theoretical and practical levels to be further elucidated， there is an urgent need for both doctors and patients to adapt to this new situation. Weight loss is a “double-edged sword”. Weight loss strategies that maximize the benefits for diabetic patients with overweight or obesity should be based on a proper understanding of the meaning of weight management. Long-term maintenance of weight loss still faces many challenges， which require accurate assessment of the disease， weighing the pros and cons of weight loss， implementation of a reasonable and feasible weight loss program， and adherence to long-term professional management.

Diabetic foot （DF）， a primary chronic complication of diabetes mellitus， contributes to a major disability and mortality in diabetic patients. DF is diagnosed mainly depending not only on clinical manifestations， signs， and related inspection， but also on recently emerging diagnostic means： biological markers. Inflammatory biomarkers are preferably used for its superiority in DF early diagnosis. In recently years， thanks to advancements of biological technologies， biomarkers such as procalcitonin （PCT）， C?reactive protein （CRP）， interleukins （ILs）， and tumor necrosis factor?alpha （TNF?α） have been comprehensively used in DF diagnosis. Moreover， biomarkers of genomics， proteomics， metabolomics， and metagenomics have been employed as well. In this review， we aim to comprehensively review the role of serum biomarkers in DF diagnosis and risk stratification， elaborating on the current research status in applying serum biomarkers for DF prevention， diagnosis， and prognosis assessment.

Diabetes mellitus erectile dysfunction （DMED） is a common diabetic-related vascular， endocrine and neuropathy in clinical practice， and patients with DMED often present with symptoms such as difficulty in erection， prolonged erection time， poor hardness， and short sexual intercourse. The etiological mechanism is complex， and it is often closely related to many factors such as oxidative stress （OS）， inflammatory response， and neurological and endocrine lesions， which often cross-react and promote the progression of DMED lesions. In recent years， relevant studies have shown that OS and ferroptosis play a key role in DMED： OS can cause neurological and Abnormal endocrine function， decreased synthesis or bioavailability of penile vascular endothelium， spongy endothelial cell dysfunction and decreased smooth muscle diastolic function， resulting in penile erectile dysfunction， and ferroptosis has also been confirmed to be closely related to DMED， controlling OS and ferroptosis to improve erectile function in diabetic patients is a reasonable and effective treatment pathway， but the mechanism of action of ferroptosis leading to DMED needs to be further studied. Therefore， this article reviews the latest information on the correlation between OS and ferroptosis and DMED， aiming to provide a useful reference for exploring the mechanism of DMED， clinical prevention and treatment of DMED， and providing potential directions for future research in this field.

Objective To explore the influencing factors of mild cognitive impairment （MCI） in patients with atrial fibrillation and diabetes mellitus， and to establish the prediction model， so as to provide guidance for the treatment of MCI in patients with atrial fibrillation and diabetes mellitus. Methods 199 patients with atrial fibrillation and diabetes diagnosed in the second ward of Cardiovascular Department of the Fifth Affiliated Hospital of Zhengzhou University from January 2023 to January 2024 were analyzed. The related factors of MCI in patients with atrial fibrillation and diabetes mellitus were analyzed by univariate analysis and multivariate logistic regression. According to the results of multivariate logistic regression analysis， the prediction model of MCI in patients with atrial fibrillation and diabetes mellitus was established. Results Univariate analysis showed that age （P =0.002 3）， homocysteine （P < 0.000 1）， fasting blood glucose （P = 0.022 5）， glycated hemoglobin （P = 0.006 6）， and blood uric acid （P = 0.032 2） were the influencing factors of MCI. Multivariate logistic regression analysis： age （OR = 1.08， P = 0.000 4）， homocysteine （OR = 1.37， P < 0.000 1）， fasting blood glucose （OR = 1.22， P =0.023 5）， glycated hemoglobin （OR = 1.61， P = 0.004 2）， and blood uric acid （OR = 1.29， P = 0.009 1） were the independent influencing factors of MCI. The optimal threshold is when the Youden index （YI = sensitivity + specificity） is maximum. At the optimal threshold， the sensitivity was 0.74， the specificity was 0.80， and the area under the curve （AUC） was 0.809， indicating that the model can effectively predict the occurrence of MCI. Conclusion Age， fasting blood glucose， blood homocysteine， blood uric acid and glycosylated hemoglobin are independent risk factors for MCI in patients with atrial fibrillation and diabetes. The clinical prediction model based on multivariate logistic regression has a certain predictive value for the occurrence of MCI in patients with atrial fibrillation and diabetes mellitus.

Objective To investigate the association between microRNA （miR）?23a， miR?150， and miR?150?5p levels and diabetic osteoporosis（DOP） through correlation analysis. Methods A total of 200 patients with diabetes who visited the hospital between March 2020 and March 2022 were selected and followed up for a duration of 2 years. Patients who developed DOP and those who did not were respectively assigned to the DOP group and the non?DOP group. The general information and serum levels of miR?23a， miR?150， and miR?150?5p between these two groups were compared. Pearson correlation analysis was conducted to examine the relationship between serum levels of miR?23a， miR?150， and miR?150?5p， as well as bone density. Logistic regression model was employed to identify factors influencing DOP. Results The incidence rate of DOP was 28.89%. The serum levels of miR?23a， miR?150， and miR?150?5p were significantly elevated in the DOP group compared to the non?DOP group （P < 0.05）. Pearson correlation analysis revealed a negative association between the serum levels of miR?23a， miR?150， and miR?150?5p in diabetic patients and bone density （P < 0.05）. Logistic regression model analysis demonstrated that age， body mass index （BMI）， as well as miR?23a， miR?150， and miR?150?5p were influential factors contributing to the development of DOP （P < 0.05）. Conclusion The levels of serum miR?23a， miR?150， and miR?150?5p are elevated in patients with DOP， and all three exhibit a negative correlation with bone density. Furthermore， these factors collectively contribute to the development of DOP.

Objective To explore the relationship between serum leucine 2-rich glycoprotein 1 （LRG1）， lactate dehydrogenase （LDH） with periodontal indicators and periodontal lesions degree in patients with type 2 diabetes mellitus （T2DM） and chronic periodontitis （CP）. Methods 112 patients with T2DM combined with CP admitted to our hospital from July 2022 to July 2023 （T2DM combined with CP group） were selected and categorized into mild， moderate， and severe groups according to the degree of periodontal pathology； 112 patients with CP alone （CP group） were selected from our hospital during the same period， and then 112 patients with T2DM alone （T2DM group） were selected； and LRG1， LDH， and periodontal indexes were measured； Pearson method was applied to analyze the correlation between serum LRG1， LDH， and periodontal indicators. The influencing factors of severe T2DM combined with CP were analyzed using multivariate logistic regression. ROC curve was plotted to analyze the diagnostic value of serum LRG1 and LDH for severe T2DM combined with CP. Results The levels of LRG1 and LDH in the CP group， T2DM group， and T2DM combined with CP group increased sequentially （P < 0.05）. The levels of serum LRG1， LDH， AL， PD， and BI increased sequentially in the mild， moderate， and severe groups （P < 0.05）. According to Pearson correlation analysis， serum LRG1 was positively correlated with LDH （P < 0.05）. Serum LRG1 and LDH were positively correlated with AL， PD， and BI （P < 0.05）. According to logistic regression analysis， LRG1， LDH， AL， PD， and BI were all factors for severe T2DM combined with CP （P < 0.05）. According to the ROC curve， the AUC for the combined diagnosis of serum LRG1 and LDH in severe T2DM with CP was 0.910， and the combination of the two was better than their individual diagnosis （Z _{combination vs LRG1}= 2.659， Z _{combination vs LDH}=2.627， P < 0.05）. Conclusion LRG1 and LDH are greatly elevated in the serum of patients with T2DM combined with CP， and they are related to periodontal indicators and the periodontal lesions degree.

Objective To investigate the association between abdominal visceral fat content and the occurrence of type 2 diabetes mellitus （T2DM） and the potential of predicting the incidence of T2DM with abdominal visceral fat content. Methods The study included 45 patients with T2DM who underwent 3.0T MRI and 80 control patients， recruited from the First Affiliated Hospital of Baotou Medical College， Inner Mongolia University of Science and Technology. IDEAL software was utilized for automated image recombination to obtain fat fraction， relaxation rate （R2^*）， lipid phase， water phase， and in-phase images. Fat fraction images were transferred to AW 4.6 workstation for measurement of fat fraction plots by two observers using a double-blind approach. ITK-SNAP software was employed for semi-automatic delineation of abdominal visceral fat and subcutaneous adipose tissue through threshold segmentation method， followed by volume calculation. Statistical analysis of the data was performed using SPSS 26.0 software. Results （1） The T2DM group exhibited significantly higher levels of abdominal visceral adipocyte volume （VATV）， hepatic fat fraction （HFF）， pancreatic fat fraction （PFF）， triglyceride （TG）， and fasting blood glucose （FBG） compared to the control group. Conversely， the high density lipoprotein （HDL） level was significantly lower in the T2DM group than in the control group （P < 0.05）. The correlation analysis revealed that in male patients， abdominal VATV exhibited positive associations with body mass index （BMI）， waist circumference， subcutaneous adipose tissue volume （SATV）， hepatic fat fraction （HFF）， TG， and FBG； while displaying a negative association with HDL. In female patients， VATV demonstrated positive correlations with BMI， waist circumference， SATV， and HFF. （2） The ROC curve analysis demonstrated that the area under the curve （AUC） for PFF in diagnosing T2DM was 0.656 （P < 0.01，95%CI：0.534 ~0.777）. The determined cut-off value was 8.44%， yielding a sensitivity of 50% and specificity of 82.5%. Similarly， HFF exhibited an AUC of 0.744 （P < 0.05， 95%CI： 0.637 ~ 0.851）， with a cut-off value of 2.99%， sensitivity of 97.5%， and specificity of 42%. In male patients， VATV displayed an optimal threshold for T2DM diagnosis at a volume of approximately 3 466 cm3， resulting in a sensitivity of 63.2%， specificity of 89.5%， and AUC of 0.78 （P < 0.01）. The sensitivity was 78.9% and specificity was 84.2% when SATV， PFF and HFF were combined and the AUC was 0.839 （P < 0.01）. The optimal threshold for diagnosing T2DM with VATV in female patients was 2 103cm3， and the sensitivity， specificity and AUC of T2DM with VATV were 66.7%， 66.7% and 0.68 （P < 0.05）. When SATV， PFF and HFF were combined， the sensitivity was 90.5%. The specificity was 76.2% and the AUC was 0.909 （P < 0.01）. （3）For each additional unit of TG and FBG， the risk of T2DM respectively increased by 3986.3% and 417.1%， in other words， TG and FBG were independent predictors of the occurrence of T2DM. Conclusion The predictive value of pancreatic fat fraction， liver fat fraction， and abdominal visceral fat tissue volume for the onset of type 2 diabetes is limited. However， combining abdominal visceral adipose tissue volume with subcutaneous adipose tissue volume， pancreatic fat fraction， and liver fat fraction significantly enhances the efficacy， sensitivity， and specificity of predicting type 2 diabetes occurrence. The IDEAL-IQ technique offers a convenient method for quantitatively evaluating intra-abdominal ectopic adipose tissue deposition in patients with type 2 diabetes mellitus. It demonstrates advantages such as simplicity， good stability， high reproducibility and holds great potential.

Objective To explore the mechanism of microRNA （miRNA）-365a-3p affecting the function of vascular endothelial cells involved in the pathogenesis of preeclampsia （PE）. Methods Primary human umbilical vein endothelial cells （HUVECs） were set as a NC group （transfected miR-365a-3p NC）， a mimics group （transfected miR-365a-3p mimics） and a inhibitor group （transfected miR-365a-3p inhibitor）. Logarithmic HUVECs cells were set as the blank group. The cell proliferation， migration and angiogenesis in each group were detected. Dual luciferin assay verified the targeting relationship between miR-365a-3p and downstream gene. The protein expressions of TGF-β₁， Smad4 and Smad7 in each group were detected. Results Compared with the blank group and the NC group， the absorbance value and mobility of 24， 48 and 72 h were decreased （P < 0.05）， the number of tubular structures per field were decreased in the mimics group （P < 0.05）， the absorbance value and mobility of 24， 48 and 72 h were increased （P < 0.05）， and the number of tubular structures per field were increased in the inhibitor group （P < 0.05）. Dual luciferin assay showed that Smad7 was a target gene of miR-365a-3p. Compared with the blank group and the NC group， the protein expressions of TGF-β₁ and Smad4 in the mimics group were increased （P < 0.05）， while the protein expression of Smad7 was decreased （P < 0.05）. The protein expression levels of TGF-β₁ and Smad4 in the inhibitor group were decreased （P < 0.05）， while the protein expression levels of Smad7 were increased （P < 0.05）. Conclusion miR-365a-3p may affect the function of vascular endothelial cells by regulating the downstream TGF-β signaling pathway， and thus participate in the pathogenesis of PE.

Objective To explore the changes and significane of USP20 and HIF-α expression in breast cancer. Methods Following transfection of shRNA-USP20 lentivirus into breast cancer MDA-MB-231 cells， the gene and protein expression levels of USP20 were detected using fluorescence quantitative PCR and Western Blot. Subsequently， the overexpression of USP20 was observed to determine its effect on HIF-α expression. Similarly， siRNA-USP20 was used to knock down USP20 in breast cancer MDA-MB-231 cells， followed by detection of gene and protein expression levels using fluorescence quantitative PCR and Western Blot. The subsequent changes in HIF-α expression were then examined. Rusults The positive expression rates of USP20 and HIF-α in breast cancer tissues were 69.6% and 46.83%， respectively， while they were negatively expressed in the adjacent normal tissues， with statistically significant differences （P < 0.01）. The positive expressions of USP20 and HIF-α were predominantly observed in the cytoplasm of breast cancer tissue， with a smaller amount present in the nucleus. There was a significant positive correlation between USP20 and HIF-α in breast cancer. Following transfection of shRNA-USP20 lentivirus into MDA-MB-231 cells， both the protein and gene expression levels of USP20 significantly increased （P < 0.01）. Over-expression of USP20 did not affect HIF-α mRNA levels but led to a significant increase in HIF-α protein expression （P < 0.01）. Conversely， siRNA-USP20 interference resulted in a significant decrease in both the protein and gene expression levels of USP20 （P < 0.01）， without affecting HIF-α mRNA levels； however， it caused a notable reduction in HIF-α protein expression （P < 0.01）. Conclusion The expression of USP20 exhibited a significant positive correlation with HIF-α in breast cancer. Overexpression of USP20 led to a substantial increase in HIF-α protein expression， while knock-down of the USP20 gene resulted in a significant decrease in HIF-α protein levels. Therefore， it can be inferred that USP20 may exert its influence on the development of breast cancer through modulation of HIF-α expression， thereby providing crucial experimental evidence for clinical treatment， prognosis， and further investigations.

Objective To investigate the effect of miR?217 on gefitinib resistance in non?small cell lung cancer （NSCLC）， and to explore the downstream target genes and related pathways. Methods qRT?PCR was used to detect the expression of miR?217 in human lung normal epithelial cell lines BEAS?2B， NSCLC cell lines A549， HCC827， PC9， NCI?H1975 and gefitinib resistant strain PC9/GR. PC9/GR cells were selected and the cells of control group， NC?mimic group， miR?217 mimic group， miR?217 mimic + si?NC group， and miR?217 mimic + si?FOXO3 group were constructed using liposome transfection technique. CCK8 and clonal formation assay were used to detect changes in cell proliferation capacity， flow cytometry was used to detect changes in cell apoptosis capacity， and western blot was used to detect protein expression related to PI3K/AKT signaling pathway. The Targetscan bioinformatics website predicted the downstream target genes of miR?217， and the correlation between miR?217 and the target gene FOXO3 was detected by dual luciferase assay. Results Compared with BEAS?2B cells， the expression of miR?217 in A549， HCC827， PC9 and NCI?H1975 cells was significantly decreased （P < 0.05）. With the increase of gefitinib concentration， the expression of miR?217 gene in PC9 cells was gradually decreased （P < 0.05）， and the expression of miR?217 in PC9/GR cells was lower than that in PC9 （P < 0.05）. Compared with the control group and NC?mimic group， the cell proliferation capacity of miR?217 mimic group was significantly decreased （P < 0.05）， the number of apoptosis was increased （P < 0.05）， and the expression levels of p?PI3K and p?AKT were decreased （P < 0.05）. Dual luciferase reporter gene assay proved that FOXO3 is the target of miR?217. Compared with miR?217 mimic group and miR?217 mimic + si?NC group， the cell drug resistance of miR?217 mimic + si?FOXO3 group was increased （P < 0.05）， the proliferation ability was significantly increased （P < 0.05）， and the number of apoptosis was decreased （P < 0.05）. The expression levels of P?PI3K and P?AKT were increased （P < 0.05）. Conclusion Overexpression of miR?217 reversed the resistance of PC9/GR to gefitinib in NSCLC cells and inhibited the proliferation and accelerated apoptosis of PC9/GR cells， which may be related to the regulation of PI3K/AKT signaling pathway by targeting FOXO3.

Objective This study aims to determine whether electroacupuncture regulates the phospholipase C （PLC）/inositol-1，4，5-trisphosphate （PLC/IP3） pathway in platelet-derived growth factor receptor α-positive （PDGFRα+） cells， thereby improving gastrointestinal motility disorders in functional dyspepsia （FD）. Methods 40 SD rats were randomly divided into blank group， model group， electroacupuncture group， U73122 （PLC inhibitor） group， and U73122+electroacupuncture group， with 8 rats in each group. Except for the blank group， all rats were subjected to multi-factor stress intervention to establish the FD model. After successful modeling， the U73122 group was given intraperitoneal injection of inhibitor， the electroacupuncture group was acupunctured at Zusanli and Taichong points， and the U73122+electroacupuncture group was injected with inhibitor 2 hours before acupuncture. Ten days later， gastrointestinal motility was tested； immunoblotting was used to detect the protein expression levels of PDGFRα， PLC， P-PLC， IP3； immunofluorescence was used to detect the average fluorescence density and co-localization expression of PDGFRα and PLC， IP3； electron microscope was used to observe the gap junction （GJ） situation in the gastric antrum area. Results After modeling， the gastrointestinal motility of rats was weakened， the protein expression levels of PDGFRα， PLC， and IP3 were significantly reduced， GJ widened， and cell morphology changed； compared with the model group， the gastrointestinal motility of rats in the electroacupuncture group， U73122 group， and U73122+electroacupuncture group was significantly improved， the expression levels of PDGFRα， PLC， P-PLC， IP3 increased， GJ was slightly tight， and cell morphology recovered； there was no significant difference in the expression levels of PDGFRα， PLC， P-PLC， IP3 in the gastric antrum of U73122 group and U73122 + electroacupuncture group； PDGFRα， PLC， and IP3 had fluorescence co-localization. Conclusion Electroacupuncture can improve gastrointestinal dyskinesia in FD rats by activating the PLC/IP3 pathway in PDGFRα⁺ cells.

Objective To investigate the predictive value of soluble growth?stimulated expressed gene 2 protein （sST2） in predicting sepsis?associated acute kidney injury （SA?AKI）. Methods From January 2020 to December 2023， a total of 395 sepsis patients with sepsis from the Emergency Department， Affiliated Hospital of Nantong University were enrolled in this retrospective observational study. These patients were further categorized into two groups： AKI group （114 cases） and non?AKI group （281 cases）. Clinical data and laboratory indicators were collected within 24 hours after admission. ROC curve analysis was used to evaluate the diagnostic ability of sST2 for SA?AKI. Logistic regression analysis was performed to assess independent risk factors for the development of SA?AKI. Concurrently， two predictive models for SA?AKI were constructed， and the predictive ability of sST2 for SA?AKI was assessed using the Area Under the Curve （AUC）， the Net Reclassification Index （NRI） and the Integrated Discrimination Improvement （IDI）. Results T The levels of sST2 were significantly higher in the AKI group compared to the non?AKI group （P < 0.001）. The AUC predicted by sST2 （0.839， 95% CI： 0.799 ~ 0.874） in sepsis patients with AKI was significantly superior to other laboratory indicators （P < 0.000 1）. An sST2 concentration greater than 85 ng/mL independently increased the risk for SA?AKI （OR： 14.315， 95% CI： 5.867 ~ 34.926， P < 0.001）. Incorporating sST2 into the prediction model substantially improved the AUC values （0.954 vs. 0.909， P < 0.000 1）， NRI （21.48%， 95% CI： 11.48% ~ 31.49%， P < 0.000 1） and IDI （8.62%， 95% CI： 5.75% ~ 11.49%， P < 0.000 1）. Conclusion sST2 has the potential to serve as a promising biomarker for prognosticating AKI in septic patients.

Objective To investigate the feasibility of monitoring the baseline of motor evoked potentials immediately following tracheal intubation without the administration of muscle relaxants in lumbar spine surgery. Methods A prospective study was conducted at Xuzhou Central Hospital， involving a total of 156 patients who were scheduled for Transforaminal Lumbar Interbody Fusion. These patients were randomly divided into two groups： a control group consisting of 72 cases （33 males and 39 females） and an observation group consisting of 75 cases （37 males and 38 females）. The control group underwent monitoring of motor evoked potentials （TceMEP） baseline after spinal exposure during the operation， while the observation group had immediate monitoring of TceMEP baseline after tracheal intubation without muscle relaxants. Hemodynamic changes， intubation satisfaction， and operation time during tracheal intubation were compared between the two patient groups. Additionally， the baseline success rate， stimulation threshold， sensitivity， and specificity of TceMEP were compared between the two groups. Results There were no significant differences in hemodynamic changes and intubation satisfaction between the two patient groups during tracheal intubation （P > 0.05）. The control group had an intubation time of （6.52 ± 1.22） min， while the observation group had a significantly longer intubation time of （9.44 ± 0.84） min （P < 0.05）. The baseline success rate of TceMEP in the observation group was 100%， with an average stimulation threshold of （225.00 ± 22.13）. In contrast， the control group had a baseline success rate of 84.72% and an average stimulation threshold of （342.01 ± 31.07）V for TceMEP monitoring prior to nailing procedures. The success rate of monitoring TceMEP after nailing in the control group was 93.06%， whereas it reached 100% in the observation group， demonstrating a statistically significant difference between the two groups （P<0.05）. There were no statistically significant differences in sensitivity and specificity between the two groups for TceMEP monitoring results（P>0.05）. Conclusions The success rate of monitoring TceMEP baseline immediately after tracheal intubation without muscle relaxation is higher， with a smaller stimulation threshold. There were no differences in sensitivity and specificity compared to the baseline monitoring of TceMEP after spinal exposure during the operation.

Objective To investigate the significance of auditory brainstem response （ABR） combined with auditory steady?state response （ASSR） for the assessment of mild sensorineural hearing loss in infants. Methods Data from 114 infants with mild sensorineural hearing loss were retrospectively analyzed， and their ABR and ASSR results were collected for rank sum test and correlation analysis. Results In the rank sum test， the difference in thresholds between tone?burst ABR （Tb?ABR） and ASSR at 0.5，1，2，4 kHz was statistically significant （P < 0.05）， and they were also correlated at 0.5， 1，2，4 kHz （P < 0.05）， r = 0.613， 0.569， 0.616， 0.71. After grouping by gender and ear， there was a correlation between ABR and ASSR at 0.5， 1，2， and 4 kHz， male： r = 0.61， 0.56， 0.671， 0.774； female： r = 0.581， 0.558， 0.546， 0.608； left ear： r = 0.61， 0.558， 0.576， 0.715； right ear： r = 0.631， 0.581， 0.662， 0.71. And after grouping by age at diagnosis， only infants diagnosed from 7 ~ 12 months of age did not correlate at 0.5 kHz and 1 kHz （P > 0.05）， while the rest of the groups had a good correlation （P < 0.05），0 ~ 3 months： r = 0.686， 0.643， 0.671， 0.742； 4 ~ 6 months： r = 0.671， 0.626， 0.616， 0.693； 7 ~ 12 months at 2 kHz and 4 kHz： r = 0.571， 0.706. Conclusion In infants with mild sensorineural hearing loss， ABR and ASSR correlate in assessing hearing thresholds at all frequencies， and the combination of the two tests could provide a more accurate assessment of the subject's true hearing.

Objective This study used resting-state functional magnetic resonance imaging （rs-fMRI） to investigate the changes of local brain regional homogeneity in patients with depression and childhood maltreatment， and we calculated the relationship between altered ReHo values and the severity of childhood maltreatment. Methods 25 patients with depression and childhood maltreatment， 25 patients with depression without childhood maltreatment， and 25 age， gender， and education-matched healthy controls were prospectively enrolled. All subjects underwent resting-state functional magnetic resonance imaging and ReHo analysis. One-way analysis of variance was used to compare the group differences， along with multiple comparison correction. Pearson correlation analysis was used to explore the relationship between region ReHo values with clinical scales. Results Compared with the group of depression without childhood maltreatment， the abnormal brain regions of depression with childhood maltreatment are mainly located in the dorsolateral prefrontal cortex， cerebellum， parietal gyrus， and precentral gyrus. The ReHo values of depression with childhood maltreatment in the left cerebellum and the left dorsolateral prefrontal cortex are correlated with the severity of childhood maltreatment. Conclusions Depression with childhood maltreatment is associated with changes in local spontaneous brain activity， which are correlated with the severity of childhood maltreatment. The brain changes in the dorsolateral prefrontal cortex and cerebellum may explain the neurobiological mechanisms of depression with childhood maltreatment.

Objective To understand the prognosis of patients with bone metastases from first-treatment non-small cell lung cancer （NSCLC） of different pathological types after different first-line treatment regimens， in order to provide clinical prediction of disease progression， guidance of treatment， and improvement of prognosis. Methods 403 NSCLC patients with bone metastases who received primary treatment with bone metastases from Chaohu Hospital of Anhui Medical University from 1 January 2019 to 31 December 2023 were selected for univariate analysis using survival analysis （Log-rank test） and multifactorial analysis with Cox regression， and it was found that histopathological subtyping was an independent factor affecting the prognosis of patients （P = 0.001， HR = 1.952）， after which the effect of this factor on prognosis was removed， and the total number of patients was divided into two groups according to histopathological classification： adenocarcinoma group （316） and squamous carcinoma group （87）， and then multifactorial analysis was performed again using Cox regression model to analyse the factors affecting survival prognosis. Results In this data analysis， patients with the pathological type of squamous carcinoma had a median overall survival （mOS） of 15 months （95% CI： 12.85 ~ 17.15） and a median progression-free survival （mPFS） of 9 months （95% CI： 7.34 ~ 10.67）， whereas patients in the adenocarcinoma group had a mOS of 25 months （95% CI： 23.26 ~ 26.74） and mPFS was 16 months （95% CI：14.43 ~ 17.57）， a statistically significant difference. The OS of the overall group was affected by multiple factors， including Eastern Cooperative Oncology Group （ECOG） score status （1/> 1） at the time of initial diagnosis， bone metastases to Trunk + limb bones + cranium， number of bone metastases ≥ 4， mutation of ALK target genes， and the use of chemotherapy+targeted therapy as the first line of treatment. therapy； similarly， PFS was also affected by the above factors. In addition， in the adenocarcinoma and squamous carcinoma models based on histopathological classification， chemotherapy + targeted therapy and chemotherapy + immunotherapy were found to be the protective factors for the two groups， and ALK target gene mutation was only a protective factor for the adenocarcinoma group. Conclusion This study further confirmed the prognostic factors influencing the prognosis of patients with bone metastases from primary NSCLC， which provides an important reference for clinical treatment.

The sensitivity of cardiac troponin testing for diagnosing acute myocardial infarction （AMI） varies over time from chest pain onset. This study aimed to determine the diagnostic performance of point?of?care testing cardiac troponin T （POCT?cTnT） at different time intervals post?symptom onset to refine rapid rule?out approaches for AMI. Methods This retrospective study included 6，024 patients presenting with chest pain from January 2018 to December 2022. POCT?cTnT and central lab cTnI levels were measured on admission. Receiver operating characteristics analysis stratified by time windows assessed the accuracy of POCT?cTnT for diagnosing AMI. Results The overall AUC of POCT?cTnT for diagnosing AMI was 0.826 （95% CI：0.816 ~ 0.836）， with a sensitivity of 72.81% and a specificity of 86.26%. According to the time intervals of chest pain onset （< 3 hours， 3 ~ 6 hours， 6 ~ 12 hours， 12 ~ 24 hours， 24 ~ 72 hours， and ≥ 72 hours）， the AUC values for groups after 6 ~ 12 hours were 0.918， 0.928， 0.920 and 0.908， respectively， with no statistically significant difference （P > 0.05）， but all were higher than the groups within 6 hours （P < 0.001）. According to the time of chest pain onset， the AUC for the ≥8h group was 0.921， with a negative predictive value （NPV） of 98.1% and a negative likelihood ratio （?LR） of 0.11. Its AUC was higher than those of the ≥ 3 h， ≥ 2 h， ≥ 1 h， and overall groups （P < 0.05）， but there was no statistically significant difference compared with the groups after ≥ 4 h （P > 0.05）. Conclusions Chest pain onset time has a certain impact on the performance of a single POCT?cTnT test for diagnosing AMI. The duration from chest pain onset to hospital admission combined with POCT?cTnT test may improve the reliability in diagnosing AMI. Specifically， a single POCT?cTnT test at four hours after chest pain onset， especially eight hours after chest pain onset， can diagnose or exclude AMI.

Objective To investigate the potential of immune?inflammatory markers and the characteristics of magnetically controlled capsule endoscopy in distinguishing gastric adenocarcinoma from precancerous lesions， as well as to develop and validate a risk prediction model. Methods Retrospective analysis was conducted on medical records of 578 patients who underwent magnetic controlled capsule endoscopy at our hospital between January 2021 and December 2023. Following the principle of Pareto's law （80/20 rule）， they were randomly divided into a training set （462 cases） and a validation set （116 cases）. Magnetic controlled capsule endoscopy and blood cell tests were performed， with pathological diagnosis results serving as the "gold standard"， to classify patients into groups of gastric adenocarcinoma and precancerous lesions. The magnetic controlled capsule endoscopic features， neutrophil?lymphocyte ratio （NLR）， platelet?lymphocyte ratio （PLR） in patients with gastric adenocarcinoma and precancerous lesions were compared to develop and validate a risk diagnostic model for gastric adenocarcinoma. Results Among the 462 patients who underwent magnetic controlled capsule endoscopy， gastric adenocarcinoma was diagnosed in 76 cases through pathological examination， accounting for 16.45% （76/462）， while precancerous lesions were observed in 386 cases， accounting for 83.55% （386/462）. In the validation set of 116 patients who underwent gastric endoscopy， there were 22 cases of gastric adenocarcinoma， representing an incidence rate of 18.97% （22/116）， and a total of 94 cases with precancerous lesions， accounting for an incidence rate of 81.03% （94/116）. No statistically significant differences （P > 0.05） were found between the two groups regarding lesion size， border appearance， mucus presence or lesion morphology. However， compared to the precancerous lesion group， the proportion of whitish coloration as well as irregular surface microstructure and grid?like microvessels was significantly higher in the gastric adenocarcinoma group （P < 0.05）. Moreover， both NLR and PLR values were significantly higher in the gastric adenocarcinoma group compared to those in the precancerous lesion group （P < 0.05）. Irregular surface microstructure （OR = 2.213， 95%CI： 1.288 ~ 3.801）， irregular grid?like microvessels （OR = 2.489， 95%CI： 1.458 ~ 4.249）， NLR （OR = 2.369， 95%CI： 1.389 ~ 4.046）， and PLR （OR = 3.016， 95%CI： 1.767 ~ 5.148） were identified as risk factors for gastric adenocarcinoma （P < 0.05）. The sensitivity of the risk model for diagnosing gastric adenocarcinoma in the training set was 0.800 （95% CI： 0.716 ~ 0.891）， with a specificity of 0.783 （95% CI： 0.694~0.851） and an area under the curve of 0.858 （95% CI： 0.787 ~ 0.931）. In the validation set， the sensitivity for diagnosing gastric adenocarcinoma was 0.861 （95% CI： 0.771 ~ 0.945）， with a specificity of 0.769 （95% CI： 0.683~0.841） and an area under the curve of 0.844 （95% CI： 0.765 ~ 0.923）. Conclusion The surface microstructure， microvascular morphology， NLR， and PLR of gastric lesions are correlated with the occurrence of gastric adenocarcinoma. Developing a risk diagnostic model facilitates early identification and diagnosis of gastric adenocarcinoma.

Objective To observe the effects of ginkgolides drops on anginal attacks and peripheral blood levels of microRNA?29 a （miR?29a） and intercellular adhesion molecule?1 （ICAM?1） in patients with stable angina pectoris. Methods 78 patients with stable angina pectoris patients， who had visited the cardiology department of our hospital during the period of January 2022 to December 2023， were selected. The patients were divided in a Chinese medicine group or a conventional group by using the random number table method， 39 in each group. The conventional group received conventional Western medicine treatment， while the Chinese medicine received ginkgo ketone ester drip pills on the basis of conventional Western medicine therapies. Occurrence of angina attack， treadmill electrocardiogram test indexes， blood rheology， 6?minute walking distance， TCM symptom scores and changes in peripheral blood miR?29a and ICAM?1 were observed in the two groups. The rate of nitroglycerin discontinuation or reduction and the incidence of adverse reactions were counted. Results Before treatment， there was no statistically significant difference in occurrence of angina attacks between the two groups （P > 0.05）. After treatment， the number of attacks per week， weekly glyceryl trinitrate uses， and duration of each attack decreased in both groups， with a greater decline in the Chinese medicine group than in the conventional group （P < 0.05）. Before treatment， there was no statistically significant difference in the indicators of treadmill electrocardiogram test between the two groups （P > 0.05）. After treatment， induction positive time， exercise termination time， and maximum ST depression time increased in both groups， with longer induction positive time and maximum ST depression time in the Chinese medicine group than in the conventional group， while exercise termination time， as compared with the baseline， did not differ statistically （P > 0.05）. Maximum ST depression amplitude and ST recovery time decreased in both groups， with a greater decrease in the Chinese medicine group than in the conventional group （P < 0.05）. Before treatment， there were no statistically significant differences in miR?29a， ICAM?1， and rheology between the two groups （P > 0.05）. After treatment， ICAM?1 and whole blood high/low shear viscosity， FIB， platelet aggregation rate， and plasma viscosity decreased in both groups， with a bigger drop in the Chinese medicine group than in the conventional group （P < 0.05）. As compared with the baseline， miR?29a did not differ statistically between the two groups （P > 0.05）. Before treatment， there were no statistically significant differences in 6min walking distance and Chinese medicine symptom scores between the two groups. After treatment， 6 min walking distance increased in both groups， with a greater increase in the Chinese medicine group than in the conventional group （P < 0.05）； Chinese medicine symptom scores decreased in both groups， with a greater decrease in the Chinese medicine group than in the conventional group （P < 0.05）. The glyceryl trinitrate reduction rate was higher in the Chinese medicine group （79.49%， 31/39 cases） than in the conventional group （56.41%， 22/39 cases）， and the incidence of adverse reactions did not differ statistically between the Chinese medicine group and the conventional group （7.69% vs. 5.13%， 3/39 vs. 2/39 cases； P > 0.05）. Conclusions Ginkgolides drops for stable angina improve the degree of myocardial ischaemia and blood rheology， reduce angina attacks， lower ICAM?1 levels， and increase the rate of nitroglycerin discontinuation or reduction.

Recurrent vulvovaginal candidiasis is a prevalent condition among women of reproductive age， significantly impacting their physical and mental well-being due to its recurrent nature and challenging treatment. The etiology remains elusive， while treatment options exhibit considerable variability. This paper provides a comprehensive review on the pathogenesis and therapeutic approaches targeting virulence factors associated with recurrent vulvovaginal candidiasis， aiming to offer valuable insights for understanding the underlying mechanisms and optimizing treatment strategies.

N6-methyladenine （m6A） modification is involved in a variety of biological processes and dynamically regulates RNA stability. When m6A modification is changed， it affects the development of follicles， granulosa cell proliferation and oocyte development， and participates in the occurrence and development of benign ovaria-related diseases， such as polycystic ovary syndrome， premature ovarian dysfunction， and endometriosis， resulting in decreased female fertility. This article reviews the role and research progress of m6A modification in benign ovaria-related diseases， aiming to provide new diagnosis and treatment ideas for subsequent research on improving fertility.