Objective To explore the clinical diagnostic value of serum dickkopf-1 (DKK1) level in menopausal women with rheumatoid arthritis (RA) secondary to osteoporosis (OP). Methods A total of 236 menopausal female patients diagnosed in the Second Affiliated Hospital of Nanchang University from May 2019 to September 2020 were collected, including 44 patients with OP secondary to RA set as RA+OP group, 150 patients with RA without OP set as RA group, and 42 patients with OP set as OP group, respectively. At the same time, 43 healthy menopausal women in our hospital at the same period were selected as control group. Serum DKK1 was detected by ELISA. The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were detected by capillary method and rate-scattering turbidimetry, respectively; The bone metabolism indexes such as parathyroid hormone(PTH), type Ⅰ procollagen C-terminal propeptide (CTX), 25-hydroxy vitamin D₃ [25-(OH)D₃], type Ⅰ procollagen N-terminal propeptide (PINP) and osteocalcin were detected by electro-chemiluminescence method. While, bone alkaline phosphatase (BALP)was determined by chromatography; The bone mineral density (BMD), Z-score and T-score of total hip joint and lumbar spine L_1-4 in all patients were detected by Lunar Prodigy dual energy X-ray absorptiometry. The area under the ROC curve was used to analyze the diagnostic efficacy of DKK1 in patients with RA combined with OP and those with RA or OP alone. Results DKK1, ESR, CRP, BMI, PTH, CTX, 25-(OH)D₃, total hip BMD, total hip T-score, total hip Z-score, lumber spine L_1-4 BMD, lumber spine L_1-4 T score and lumber spine L_1-4 Z score, CTX and BALP were significantly different among the 4 groups (P<0.01 or P<0.05); The difference of fracture story was statistically significant between RA+OP group and OP group (P<0.01). Bivariate correlation analysis conducted between DKK1 and each index showed that serum DKK1 was positively correlated with ESR, CRP, fracture story and BALP (P<0.05), and negatively correlated with BMI, total hip BMD, total hip T-score, total hip Z-score, lumber spine L_1-4 BMD, lumber spine L_1-4 T-score and lumber spine L_1-4 Z-score, PINP, 25-(OH)D₃ and PTH (P<0.01 or P<0.05). Multiple linear regression analysis showed that DKK1 was positively correlated with CRP and BMI (R²=0.048, β=0.034, P=0.003; and R²=0.008, β=0.178, P=0.042, respectively), and negatively correlated with PINP and total hip T-score (R²=0.003, β=–0.022, P=0.009; and R²=0.235, β=–2.375, P=0.000). ROC curve analysis showed that and the optimal cut-off value of DKK1 in the diagnosis of RA secondary to OP was 9.21 μg/L, the sensitivity was 93.2%, the specificity was 91.1%, and the Kappa consistency index was 0.630. The diagnostic efficiency of DKK1 for OP was higher than that of DKK1 for RA, and the Kappa consistency index was relatively stable. Conclusion The serum level of DKK1 is increased in menopausal women with RA secondary to OP, the detection of DKK1 has good diagnostic efficiency in the diagnosis of menopausal women with RA secondary to OP.

Non-alcoholic fatty liver disease (NAFLD) has gradually become an important factor causing hepatocellular carcinoma (HCC), and the clinical treatment effects of NAFLD-HCC and general liver cancer are significantly different, and there are many differences in drug sensitivity. At present, the pathogenesis of NAFLD-HCC is not yet clear. Therefore, it is particularly important to construct pre-clinical animal models of NAFLD-HCC. There are various induction methods for animal models of NAFLD-HCC, including dietary induction, chemical induction, genetic induction, dietary combined with chemical induction, genetic combined with dietary and other induction methods. More and more studies have found that there are certain differences in the histopathological types of animal models of NAFLD-HCC induced by different methods. Therefore, according to the research problem, choosing the most suitable animal model is of great significance for studying the causes of NAFLD-HCC and subsequent development of new drugs. The mouse models established for preclinical studies of the progression of NAFLD-HCC were summarized in this paper to reveal the pathogenesis of NAFLD-HCC, and to explore possible new targets for prevention or treatment of NAFLD-HCC.

Objective To investigate the diagnostic efficacy of serum lipids in patients with neuromyelitis optica spectrum disorders (NMOSD), and to analyze the relationship between serum lipids and clinical features of NMOSD. Methods The clinical and laboratory diagnosis information of 324 patients with NMOSD (NMOSD group), 147 patients with multiple sclerosis (MS, MS group) and 252 healthy controls (HCs, HCs group) were collected from the First Medical Center of PLA General Hospital from January 2018 to July 2020. Logistic regression analysis was used to control the age, gender, disease duration, affected sites and the interaction of various serum lipid indexes. The differences of serum total cholesterol (TC), triglyceride (TG), Apolipoprotein A₁ (Apo A₁), Apolipoprotein B (Apo B), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) in three groups of patients were analyzed, and the concentration differences of each index in the acute stage, relapse stage and remission stage of NMOSD were also analyzed. According to the clinical features of NMOSD, such as AQP4 antibody titer and affected sites, the concentration difference of lipid index in different subgroups was analyzed. Results The average disease duration in the NMOSD group was 20 months, and magnetic resonance imaging (MRI) showed that the most affected region is the optic nerve (198/324, 61.1%). In the MS group, the disease duration was longer (48 months) and multiple sites were affected (56/147, 38.1%). There were significant differences in TC, Apo A₁, LDL, TG and Apo B between NMOSD group and MS group or HCs group (P<0.05). Subgroup analysis showed that only Apo B was significantly different in the acute stage, relapse stage and remission stage of NMOSD group (P<0.05). Further analysis on the subgroups of NMOSD showed that there were significant differences in TC, Apo A₁, Apo B, HDL and LDL in different sites(P<0.05). The receiver operating characteristic (ROC) analysis showed that the combination of serum TC, Apo A₁, Apo B and LDL could specifically diagnose NMOSD with the AUC of 0.732, sensitivity of 57.86% and specificity of 81.15%. Conclusion The combination of serum TC, Apo A₁, Apo B and LDL can specifically diagnose NMOSD, and Apo A₁ and Apo B can be used as indicators of affected sites and disease activity of NMOSD respectively.

Objective To construct a prediction model based on machine learning algorithm for cirrhosis-related hepatic encephalopathy. Methods A cross-sectional survey was conducted in 1498 patients from 7 medical institutions in Chongqing from June 2019 to June 2020, who were divided into hepatic encephalopathy group (n=285) and non-hepatic encephalopathy group(n=1213) according to whether hepatic encephalopathy occurred. 70% (1048 in total) of the data collected from 1498 patients was randomly chosen as the training set for establishing the prediction model and the rest 30% (450 in total) was used for internal verification. Univariate logistic regression was used to filter input indicators. Logistic regression, random forest, decision tree and XGBoost algorithm based on machine learning were used to construct a diagnostic predictive model. The models constructed by the four methods were compared for predictive and diagnostic value of cirrhosis-related hepatic encephalopathy. Results Logistic regression, random forest, decision tree and XGBoost models all suggested prothrombin activity (OR=0.933, 95%CI 0.921-0.946), age (OR=1.045, 95%CI 1.029-1.061), blood sodium (OR=0.964, 95%CI 0.928-1.000) and urea nitrogen (OR=1.063, 95%CI 1.022-1.105) are important influencing factors of hepatic encephalopathy. The sensitivities of the four models were 0.843, 0.904, 0.759 and 0.892; the specificities were 0.785, 0.695, 0.717 and 0.706; the area under the curve (AUC) were 0.875, 0.883, 0.767 and 0.847 respectively. Conclusions The risk prediction model of cirrhosis-related hepatic encephalopathy established based on machine learning has high diagnostic value. The diagnostic effects of logistic and random forest models are better than those of decision tree and XGBoost models.

The weapons in modern warfare are different from those in traditional. Along with the increasing use of precision-guided and high-energy explosive weapons, the combat environment and traumatic condition of eye injuries have changed dramatically. Traditional War Injury Treatment System of the Chinese PLA has not been able to better meet the needs of modern warfare. In order to improve the abilities of treating and protecting from combat-related eye injuries, this paper reviews the research advances in the combat-related eye injuries in 21st century through the aspects of epidemiology, combat environment, injury factors, treatment system and protection work. The present situation of the research on the combat-related eye injuries in Chinese PLA is analyzed, and the research directions in the future are prospected.

Activated transcription factor 6 (ATF6) is a transmembrane glycoprotein located in the endoplasmic reticulum.It exists widely in various tissues including myocardium and participates in endoplasmic reticulum stress (ERS) by regulating the unfolded protein response (UPR) signal pathway, which has become one of the major regulators of organs/tissues homeostasis and is of great significance in signal transduction, gene expression and protein synthesis. A number of studies have shown that ATF6 plays an important regulatory role in the occurrence and development of atherosclerosis, myocardial infarction, cardiac hypertrophy, diabetic cardiomyopathy, arrhythmia and other common cardiovascular diseases (CVD). At present, some studies have proved that ATF6 can regulate its activity and function to intervene the occurrence and development of some CVD. As a result, whether a small molecule regulator can be designed to treat some CVD by regulating ATF6 has become a research hot-spot. ATF6-based therapies have made great progress and have shown promising efficacy in small animal models of CVD and other systemic protein-based diseases. The small molecule regulator to ATF6 has a broad application prospect in cardiovascular disease, but further basic and clinical studies are still needed to lay the theoretical and practical foundation for its application. In present paper, the structure, classification and correlation of ATF6 with CVD are reviewed in order to provide references for experimental researches, clinical diagnoses and treatments of CVD.

Objective To investigate the expression level and clinical significance of serum miR-21 and Peli1 mRNA in peripheral blood mononuclear cells (PBMC) of patients with autoimmune premature ovarian insufficiency (aPOI). Methods A total of 26 patients untreated and initially diagnosed as autoimmune POI (aPOI group) and 30 healthy young females (control group), visited during April 2018 to October 2019 in Zhujiang Hospital of Southern Medical University, were included in present study. The general data of each subject were recorded. The expression levels of serum miR-21 and PBMC Peli1 mRNA were detected by qRT-PCR, and the serum sex hormone [estradiol (E₂), follicle stimulating hormone (FSH), luteinizing hormone (LH)], anti-Mullerian hormone (AMH), thyroid hormones and immune-related indicators were evaluated. Uterus and ovary index of all subjects were assessed by ultrasonography. Results The expression levels of serum miR-21 and PBMC Peli1 mRNA were significantly lower in aPOI group than those in control group (0.60±0.14 vs. 1.01±0.07; 0.30±0.14 vs. 1.63±0.54, P<0.05), and Peli1 mRNA was positively related with miR-21 (r=0.719, P<0.05). Compared with control group, aPOI group showed earlier menarche age, shorter menstrual period, fewer gravidity and parity, less contents of E₂ and AMH, smaller uterus and ovaries; while longer menstrual cycle, higher levels of FSH and LH, and the number of positive menopausal symptoms and immune indexes were significantly higher than those in control group (P<0.05). MiR-21 and Peli1 mRNA were positively related to E₂, AMH, the size of uterus and ovarian volume, respectively; and negatively related to FSH, LH, and the number of positive immune indexes. Conclusions The serum miR-21 is positively related to the decreased expression level of PBMC Peli1 in aPOI patients, and both miR-21 and Peli1 might be involved in the pathogenesis of aPOI, therefore show some values for the auxiliary diagnosis of aPOI.

Objective To investigate the effects of Schisandrin C (SchC) on hydrogen peroxide (H₂O₂) treated human immortalized keratinocyte cells (HaCaT) and to understand its potential mechanisms on ageing. Methods HaCaT cells were cultured in vitro and divided into control group, H₂O₂ model group, and SchC treatment group. Cell viability was evaluated by CCK-8 assay. The levels of superoxide dismutase (SOD), malondialdehyde (MDA) and glutathione (GSH) were determined by WST-1 assay. The level of reactive oxygen species (ROS) was determined by chemical fluorescence assay. The mRNA expression of matrix metalloproteinase, cyclooxygenase-2 (COX-2) and apoptosis-related genes were detected by qRT-PCR. The expression of COX-2, matrix metalloproteinase, apoptosis-related protein, ageing-related protein, transcription factor NF-E₂ related factor 2 (Nrf-2), heme oxygenase (HO-1), cytoplasmic transcription factor-κB (NF-κB) and p-NF-κB was detected by Western blotting. Results SchC at the concentration of less than 100 μmol/L had no significant effects on the proliferation of HaCaT cells; while cell viability decreased to (57.0±3.0)% (P<0.001) after treated with 800 μmol/L H₂O₂. Compared with the H₂O₂ model group, the cell viability, SOD, and GSH levels were significantly increased; MDA and ROS levels were significantly decreased (P<0.05 or P<0.01). Western blotting results showed that the expression of P16, P21 and p-NF-κB were significantly down-regulated, and the expression of Nrf-2 and HO-1 were up-regulated by SchC (P<0.05 or P<0.01). qRT-PCR and Western blotting results showed that SchC could up-regulate the expression of caspase-3 and caspase-9, and down-regulate the expression of Bcl-2, matrix metalloproteinase (MMP-1, MMP-9) and inflammatory factor COX-2 by regulating NF-κB pathway (P<0.05 or P<0.01). Conclusion SchC had a protective effect on the aging model of oxidative stress damage of H₂O₂-induced HaCaT cells, which could lay a foundation for the development of anti-ageing products of Schisandra C.

Cardiac computed tomography angiography (CCTA) has become an important non-invasive method to evaluate coronary artery disease. With the extensive application and increased image analysis features, more demands on operational technique and efficiency are asked. Machine learning (ML) is the subarea of artificial intelligence (AI), which is completely data driven, by computer algorithm to identify and analyze the potential relationship of centralized variables in large data sets for realizing the prediction of external data. In the field of cardiac CT, the application of various ML algorithms would improve the efficiency and quality of CCTA, helping accurate lesion assessment and risk stratification. It also brings new applications in cardiac functional imaging. The applications of ML in cardiac CT have been reviewed in present paper including CT-image analysis, risk stratification, CT-myocardial perfusion and CT-fractional flow reserve.

Objective To investigate the clinical characteristics of severe coronavirus disease 2019 (COVID-19) and explore the relevant risk factors that affect outcomes of the patients. Methods A retrospective analysis was performed on the data of the patients with severe COVID-19 admitted to the ICU of Huoshenshan Hospital of Wuhan City during the period from February to April, 2019. The patients were classified into survival group and death group. The general data, clinical manifestations, laboratory examinations, and treatments were compared between the 2 groups. Results A total of 122 severe COVID-19 patients were included in the study, 56 died and the fatality rate was 45.9%. The proportion of comorbidities of coronary heart disease in death group was significantly higher than that in the survival group [19.6%(11/56) vs. 7.6%(5/66), P=0.049]. Compared with patients in the survival group, the platelet count in the death group decreased [190.1(132.3, 245.0)×10⁹/L vs. 217.0(176.0,262.3)×10⁹/L, P=0.015] and the levels of C-reactive protein and brain natriuretic peptide in the death group increased [37.4(4.3,125.6) mg/L vs. 8.9(2.7, 51.4) mg/L, P=0.027 and 65.17(18.84, 167.71) pg/ml vs. 16.60(0.01, 67.68) pg/ml, P=0.007]. The prothrombin time and thrombin time in the death group were longer than those in the survival group [14.20(13.22, 15.86) s vs.13.27(12.16, 14.27) s, P<0.01 and 16.32(15.11, 18.02) s vs. 15.75(14.81, 16.62) s, P=0.037]. Dynamic observation data showed that there were significant differences in neutrophil count, lymphocyte count, neutrophil/lymphocyte ratio and levels of both lactate dehydrogenase and α-hydroxybutyrate dehydrogenase (α-HBDH) between the two groups. ROC curve analysis showed that LDH and α-HBDH were of high value in predicting outcome, and the area under the curve was more than 0.7. Conclusions We should pay close attention to the changes of blood routine, LDH, and α-HBDH for older patients with underlying diseases. This will help us to identify the patients with high risk of death in the early stage, and take effective treatment measures as early as possible to improve the prognosis.