Objective: To investigate the therapeutic effects and potential mechanism of berberine on rat models of periodontitis. Methods: Rats were randomly divided into control group, model group and treatment group (n=6). Periodontitis model was established by silk ligation combined with lipopolysaccharide injection and high-fat and high-sugar diet in model group and treatment group. After successful modeling, the treatment group was given berberine suspension by gavage for 28 d, while the model group and control group were given the same volume of normal saline. Serum samples were collected before and after administration, and imaging examination and clinical periodontal probing were performed to evaluate inflammation and alveolar bone resorption. After treatment, bilateral gingival tissues were harvested and HE staining, immunohistochemical staining and tartrate-resistant acid phosphatase (TRAP) staining were used to observe histopathological changes. Differentially expressed genes were screened by RNA highthroughput sequencing. The expression levels of triggering receptor expressed on myeloid cells 2 (TREM2) and DNAX activation protein 12 (DAP12) were detected by Western blotting. Raw264.7 macrophages were stimulated with lipopolysaccharide or lipopolysaccharide combined with berberine, and intracellular reactive oxygen species levels were detected by immunofluorescence. Results: Compared with the model group, periodontal inflammation was significantly relieved in the treatment group, serum levels of TNF-α and IL-6 were decreased by 26.65% and 2237% (P<0.05), and alveolar bone resorption was decreased by 29.72% (P<0.01). RNA high-throughput sequencing and Western blotting results showed that TREM2 expression was significantly upregulated in the model group, which was reversed by berberine treatment (P<0.01). Compared with lipopolysaccharide treatment alone, the intracellular reactive oxygen species level of Raw264.7 macrophages treated with lipopolysaccharide combined with berberine was significantly decreased (P<0.01). Conclusion: Berberine can reverse alveolar bone resorption caused by periodontitis and promote bone remodeling. The mechanism may be related to inhibiting the TREM2/DAP12 pathway and regulating osteoclast differentiation.

Objective: To investigate the potential mediating effects of body mass index (BMI) andwaist circumference on the association between depression and the risk of type 2 diabetes mellitus (T2DM) in adults. The findings will provide valuable insights for the prevention and control of diabetes. Methods: This cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey between 2011 and 2018. A total of 20 576 adults aged 18 years and older were enrolled. Participants were classified into two groups according to patient health questionnaire-9 (PHQ-9) scores: PHQ-9<10 group and PHQ-9≥10 group, and further stratified by BMI and waist circumference. Multivariate Logistic regression and restricted cubic splines were used to explore the dose-response relationship between depressive symptoms and T2DM risk. The sequential test method was applied to analyze the mediating effects of BMI and waist circumference on the association between depression and T2DM risk. Results: Participants with PHQ-9 score≥10 had significantly higher prevalence of T2DM, fasting plasma glucose (FPG), and glycated hemoglobin (HbA1c) levels than those with PHQ-9 score<10 (all P<0.01). The risk of T2DM increased progressively with higher PHQ-9 scores (all P<0.01). Mediation analysis revealed that the mediating proportions of BMI in the associations between PHQ9 score and T2DM risk, FPG, and HbA1c were 21.82%, 27.03%, and 34.87%, respectively; those of waist circumference were 21.82%, 34.71%, and 42.76%, respectively (all P<0.01). Conclusion: Depressive symptoms are significantly associated with the risk of T2DM, and the risk increases with the severity of depression. BMI and waist circumference play important mediating roles in this association. Therefore, for overweight or obese patients with depression, greater attention should be paid to the prevention and management of T2DM.

Objective: To investigate the association between triglycerides-total cholesterol-body mass index (TCBI) and metabolic dysfunction-associated steatotic liver disease (MASLD) in patients with type 2 diabetes mellitus (T2DM) and evaluate its predictive value for MASLD. Methods: A total of 1 361 T2DM patients who were treated in the Department of Endocrinology and Metabolism at the Affiliated Hospital of Jiangsu University from December 2018 to February 2025 were included in this study. Participants were classified into MASLD (n=836) and control (n=525) groups according to diagnostic criteria. Clinical characteristics and TCBI levels were compared between groups. Participants were further stratified into four groups based on TCBI index, including Q1 (TCBI<1 361.6), Q2 (1 361.6≤TCBI<2 088.9), Q3 (2 088.9≤TCBI<3 398.8), and Q4 (TCBI≥3 398.8). Binary logistic regression models were used to examine the independent association between TCBI and MASLD, and receiver operating characteristic (ROC) curves analysis was used to assess the predictive performance of TCBI. Results: Compared with the control group, patients in the MASLD group had a higher TCBI level (P<0.01). With the increase of TCBI quartiles, body mass index and waist circumference showed an increasing trend (P<0.01), while the level of high-density lipoprotein cholesterol presented a decreasing trend (P<0.01), and the proportion of males gradually increased (P<0.05). After adjusting for confounders, compared with Q1, the odds ratios (95%CI) for MASLD in Q2, Q3, and Q4 were 2.68 (1.79,4.03), 4.58 (2.92,7.18) and 6.30 (3.76,10.56), respectively, indicating that TCBI was an independent risk factor for MASLD in T2DM. The area under the ROC curve of TCBI was 0.781 (95%CI: 0.756-0.807, P<0.01), the sensitivity was 0.839, and the specificity was 0.657. Conclusion: TCBI is independently and significantly associated with MASLD in patients with T2DM. TCBI has predictive value for MASLD in patients with T2DM.
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Objective: To explore the correlation of endothelial cell specific molecule-1 (ESM1) and soluble hemoglobin scavenger receptor CD163 (sCD163) with foot ulcer in patients with type 2 diabetes mellitus (T2DM), and to evaluate the efficacy of the two indicators in identifying diabetic foot ulcer. Methods: A retrospective analysis was performed on the clinical data of 226 patients with T2DM admitted to our hospital from January 2022 to December 2024. The patients were divided into foot ulcer group (n=60) and control group (n=166) according to whether complicated with foot ulcer. Laboratory examination indicators and clinicopathological characteristics were compared between the two groups. Logistic regression analysis was used to screen the influencing factors of foot ulcer in T2DM patients. Receiver operating characteristic curve was adopted to evaluate the diagnostic value of single and combined detection of ESM-1 and sCD163. The differences in ESM-1 and sCD163 levels were compared among T2DM patients with different ulcer types and Wagner grades. Results: The prevalence of foot ulcer in T2DM patients was 26.55%. The levels of ESM-1 and sCD163 in the foot ulcer group were significantly higher than those in the control group (both P<0.05), and the two indicators were positively correlated (r=0.682, P<0.01). Complicated peripheral neuropathy, glycated hemoglobin, C-reactive protein, ESM-1 and sCD163 were independent influencing factors for foot ulcer in T2DM patients (all P<0.05). The area under the curve (AUC) of ESM-1 and sCD163 alone in diagnosing T2DM foot ulcer was 0.846 and 0.845, respectively (both P<0.01); the AUC of combined detection was 0.927, with a sensitivity of 0.833 and a specificity of 0.904 (P<0.01). The levels of ESM.1 and sCD163 increased with the elevation of Wagner grade, and were higher in neuroischemic ulcers than in ischemic ulcers and neuropathic ulcers (both P<0.05). Conclusion: ESM-1 and sCD163 are closely associated with the occurrence of foot ulcer in T2DM patients. Combined detection of the two indicators can be used to significantly improve the identification efficiency of diabetic foot ulcer, and their expression levels are correlated with ulcer type and severity.

Objective: To explore the effects of obstructive sleep apnea hypopnea syndrome (OSAHS) combined with obesity on the gastrocnemius muscle in mice and its possible mechanism. Methods: Forty male C57BL/6 mice (6-8 weeks, 25-30 g) were randomly and evenly divided into 4 groups, with 10 mice in each group: control group (untreated), CIH group (intermittent hypoxia), high-fat diet (HFD) group (fed with HFD), CIH+HFD group (intermittent hypoxia with HFD). After 14 weeks, the gastrocnemius muscle tissues of the mice were collected. HE staining was used to observe the morphological changes of the gastrocnemius muscle. Western blotting was performed to detect the expression of skeletal muscle fiber types, myocyte generation and differentiation, endoplasmic reticulum stress (ERS), inflammatory factors, and apoptosis-related proteins in the gastrocnemius muscle tissues. Real-time fluorescence quantitative PCR was used to detect the relative mRNA expression levels of skeletal muscle fiber types, myotube formation and ERS. C2C12 myotubes were induced with different concentrations of sodium palmitate (PA), and the formation of lipid droplets was observed by Oil Red O staining. C2C12 myotubes were divided into the control group (untreated), CIH group (intermittent hypoxia), PA group (200 μmol/L PA), and CIH+PA group (200 μmol/L PA combined with intermittent hypoxia). After 5 days, morphological changes were observed under an optical microscope. Western blotting was used to detect the expression of skeletal muscle fiber types, myogenesis, endoplasmic reticulum stress, inflammatory factors, and apoptosis-related proteins. Results: Compared with the control group, the gastrocnemius muscle fibers of mice in CIH+HFD group were significantly damaged, with a significant decrease in the relative expression of MYHC7 protein and MYHCⅠ mRNA (P<0.01), and a significant increase in the expression of MYHCⅡx protein and mRNA (P<0.01); the expression of MYOG, MYOD1 protein and MYOG, MYOD mRNA decreased significantly (P<0.01); the expression of IRE1α, XBP1s and CHOP protein and mRNA increased greatly (P<0.05); the expression of Caspase-3, TNF-α and IL-6 protein increased markedly (P<0.05). Compared with the control group, the structure of C2C12 myotubes in CIH+PA group was damaged, with a significant decrease in MYHC7, MYOG, MYOD1 protein and Bcl-2 protein (P<0.01 or P<0.05), and a significant increase in MYHCⅡx protein, GRP78, CHOP, IRE1α, XBP1s protein and IL-6, Caspase-3, Bax protein (P<0.05 or P<0.01). Conclusion: OSAHS combined with obesity may induce damage to the gastrocnemius muscle in mice by activating ERS-mediated apoptosis pathways, while also causing a shift in gastrocnemius muscle fiber from type Ⅰ to type Ⅱ, thereby inhibiting muscle formation and differentiation.

Objective: Based on whole-genome sequencing, this study analyzed the molecular and phenotypic characteristics of Klebsiella pneumoniae (KP) were analysed to provide a basis for the prevention of the spread of highly virulent drug-resistant strains and clinical treatment. Methods: A total of 117 KP isolates were collected from a hospital in Jiangsu Province between February 2023 and February 2024. Antimicrobial susceptibility testing and whole-genome sequencing were performed to determine the resistance phenotype, hypermucoviscosity phenotype, and to clarify the capsular serotype, multi-locus sequence typing, as well as the carriage status of virulence genes and resistance genes. Results: A high resistance rate to ampicillin (98.7%) and doxycycline (41.0%) was observed among the tested strains. Resistance rates to cephalosporins ranged from 1.3% to 16.5%, and the detection rate of multidrug-resistant strains was 23.9%. A total of 67 resistance genes from 13 categories were detected, among which 4 strains carried carbapenem-resistant genes. The predominant capsular serotypes were K1 and K2, accounting for 24.0% in total; O1 was the major O antigen type, accounting for 52.1%. The 117 strains were classified into 67 sequence types (ST), with ST23, ST412, ST29, and ST111 each accounting for more than 5.0%. The carriage rates of Aerobactin (Aer), Yersiniabactin (Ybt), Colibactin (Clb), Salmochelin (Sal), the mucoviscosity phenotype regulators RmpADC and RmpA2 were 44.4%, 47.9%, 11.1%, 54.7%, 55.6% and 29.9%, respectively; all ST23 strains carried the above virulence genes. Hypermucoviscosity strains accounted for 28.2%, and carried significantly more virulence genes than non-hypermucoviscosity strains (P<0.05). Conclusion: The isolates of KP from this hospital exhibited high resistance rates to ampicillin and doxycycline, while the overall resistance rates to other commonly used antimicrobial drugs were relatively low. No dominant prevalence of a single clonal group, serotype or sequence type was found. ST23 strains carrying multiple virulence genes were relatively dominant strains, which have potential risks of evolving into carbapenem-resistant strains, and continuous monitoring is needed.

Objective: To explore the clinical efficacy of kidney-tonifying and phlegm-resolving therapy combined with drospirenone and ethinylestradiol in the treatment of adolescent polycystic ovary syndrome (PCOS) with kidney deficiency and phlegm-dampness syndrome, and to analyze its effects on endocrine metabolism, ovarian function and long-term prognosis of patients. Methods: A total of 133 adolescent PCOS patients with kidney deficiency and phlegm-dampness syndrome admitted to Beijing Children′s Hospital, Capital Medical University from January 2021 to September 2024 were enrolled and randomly divided into the combined treatment group (68 cases) and the control group (65 cases). The control group received conventional cyclic therapy with drospirenone and ethinylestradiol (21 days of medication followed by 7 days of drug withdrawal). On the basis of the control group, the combined treatment group was additionally treated with kidney-tonifying and phlegm-resolving prescription, one dose per day taken orally in two divided doses. Both groups were treated continuously for 3 menstrual cycles and followed up for 3 months after treatment. The menstrual cycle recovery rate, sex hormone levels, glycolipid metabolism indexes, ovarian ultrasound parameters, traditional Chinese medicine syndrome scores and adverse reactions were compared between the two groups. Results: After treatment, the menstrual cycle recovery rate of the combined treatment group was 85.29%, which was significantly higher than 69.23% of the control group (P<0.05). At the 3-month follow-up, the maintained menstrual recovery rate of the combined treatment group was 77.94%, which was obviously higher than 58.46% of the control group (P<0.05). In terms of sex hormone indexes, the combined treatment group showed significantly superior improvements in total testosterone (TT) level and luteinizing hormone/follicle-stimulating hormone (LH/FSH) ratio compared with the control group (P<0.01, P<0.05). After correcting baseline confounding factors by covariance analysis, the improvement of homeostasis model assessment of insulin resistance (HOMA-IR) in the combined treatment group was still significantly better than that in the control group (P<0.01). The levels of triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), ovarian volume and follicle number were improved in both groups, with a better improving trend in the combined treatment group, but no significant differences were found between the two groups (P>0.05). Multivariate Logistic regression analysis indicated that combined treatment was an independent protective factor for menstrual cycle recovery (OR=2.45, 95%CI: 1.30-4.62), and baseline HOMA-IR level was negatively correlated with menstrual recovery efficacy (OR=0.78, 95%CI: 0.62-0.98). Conclusion: Kidney-tonifying and phlegm-resolving therapy combined with drospirenone and ethinylestradiol can effectively ameliorate endocrine and metabolic disorders, repair ovarian function, and reduce the recurrence rate after drug withdrawal in adolescent PCOS patients with kidney deficiency and phlegm-dampness syndrome, with better clinical efficacy than simple western medicine treatment. Baseline insulin resistance is an important prognostic factor, and synchronous metabolic intervention can effectively improve the long-term clinical efficacy.

Objective: To investigate the relationship between D-dimer/lymphocyte ratio (DLR) and clinicopathological characteristics in patients with multiple myeloma (MM) and its predictive value for prognosis. Methods: A total of 80 patients with MM admitted to the Affiliated Suzhou Hospital of Nanjing Medical University from August 2019 to August 2023 were enrolled. According to the median DLR, patients were divided into low DLR group (DLR≤0.58) and high DLR group (DLR＞0.58), with 40 cases in each group. Clinicopathological characteristics were compared between the two groups. The correlation between clinicopathological characteristics and DLR was analyzed by stratified regression. Univariate and multivariate Cox proportional hazards regression were used to analyze factors affecting overall survival (OS) and progression-free survival (PFS). Receiver operating characteristic (ROC) curve was used to evaluate the prognostic value of DLR. Patients were divided into DLR≤0.65 group and DLR＞0.65 group based on the optimal cutoff value, and survival curves were compared. Results: Compared with the low DLR group, the high DLR group had higher proportions of IgG type, ISS stage Ⅲ, hemoglobin＜85 g/L, and β2-microglobulin≥5.5 mg/L (P＜0.05). M protein typing, ISS stage, and β2-microglobulin were independently positively correlated with DLR (t=3.596, 3.465, 7.302, all P＜0.05), while hemoglobin was negatively correlated (t=5.590, P＜0.001). ISS stage Ⅲ, bone marrow plasma cell ratio≥30%, albumin＜35 g/L, and high DLR were independent positive factors for shorter OS (P＜0.05). ISS stage Ⅲ, albumin＜35 g/L, and high DLR were independent positive factors for shorter PFS (P＜0.05). The AUC of DLR for predicting prognosis was 0.849 (95%CI: 0.796-0.902), with a sensitivity of 0.974 and a specificity of 0.581, and the optimal cutoff value was 0.65. The PFS and OS in the DLR≤0.65 group were significantly longer than those in the DLR＞0.65 group (P=0.004, 0.013). The PFS of IgG subtype in the DLR≤0.65 group was also longer (P=0.045). Conclusion: DLR is closely associated with M protein typing, ISS stage, hemoglobin, and β2-microglobulin in MM patients, and serves as a prognostic factor.

Objective: To establish a prediction model for cesarean delivery after induction (CDaI) in primiparous women based on real-world clinical data. Methods: A total of 3 069 primiparous women with full-term pregnancies who underwent induction of labor at Songjiang Maternal and Child Health Hospital in Shanghai from March 1, 2020 to December 31, 2023 were selected and divided into the CDaI group (n=970) and the vaginal delivery (VD) group (n=2 099) based on the mode of delivery. The clinical and pathological characteristics of the two groups were compared. Logistic regression and LASSO regression models were used to screen the predictive factors. The predictive ability of the model was evaluated using the receiver operating characteristic (ROC) curve, and the goodness-of-fit of the model was tested using the Hosmer-Lemeshow goodness-of-fit test. Results: The CDaI group had significantly higher age, gestational age at delivery, prepregnancy body mass index (BMI), gestational weight gain, oxytocin dosage, proportion of pregnancies achieved through assisted reproductive technology (ART), and incidence of hypertensive disorders of pregnancy (HDP) compared with the VD group (all P<0.05), but the proportion of epidural labor analgesia and doula-assisted delivery in the CDaI group was significantly lower than that in the VD group (both P<0.05). Logistic regression analysis showed that age, gestational age at delivery, pre-pregnancy BMI, gestational weight gain, induction method, oxytocin dosage, epidural labor analgesia, and doula-assisted delivery were independent influencing factors for CDaI in primiparous women. The AUC of the prediction model in the training set and validation set were 0.83 and 0.82, respectively. The Hosmer-Lemeshow goodness-of-fit test showed that the model had a good fit (P=0.62, 0.38). The AUC of the prediction model constructed using the 8 variables selected by LASSO regression was 0.82. Conclusion: A prediction model for CDaI in primiparous women based on 8 clinical routine variables, including age, gestational age at delivery, pre-pregnancy BMI, gestational weight gain, induction method, oxytocin dosage, epidural labor analgesia and doula-assisted delivery, was established and exhibited good performance.