Shouxin Wei

With global population aging, the prevalence of frailty is steadily increasing. Insulin resistance plays a key role in the development of frailty and cardiovascular disease (CVD) mortality. The estimated glucose disposal rate (eGDR) has been recognized as a reliable surrogate marker of insulin resistance. To date, no studies have investigated the association between eGDR, frailty, and CVD mortality in the U.S. population. We used data from the National Health and Nutrition Examination Survey 2001 to 2018 cycles and employed weighted logistic regression and weighted Cox proportional hazards models to evaluate the associations between eGDR and frailty, as well as CVD mortality among frail and non-frail individuals. Restricted cubic spline analysis was used to explore potential nonlinear relationships, and subgroup analyses were conducted to test the robustness of the findings. The results indicated a significant inverse association between eGDR and frailty prevalence; each 1 standard deviation increase in eGDR was associated with a 22.3% decrease in frailty risk (odds ratio = 0.777 [0.760, 0.795]). Higher eGDR levels were also significantly associated with lower CVD mortality risk. Among frail individuals, each standard deviation increase in eGDR was associated with a 4.3% lower risk of CVD mortality (hazard ratio = 0.957 [0.916, 0.988]); among non-frail individuals, the corresponding reduction was 7% (hazard ratio = 0.930 [0.885, 0.977]). The inverse association showed a stronger gradient across eGDR levels among non-frail individuals, whereas this pattern was not observed among frail individuals. Restricted cubic spline analysis revealed a nonlinear association between eGDR and both frailty and CVD mortality among frail individuals, whereas a linear relationship was observed among non-frail individuals. Subgroup analysis indicated that age modified the associations between eGDR, frailty, and CVD mortality in frail individuals. Smoking status influenced the relationship between eGDR and frailty, while race modified the association between eGDR and CVD mortality among non-frail individuals. eGDR was significantly and inversely associated with frailty and CVD mortality in both frail and non-frail populations. Higher eGDR levels were associated with a lower prevalence of frailty and lower cardiovascular mortality risk, suggesting that eGDR may serve as a potential marker for metabolic and cardiovascular risk stratification.

Objective: To examine the association between oxidative balance score and the risks of gallstones and gallbladder surgery in US adults, addressing the lack of reliable oxidative stress–related indicators for gallstone prediction. Methods: A cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey 2017–2020. Multivariate logistic regression, subgroup analyses, and smoothed curve fitting models were applied to investigate the relationship between oxidative balance scores and gallstone outcomes, adjusting for age, sex, race, and health conditions. Results: Higher oxidative balance score was significantly associated with lower risks of gallstones and gallbladder surgery. Each 1-unit increase in the oxidative balance score corresponded to a 2.6% reduction in gallstone risk (odds ratio = 0.974; 95% confidence interval: 0.958, 0.990) and a 3.3% reduction in gallbladder surgery risk (odds ratio = 0.967; 95% confidence interval: 0.950, 0.983). Subgroup and dose–response analyses confirmed these consistent, negative associations. Conclusions: Higher oxidative balance score is independently associated with a reduced prevalence of gallstones and gallbladder surgery. Furthermore, maintaining a higher antioxidant status may play a role in the management of gallstone disease risk.

Background: ‘Soluble’ total colon necrosis is a rare condition with an unclear etiology and few reports on treatment modalities. This case report describes severe intestinal necrosis in an HIV-infected patient, detailing clinical manifestations, diagnostic process, treatment regimen, and outcomes, thereby providing a reference for similar cases in the future. Case description: The patient is a 41-year-old man diagnosed with HIV 6 years ago, receiving long-term therapy with tenofovir, lamivudine, and efavirenz. He has no history of smoking, alcohol consumption, inflammatory bowel disease, or intestinal tuberculosis, but has had multiple sexual partners. He was admitted with 3 h of abdominal pain; a blood pressure of 108/76 mmHg; a heart rate of 148 bpm, and physical findings of generalized abdominal tenderness, rebound tenderness, muscle rigidity, and diminished bowel sounds. Laboratory results showed elevated procalcitonin (5.15 ng/mL), white blood cells (9.2 × 10^9/L), and C-reactive protein (232.10 mg/L). Abdominal CT revealed thickened walls in the ileocecal region, colon, and rectum, with small bowel dilation, gas, and fluid accumulation, indicating hollow organ perforation and diffuse peritonitis. Emergency laparotomy revealed extensive necrosis of the colon and rectum, with perforation at the hepatic flexure of the colon. A total colectomy, rectal resection, and ileostomy were performed. Postoperative pathology revealed acute and chronic suppurative inflammation with necrosis and perforation. Postoperative sepsis developed, and further examination revealed the presence of syphilis antibodies and liver function impairment. Following treatment with anti-infective, anti-inflammatory, liver-protective, and nutritional support therapies, the patient’s condition improved. On the 9th postoperative day, the patient was transferred to a community hospital for further treatment and was discharged on the 23rd postoperative day. Conclusion: This case illustrates the rare occurrence of extensive necrosis and perforation of the colon in an HIV-infected patient with co-occurring syphilis. Although the precise role of syphilis in the development of gastrointestinal complications remains uncertain, this case highlights the need for heightened clinical awareness of co-infections in immunocompromised patients.

Introduction Breast and colorectal cancer are a major global public health problem. Breast cancer is one of the most common cancers worldwide. Colorectal cancer is the third most common cancer and the second most common cause of tumor death worldwide. Central memory T (TCM) cells are closely related to the development of tumors and important targets for immunotherapy. Therefore, identifying the common signaling molecules of these two diseases in TCM cells can improve our understanding of these diseases and lead to the development of therapies that can be effective for treating both. Methods Single-cell RNA (scRNA) data of breast cancer (GSE161529) and colorectal cancer (GSE222300) patients was downloaded from the GEO database. The data were normalized and dimension reduced, then different T cell subsets were identified and differential gene expression analysis of central memory CD8 + T cells was conducted. Mendelian randomization analysis, reverse causality detection, and co-localization analysis was performed to explore the relationship between differentially-expressed genes and the disease. Quasi-temporal analysis and metabolic analysis was done using scRNA sequencing technology and further analysis of gene expression and metabolism in spatial transcriptomes. Finally, the degree of association between drug target genes was analyzed by protein-protein interaction (PPI) analysis. Results Our analysis identified four genes (ZFP36L2, CKS1B, PTTG1, and ITGAE) that were associated with risk of both breast and colorectal cancer. In the pseudotime analysis, we found that the expression levels of CKS1B and PTTG1 decreased over time (p < 0.05) while ZFP36L2 and ITGAE increased over time (p < 0.05). In the metabolic analysis, these four genes were closely associated with the cysteine and methionine metabolism pathways, which was corroborated in the spatial transcription analysis. Finally, the PPI analysis among the drug target genes identified an interaction between PTTG1 and CKS1B genes. Conclusion This study reports that the ZFP36L2, CKS1B, PTTG1, and ITGAE genes could potentially influence breast cancer and colorectal cancer development via TCM CD8 + T cells. These four genes are putative common markers for diagnosis, treatment, and monitoring tumor response to therapies.

With the development of society, the prevalence of metabolic syndrome (MetS) has been increasing year by year and has become a major global health threat. The dietary index for gut microbiota (DI‐GM), a recently proposed dietary assessment metric, has attracted considerable attention. However, its association with MetS has lacked systematic research evidence. This study was based on data from 59,842 nationally representative participants in the 2007–2018 National Health and Nutrition Examination Survey (NHANES) database, using methods such as multivariable weighted logistic regression, restricted cubic splines (RCS), subgroup analysis, and mediation effect analysis to explore the association between DI‐GM and MetS. The study showed a significant negative correlation between the DI‐GM score and the risk of MetS (OR = 0.947 [0.921, 0.974]), and as the DI‐GM score increases, this association becomes more pronounced. Subgroup analysis found no significant interactions, while mediation effect analysis further revealed that serum albumin and the systemic immune–inflammation index (SII) played a partial mediating role in this association. This study is the first to confirm a significant negative correlation between DI‐GM and MetS risk, suggesting that optimizing dietary structure may be a feasible intervention for the prevention and treatment of metabolic syndrome.

Cancer immunotherapy represents a major breakthrough in oncology, particularly with immune checkpoint inhibitors (ICIs) and CAR-T cell therapies. Despite improved outcomes, challenges such as immune-related adverse events (irAEs) and treatment resistance limit clinical use. Artificial intelligence (AI) offers new opportunities to address these barriers, including target identification, efficacy prediction, toxicity monitoring, and personalized treatment design. This review highlights recent advances in AI applications for biomarker discovery, safety evaluation, gene editing, nanotechnology, and microbiome modulation, integrating evidence from clinical and preclinical studies. We also discuss future directions and challenges in applying AI to cancer immunotherapy, aiming to support further research and clinical translation.

Metabolic syndrome (MetS) is a worldwide condition that markedly elevates the risk of chronic conditions. The cholesterol, high-density lipoprotein, and glucose (CHG) indices simultaneously reflect various metabolic parameters, including lipid metabolism, cardiovascular function, and insulin sensitivity, providing considerable clinical value. This study aimed to investigate the association between the CHG index and MetS, along with their connections with all-cause death and cardiovascular disease (CVD) death in individuals with MetS. The NHANES dataset (2001–2018) was used to assess the relationship between the CHG index and MetS via cross-sectional research and weighted logistic regression analysis. Cohort studies and a weighted Cox proportional hazards model were employed to investigate the relationships of CHG with all-cause mortality and cardiovascular mortality in individuals with MetS. A possible nonlinear association between the CHG score and MetS, along with all-cause and CVD mortality in MetS patients, was assessed via general additive models and smooth fitting of curves. Kaplan‒Meier (K‒M) survival curves were generated to illustrate prognostic variations across CHG index quartiles. Subgroup analyses were performed to investigate discrepancies in these associations across different populations. Finally, the consistency and dependability of the outcomes were verified through repeated analysis via multiple imputation of the data and external validation with CHARLS. After adjusting for relevant confounding factors, the CHG index was positively correlated with all-cause Mortality and CVD Mortality among individuals with MetS. Further analysis revealed a U-shaped nonlinear relationship for these associations, with inflection points at 46.12, 52.67, and 50.82, respectively. K‒M survival curve analysis indicated that the prognosis for the middle quartile of the CHG index was better than that for both the lower and upper quartiles. Subgroup analyses further highlighted differences in these associations across various populations. Ultimately, the sensitivity analysis demonstrated the robustness of the findings. The CHG index has a substantial U-shaped nonlinear association with the incidence of MetS and the risk of all-cause and cardiovascular death in patients with MetS. Previous interventions have focused primarily on high-risk extremes, but the findings of this study suggest that patients with low CHG levels should also be included in monitoring. Future prospective studies are needed to validate these findings and explore their potential clinical applications in managing MetS patients.

PE is a life‐threatening pregnancy disorder that can lead to adverse events for both the fetus and the mother. Autophagy is a cellular process involved in cellular renovation and maintaining homeostasis. There is a growing body of evidence suggesting that autophagy in trophoblasts plays a significant role in the development and pathogenesis of PE. However, the exact mechanisms are not yet fully understood. This article provides an overview of recent evidence regarding the role of autophagy in trophoblast invasion, vascular remodelling, inflammation, immune response, and maternal factors in the context of PE. It is believed that impaired or excessive autophagy can contribute to placental ischaemia and hypoxia, thereby exacerbating PE progression. Therefore, understanding the molecular mechanisms that regulate autophagy in PE is crucial for the development of targeted therapeutic interventions in the future.

Background: Frailty severely impacts patients’ quality of life and imposes a significant burden on healthcare systems. The Dietary Index for Gut Microbiota (DI-GM) is an emerging dietary indicator, and its association with frailty has not been thoroughly investigated.Methods: This study utilized data from NHANES 2007–2018 and assessed the association between DI-GM and frailty using multivariable weighted logistic regression, restricted cubic splines (RCS), subgroup analysis, and mediation analysis, after adjusting for relevant covariates.Results: The results indicate a significant negative correlation between DI-GM and frailty, with each standard unit increase in DI-GM reducing the risk of frailty by 6% (OR = 0.940 [0.899, 0.984]). DI-GM at different quartiles showed a strong dose–response relationship, with the highest quartile showing a 21.6% risk reduction. RCS analysis revealed a linear relationship between DI-GM and frailty. Subgroup analysis suggested that age and smoking status may influence the association between DI-GM and frailty. Furthermore, albumin and high-density lipoprotein (HDL) played significant mediating roles in the relationship between DI-GM and frailty, accounting for 30.34 and 9.05% of the total effect, respectively.Conclusion: Dietary Index for Gut Microbiota is negatively associated with frailty risk, and albumin and HDL mediate this association. Improving dietary quality may be an effective strategy for reducing frailty risk.