Adult-onset Still's disease (AOSD) is a chronic systemic inflammatory disorder with sustained elevation of pro-inflammatory cytokines and frequent glucocorticoid use. Real-world data on bone health in AOSD remain scarce. This study aimed to evaluate bone health parameters and their associations with inflammatory markers in patients with AOSD. This cross-sectional study included 54 patients with AOSD who underwent dual-energy x-ray absorptiometry (DXA) at a tertiary referral center. Bone mineral density (BMD) at the lumbar spine, femoral neck, and total hip, and trabecular bone score (TBS) were assessed. Associations between C-reactive protein (CRP), ferritin, cumulative glucocorticoid dose, and bone parameters were analyzed using Spearman correlation, partial correlation adjusted for age, sex, and body mass index (BMI), and multivariable logistic regression. The mean age was 58.2 ± 12.0 years (79.6% female). Osteoporosis and osteopenia were present in 40.7% and 38.9%, respectively. TBS assessment (n = 52) revealed that 38 patients (73.1%) had normal microarchitecture (TBS > 1.350) and 14 (26.9%) had partially degraded microarchitecture (TBS 1.200-1.350). CRP showed a significant negative correlation with TBS (r = -0.445, P = .001), which remained significant after Bonferroni correction (adjusted P = .019) and after partial correlation adjusting for age, sex, and BMI (r = -0.336, P = .015). In multivariable logistic regression adjusted for age, sex, and BMI, CRP was independently associated with osteoporosis (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.01-1.27, P = .039). In patients aged ≥ 50 years, log-transformed ferritin was independently associated with osteoporosis (OR 4.34, 95% CI 1.43-13.13, P = .009). Cumulative glucocorticoid dose was not significantly associated with bone parameters. These real-world data demonstrate a high burden of impaired bone health in patients with AOSD. CRP was independently associated with TBS and osteoporosis after adjustment for age, sex, and BMI, and ferritin was associated with osteoporosis in patients aged ≥50 years. These findings support the need for routine bone health screening in AOSD.

Diabetes mellitus (DM) is a chronic, multisystemic metabolic disorder characterized by hyperglycemia resulting from absolute or relative insulin resistance (IR) in peripheral tissues. Diabetic foot ulcers, arising from peripheral arterial disease (a macrovascular complication) and neuropathy (a microvascular complication), represent a major cause of morbidity among diabetic patients. Asprosin is a diabetogenic adipokine involved in glucose metabolism and IR. This study aimed to investigate whether serum asprosin plays a role in the progression of diabetes and the development of diabetic foot ulcers. This comparative cross-sectional observational study included 3 groups: 32 patients with diabetic foot ulcers, 31 patients with type 2 diabetes mellitus (T2DM) without ulcers, and 27 healthy controls. Demographic data (age, gender, family history, body mass index), biochemical parameters, culture results, and serum asprosin levels were evaluated. Serum asprosin concentrations were measured using the Enzyme-Linked Immunosorbent Assay (ELISA) method. Serum asprosin levels differed significantly among the groups (P < .001), being lowest in the control group. Both the diabetic foot and T2DM groups exhibited significantly higher asprosin levels compared to controls (P < .001), although there was no significant difference between the 2 diabetic groups. Additionally, asprosin levels were not significantly affected by the presence of wound infection, positive culture growth, or elevated acute-phase reactants. In this study, serum asprosin was not found to be associated with the development of peripheral complications of diabetes. Further studies with larger cohorts are warranted to clarify the role of asprosin in diabetic vascular and metabolic pathophysiology.

Hemoptysis is a severe and potentially life-threatening complication of bronchiectasis. There is currently a lack of reliable tools for the individualized prediction of hemoptysis risk in these patients. This study aimed to utilize a machine learning algorithm to develop and validate a nomogram for predicting the risk of hemoptysis in patients with bronchiectasis. This retrospective study enrolled 131 patients with bronchiectasis, who were randomly divided into a training set and an internal validation set in a 7:3 ratio. The Random Forest algorithm was employed, using mean decrease accuracy as the metric, to screen for important predictors from clinical variables. Subsequently, the selected variables were incorporated into a multivariate logistic regression model to construct the predictive nomogram. The model's discrimination, calibration, and clinical utility were comprehensively evaluated using the receiver operating characteristic curve, calibration curve, decision curve analysis, and clinical impact curve. The top 10 important predictors identified by the Random Forest algorithm included body mass index, C-reactive protein, creatinine, age, urea, low-density lipoprotein, platelet count, total cholesterol, diabetes, and fasting plasma glucose. Multivariate logistic analysis confirmed that body mass index, C-reactive protein, creatinine, age, and urea were independent predictors of hemoptysis. After correcting the mismatched logistic regression parameters, the constructed nomogram still demonstrated excellent predictive performance in both the training and validation sets, with an area under the curve of 0.944 (95% confidence interval: 0.873-1.000) in the validation set. The calibration curve showed a high degree of consistency between predicted probabilities and observed outcomes. Decision curve analysis and the clinical impact curve further confirmed that the model provided significant net clinical benefit across a wide range of threshold probabilities. This study successfully developed and validated a nomogram that incorporates Random Forest-based variable screening. The model integrates 5 readily available clinical parameters to accurately and individually predict the risk of hemoptysis in patients with bronchiectasis, demonstrating good calibration and clinical utility. It serves as a valuable tool to assist clinicians in the early identification and management of high-risk patients.

Aortic dissection (AD) is a life-threatening cardiovascular disease with exceedingly high mortality, particularly during the acute phase. Ubiquitination modification is implicated in the pathogenesis of cardiovascular diseases through diverse biological processes. However, the role of TRIM9, an E3 ubiquitin ligase, in AD remains unexplored. In this study, the expression profiles of TRIM9 and SMAD4 were analyzed using clinical samples, as well as Angiotensin II (Ang II)-induced mouse and human aortic endothelial cell (HAEC) models. Endothelial barrier function in AD was assessed through CCK-8 assays, vascular permeability measurements, immunofluorescence staining, hematoxylin-eosin and Verhoeff's van Gieson staining, and Western blot analysis. The underlying molecular mechanisms were elucidated using quantitative real-time PCR, immunoprecipitation (IP), co-immunoprecipitation (Co-IP), and enzyme-linked immunosorbent assay (ELISA). TRIM9 was markedly overexpressed, whereas SMAD4 was significantly downregulated in AD. Knockdown of TRIM9 attenuated endothelial permeability, preserved the endothelial barrier integrity, and inhibited pyroptosis both in vivo and in vitro. Mechanistically, TRIM9 promoted the ubiquitination and subsequent proteasomal degradation of SMAD4, thereby exacerbating AD progression. Collectively, these findings demonstrate that elevated TRIM9 expression aggravates AD progression through SMAD4 destabilization, offering novel therapeutic insights for AD management.

Canine leishmaniosis causes clinical and clinicopathological abnormalities, including hematological and acute phase proteins changes. Although quantitative polymerase chain reaction (qPCR) improves diagnosis and bone marrow is one of the most sensitive samples for parasite detection, their correlation with parasite burden remains unclear. This cross-sectional study evaluated the correlation and agreement between bone marrow qPCR parasite load, clinical status, LeishVet stage, acute phase proteins, and cell blood count (CBC) alterations in dogs with leishmaniosis at diagnosis. Diagnosis was based on compatible clinical signs and/or clinicopathological findings together with positive serology and/or bone marrow qPCR for Leishmania Infantum. Dogs were excluded if they had received anti-Leishmania or immunomodulatory treatment in the previous 12 months. Published clinical score (used as surrogate of the clinical status), acute phase proteins and bone marrow qPCR parasite load scores were used, while a new CBC score based on peripheral cytopenia was developed; all scores and the LeishVet staging system were categorized into four levels. Correlation and agreement between scores were assessed using Spearman's correlation and Weighted Cohen's kappa tests, respectively. Two-hundred and seventy dogs were included into the study. The bone marrow qPCR score showed significant weak-to-moderate positive correlations with all variables and slight-to-fair agreement with all scoring systems except the CBC score. In conclusion, bone marrow qPCR parasite load in untreated dogs with canine leishmaniosis showed only weak-to-moderate associations with disease severity across the study population. However, the substantial overlap in parasite load values among clinical stages limits its usefulness for predicting disease severity in individual dogs, highlighting the need to further evaluate current staging systems for clinical management.

To assess the protective effects of live combined bifidobacterium, lactobacillus, enterococcus, and glutamine on diarrhea associated with chemotherapy and inflammatory markers in colorectal cancer patients (CCP). A retrospective analysis was conducted on the clinical data of patients with colorectal cancer who received chemotherapy at the People's Hospital of Pailin County, Chongqing from December 2022 to December 2024. There were 59 cases in the control group and 59 cases in the study group. The control group received treatment with triple live bifidobacterium, while the study group received combined treatment with glutamine in addition to the treatment of the control group. We compared levels of inflammatory markers, intestinal barrier functions, immune responses, and diarrhea incidence during chemotherapy. No significant pre-chemotherapy differences were noted in inflammatory or intestinal barrier markers (P > 0.05). Throughout the course of treatment, we observed a reduction in inflammatory markers in both groups (P < 0.05), with the experimental group showing more significant declines. Intestinal barrier functions degraded over time in both groups, with more significant reductions in the study group (P < 0.05). The therapy combining significantly mitigates inflammation, bolsters intestinal and immune functions, and alleviates diarrhea in CCP. Clinical Registration: The authors have nothing to report.