BACKGROUND:Radiotherapy significantly improves survival rates in patients with various malignant tumors.However,with prolonged post-treatment survival,many patients face the risk of radiation-related cardiac toxicity.This is especially true after chest radiotherapy,where the risk of radiation-induced heart disease significantly increases,becoming one of the most severe complications affecting prognosis survival.OBJECTIVE:To identify diagnostic markers of endothelial cellular senescence in radiation-induced heart disease through systematic transcriptomic analysis.METHODS:Firstly,genes associated with cellular senescence were screened from the CellAge database and intersected with the transcriptomic training dataset of a mouse model of radiation-induced heart disease to identify differentially expressed senescence-related genes.Secondly,weighted gene co-expression network analysis and machine learning were used to identify key hub genes that play critical roles in radiation-induced heart disease.The expression of these genes was validated using a dataset of radiation-induced endothelial injury.Additionally,the quanTlseq method was employed to assess the immune infiltration status related to radiation-induced heart disease.The expression levels of key genes and their association with survival in esophageal squamous cell carcinoma patients receiving chest radiotherapy were explored through the analysis of The Cancer Genome Atlas database.RESULTS AND CONCLUSION:(1)Systematic transcriptomic analysis identified CCND1 as the core gene of endothelial cellular senescence in radiation-induced heart disease,and this finding was validated in the mouse model of radiation-induced heart disease.(2)The diagnostic model constructed from these data indicated that CCND1 had high specificity and sensitivity for diagnosing radiation-induced heart disease.(3)Immune infiltration analysis revealed significant immune response dysregulation in the mouse model of radiation-induced heart disease,and CCND1 was closely related to various immune cells.(4)Kaplan-Meier survival analysis showed that CCND1 was associated with poorer disease-specific survival in esophageal squamous cell carcinoma patients receiving chest radiotherapy.This study systematically uncovers,for the first time,the pivotal role of CCND1 in endothelial cell senescence associated with radiation-induced heart disease.CCND1,a gene integral to cell cycle regulation,can induce cellular senescence when abnormally expressed.Furthermore,the findings highlight its potential as an early diagnostic marker.

BACKGROUND:Radiotherapy significantly improves survival rates in patients with various malignant tumors.However,with prolonged post-treatment survival,many patients face the risk of radiation-related cardiac toxicity.This is especially true after chest radiotherapy,where the risk of radiation-induced heart disease significantly increases,becoming one of the most severe complications affecting prognosis survival.OBJECTIVE:To identify diagnostic markers of endothelial cellular senescence in radiation-induced heart disease through systematic transcriptomic analysis.METHODS:Firstly,genes associated with cellular senescence were screened from the CellAge database and intersected with the transcriptomic training dataset of a mouse model of radiation-induced heart disease to identify differentially expressed senescence-related genes.Secondly,weighted gene co-expression network analysis and machine learning were used to identify key hub genes that play critical roles in radiation-induced heart disease.The expression of these genes was validated using a dataset of radiation-induced endothelial injury.Additionally,the quanTlseq method was employed to assess the immune infiltration status related to radiation-induced heart disease.The expression levels of key genes and their association with survival in esophageal squamous cell carcinoma patients receiving chest radiotherapy were explored through the analysis of The Cancer Genome Atlas database.RESULTS AND CONCLUSION:(1)Systematic transcriptomic analysis identified CCND1 as the core gene of endothelial cellular senescence in radiation-induced heart disease,and this finding was validated in the mouse model of radiation-induced heart disease.(2)The diagnostic model constructed from these data indicated that CCND1 had high specificity and sensitivity for diagnosing radiation-induced heart disease.(3)Immune infiltration analysis revealed significant immune response dysregulation in the mouse model of radiation-induced heart disease,and CCND1 was closely related to various immune cells.(4)Kaplan-Meier survival analysis showed that CCND1 was associated with poorer disease-specific survival in esophageal squamous cell carcinoma patients receiving chest radiotherapy.This study systematically uncovers,for the first time,the pivotal role of CCND1 in endothelial cell senescence associated with radiation-induced heart disease.CCND1,a gene integral to cell cycle regulation,can induce cellular senescence when abnormally expressed.Furthermore,the findings highlight its potential as an early diagnostic marker.

Lupus nephritis (LN) is the most common complication of systemic lupus erythematosus (SLE). The immune pathogenesis is closely related to the progression and clinical treatment of LN. This review reviews the relevant literature on the role of immune cells in the pathogenesis of LN at home and abroad. This paper summarized and analyzed the pathogenesis of immune cells in the pathogenesis of LN and the research progress of related targeted therapy, aiming to improve the understanding of the pathogenesis of immune cells in LN, improve the treatment status of LN and better improve the prognosis.

Objective To investigate the relationship between serum peroxiredoxin 6(PRDX6)and annexin A1(ANXA1)levels and the severity and prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)compli-cated with type II respiratory failure.Methods A total of 257 patients with AECOPD complicated with type II respiratory failure(respiratory failure group),130 patients with stable COPD(stable COPD group)and 130 healthy subjects(control group)were selected from the Panzhihua University Affiliated Hospital from December 2021 to December 2023.According to the oxygenation index,AECOPD patients with type II respiratory failure were divided into mild respiratory failure group(n=101),moderate respi-ratory failure group(n=80)and severe respiratory failure group(n=76).According to the 28-day prognosis,they were divided into death group(n=62)and survival group(n=195).Serum PRDX6 and ANXA1 levels were detected by enzyme-linked immu-nosorbent assay(ELISA).The correlation between serum PRDX6,ANXA1 levels and oxygenation index in AECOPD patients with type II respiratory failure was analyzed by Spearman correlation coefficient.Multivariate Logistic regression model was used to analyze the influencing factors of poor prognosis in patients with AECOPD complicated with type II respiratory fail-ure,and receiver iperating characteristic(ROC)curve was drawn to evaluate the predictive value of serum PRDX6 and ANXA1.Results The serum PRDX6 level in the respiratory failure group(41.54±4.28 pg/ml)was lower than that in the stable COPD group(61.38±4.94 pg/ml)and the control group(80.65±8.93 pg/ml),and the ANXA1 level(3.35±0.69 μg/L)was higher than that in the stable COPD group(2.13±0.61 μg/L)and the control group(1.03±0.14 μg/L),the differences were statistically sig-nificant(t=-33.894～21.727,all P<0.001).The serum level of PRDX6 in severe respiratory failure group(34.54±5.05 pg/ml)was lower than that in moderate respiratory failure group(43.90±4.72 pg/ml)and mild respiratory failure group(54.28±6.34 pg/ml),the serum level of ANXA1 in severe respiratory failure group(3.94±0.43 μg/L)was higher than that in moderate respi-ratory failure group(3.57±0.46 μg/L)and mild respiratory failure group(2.70±0.43 μg/L),the differences were statistically sig-nificant(t=-19.018～22.338,all P<0.001).Oxygen index was positively correlated with serum PRDX6(r=0.815,P<0.001)and negatively correlated with ANXA1(r=-0.781,P<0.001)in AECOPD patients with type II respiratory failure.The mortality rate of 257 AECOPD patients with type II respiratory failure was 24.12%(62/257)after 28 days of follow-up.Increase forced expi-ratory volume in the first second(FEV1)as a percentage of the predicted value,increased oxygenation index and increased PRDX6 were independent protective factors for the poor prognosis of AECOPD patients with type II respiratory failure(Wald χ2=-0.154,-0.014,-0.173,all P<0.05),increased ANXA1 was an independent risk factor(Wald χ2=0.250,P<0.05).The area un-der the curve of serum PRDX6 and ANXA1 combined to predict the poor prognosis of AECOPD patients with type II respiratory failure was 0.906,which was greater than 0.788 and 0.781 predicted by the two indicators alone,and the differences were statisti-cally significant(Z=4.243,4.224,all P<0.001).Conclusion The decrease of serum PRDX6 level and the increase of ANXA1 level are related to the aggravation and poor prognosis of AECOPD patients with type II respiratory failure.The value of serum PRDX6 combined with ANXA1 in predicting the prognosis of AECOPD patients with type II respiratory failure is high.

Tumor is the result of long-term and unlimited proliferation of cells. Tumor cells adjust various metabolic fluxes to meet increased bioenergy and biosynthetic requirements. Serine is one of the eight non-essential amino acids in the human body. It plays an important role in a variety of physiological activities and can provide one carbon unit, glycine, etc. for cell proliferation. Serine hydroxymethyltransferase (SHMT) is a key enzyme that catalyzes the conversion of glycine and serine. It is highly expressed in a variety of tumors and is a potential target for anti-tumor drugs. This article focuses on the potential of SHMT as a new target for cancer treatment and the preliminary application of its inhibitors in preclinical studies of tumors, providing reference for the development of new targeted drugs for tumors.

Objective To analyze the endowment features of patients with primary angle-closure glaucoma(PACG)based on circuit-qi theory,thus to provide approaches for revealing the etiology,pathogenesis and prevalence of PACG.Methods From October 2023 to March 2024,a total of 204 patients with PACG admitted to the Eye Hospital,China Academy of Chinese Medical Sciences were enrolled into the analysis.The natal day of the patients was used for the calculation of conception day,and then the conception day was used for the analysis of the features of five circuits and six qi based on the stem-branch lunar year of conception day.A database of information of five circuits and six qi on conception day was constructed,and then the features of their endowments at conception were statistically analyzed.Results No statistically significant differences were shown in the distribution of the dominant qi,guest qi,sitian(celestial control)and zaiquan(terrestrial effect)at conception in PACG patients(P＞0.05),but there were statistically significant differences in the distribution of yearly circuit,comprehensive circuit-qi,and combined circuit-qi at conception in PACG patients(P＜0.05).Most of PACG patients had the circuit-qi features of shaomu(deficiency of wood)-yangming dryness gold-shaoyin monarch fire,and taitu(excess of earth)-shaoyin monarch fire-yangming dryness gold at conception.Conclusion Those who are conceived at the date with circuit-qi features of shaomu and taitu,comprehensive circuit-qi features of shaomu-yangming dryness gold-shaoyin monarch fire and taitu-shaoyin monarch fire-yangming dryness gold,and combined circuit-qi features of shunhua(qi generating circuit)and celestial restriction(qi restricting circuit)are vulnerability to PACG.The development of the constitution of PACG patients may be related to the congenital circuit-qi features of pathogenic dryness attacking the lung,and metal exuberance restricting wood.

Objective To explore the effect of nuclear respiratory factor 1(NRF1)activation of ATP binding cas-sette transporter C1(ABCC1)transcription on cisplatin resistance in lung adenocarcinoma cells and its potential mechanisms.Methods The expression levels of ABCC1 in lung adenocarcinoma tumor tissues were analyzed by on-cogenomic datasets.Cells were grouped into:sh-NC,sh-ABCC1,sh-NC+oe-NC,sh-NRF1+oe-NC and sh-NRF1+oe-ABCC1.Real-time polymerase chain reaction(RT-qPCR)was used to detect the expression of ABCC1 in lung adenocarcinoma cells.Cisplatin-resistant lung adenocarcinoma cell strains were constructed to detect the expression level of ABCC1.Cell proliferation,migration and invasion were assessed by colony formation and Transwell assay.The IC50 values of drug-resistant lung adenocarcinoma cells treated with different doses(0,0.001,0.002,0.004,0.008,0.016 and 0.032 mg/mL)of cisplatin were detected by CCK-8 assay.Western blot was used to detect the protein expression of epithelial-mesenchymal transition markers(E-cadherin,N-cadherin).Dual luciferase and ChIP assays were performed to verify the binding relationship between NRF1 and ABCC1.Results ABCC1 was highly expressed in lung adenocarcinoma tumor tissues and cells.Compared with cisplatin-sensitive lung adenocarci-noma cells,ABCC1 was highly expressed in cisplatin-resistant lung adenocarcinoma cells,and knockdown of ABCC1 significantly inhibited cell proliferation,migration and invasion,and increased the expression of E-cadherin(P<0.05)and decreased the expression of N-cadherin(P<0.05).Knockdown of ABCC1 significantly increased the sensitivity of lung adenocarcinoma cells to cisplatin(P<0.05).In addition,dual luciferase and ChIP experi-ments confirmed the binding relationship between NRF1 and ABCC1 promoter de-binding,and NRF1 could activate the transcription of ABCC1.Knockdown of NRF1 attenuated the inhibitory effect of over-expressed ABCC1 on the proliferation,migration,invasion and cisplatin-resistance of lung adenocarcinoma cells(P<0.05).Conclusions This study revealed the effect of the NRF1/ABCC1 axis enhancement is a potential strategy to overcome the barrier of cisplatin-resistance in chemotherapy of lung adenocarcinoma.

Objective To explore the cost-benefit of computerized tomography perfusion imaging(CTP)in guiding endovascular treatment of patients with large vessel occlusion associated with delayed time window.Methods A total of 365 patients with great vascular occlusive stroke associated with delayed time window(6-24 h),who were admitted to the Tangshan Municipal Workers' Hospital of China to receive endovascular treatment from January 2016 to February 2022,were enrolled in this study.Based on whether the patient received CTP imaging guidance or not,the treatment cost and benefit of different treatment strategies were analyzed.Modified Rankin scale(mRS)was used to evaluate the patient's postoperative 3-month and 12-month neurological functions.The decision tree-Markov model was used to make cost-benefit analysis.Probability sensitivity analysis(PSA)was used to assess the influence of parameter uncertainty.Results The operation cost of CTP-guided endovascular treatment of large vessel occlusion was 1 526.87 Chinese yuan.According to the calculation method of disease and sequelae burden,it could bring direct burden of 1 089.23 Chinese yuan,direct+indirect burden of 3 204.85 Chinese yuan and direct+indirect+intangible burden of 5 083.07 Chinese yuan.Each Chinese yuan could get 0.178 8,0.231 8 and 0.263 4 earnings,respectively.The therapeutic cost of CTP-guided endovascular treatment of great vascular occlusive stroke was 26 689.13 Chinese yuan,producing 2.065 quality-adjusted life-year(QALY)for each patient,while the therapeutic cost and QALY of non-CTP-guided endovascular treatment were 33 299.07 Chinese yuan and 1.776 QALY respectively.PAS-analyzed incremental cost-benefit ratio(ICER)and incremental net monetary benefit(iNMB)were 22 592.82 and 7 846.43 respectively.At the cost-benefit threshold of ￥50 000/QALY,the probability that CTP guidance could get cost-benefit was up to 90.0％.The tornado chart analysis of one-way sensitivity analysis revealed that the initial mRS distribution guided by CTP had the greatest influence on iNMB,followed by the cost input in the first three months after operation.Conclusion For patients with great vascular occlusive stroke associated with delayed time window,CTP-guided endovascular treatment has high cost-benefit and effect value.

Objective To investigate the relationship between serum peroxiredoxin 6(PRDX6)and annexin A1(ANXA1)levels and the severity and prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)compli-cated with type II respiratory failure.Methods A total of 257 patients with AECOPD complicated with type II respiratory failure(respiratory failure group),130 patients with stable COPD(stable COPD group)and 130 healthy subjects(control group)were selected from the Panzhihua University Affiliated Hospital from December 2021 to December 2023.According to the oxygenation index,AECOPD patients with type II respiratory failure were divided into mild respiratory failure group(n=101),moderate respi-ratory failure group(n=80)and severe respiratory failure group(n=76).According to the 28-day prognosis,they were divided into death group(n=62)and survival group(n=195).Serum PRDX6 and ANXA1 levels were detected by enzyme-linked immu-nosorbent assay(ELISA).The correlation between serum PRDX6,ANXA1 levels and oxygenation index in AECOPD patients with type II respiratory failure was analyzed by Spearman correlation coefficient.Multivariate Logistic regression model was used to analyze the influencing factors of poor prognosis in patients with AECOPD complicated with type II respiratory fail-ure,and receiver iperating characteristic(ROC)curve was drawn to evaluate the predictive value of serum PRDX6 and ANXA1.Results The serum PRDX6 level in the respiratory failure group(41.54±4.28 pg/ml)was lower than that in the stable COPD group(61.38±4.94 pg/ml)and the control group(80.65±8.93 pg/ml),and the ANXA1 level(3.35±0.69 μg/L)was higher than that in the stable COPD group(2.13±0.61 μg/L)and the control group(1.03±0.14 μg/L),the differences were statistically sig-nificant(t=-33.894～21.727,all P<0.001).The serum level of PRDX6 in severe respiratory failure group(34.54±5.05 pg/ml)was lower than that in moderate respiratory failure group(43.90±4.72 pg/ml)and mild respiratory failure group(54.28±6.34 pg/ml),the serum level of ANXA1 in severe respiratory failure group(3.94±0.43 μg/L)was higher than that in moderate respi-ratory failure group(3.57±0.46 μg/L)and mild respiratory failure group(2.70±0.43 μg/L),the differences were statistically sig-nificant(t=-19.018～22.338,all P<0.001).Oxygen index was positively correlated with serum PRDX6(r=0.815,P<0.001)and negatively correlated with ANXA1(r=-0.781,P<0.001)in AECOPD patients with type II respiratory failure.The mortality rate of 257 AECOPD patients with type II respiratory failure was 24.12%(62/257)after 28 days of follow-up.Increase forced expi-ratory volume in the first second(FEV1)as a percentage of the predicted value,increased oxygenation index and increased PRDX6 were independent protective factors for the poor prognosis of AECOPD patients with type II respiratory failure(Wald χ2=-0.154,-0.014,-0.173,all P<0.05),increased ANXA1 was an independent risk factor(Wald χ2=0.250,P<0.05).The area un-der the curve of serum PRDX6 and ANXA1 combined to predict the poor prognosis of AECOPD patients with type II respiratory failure was 0.906,which was greater than 0.788 and 0.781 predicted by the two indicators alone,and the differences were statisti-cally significant(Z=4.243,4.224,all P<0.001).Conclusion The decrease of serum PRDX6 level and the increase of ANXA1 level are related to the aggravation and poor prognosis of AECOPD patients with type II respiratory failure.The value of serum PRDX6 combined with ANXA1 in predicting the prognosis of AECOPD patients with type II respiratory failure is high.

Objective:To investigate the current status of pruritus care in dermatology departments of public hospitals in China.Methods:A multicenter, cross-sectional survey was conducted. By convenience sampling, dermatology nurses were selected from 85 public hospitals across 17 provinces in China from September 2 to September 14, 2024, and a self-designed pruritus care questionnaire survey was conducted. The survey content included two parts: general information (e.g., education levels, professional titles, regions, hospital grades) and current status of pruritus care (e.g., pruritus care systems or standards, establishment of pruritus clinics, pruritus assessment, pruritus intervention measures, pruritus nursing training, and challenges in pruritus care) .Results:A total of 607 nurses were investigated, including 322 (53.0%) from general hospitals and 285 (47.0%) from specialized hospitals; 359 (59.1%) were from tertiary grade-A hospitals. In total, 264 (43.5%) nurses reported that pruritus clinics had been established in their hospitals, 218 (35.9%) reported that pruritus nursing teams had been set up, and 283 (46.6%) noted a lack of pruritus care systems or standards in their hospitals. The most commonly used anti-pruritus measures were physical therapy (51.2%) , drug treatment (37.9%) , and environmental management (10.9%) . There were 418 (68.9%) nurses who had received pruritus nursing training. The most frequently used pruritus assessment tools were the numeric rating scale ( n = 341, 56.2%) and the visual analog scale ( n = 268, 44.2%) , while 165 (27.2%) nurses had not used any assessment tools. The most challenging issues in pruritus care were the selection of pruritus assessment tools ( n = 303, 49.9%) and poor efficacy of pruritus control ( n = 113, 18.6%) . Tertiary grade-A hospitals and hospitals with pruritus clinics exhibited higher rates of establishing pruritus care systems/standards and providing pruritus nursing training compared with non-tertiary grade-A hospitals and hospitals without pruritus clinics respectively (all P < 0.05) . Conclusions:Public hospitals in China currently face issues such as inadequate pruritus care management systems, non-standardized pruritus assessment, and insufficient pruritus nursing training. Pruritus nursing levels were variable among different hospitals, and the standardization and homogeneity of pruritus nursing urgently need to be improved.