Objective To investigate the status and predictive factors of future acute exacerbation of asthma in adults. Methods Adult patients with asthma who were admitted to the hospital from March 2023 to July 2025 were selected. Based on the acute exacerbation status after follow-up, the patients were categorized into acute exacerbation group (n=107) and control group (n=245). The clinical data, pulmonary function [peak expiratory flow (PEF) and forced expiratory volume in the 1st second/forced vital capacity (FEV₁/FVC)] and health status [asthma control questionnaire (ACQ), Morisky medication adherence scale (MMAS-8), short form 36-item health survey (SF-36)] of the study subjects were collected. The correlation between the indicators and acute exacerbation was explored by logistic regression analysis, and the predictive efficiency was evaluated by ROC curve. Results The age, smoking history, asthma course, allergen exposure and ACQ in the acute exacerbation group were higher than those in the control group, while the average monthly family income, glucocorticoid treatment, PEF, FEV₁/FVC, MMAS-8 and SF-36 were lower (P<0.05). Multivariate logistic regression suggested that ACQ score, glucocorticoid treatment, MMAS-8 score, FEV₁/FVC, PEF and smoking history were the influencing factors of acute asthma exacerbation (P<0.05). ROC analysis revealed that the diagnostic efficiency of combined prediction was the highest (AUC=0.965), with sensitivity of 0.944 and specificity of 0.857 (P<0.05). Conclusion It is necessary to pay more attention to the medication compliance and asthma control level of patients, and integrate multi-dimensional information such as smoking history, pulmonary function and treatment conditions to accurately identify patients with high-risk acute exacerbation and implement targeted intervention measures.

The Masquelet technique, also known as the induced membrane technique, is a surgical technique for repairing large bone defects based on the use of a membrane generated by a foreign body reaction for bone grafting. This technique is not only simple to perform, with few complications and quick recovery, but also has excellent clinical results. To better understand the mechanisms by which this technique promotes bone defect repair and the factors that require special attention in practice, we examined and summarized the relevant research advances in this technique by searching, reading, and analysing the literature. Literature show that the Masquelet technique may promote the repair of bone defects through the physical septum and molecular barrier, vascular network, enrichment of mesenchymal stem cells, and high expression of bone-related growth factors, and the repair process is affected by the properties of spacers, the timing of bone graft, mechanical environment, intramembrane filling materials, artificial membrane, and pharmaceutical/biological agents/physical stimulation.
Humans ; Bone Transplantation/methods* ; Membranes, Artificial ; Bone Regeneration ; Animals

Obesity, as a chronic recurrent disease, has become a major public health challenge in China. To implement the requirements of the Healthy China Initiative (2019—2030), under domestic guidelines or consensus statements on overweight and obesity, and in alignment with the latest scientific advances globally, the Quality control protocol for adult overweight and obesity screening in health management (examination) institutions (2025 edition) was developed. This protocol was drafted by the Health Management Center of Shanghai Changzheng Hospital and formulated through multiple rounds of deliberation by experts in China’s health examination quality control field. The protocol establishes unified standards for screening facilities, personnel qualifications, and measurement or testing procedures. It defines specific screening items, outlines a standardized screening pathway, and sets requirements for the final medical review, ensuring the scientific validity, effectiveness, and safety of the screening process. The implementation of this protocol will enhance the consistency of weight management practices for adults across health examination institutions and strengthen the quality control of overweight and obesity screening programs.

After two decades of development, transcatheter left atrial appendage closure has emerged as a safe and effective intervention for stroke prevention in patients with atrial fibrillation. In 2024, significant advancements were made in the field of left atrial appendage closure in terms of evidence-based medicine, device research and development, and guideline consensus. The annual report on transcatheter left atrial appendage closure systematically reviews global academic progress in 2024, encompassing newly published clinical evidence, recently developed occlusion devices, and updated international guidelines/consensus statements. In the future, the development direction of transcatheter left atrial appendage closure mainly includes expanding surgical indications, optimizing imaging assistance technology, improving closure device design, and exploring individualized strategies for postoperative antithrombotic therapy.

Objective To analyze the risk factors for cough variant asthma (CVA) and investigate the influence of indoor environment on CVA. Methods From July 2021 to August 2024, 315 patients admitted to the hospital due to CVA were selected as the CAV group. Meanwhile, 100 healthy individuals were selected as the control group. Clinical data of all subjects were collected. Univariate analysis and multivariate logistic regression analysis were used to identify the influencing factors of CVA. Results The proportions of subjects with family history and recurrent respiratory tract infection in the CVA group were higher than those in the control group (P<0.05). The CVA group had significantly higher rates of indoor renovation, mold growth, infrequent bedding cleaning, opening window for ventilation once to 3 times a week, keeping pets, and passive smoking compared to the control group within one year, and the differences were statistically significant (P<0.05). Multivariate logistic regression analysis results showed that indoor-decoration in the past year (OR=2.282, 95%CI: 1.1454.549), mould growth (OR=2.036, 95%CI: 1.228-3.376), opening window for ventilation once to 3 times a week (OR=1.895, 95%CI: 1.253-2.865), seldom cleaning bedding (OR=2.257, 95%CI: 1.132-4.499), keeping pets (OR=2.071, 95%CI: 1.146-3.743), and passive smoking (OR=2.208, 95%CI: 1.377-3.541) were independent risk factors for CVA (P<0.05). Conclusion There is a significant correlation between the occurrence of CVA and indoor environment. Changes in indoor environment include indoor-decoration in the past year, mould growth, low frequency of opening window for ventilation, low frequency of bedding cleaning, keeping pets and passive smoking which are risk factors for the occurrence of CVA.

BACKGROUND: Diabetic foot is a complex condition with high incidence, recurrence, mortality, and disability rates. Current treatments for diabetic foot ulcers are often insufficient. This study was conducted to identify potential therapeutic targets for diabetic foot. METHODS: Datasets related to diabetic foot and diabetic skin were retrieved from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) were identified using R software. Enrichment analysis was conducted to screen for critical gene functions and pathways. A protein interaction network was constructed to identify node genes corresponding to key proteins. The DEGs and node genes were overlapped to pinpoint target genes. Plasma and chronic ulcer samples from diabetic and non-diabetic individuals were collected. Western blotting, immunohistochemistry, and enzyme-linked immunosorbent assays were performed to verify the S100 calcium binding protein A9 (S100A9), inflammatory cytokine, and related pathway protein levels. Hematoxylin and eosin staining was used to measure epidermal layer thickness. RESULTS: In total, 283 common DEGs and 42 node genes in diabetic foot ulcers were identified. Forty-three genes were differentially expressed in the skin of diabetic and non-diabetic individuals. The overlapping of the most significant DEGs and node genes led to the identification of S100A9 as a target gene. The S100A9 level was significantly higher in diabetic than in non-diabetic plasma (178.40 ± 44.65 ng/mL vs. 40.84 ± 18.86 ng/mL) and in chronic ulcers, and the wound healing time correlated positively with the plasma S100A9 level. The levels of inflammatory cytokines (tumor necrosis factor-α, interleukin [IL]-1, and IL-6) and related pathway proteins (phospho-extracellular signal regulated kinase [ERK], phospho-p38, phospho-p65, and p-protein kinase B [Akt]) were also elevated. The epidermal layer was notably thinner in chronic diabetic ulcers than in non-diabetic skin (24.17 ± 25.60 μm vs. 412.00 ± 181.60 μm). CONCLUSIONS S100A9 was significantly upregulated in diabetic foot and was associated with prolonged wound healing. S100A9 may impair diabetic wound healing by disrupting local inflammatory responses and skin re-epithelialization.
Calgranulin B/therapeutic use* ; Diabetic Foot/metabolism* ; Humans ; Datasets as Topic ; Computational Biology ; Mice, Inbred C57BL ; Animals ; Mice ; Protein Interaction Maps ; Immunohistochemistry

Objective To explore the associations of dietary patterns with bone mineral density(BMD)and osteoporosis(OP)in patients with knee osteoarthritis(KOA)in south China,identify the dietary patterns that could reduce the risk of OP,and provide a reference for prevention of OP.Methods Data from 600 KOA patients who were enrolled in the Pearl River Osteoarthritis Cohort(PROC)between April 2020 and April 2024 were extracted,including general characteristics,dietary questionnaire and BMD test.Factor analysis was employed to identify dietary patterns.Scores of dietary pattern were treated as continuous or categorical variables(quartile-based groups).Multivariable linear regression was used to assess associations between scores of dietary pattern and BMD,while the relationships with OP were analysed by binary logistic regression.Results The prevalence of OP in KOA patients was 19.8%.Factor analysis extracted eight dietary patterns:seafood-nuts,livestock-poultry meats,coarse grains-fruits,wheat-eggs,fish-dairy-vegetables,legumes-fruits,rice-wheat flour,and soy-dairy.After adjusting for confounders,it was found that the pattern of coarse grains-fruits was positively correlated with the BMD of left femoral neck and lumbar spine(P<0.01)and the fish-dairy-vegetables pattern was positively correlated with the BMD of lumbar spine(P<0.01).When pattern scores were discretized into quartiles,the legumes-fruits pattern(Q3 vs.Q1)was found in association with a 68.2%reduction in the risk of OP(P<0.05).Conclusion This study has identified that the pattern of legumes-fruits may lower a risk of OP,while the patterns of coarse grains-fruits and fish-dairy-vegetables correlate with higher BMD.The diet patterns are potentially beneficial to prevention of OP.For bone health,a balanced diet rich in legumes,fruits,vegetables,coarse grains,fish,nuts and dairy is recommended.

Objective To explore the associations of dietary patterns with bone mineral density(BMD)and osteoporosis(OP)in patients with knee osteoarthritis(KOA)in south China,identify the dietary patterns that could reduce the risk of OP,and provide a reference for prevention of OP.Methods Data from 600 KOA patients who were enrolled in the Pearl River Osteoarthritis Cohort(PROC)between April 2020 and April 2024 were extracted,including general characteristics,dietary questionnaire and BMD test.Factor analysis was employed to identify dietary patterns.Scores of dietary pattern were treated as continuous or categorical variables(quartile-based groups).Multivariable linear regression was used to assess associations between scores of dietary pattern and BMD,while the relationships with OP were analysed by binary logistic regression.Results The prevalence of OP in KOA patients was 19.8%.Factor analysis extracted eight dietary patterns:seafood-nuts,livestock-poultry meats,coarse grains-fruits,wheat-eggs,fish-dairy-vegetables,legumes-fruits,rice-wheat flour,and soy-dairy.After adjusting for confounders,it was found that the pattern of coarse grains-fruits was positively correlated with the BMD of left femoral neck and lumbar spine(P<0.01)and the fish-dairy-vegetables pattern was positively correlated with the BMD of lumbar spine(P<0.01).When pattern scores were discretized into quartiles,the legumes-fruits pattern(Q3 vs.Q1)was found in association with a 68.2%reduction in the risk of OP(P<0.05).Conclusion This study has identified that the pattern of legumes-fruits may lower a risk of OP,while the patterns of coarse grains-fruits and fish-dairy-vegetables correlate with higher BMD.The diet patterns are potentially beneficial to prevention of OP.For bone health,a balanced diet rich in legumes,fruits,vegetables,coarse grains,fish,nuts and dairy is recommended.

Dysregulated RNA splicing events produce transcripts that facilitate esophageal squamous cell carcinoma (ESCC) progression, but how this splicing process is abnormally regulated remains elusive. Here, we unveiled a novel alternative splicing axis of BOLA3 transcripts and its regulator HNRNPC in ESCC. The long-form BOLA3 (BOLA3-L) containing exon 3 exhibited high expression levels in ESCC and was associated with poor prognosis. Functional assays demonstrated the protumorigenic function of BOLA3-L in ESCC cells. Additionally, HNRNPC bound to BOLA3 mRNA and promoted BOLA3 exon 3 inclusion forming BOLA3-L. High HNRNPC expression was positively correlated with the presence of BOLA3-L and associated with an unfavorable prognosis. HNRNPC knockdown effectively suppressed the malignant biological behavior of ESCC cells, which were significantly rescued by BOLA3-L overexpression. Moreover, BOLA3-L played a significant role in mitochondrial structural and functional stability. E2F7 acted as a key transcription factor that promoted the upregulation of HNRNPC and inclusion of BOLA3 exon 3. Our findings provided novel insights into how alternative splicing contributes to ESCC progression.
Female ; Humans ; Male ; Mice ; Alternative Splicing ; Cell Line, Tumor ; Disease Progression ; Esophageal Neoplasms/pathology* ; Esophageal Squamous Cell Carcinoma/pathology* ; Exons/genetics* ; Gene Expression Regulation, Neoplastic ; Heterogeneous-Nuclear Ribonucleoprotein Group C/metabolism* ; Prognosis ; RNA, Long Noncoding/metabolism* ; Animals

Background::Early detection of esophageal squamous cell carcinoma (ESCC) can considerably improve the prognosis of patients. Aberrant cell-free DNA (cfDNA) methylation signatures are a promising tool for detecting ESCC. However, available markers based on cell-free DNA methylation are still inadequate. This study aimed to identify ESCC-specific cfDNA methylation markers and evaluate the diagnostic performance in the early detection of ESCC.Methods::We performed whole-genome bisulfite sequencing (WGBS) for 24 ESCC tissues and their normal adjacent tissues. Based on the WGBS data, we identified 21,469,837 eligible CpG sites (CpGs). By integrating several methylation datasets, we identified several promising ESCC-specific cell-free DNA methylation markers. Finally, we developed a dual-marker panel based on methylated KCNA3 and OTOP2, and then, we evaluated its performance in our training and validation cohorts. Results::The ESCC diagnostic model constructed based on KCNA3 and OTOP2 had an AUC of 0.91 [95% CI: 0.85–0.95], and an optimal sensitivity and specificity of 84.91% and 94.32%, respectively, in the training cohort. In the independent validation cohort, the AUC was 0.88 [95% CI: 0.83–0.92], along with an optimal sensitivity of 81.5% and specificity of 92.9%. The model sensitivity for stage I–II ESCC was 78.4%, which was slightly lower than the sensitivity of the model (85.7%) for stage III–IV ESCC. Conclusion::The dual-target panel based on cfDNA showed excellent performance for detecting ESCC and might be an alternative strategy for screening ESCC.