Objective To construct a prediction model for the population with hypertension and diabetes to assess the risk of chronic kidney disease (CKD), and to provide a scientific basis for formulating targeted CKD prevention and control measures. Methods Based on physical examination data from community residents aged 60 years and above in Nanjing in 2022, 10 221 patients with hypertension and diabetes were selected as the study subjects. Variables associated with CKD prevalence were screened using univariate analysis, and further variable selection was performed using LASSO regression. Finally, a CKD risk prediction model was constructed based on logistic regression. The model's performance was evaluated using the ROC curve and calibration curve. Results The prevalence rate of CKD in the study population was 22.71%, with a mean age of 71.66 years. LASSO regression identified seven variables associated with CKD: age, blood urea nitrogen (BUN), hemoglobin, uric acid, triglyceride-glucose (TyG) index, urine protein-to-creatinine ratio (UPCR), and medical insurance type. The final logistic regression model incorporated six variables: age [OR=1.067 (95% CI: 1.058-1.076)], BUN [OR=1.377 (95% CI: 1.338-1.418)], hemoglobin [OR=0.992 (95% CI: 0.989-0.995)], uric acid [OR=1.004 (95% CI: 1.003-1.004)], TyG index [OR=1.445 (95% CI: 1.324-1.577)], and self-payment medical insurance [OR=1.732 (95% CI: 1.542-1.945)]. The model had an AUC of 0.759 (95% CI: 0.747-0.770) and a Brier score of 0.140 (95% CI: 0.136-0.145), indicating good predictive performance. The calibration curve showed good agreement between the predicted risk and the observed value. Conclusion The constructed LASSO-logistic regression risk prediction model in this study can effectively assess the risk of CKD in elderly individuals aged 60 years and above with hypertension and diabetes, providing a basis for early identification of high-risk individuals and the formulation of targeted CKD prevention and control measures.

Objective To analyze the clinical and imaging features of primary anorectal malignant melanoma (ARMM) and to improve the level of its early diagnosis and clinical management. Methods A retrospective analysis was performed on the clinical data, multimodal imaging features, treatment methods, pathological results, and follow-up information of 31 patients with pathologically diagnosed ARMM at Zhongshan Hospital, Fudan University from December 2016 to October 2025. Results Among the 31 patients, there were 11 males and 20 females, with age of 65 (55, 71) years. Twenty-one patients presented with hematochezia as the initial symptom (67.7%), and four asymptomatic patients were detected incidentally by physical examination. All the patients showed negative alpha-fetoprotein, carcinoembryonic antigen, and carbohydrate antigen 19-9. All 31 cases were solitary ARMM, of which 14 (45.2%) were located in the anorectal region. CT was characterized by polypoid or fungating masses, absence of intestinal obstruction, moderate to marked enhancement; MRI was characterized by specific T₁WI hyperintensity and restricted diffusion; PET/CT is characterized by high metabolism. According to Ballantyne staging, 10 cases of stage Ⅰ, 11 cases of stage Ⅱ and 10 cases of stage Ⅲ were found. Endoscopic resection was performed in 1 patient, transanal resection in 2 patients, and abdominoperineal resection (Miles operation) with routine lymph node dissection in 17 patients. The positive rates of S-100, HMB-45 and Melan-A in 20 surgical patients were 100%, 95% and 100%, respectively, with a median Ki-67 proliferation index of 65%. Median postoperative follow-up duration of surgical patients was 34.5 (2−90) months. During follow-up, 8 patients (40%) developed recurrence and/or metastasis (median time was 11 months after surgery), with the liver and lungs being the most common metastatic sites. Conclusions Primary ARMM predominantly occurs in middle-aged and elderly women, hematochezia is the most common initial symptom. Diagnostic efficacy can be improved by combining characteristic imaging manifestations and immunohistochemical findings. ARMM is a highly malignant tumor with an overall poor prognosis, surgery remains the main therapeutic approach.

As a basic technology in clinical dentistry,bending dental wire has been widely used in prosthodontics,orthodontics,oral surgery and other fields.Wire bending robots based on the concept of digital manufacturing have attracted the attention due to their advantages of automation,standardization and precision,and are expected to gradually replace the traditional manual bending technology.This article describes the development of dental wire bending robot in detail,and introduces its application in orthodon-tic arch wires,removable denture clasps,and fixation of traumatic teeth.

Objective To investigate the mechanism of autophagy induced by House dust mites(HDM)on airway epithelial tight junction through β-catenin-Snail signaling pathway.Methods Human bronchial epithelial cells(16HBE)were stimulated with HDM at different time points(0,3,6,12,24,48 h)and different concen-trations(0,40,100,200 μg/mL)to screen the appropriate stimulation concentration and stimulation time.16HBE cells were treated with oxidative stress inhibitor N-acetylcysteine(NAC),autophagy inhibitor 3-methylad-enine(3-MA),HDM,and their combinations.Cells were transfected with mCherry-EGFP-LC3B,Beclin-1-siRNA,and ATG14-siRNA lentivirus and then stimulated with NAC and HDM.Immunofluorescence was used to detect the expression levels of autophagy-related protein LC3B,tight junction-related proteins Occludin,and ZO-1 in airway epithelial cells.The level of reactive oxygen species(ROS)was detected by using DCFH-DA in each group.The protein expression levels of Occludin,ZO-1,LC3B,Beclin-1,ATG5,ATG14,P62,Snail,β-catenin and p-β-catenin were detected by Western blot method.Results Immunofluorescence results showed that compared with the control group,200 μg/mL HDM stimulation induced cellular autophagy,increased the expression level of LC3B protein,and promoted the level of ROS,all with statistical significances(all P<0.05).Compared with the HDM group,the HDM+3-MA,HDM+ATG14-si,and HDM+Beclin-1-si groupsall showed significantincreases in the expression levels of tight junction-related proteins Occludin and ZO-1(P<0.05).The HDM+NAC group demonstrated significant decreases both in the level of ROS andin the expression level of LC3B protein.Western blot results revealed that compared with HDM,3-MA and autophagy protein low-expression beads(Beclin-1-si,ATG14-si)attenuated HDM-induced cellular autophagy(P<0.05),inhibited HDM-induced upregulation of Snail and p-β-catenin expression,and improved HDM-induced decreases in Occludin and ZO-1(P<0.05).Moreover,compared with the HDM group,the NAC+HDM group exhibited significant decreases both in the conversion of LC3BⅠ to LC3BⅡ(P<0.001)in the protein levels of Snail,p-β-catenin,Beclin-1 and ATG14(P<0.01),but significant increases in the protein levels of Occludin and ZO-1(P<0.05).Conclusion HDM affects the tight connections between airway epithelial cells by inducing autophagy,which may be attributed to the β-catenin-Snail signaling pathway.

Objective In this study,exogenous hormones combined with variable temperature stratification were used to relieve seed dormannia of Coptis chinensis and promote seed germination,and the effects of gibberellin on the physiological,biochemical and embryonic morphological changes of C.chinensis seeds during post-mature germination were further evaluated.Methods Using orthogonal test,different exogenous hormones(GA3,6-BA,NAA,ABA)and different temperature changing stratification(20℃/4℃)were set up,and the germination index(germination rate and split rate)of C.chinensis seeds were statistically compared.The activity of antioxidant enzymes(peroxidase POD,catalase CAT),the content of malondialdehyde(MDA)and endogenous hormones(GA,IAA,ABA)during the germination of C.chinensis seeds under optimal treatment were measured.The microscopic structure of the seeds was observed by paraffin embedding section.Results The results of range analysis showed that the best budding method was:100 mg·L-1 of gibberellin for 12 h,20℃for 60 day,4℃for 10 day.Physiological and biochemical index analysis showed that 100 mg·L-1 exogenous gibberellin treatment promoted the endogenous GA content to reach the peak in advance,maintained the POD and CAT contents at a higher level,and maintained the malondialdehyde(MDA)content at a lower level.The transformation from torpedo embryo to cotyledonous embryo was observed by electron microscope during postmature germination.Conclusion Exogenous gibberellin combined with variable temperature stratification treatment could significantly accelerate seed germination of C.chinensis,mainly by promoting seed embryo morphological development,affecting the contents of GA,POD and CAT,and rapidly relieving seed dormancy to promote seed germination.Compared with natural conditions,the germination period could be shortened by about six months.

Objective To investigate the correlation between glycemic variability metrics and the risk of diabetic foot(DF)in patients with type 2 diabetes mellitus(T2DM)utilizing flash glucose monitoring(FGM)tech-nology.Methods A retrospective analysis was conducted on 233 hospitalized patients with T2DM,with or without DF,who were treated in the Department of Endocrinology at Lianyungang First People's Hospital from January 2021 to May 2022 and monitored using FGM.Patients were categorized into a non-DF group(n=147)and a DF group(n=86)based on the presence of DF.The study compared general clinical characteristics,biochemical parameters,and glycemic variability metrics between the two groups and performed subgroup analyses.Binary logistic regression was employed to identify factors associated with the risk of DF,while receiver operating characteristic(ROC)curves were utilized to assess the predictive value of glycemic variability metrics for DF.Results Compared with the non-DF group,patients in the DF group exhibited significantly longer disease duration,higher body mass index(BMI),glycated hemoglobin(HbA1c),urinary albumin-to-creatinine ratio(UACR),alanine aminotransferase(ALT),serum uric acid(SUA),mean amplitude of glycemic excursions(MAGE),coefficient of variation(CV),mean of daily differences(MODD),and mean blood glucose(MBG),but lower fasting C-peptide(FCP),fasting insulin(FINS),high-density lipoprotein cholesterol(HDL-C),and time in range(TIR),with statistically signifi-cant differences(P<0.05).Subgroup analysis revealed that TIR was associated with the incidence of DF and diabetic retinopathy(DR).Binary logistic regression analysis identified HbA1c,MAGE,MODD,and MBG as risk factors for DF,while TIR was a protective factor(P<0.05).ROC curve analysis demonstrated that the area under the curve(AUC)for predicting DF using HbA1c,TIR,MAGE,MODD,MBG,and their combination were 0.646,0.850,0.868,0.764,0.619,and 0.967,respectively,indicating superior performance of the combined prediction model.Conclusions HbA1c,TIR,MAGE,MODD,and MBG are critical factors associated with the development of DF in patients with T2DM.Targeted early interventions aimed at optimizing these glycemic variability indicators may effectively reduce the incidence of DF.

Objective:To investigate the regulatory role and mechanism of synaptic vesicle protein 2A (SV2A) in apoptosis of drug-resistant epilepsy neurons.Methods:One hundred and fifty specific pathogen-free (SPF) Sprague-Dawley (SD) rats were randomly numbered; 20 rats were selected as a normal control group (NC group), and the remaining 130 rats were subjected to chronic epilepsy models of lithium-pilocarpine. Phenobarbital and phenytoin sodium for 2 weeks were given to these rats after modeling; fanally, 94 rats with chronic epilepsy were divided into a drug-resistant group (phenobarbital and phenytoin sodium-resistant epilepsy [PRE] group, reduction in episodes<50%, n= 55) and a drug-sensitive group (phenobarbital and phenytoin sodium-sensitive epilepsy [PSE] group, reduction in episodes by≥50%, n=38). Rats in the PRE group were further randomly divided into 5 groups, namely a up-regulated-SV2A PRE group (UPRE group), a down-regulated-SV2A PRE group (DPRE group), a up-regulated-SV2A control group (UPRC group), a down-regulated-SV2A control group (DPRC group), and a non-transfected PRE group; different types of lentivirus were given to the first 4 groups via stereotactic brain injection. Ten days after lentiviral transfection, virus detection was performed; and 2 weeks after lentiviral transfection, occurrence of epileptic seizures was observed, and after that, rats were sacrificed and the hippocampal tissues were collected for subsequent experiments. Western blotting was used to detect the expressions of SV2A, cyclophilin A (CyPA), apoptosis-inducing factor (AIF), and superoxide dismutase 2 (SOD2) in the cell nucleus or mitochondria; coimmunoprecipitation experiment was performed to observe the interaction among SV2A, CyPA and AIF proteins; immunofluorescent co-staining was used to observe the CyPA/AIF localization; mitochondrial damage was detected by electron microscopy; ATP content in the hippocampal tissues was detected by luciferase method, 8-hydroxy-2-deoxyguanosine (8-OHDG) expression was detected by immunofluorescent staining, and neuronal apoptosis rate was calculated by double staining with neuron-specific nuclear protein (NeuN) and TUNEL. Results:(1) Confocal microscopy revealed that the hippocampal tissues in the 4 transfected groups showed green fluorescence inherent to the lentivirus, indicating successful viral infection. Compared with the UPRC group, the UPRE group had significantly reduced frequency of epileptic seizures and seizure duration ( P<0.05). (2) Western blotting showed that, in mitochondria, the UPRE group had significantly higher expressions of SV2A (0.475± 0.105 vs. 0.136±0.043), CyPA (0.473±0.041 vs. 0.175±0.047), AIF (0.443±0.058 vs. 0.131±0.037), and SOD2 (0.457±0.037 vs. 0.152±0.038) compared with the UPRC group ( P<0.05); the DPRE group had significantly decreased expressions of SV2A (0.038±0.013 vs. 0.184±0.047), CyPA (0.041±0.010 vs. 0.214±0.040), AIF (0.040±0.019 vs. 0.175±0.046), and SOD2 (0.043±0.017 vs. 0.187±0.039) compared with the DPRC group ( P<0.05). In the cell nucleus, the UPRE group had significantly lower expressions of AIF (0.336±0.084 vs. 0.649±0.209) and CyPA (0.331±0.086 vs. 0.620±0.162) compared with the UPRC group ( P<0.05); the DPRE group had statistically higher expressions of AIF (0.771± 0.180 vs. 0.519±0.144) and CyPA (0.738±0.223 vs. 0.488±0.091) compared with the DPRC group ( P< 0.05). (3) Co-immunoprecipitation experiment results showed that the bidirectional precipitation results of SV2A and AIF, SV2A and CyPA, and AIF and CyPA were all positive, suggesting existence of interactions. (4) Immunofluorescent co-staining showed that the fluorescence changes of CyPA and AIF were consistent. (5) Electron microscopy showed that mitochondria in the NC group had intact structure; mitochondria in the UPRE group, UPRC group, DPRC group and DPRE group showed swelling and cristae fragmentation; among them, injury in the UPRE group was relatively less severe than that in the UPRC group, while that in the DPRC group was more severe than that in the DPRE group. (6) Compared with the UPRC group, the UPRE group had statistically higher ATP content ( P<0.05); compared with the DPRC group, the DPRE group had significantly lower ATP content ( P<0.05).(7) Immunofluorescent staining results showed that the UPRE group had significantly lower 8-OHDG expression than the UPRC group ( P<0.05); compared with the DPRC group, the DPRE group had statistically higher 8-OHDG expression ( P<0.05). (8) The UPRE group had significantly lower NeuN-TUNEL double staining positive rate than the UPRC group ( P<0.05); compared with the DPRC group, the DPRE group had significantly higher NeuN-TUNEL double staining positive rate ( P<0.05). Conclusion:SV2A can play a role in the apoptosis of hippocampal neurons in rats with drug-resistant epilepsy by regulating the nuclear translocation of AIF/CyPA and mitochondrial damage.

Objective To study the correlation between apolipoprotein AⅣ (APOA4) and leucine-rich α-2 glycoprotein 1 (LRG1) expression and clinicopathological features in breast cancer tissues. Methods Clinical data of 120 patients diagnosed with breast cancer after surgical treatment and postoperative pathology were collected from the Third People's Hospital of Zigong City from March 2020 to September 2022. Western blotting (WB) was used to observe the expression of APOA4 and LRG1 in breast cancer tissues and corresponding paracuncinoma tissues (>5cm from the margin of cancer tissues). Analyzed the relationship between the expression of APOA4 and LRG1 and the clinicopathological features of breast cancer. The correlation between the expression of APOA4 and LRG1 was analyzed by Pearson methed. Kaplan-Meier survival analysis of the relationship between APOA4 and LRG1 protein expression and prognosis. Results The results of WB detection showed that the expression levels of APOA4 (2.81±0.74)and LRG1(1.01±0.26)in breast cancer tissues were significantly higher than those in normal breast tissues (1.26±0.38,0.57±0.12),and the differences were statistically significant (t=20.411,16.832,all P<0.05). Pearson correlation analysis showed that APOA4 was positively correlated with LRG1 protein expression in breast cancer tissues (r=0.624,P=0.014). The expression levels of APOA4 and LRG1 proteins in breast cancer tissues with ER positive,PR positive and lymph node metastasis in cTNM stage Ⅱ to Ⅲ were higher than those in breast cancer tissues with ER negative,PR negative and no lymph node metastasis in cTNM stage Ⅰ,and the differences were statistically significant (t=1.770～3.284,all P<0.05). The expression of APOA4 protein in breast cancer tissues with BMI ≥ 23.5kg/m2 was higher than that in breast cancer tissues with BMI<23.5kg/m2,and the difference was statistically significant (t=1.736,P=0.043). Kaplan-Meier survival analysis showed that the cumulative overall survival rates (83.13％,84.93％) of the APOA4 high expression group and LRG1 high expression group were lower than those of the APOA4 low expression group and LRG1 low expression group (94.74％,91.49％,and the differences were statistically significant (Log Rankx2==4.778,3.956,P=0.029,0.047). Conclusion Both APOA4 and LRG1 proteins are highly expressed in breast cancer tissues,and are involved in the occurrence and invasion of breast cancer. They are expected to become a reference index for diagnosis and treatment and prognosis prediction.

Objective To explore the acupoint selection law and staged acupuncture prescriptions in the treatment of post-stroke dysphagia using data mining technology.Methods Clinical research literature about acupuncture treatment of post-stroke dysphagia was retrieved from CNKI,Wanfang Data,VIP,SinoMed,PubMed,Embase,Cochrane Library from January 1,2004 to October 1,2024.Prescription information was organized and summarized,and was entered into the database.Descriptive analysis,association rule analysis,complex network analysis and clustering analysis on prescription acupoints were conducted with Excel 2021,SPSS Modeler 18.0 and SPSS 26.0 softwares.Results A total of 306 articles were included,including 328 acupuncture prescriptions involving 118 acupoints,with a cumulative frequency of 1 541 times.The core acupoints were Lianquan,Fengchi,Yuye,Jinjin,Yifeng,Jialianquan,Fengfu and Wangu.The main meridians were Conception Vessel,gallbladder meridian,Governor Vessel and stomach meridian.The distribution was concentrated in the head,face and neck,and the use of intersection acupoints were the most.Association rule analysis showed that Lianquan-Fengchi,Lianquan-Jinjin-Yuye had the highest degree of support for association rules,and the clustering analysis showed 4 categories such as Jialianquan-Baihui-Fengfu.The analysis obtained corresponding acupuncture prescriptions for oral stage,pharyngeal stage and esophageal stage of dysphagia.Conclusion Acupuncture treatment of post-stroke dysphagia is mainly based on local acupoint and acupoint along meridians,mostly using intersection acupoints,combined with distal acupoints,and selecting the corresponding acupoints in different periods,which can improve the clinical efficacy.

Objective To study the correlation between apolipoprotein AⅣ (APOA4) and leucine-rich α-2 glycoprotein 1 (LRG1) expression and clinicopathological features in breast cancer tissues. Methods Clinical data of 120 patients diagnosed with breast cancer after surgical treatment and postoperative pathology were collected from the Third People's Hospital of Zigong City from March 2020 to September 2022. Western blotting (WB) was used to observe the expression of APOA4 and LRG1 in breast cancer tissues and corresponding paracuncinoma tissues (>5cm from the margin of cancer tissues). Analyzed the relationship between the expression of APOA4 and LRG1 and the clinicopathological features of breast cancer. The correlation between the expression of APOA4 and LRG1 was analyzed by Pearson methed. Kaplan-Meier survival analysis of the relationship between APOA4 and LRG1 protein expression and prognosis. Results The results of WB detection showed that the expression levels of APOA4 (2.81±0.74)and LRG1(1.01±0.26)in breast cancer tissues were significantly higher than those in normal breast tissues (1.26±0.38,0.57±0.12),and the differences were statistically significant (t=20.411,16.832,all P<0.05). Pearson correlation analysis showed that APOA4 was positively correlated with LRG1 protein expression in breast cancer tissues (r=0.624,P=0.014). The expression levels of APOA4 and LRG1 proteins in breast cancer tissues with ER positive,PR positive and lymph node metastasis in cTNM stage Ⅱ to Ⅲ were higher than those in breast cancer tissues with ER negative,PR negative and no lymph node metastasis in cTNM stage Ⅰ,and the differences were statistically significant (t=1.770～3.284,all P<0.05). The expression of APOA4 protein in breast cancer tissues with BMI ≥ 23.5kg/m2 was higher than that in breast cancer tissues with BMI<23.5kg/m2,and the difference was statistically significant (t=1.736,P=0.043). Kaplan-Meier survival analysis showed that the cumulative overall survival rates (83.13％,84.93％) of the APOA4 high expression group and LRG1 high expression group were lower than those of the APOA4 low expression group and LRG1 low expression group (94.74％,91.49％,and the differences were statistically significant (Log Rankx2==4.778,3.956,P=0.029,0.047). Conclusion Both APOA4 and LRG1 proteins are highly expressed in breast cancer tissues,and are involved in the occurrence and invasion of breast cancer. They are expected to become a reference index for diagnosis and treatment and prognosis prediction.