Objective To explore the efficacy and safety of converting the triple immunosuppressive regimen of tacrolimus (Tac) + mycophenolate mofetil (MMF) + prednisone (Pred) to a quadruple regimen of low-dose sirolimus (SRL) + low-dose Tac + MMF + Pred at 3 to 6 months after expanded criteria donor (ECD) kidney transplantation. Methods A single-center, retrospective, donor-matched controlled study included 22 ECD kidney transplant recipients from September 2021 to June 2024. Two recipients from the same donor kidneys were respectively assigned to the SRL group and the conventional triple regimen control group. The main outcome measures were the differences in serum creatinine (Scr), estimated glomerular filtration rate (eGFR), and adverse events before the regimen conversion and after conversion during the 1, 3, 6, and 12-month follow-up. Results There were no statistically significant differences in baseline characteristics between the two groups. In the SRL group, Scr decreased and eGFR increased starting from 3 months after conversion, and this was superior to the control group starting from 6 months(all P < 0.05). There were no statistically significant differences in the incidence of rejection reactions, pulmonary infections, hyperlipidemia and proteinuria between the two groups after conversion and during the 12-month follow-up (all P > 0.05). Conclusions For ECD kidney transplant recipients, converting the triple regimen to the SRL quadruple regimen at 3 to 6 months after transplantation may improve the function of the transplanted kidney without increasing the risk of adverse events.

Objective To explore the effect of curcumin(CUR)on oxidative damage of keratinocytes induced by ultraviolet B(UVB)irradiation through Toll-like receptor 4(TLR4)/nuclear factor-kappa B(NF-κB)/nucleotide-binding oligomerization domain-containing protein 3(NLRP3)signaling pathway.Methods Human keratinocytes of HaCaT were cultured normally in vitro,and the keratinocyte oxidative damage model was established by the irradiation of 57 mJ/cm2 UVB.The cells with normal culture were as the control group,the cells treated after modeling were as the UVB group,the cells treated with 5 μmol/L CUR after modeling were as the CUR group,the cells treated with 100 μg/L TLR4 inhibitor of TAK-242 after modeling were as the TAK-242 group,and the cells treated with 5 μmol/L CUR and 100 nmol/L TLR4 activator of lipopolysaccharide(LPS)were as the CUR+LPS group.qRT-PCR was applied to detect the relative expression levels of TLR4,NF-κB,and NLRP3 mRNAs of cells in each group.CCK-8 was applied to detect the cell proliferation in each group.The relative content of reactive oxygen species(ROS),the viabilities of superoxide dismutase(SOD)and catalase(CAT),and the concentrations of glutathione(MDA)and glutathione(GSH)of cells in each group were detected by fluorescence assay according to the kit instruction.ELISA kit was used to detect the expression of inflammatory factors of tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)of cells in each group.Flow cytometry was applied to detect the cell apoptosis in each group.Western blot was applied to detect the expression of proliferation related protein of proliferating cell nuclear antigen(PCNA),apoptosis related proteins[B-cell lymphoma-2(Bcl-2)and Bcl-2-associated X protein(Bax)],and TLR4/NF-κB/NLRP3 signaling pathway related proteins(TLR4,NF-κB and NLRP3)of cells in each group.Results Compared with the Control group,the cell survival rate,the expression levels of PCNA and Bcl-2 proteins,the viabilities of SOD and CAT,and the GSH concentration in the UVB group decreased,while the apoptosis rate,the level of Bax protein,the relative content of ROS,the concentration of MDA,the levels of TNF-α and IL-1β,and the mRNA and protein levels of TLR4,NF-κB and NLRP3 increased(P<0.05).Compared with the UVB group,the cell survival rate,the expression levels of PCNA and Bcl-2 proteins,the viabilities of SOD and CAT,and the GSH concentration in the TAK-242 group and CUR group increased,while the apoptosis rate,the level of Bax protein,the relative content of ROS,the concentration of MDA,the levels of TNF-α and IL-1β,and the mRNA and protein levels of TLR4,NF-κB and NLRP3 decreased(P<0.05).Compared with the CUR group,the cell survival rate,the expression levels of PCNA and Bcl-2 proteins,the viabilities of SOD and CAT,and the GSH concentration in the CUR+LPS group decreased,while the apoptosis rate,the level of Bax protein,the relative content of ROS,the concentration of MDA,the levels of TNF-α and IL-1β,and the mRNA and protein levels of TLR4,NF-κB and NLRP3 increased(P<0.05).Conclusion CUR can increase the antioxidant stress level of keratinocytes,alleviate inflammatory response,promote cell proliferation,and improve cell damage caused by UVB irradiation,which may be related to the inhibition of TLR4/NF-κB/NLRP3 signaling pathway.

Objective:To validate the diagnostic value of soluble scavenger receptor class A (sSRA) in rheumatoid arthritis (RA) and evaluate the clinical utility of enzyme-linked immunosorbent assay (ELISA) and chemiluminescence immunoassay (CLIA) for sSR-A detection.Methods:A total of 200 RA patients (including 37 seronegative RA cases), 19 osteoarthritis (OA) patients, 45 gouty arthritis (GA) patients, and 86 healthy controls (HC) were enrolled from the Department of Rheumatology and Immunology, Northern Jiangsu People′s Hospital, between July 2023 and December 2023. Serum sSR-A levels were measured using ELISA and CLIA, and clinical data were collected. Statistical analyses included t-tests, Mann-Whitney U tests, chi-square tests, Fisher′s exact tests, Kruskal-Wallis tests with Dunn′s post hoc analysis, Spearman correlation, and receiver operating characteristic (ROC) curve analysis. Results:ELISA Detection of sSR-A, RA patients exhibited significantly higher sSR-A levels [0.46(0.25, 0.78) ng/ml] than OA [0.15(0.08, 0.30) ng/ml; Z=4.11, P<0.001], GA [0.22(0.14, 0.44) ng/ml; Z=3.51, P<0.01], and HC [0.15(0.06, 0.24) ng/ml; Z=9.10, P<0.001]. ROC curve analysis revealed that sSR-A had a sensitivity of 68.00% and specificity of 89.41% for diagnosing RA, with an area under the curve (AUC)(95% CI) of 0.834 2(0.787 5, 0.880 8) ( P<0.001), and an optimal cut-off value of 0.291 7 ng/ml. The sSR-A positivity rates in RF/ACPA double-positive RA, RF/ACPA single-negative RA, and seronegative RA subgroups were 74.4% (99/133), 56.7% (17/30), and 54.1% (20/37), respectively, with all subgroups showing significantly higher sSR-A levels than HC ( P<0.001). sSR-A correlated positively with DAS28 ( r=0.60, P<0.001), ESR ( r=0.29, P<0.001), globulin ( r=0.25, P<0.001), IgM ( r=0.26, P=0.044), IgG ( r=0.39, P=0.002), IgA ( r=0.31, P=0.017), RF-IgG ( r=0.47, P<0.001), RF-IgA ( r=0.46, P<0.001), RF-IgM ( r=0.50, P <0.001), and ACPA ( r=0.26, P <0.001). sSR-A levels in high-activity [0.85 (0.65, 1.33) ng/ml], moderate-activity [0.46 (0.27, 0.68) ng/ml], and low-activity RA groups [0.24 (0.11, 0.40) ng/ml] were significantly higher than HC [0.15(0.06, 0.24) ng/ml, Z=7.08, P<0.001; Z=7.45, P<0.001; Z=2.68, P<0.001], with levels increasing with disease activity. RA patients were divided into three groups based on ESR and CRP levels including ESR +CRP + [0.54(0.26, 0.87) ng/ml], ESR/CRP - [0.53(0.25, 0.89) ng/ml], and ESR -/CRP - [0.36(0.18, 0.53) ng/ml], All three groups showed significantly higher sSR-A levels compared to the HC group [0.15(0.06, 0.24) ng/ml, Z=8.02, P<0.001; Z=7.61, P<0.001; Z=5.06, P<0.001]. Moreover, sSR-A levels were significantly positively correlated with grayscale synovitis scores ( r=0.30, P<0.001), power Doppler blood flow scores ( r=0.26, P<0.001), and total semi-quantitative ultrasound scores ( r=0.32, P<0.001), patients who were tested positive for sSR-A exhibited significantly higher grayscale synovitis, power Doppler blood flow, and total ultrasound scores compared to those who were negative for sSR-A ( Z=-2.90, P=0.004; Z=-2.37, P=0.018; Z=-3.09, P=0.002). CLIA detection of sSR-A, the RA group [6.83(3.22, 10.65) ng/ml] demonstrated significantly elevated sSR-A concentrations compared to both the OA+GA [1.99(1.27, 4.18) ng/ml] and HC groups [1.03 (0.50, 1.73) ng/ml] ( Z=4.20, P<0.001; Z=9.62, P<0.001). ROC curve analysis revealed AUC (95% CI) of 0.924 6(0.787 5, 0.880 8), with a sensitivity of 86.92% and a specificity of 93.10% for the diagnosis of RA. Conclusion:sSR-A is a reliable biomarker for diagnosing RA, particularly in seronegative patients, and is closely associated with disease activity. CLIA offers superior diagnostic performance over ELISA in detecting sSR-A in RA patients.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To investigate the factors that influence ocular surface biology and visual acuity in individuals with diabetic dry eye(DDE)and analyze how these factors contribute to changes in visual quality.Methods Based on the disease duration,fasting blood glucose(FBG),and glycated hemoglobin(HbA1c)levels of patients with type 2 diabe-tes mellitus(T2DM),the DDE patients were divided into different groups.Logistic regression analysis was used to identify influencing factors related to ocular surface biology and visual quality in each group of DDE patients.Tear film stability was evaluated based on the tear film rupture time(BUT),Schirmer I test(SIt),and ocular surface disease index(OSDI).Lip-iview? Surface interferometers were used to measure tear film lipid layer thickness(LLT),meibomian gland loss rate(MGP),meibomian gland opening number(MGYLS),and meibomian gland secretion score(MGYSS).Wavefront aber-rometry was used to measure corneal wavefront aberration values at 4 mm and 6 mm pupil diameters.Ocular response ana-lyzer(ORA)was adopted to analyze corneal hysteresis(CH)and corneal resistance factor(CRF).Moreover,ELISA ex-periment to evaluate the trend of changes in inflammatory factors in tears.Results Logistic regression analysis revealed that T2DM duration,smoking history,FBG,HbA1c,total cholesterol(TC),triglycerides(TG),OSDI score,LLT,BUT,SIt,MGP,MGYLS,MGYSS,total higher-order aberrations,spherical aberration,coma aberration,trefoil aberration,tumor necrosis factor-α,interleukin-6,matrix metalloproteinase-9,receptor for advanced glycation end products,and insu-lin were all influencing factors for the risk of DDE(all P＜0.05).As the T2DM course prolonged and FBG or HbA1 c levels rose,tear film-related indicators(LLT,BUT,and SIt)and meibomian gland-related indicators(MGYLS and MGYSS)inpa-tients gradually decreased,while OSDI scores and MGP gradually increased(all P＜0.05).As the T2DM course prolonged and FBG or HbA1c levels rose,the total higher-order aberrations,spherical aberration,coma aberration,and trefoil aber-ration in DDE patients under 4 mm and 6 mm pupil diameters gradually increased;Meanwhile,best corrected visual acuity,corneal hysteresis,and corneal resistance factor gradually decreased;The contents of tumor necrosis factor-α,interleukin-6,matrix metalloproteinase-9,receptor for advanced glycation end products,and insulin in tears all gradually increased,while mucin-5AC gradually decreased(all P＜0.05).Conclusion With the prolongation of T2DM duration and the in-crease of FBG or HbA1c,the ocular surface inflammatory response in DDE patients gradually worsens,corneal biological function decreases,and visual quality deteriorates.Timely systemic and local interventions are of great significance for im-proving dry eye symptoms and visual quality in DDE patients.

The background of revising GB 19083-2023 Protective face mask for medical use was introduced.GB 19083-2023 was compared with GB 19083-2010 Technical requirements for protective face mask for medical use.The revision points were described in detail involving in dead space,total leakage rate,respiratory resistance,resistance to synthetic blood penetration,microbial indicators,biocompatibility and etc,and the convergence between GB 19083-2023 and international mainstream standards was analyzed.References were provided for the understanding of the standard for the production enterprises and consumers.[Chinese Medical Equipment Journal,2025,46(1):73-77]

BACKGROUND:The changes in peripheral blood erythrocytes of rats exposed to hypoxia are related to changes in proliferation of erythroblasts in the bone marrow.Related regulatory factors such as hypoxia-inducible factor and erythropoietin are involved.OBJECTIVE:To explore the changes and related factors of peripheral blood erythrocytes and bone marrow erythroblasts in rats after hypoxic exposure.METHODS:An altitude of 5 000 meters was simulated to establish an experimental rat model under a low-pressure and low-oxygen environment.The control group was raised in a laboratory at an altitude of 2 260 meters.The blood routine,bone marrow erythroblast ratio,hypoxia-inducible factor,and erythropoietin of rats were compared before and after hypoxic exposure.RESULTS AND CONCLUSION:(1)The peripheral blood erythrocyte count,hemoglobin,hematocrit and other indicators of the experimental group rats were higher than those of the control group(P＜0.05).(2)The proportion of bone marrow CD71+erythroblasts of the experimental group rats increased compared with the control group(P＜0.05).(3)The expression level of hypoxia-inducible factor-2α in bone marrow CD71+erythroblasts of experimental group rats increased compared with the control group(P＜0.05).(4)The erythropoietin level in the bone marrow supernatant of the experimental group rats was higher than that of the control group(P＜0.05).The results indicate that the proportion of peripheral blood erythrocytes and bone marrow erythroblasts in rats increases after hypoxic exposure,which may be related to the increased levels of hypoxia-inducible factor-2α in bone marrow erythroblasts and erythropoietin in bone marrow supernatant.

Bovine rotavirus(BRV)is an important pathogen causing diarrhea in calves.To understand the genomic charac-teristics and genetic variations in bovine rotavirus,and to further enrich data on the biological characteristics of rotavirus,we aimed to amplify 11 gene segments of the isolated and cultured G6P[1]bovine rotavirus BLL strain,perform whole genome se-quencing,and analyze the molecular characteristics.MEGA7.0 and DNAMAN software were used for homology and typing a-nalysis,and the whole genome phylogenetic tree was constructed to analyze genetic evolution relationships.The complete geno-type of the BLL strain was G6-P[1]-I2-R2-C2-M2-A3-N2-T6-E2-H3.Phylogenetic analysis of the VP7 and VP4 genes of the BLL strain showed that the VP7 gene had the highest homology with RVA/Cow-wt/HB01/China/2021,and the VP4 gene of the BLL strain was in the same branch as RVA/Human-tc/ISR/Ro8059/1995.From the sequence alignment of VP8*amino acids,the sialic acid domain of the BLL strain was found to be similar to that in other P[1]strains,but different from those in other types of strains,except for residue 189,which was the same as that in Ro8059 but different from that in other strains.The results suggested that the BLL strain might potentially infect humans.Therefore,continued monitoring and study of the biological characteristics of this strain are necessary to provide more information and evidence supporting further research on the cross-species transmission of group A rotavirus in China.

Objective To observe the clinical efficacy of oral use combined with targeted transdermal delivery of Osteoking in treating knee osteoarthritis(KOA)of cold-damp blockage type.Methods A total of 120 patients with KOA of cold-damp blockage type who admitted to Hunan Provincial Hospital of Integrated Traditional Chinese And West Medicine from September 2022 to September 2023 were randomly divided into the control group,oral use group,transdermal delivery group and combination group according to the random number table method,with 30 cases in each group.The control group was treated with Celecoxib Capsule orally,the oral use group was treated with Osteoking orally,the transdermal delivery group was treated with Osteoking by targeted transdermal delivery,and the combination group was treated with oral use combined with targeted transdermal delivery of Osteoking.One course of treatment covered 12 days,and all of the four groups were treated for two continuous courses.Before and after treatment,the scores of traditional Chinese medicine(TCM)syndrome,Visual Analogue Scale(VAS)for pain,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)for joint function,36-Item Short Form Health Survey(SF-36)for quality of life(QOL),as well as the levels of serum interleukin 1β(IL-1β),interleukin 6(IL-6),and tumor necrosis factor α(TNF-α)were observed in the patients of each group.After treatment,the clinical efficacy and safety of patients in each group were evaluated.Results(1)After two courses of treatment,the total effective rate of the combination group was 96.67%(29/30),which was higher than those of the control group[73.33%(22/30)],oral use group and transdermal delivery group[both being 70.00%(21/30)],and the difference was statistically significant(P<0.05).However,no statistically significant difference of the total effective rate was presented among the control group,oral use group,and transdermal delivery group(P>0.05).(2)After treatment,the scores of TCM syndrome,VAS for pain and WOMAC for joint function in the four groups were decreased compared with those before treatment(P<0.01).The intergroup comparison showed that the scores of TCM syndrome,VAS for pain and WOMAC in the combination group were lower than those in the other three groups(P<0.05),while no statistically significant difference of the scores of TCM syndrome,VAS for pain and WOMAC were presented among the control group,oral use group,and transdermal delivery group(P>0.05).(3)After treatment,the QOL scores of the eight dimensions of SF-36 such as physical functioning(PF),bodily pain(BP),general health(GH),vitality(VT),role-physical(RP),social functioning(SF),role-emotional(RE),and mental health(MH)in the four groups were significantly increased compared with those before treatment(P<0.01).The intergroup comparison showed that the scores of each dimension of SF-36 in the combination group were significantly higher than those in the other three groups(P<0.05),while no statistically significant difference of the dimension score of SF-36 was presented among the control group,oral use group,and transdermal delivery group(P>0.05).(4)After treatment,the levels of serum inflammatory factors of IL-1β,IL-6,and TNF-α in the four groups were decreased compared with those before treatment(P<0.01).The intergroup comparison showed that the decrease of serum levels of inflammatory factors in the combination group were significantly superior to those in the other three groups(P<0.05),and the decrease in the control group and oral use group were all superior to those in the transdermal delivery group(P<0.05),while the difference between the control group and oral use group was not statistically significant(P>0.05).(5)During the trial,no serious adverse reactions were found in the patients of four groups,which is of high safety.Conclusion Oral use combined with targeted transdermal delivery of Osteoking is effective on improving the joint pain,joint function and QOL of patients with KOA of cold-damp blockage type,and can speed up the rehabilitation of patients.Its therapeutic mechanism may be related to the decrease of the expression level of inflammatory factors.

Objective To investigate the current status of sleep quality,depression,anxiety and stress of special service convalescents and their correlation.Methods A questionnaire survey was conducted on 311 special service convalescents by the Pittsburgh sleep quality index(PSQI)and the depression-anxiety-stress self-rating scale-21(DASS-21)from May to July 2022.Results The mean total PSQI score of 311 special service convalescents was 4.93±3.14,and 63 of them(20.26%)had sleep quality problems(total score of PSQI>7).The proportions of respondents with the scores≥2 in sleep time,daytime dysfunction,subjective sleep quality,and fall-asleep time were 30.87%,26.05%,21.22%,and 20.26%,respectively.The proportions of respondents with mild depression,anxiety and stress were 6.11%,4.50%and 2.57%,respectively,which were higher than the other three grades(moderate,severe and very serious).The incidence of sleep quality problems,depression,anxiety,and stress in respondents aged 40 years and above was higher than those in the other age groups,and there was a tendency to increase with age.The total score of PSQI and all factors(except hypnotic drugs)were positively correlated with depression,anxiety,and stress in special service convalescents(all P<0.01).Regression analysis showed that depression and stress were the direct influencing factors of sleep quality.Conclusion The special service convalescents have varying degrees of sleep quality problems and negative emotions such as depression,anxiety,and stress,especially those aged 40 years and above.Sleep quality is closely related to depression,anxiety,and stress.