Objective:To summarize domestic and foreign transitional readiness assessment tools for adolescents with chronic diseases and analyze the current status of their application in the clinic, so as to provide references for healthcare professionals to select appropriate tools.Methods:China National Knowledge Infrastructure, Wanfang Data, VIP and China Biomedical Literature Database, PubMed, Web of Science, Embase, Medline, CINAHL, Cochrane Library and scholar.google.com were searched for literature related to the assessment tools of transition readiness in adolescents with chronic illnesses from inception to March 29, 2024. Two researchers independently screened the literature and extracted the data.Results:A total of 491 articles were initially retrieved and 24 were included, involving a total of 8 transitional readiness assessment tools for adolescents with chronic diseases, including the Transition Readiness Assessment questionnaire, the University of North Carolina TRxANSITION Scale, Am I ON TRAC for adult care? Questionnaire, Transition Questionnaire, Self-Management and Transition to Adulthood with Rx=Treatment Questionnaire, Good 2 Go Questionnaire, State Assessment Questionnaire for Transition, and Self-assessment Scale of Transition Readiness for Adolescents. The Transition Readiness Assessment questionnaire and Self-Management and Transition to Adulthood with Rx=Treatment Questionnaire have good reliability and validity, comprehensive evaluation, wide applicability, simple use, and are suitable for clinical use.Conclusions:The quality of existing tools for assessing transitional readiness of adolescents with chronic diseases is mixed. The Transition Readiness Assessment questionnaire and Self-Management and Transition to Adulthood with Rx=Treatment Questionnaire are more appropriate options in the clinic, but they still need to be improved. Future studies need to continue to introduce tools to assess transitional readiness for chronic diseases in adolescents and develop localized assessment tools.

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 early predictive value of ECG PR interval for the risk of coronary heart disease(CHD) in patients with T2DM.Methods:A total of 7 886 participants from Guiyang who enrolled in the REACTION study between May and August 2011 were included. Baseline data were collected, and participants were followed for 10 years to monitor the occurrence of CHD. Logistic regression was used to identify risk factors for CHD, and a Cox proportional hazards model was employed to assess the predictive value of the PR interval for CHD incidence. Results:Over 10 years of follow-up, the overall incidence of CHD was 4.22%(245/5 812). The incidence was significantly higher in the T2DM group(7.57%, 96/1 268) than in the non-T2DM(3.28%, 149/4 544), and the shortened PR group(3.19%, 36/1 130; all P<0.05). Multiple logistic regression analysis identified both T2DM and prolonged PR interval as significant risk factors for CHD, with HR(95% CI) of 1.98(1.64-2.42) and 1.07(1.04-1.10), respectively(both P<0.01). The Cox proportional hazards model further revealed that the risk of CHD was significantly higher in the prolonged PR group than in the normal PR group, with an HR of 2.82(95% CI 2.34-3.12, P<0.01). Subgroup analysis showed that the risk of CHD was elevated in the non-T2DM with prolonged PR group, T2DM with normal PR group, and T2DM with prolonged PR group compared to the non-T2DM with normal PR group, with HRs(95% CI) of 1.43(1.14-1.82), 2.16(1.78-2.56), and 5.24(3.12-7.94), respectively. A significant interaction was observed between T2DM status and PR prolongation in predicting CHD risk(all P<0.01). Conclusions:Both T2DM and prolonged PR interval are independent risk factors for 10-year CHD incidence. Moreover, an interaction exists between T2DM and prolonged PR interval in predicting CHD risk. The PR interval may serve as an early predictor of CHD risk in patients with T2DM.

Objective:To investigate the 10-year incidence of reproductive system malignancies and their associated risk factors among overweight and obese women with different metabolic phenotypes aged 40 years and older in Guiyang City.Methods:A total of 6 444 female residents in Yunyan District, Guiyang City were included from the 2011 " Epidemiological Study on the Risk of Malignancy in Chinese Patients with Type 2 Diabetes Mellitus(REACTION)". Based on body mass index(BMI) and the presence or absence of metabolic syndrome(MetS), participants were categorized into four groups: metabolically healthy normal weight(MHNW, n=2 373), metabolically unhealthy normal weight(MUNW, n=1 098), metabolically healthy overweight/obese(MHO, n=2 229), and metabolically unhealthy overweight/obese(MUO, n=744). Baseline data were collected, and participants were followed up for 10 years to document the incidence of female reproductive system malignancies, including breast cancer, ovarian cancer, cervical cancer, and endometrial cancer. Logistic regression models were used to evaluate the association between metabolic phenotype and the 10-year risk of developing reproductive system malignancies. Results:Over a mean follow-up period of (9.89±0.77) years, the overall incidence of reproductive system malignancies was 1.15%(74/6, 444). Baseline characteristics such as age, BMI, high-density lipoprotein-cholesterol(HDL-C), and triglycerides(TG) differed significantly among the groups( P<0.05). The cumulative incidence of reproductive system malignancies in each group was: MHNW 0.93%(22/2 373), MUNW 0.73%(8/1 098), MHO 1.57%(35/2 229), and MUO 1.21%(9/744). There were no statistically significant differences in incidence across the four groups( P>0.05). However, multivariable logistic regression analysis revealed that, compared with the MHNW group, the adjusted HR (95% CI) were: MUNW 0.787(0.349-1.774, P>0.05), MHO 4.835(1.708-13.688, P<0.05), and MUO 3.719(1.144-12.089, P<0.05). Conclusion:Overweight and obesity are significant risk factors for reproductive system malignancies in women aged 40 and above. The presence of metabolic abnormalities in overweight or obese women further increases the risk of developing such malignancies.

Objective:To explore the value of prenatal three-dimensional ultrasonography（3DUS）in displaying auricular morphotyping and dimensions for predicting congenital aural atresia（CAA）.Methods:A retrospective collection of 227 fetuses who underwent ultrasound scans and retained auricular 3DUS volumes from January 2018 to December 2023 at the First Affiliated Hospital of Sun Yat-sen University was conducted. Fetuses were divided into two groups：a CAA group（52 fetuses，62 auricles）and a non-CAA group（175 fetuses，202 auricles），based on the presence or absence of external auditory canal identified through postnatal examination. According to 3DUS auricular contour and presence or absence of the concha，the auricles were divided into 4 types：type Ⅰ，C-shaped auricle with a concha；type Ⅱ，Irregular auricle with a concha；type Ⅲ，C-shaped auricle without a concha；type Ⅳ，Irregular auricle without a concha. And auricular length（AL）and width（AW）were measured to calculate the product of the auricular length and width（ALW）. Normal reference ranges for ALW from the non-CAA group were developed. Differences of the auricular morphotyping and Z-score of ALW（ALWZ）were compared between the two groups. Receiver operating characteristic（ROC）curves were used to evaluate the diagnostic efficiency of auricular morphotyping，ALWZ and the regression model. A Logistic regression model for CAA based on auricular morphotyping and ALWZ were established.Results:The auricular morphotyping and ALWZ between the two groups were different statistically（both P<0.05）. The AUC of the auricular morphotyping and ALWZ predicting CAA were 0.960（95% CI = 0.923 - 0.997）and 0.975（95% CI = 0.959 - 0.991）individually. Formula for CAA prediction model combining the two indicators（5.379 × morphotyping - 2.386 × ALWZ - Conclusions:The auricular morphotyping and dimensions can effectively predict CAA.

OBJECTIVE To explore the ameliorative effect of ursolic acid on carbon tetrachloride-induced acute liver injury in mice,and the feasibility of multispectral optoacoustic tomography(MSOT)for characteristic structural and functional imaging of liver tissues.METHODS Kunming mice were randomly divided into the normal control group,model group,model+ursolic acid 30,60 mg·kg-1 groups and model+bifendate 5.625 mg·kg-1 group,with 14 mice in each.Each group was given the corresponding drug once daily for 7 days.An acute liver injury model was established in mice by intraperitoneal injection of 0.2％carbon tetrachloride in olive oil solution after the last administration.Blood was collected,liver tissues were taken 24 h after modeling,and the liver index was calculated,8 mice from each group and the levels of serum glutamic pyruciv transaminase(GPT)and glutamic oxaloacetic transaminase(GOT),as well as superoxide dismutase(SOD)activity and malondialdehyde(MDA)content in liver tissues were measured.The enzyme-linked immunosorbent assay(ELISA)method was used to detect the level ofα-glutathione S-transferase(α-GST)in serum.The histopathological changes of the liver were observed under a light microscope.The remaining 6 mice in each group underwent MSOT technique was used for characteristic structural and functional imaging of liver tissue.Levels of oxygenated hemoglobin(HbO2)and deoxygenated hemoglobin(Hb)were analyzed,oxygen saturation was calculated,and the extent of liver injury was assessed by examining the intrahepatic distribution of indocyanine green(ICG).RESULTS Compared with the normal group,the levels of GPT,GOT and α-GST in serum,content of MDA in liver tissues and the liver index in the model control group were significantly increased while the activity of SOD in liver tissues were significantly decreased.Compared with the model group,ursolic acid in each dose group significantly reduced the liver index of mice,lowered the serum levels of GPT and GOT as well as the level of α-GST,decreased the content of MDA in liver tissues,and elevated the activity of SOD in liver-injured mice.Hematoxylin-eosin staining showed that significant steatosis and hepatocyte necrosis and inflammatory cell infiltration in hepatocytes of mice in the model group.Ursolic acid significantly attenuated the degree of hepatocellular lesions and markedly reduced steatosis in mice.MSOT imaging showed that the HbO2 level and oxygen saturation were significantly lower while the Hb level was remarkably higher in the liver of mice in the model group.In each administration group,the level of HbO2 significantly increased,the level of Hb was significantly decreased,oxygen saturation was significantly increased in the liver of model mice and the accumulation of ICG dye probe was atten-uated in the body after hepatocyte injury.CONCLUSION Ursolic acid can elevate the hepatic oxygen saturation,improve the metabolism of ICG,reduce the degree of hepatic necrosis in mice,and help protect against carbon tetrachloride-induced hepatic injury in mice.The mechanism is probably related to the inhibition of oxidative stress.

Objective To investigate the expression of ferritinophagy-related gene ELAV-like RNA binding protein 1(ELAVL1)in multiple myeloma(MM)and elucidate its diagnostic and prognostic value for MM.Methods First,we analyzed ELAVL1 expression level in healthy controls and MM patients using data from the GEO and TCGA databases.Subsequently,bone marrow specimens were collected from 28 newly diagnosed MM patients and 20 healthy controls,and qRT-PCR was employed to validate ELAVL1 expression.The diagnostic and prognostic potential of ELAVL1 was assessed using ROC curve analysis and Kaplan-Meier survival curves.Additionally,univariate and multivariate COX regression analyses were performed to identify independent risk factors for MM prognosis.Finally,KEGG and GO enrichment analyses were performed using the DAVID online platform.Results The level of ELAVL1 expression was significantly higher in newly diagnosed MM patients and refractory/relapsed MM patients than in the healthy controls(P＜0.001).Moreover,ELAVL1 expression was positively correlated with the International Staging System(ISS)stage of MM(P＜0.01).Furthermore,qRT-PCR validation confirmed that ELAVL1 expression was elevated in the 28 newly diagnosed MM patients compared to the 20 healthy controls(P＜0.001).ROC curve analysis demonstrated that ELAVL1 could effectively differentiate between newly diagnosed MM patients,healthy controls,and MGUS patients(P＜0.001 and P=0.000 2,respectively).Survival analysis revealed that high ELAVL1 expression was associated with shorter progression-free survival(P=0.0141)and overall survival(P=0.008 0).Univariate and multivariate COX regression analyses identified high ELAVL1 expression as an independent risk factor for poor MM prognosis(P=0.005 0).KEGG analysis suggested that ELAVL1 might be involved in the Hippo and MAPK signaling pathways.Conclusion High ELAVL1 expression in MM may serve as a biomarker for diagnosis and poor prognosis.ELAVL1 may promote MM initiation and progression via the Hippo and MAPK signaling pathways.

Objective To investigate the expression of ferritinophagy-related gene ELAV-like RNA binding protein 1(ELAVL1)in multiple myeloma(MM)and elucidate its diagnostic and prognostic value for MM.Methods First,we analyzed ELAVL1 expression level in healthy controls and MM patients using data from the GEO and TCGA databases.Subsequently,bone marrow specimens were collected from 28 newly diagnosed MM patients and 20 healthy controls,and qRT-PCR was employed to validate ELAVL1 expression.The diagnostic and prognostic potential of ELAVL1 was assessed using ROC curve analysis and Kaplan-Meier survival curves.Additionally,univariate and multivariate COX regression analyses were performed to identify independent risk factors for MM prognosis.Finally,KEGG and GO enrichment analyses were performed using the DAVID online platform.Results The level of ELAVL1 expression was significantly higher in newly diagnosed MM patients and refractory/relapsed MM patients than in the healthy controls(P＜0.001).Moreover,ELAVL1 expression was positively correlated with the International Staging System(ISS)stage of MM(P＜0.01).Furthermore,qRT-PCR validation confirmed that ELAVL1 expression was elevated in the 28 newly diagnosed MM patients compared to the 20 healthy controls(P＜0.001).ROC curve analysis demonstrated that ELAVL1 could effectively differentiate between newly diagnosed MM patients,healthy controls,and MGUS patients(P＜0.001 and P=0.000 2,respectively).Survival analysis revealed that high ELAVL1 expression was associated with shorter progression-free survival(P=0.0141)and overall survival(P=0.008 0).Univariate and multivariate COX regression analyses identified high ELAVL1 expression as an independent risk factor for poor MM prognosis(P=0.005 0).KEGG analysis suggested that ELAVL1 might be involved in the Hippo and MAPK signaling pathways.Conclusion High ELAVL1 expression in MM may serve as a biomarker for diagnosis and poor prognosis.ELAVL1 may promote MM initiation and progression via the Hippo and MAPK signaling pathways.

[Purpose]To analyze the trends of brain tumor incidence and age of onset in cancer registration areas of Jiangsu Province from 2009 to 2019.[Methods]The incidence data of brain tumors from 2009 to 2019 were obtained from 16 national cancer registration areas of Jiangsu Province.The crude incidence rate,age-standardized incidence rate by Chinese standard popula-tion(ASIRC),average age of onset,standardized age-specific incidence rate,and annual average percentage change(AAPC)by sexes and regions were calculated.[Results]The incidence rate of brain tumor in Jiangsu Province from 2009 to 2019 showed an increasing trend(AAPC=4.12％,95％CI:3.31％～4.95％),and the increase in female(AAPC=5.79％,95％CI:4.44％～7.15％)was higher than that in male(AAPC=2.31％,95％CI:1.66％～2.97％);and the increase in urban areas(AAPC=4.84％,95％CI:3.52％～6.18％)was higher than that in rural areas(AAPC=3.04％,95％CI:2.12％～3.98％).The ASIRC also showed an increasing trend(AAPC=2.14％,95％CI:1.27％～3.02％).Birth cohort analysis showed that within the same age group,the incidence rate of brain tumors increased with increasing birth years.The average age of onset for crude incidence showed a delaying trend of 0.43 years old per year(t=7.09,P＜0.001);that for ASIRC was 0.20 years old per year(t=3.33,P=0.009).The proportion of patients in the age group of 60 years old and above increased from 35.79％in 2009 to 44.18％in 2019.[Conclusion]The incidence of brain tumor in cancer registration areas of Jiangsu Province showed an increasing trend from 2009 to 2019 with a delaying trend of average age of onset.

Objective:To elucidate the genomic characteristics of the immunoglobulin (IG) heavy-chain variable region and light-chain variable region, the expression of subclones, and the prognostic significance in patients with CLL.Methods:Blood and/or bone marrow specimens were gathered from a cohort of 36 patients with CLL diagnosed at Jiangsu Province Hospital from December 2018 to May 2023, including 12 cases of B cell receptor (BCR) stereotyped patients. IG heavy-chain (IGH) and light-chain (IG Kappa [IGK] and IG lambda [IGL]) gene rearrangements were performed using next-generation sequencing (NGS) technology to analyze the characteristics and prognostic value in CLL.Results:NGS detection of IG variable region (IGHV) demonstrated a significant correlation and superior consistency with Sanger sequencing ( r=0.957, P < 0.001). Among the 36 patients, the IGH variant (IGHV) was observed in 9 (25.0%) but not in 27 (75.0%) participants. The incidence of the MYD88 mutation was higher among patients with mutated IGHV [1/27 (3.7%) vs 4/9 (44.4%), P=0.00]. A high incidence of trisomy 12 was observed in the IGHV #8/#8B subset [4/11 (36.4%) vs 1/25 (4.0%), P=0.023], which were more likely to develop Richter transformation [8/11 (72.7%) vs 4/25 (16.0%), P=0.002]. In the patient cohort, 36 individuals (36/36, 100.0%) used the IGK variable, whereas 15 individuals (15/36, 41.7%) employed the IGL variable (IGLV). IGLV3 - 21 reported the highest utilization rate in IGLV (5/15, 33.3%). Remarkably, patients with CLL with IGLV3-21 fragments were exclusively observed in the Binet C stage and Rai Phase Ⅲ-Ⅳ, with an incidence of del (13) (q14) at 60.0% (3/5). The median time to first treatment (TTFT) of patients with or without IGLV3 - 21 fragments was 5.2 (1.1 - 41.5) and 9.9 (0.1 - 94.4) months, respectively. Using the total reads threshold of 2.5%, 4 (4/36, 11.1%) samples were detected to have two IGHV productive clones. The median TTFT and overall survival (OS) time were 2.8 (0.9-72.7) and 12.8 months in patients with one mutated clone and 57.5 (32.0-120.7) and 51.8 months in those with two mutated clones, respectively. The median TTFT and OS time were 10.9 (0.3-94.4) and 6.3 (0.1 - 12.5) months in patients with one unmutated clone and 49.9 (22.2 - 211.1) and 30.0 (9.6 - 50.3) months in those with multiple unmutated clones, respectively ( P>0.05) . Conclusions:Detection of IG gene rearrangements using NGS technology not only facilitates the analysis of the IGHV mutation status, dominant clones, and prognostic value but also contributes to the exploration of IGK/IGL gene rearrangement fragments and the utilization of subclones. Further, it provides information about the poor prognosis of IGLV3 - 21 CLL. The shortened survival of the two unmutated clone groups in the IGHV unmutated group may indicate a poor prognosis.