BACKGROUND:Osteoarthritis is pathologically characterized by progressive degeneration of the articular cartilage and abnormal deformation of the subchondral bone.In recent years,with the deepening of medical research,it has been found that the mitogen-activated protein kinases(MAPK)signaling pathway has a regulatory role in inflammatory cell infiltration,inflammatory factor release,and chondrocyte proliferation,which is particularly important for the treatment of osteoarthritis.OBJECTIVE:To briefly review the main research progress in the mechanism of MAPK signaling pathway regulating osteoarthritis in recent years,aiming to provide new ideas for the treatment of osteoarthritis.METHODS:CNKI,WanFang and PubMed databases were searched for relevant literature using the search terms of"mitogen-activated protein kinases,osteoarthritis,extracellular signal-regulated MAP kinases,p38 mitogen-activated protein kinases,JNK mitogen-activated protein kinase"in Chinese and English.Relevant literature published from January 2019 to November 2024 was searched,and 108 articles were finally included for summary analysis.RESULTS AND CONCLUSION:(1)Various stimuli inside and outside the cells activate the MAPK signaling pathway,regulate gene transcription and protein synthesis,and promote the release of inflammatory factors,such as tumor necrosis factor-α,interleukin-1β,and interleukin-6.The release of these inflammatory factors aggravates the progression of osteoarthritis.(2)The active ingredients of traditional Chinese medicine,mainly saponins and flavonoids,as well as Chinese herbal formulas and preparations with the main effects of activating blood circulation and removing blood stasis,tonifying the liver and kidney,can play a therapeutic role in osteoarthritis by inhibiting the MAPK signaling pathway,regulating the release of matrix metalloproteinases,balancing the homeostatic state of osteogenesis and osteoblastogenesis,attenuating the synovial inflammation,decreasing the release of inflammatory factors and inflammatory vesicles,decreasing cellular pyroptosis,promoting autophagy,and ameliorating oxidative stress.(3)Although traditional Chinese medicine has become popular in the treatment of osteoarthritis by virtue of its own advantages of multi-components,multi-targets,multi-pathways,and low side effects,the use of MAPK signaling pathway to guide the treatment of individual osteoarthritis is the difficulty of the technology,which needs to be continuously researched and explored.(4)Therefore,further development of relevant herbal inhibitors that can modulate the MAPK signaling pathway may be a potential drug strategy for the treatment of osteoarthritis in the future.

BACKGROUND:Osteoarthritis is pathologically characterized by progressive degeneration of the articular cartilage and abnormal deformation of the subchondral bone.In recent years,with the deepening of medical research,it has been found that the mitogen-activated protein kinases(MAPK)signaling pathway has a regulatory role in inflammatory cell infiltration,inflammatory factor release,and chondrocyte proliferation,which is particularly important for the treatment of osteoarthritis.OBJECTIVE:To briefly review the main research progress in the mechanism of MAPK signaling pathway regulating osteoarthritis in recent years,aiming to provide new ideas for the treatment of osteoarthritis.METHODS:CNKI,WanFang and PubMed databases were searched for relevant literature using the search terms of"mitogen-activated protein kinases,osteoarthritis,extracellular signal-regulated MAP kinases,p38 mitogen-activated protein kinases,JNK mitogen-activated protein kinase"in Chinese and English.Relevant literature published from January 2019 to November 2024 was searched,and 108 articles were finally included for summary analysis.RESULTS AND CONCLUSION:(1)Various stimuli inside and outside the cells activate the MAPK signaling pathway,regulate gene transcription and protein synthesis,and promote the release of inflammatory factors,such as tumor necrosis factor-α,interleukin-1β,and interleukin-6.The release of these inflammatory factors aggravates the progression of osteoarthritis.(2)The active ingredients of traditional Chinese medicine,mainly saponins and flavonoids,as well as Chinese herbal formulas and preparations with the main effects of activating blood circulation and removing blood stasis,tonifying the liver and kidney,can play a therapeutic role in osteoarthritis by inhibiting the MAPK signaling pathway,regulating the release of matrix metalloproteinases,balancing the homeostatic state of osteogenesis and osteoblastogenesis,attenuating the synovial inflammation,decreasing the release of inflammatory factors and inflammatory vesicles,decreasing cellular pyroptosis,promoting autophagy,and ameliorating oxidative stress.(3)Although traditional Chinese medicine has become popular in the treatment of osteoarthritis by virtue of its own advantages of multi-components,multi-targets,multi-pathways,and low side effects,the use of MAPK signaling pathway to guide the treatment of individual osteoarthritis is the difficulty of the technology,which needs to be continuously researched and explored.(4)Therefore,further development of relevant herbal inhibitors that can modulate the MAPK signaling pathway may be a potential drug strategy for the treatment of osteoarthritis in the future.

OBJECTIVE To investigate the epidemiological characteristics,clinical features and distribution of pathogens isolated from the burn wound patients with infections in a northwestern hospital from 2014 to 2023 so as to provide bases for prevention and treatment of burn wound infections in the northwestern region.METHODS The epidemiological characteristics,clinical features and distribution of pathogenic isolated from the burn wound patients with infections who were treated in the 940th Hospital of Joint Logistic Support Force from 2014 to 2023 were retrospectively analyzed.RESULTS A total of 2122 burn wound patients were enrolled in the study,397(18.71％)of whom had infections,including 306(14.42％)patients with community-acquired infections and 91(4.29％)patients with hospital-acquired infections.The proportion infections was higher among the patients aged no less than 60 years old(63/154)than among the patients aged less than 14 years old(231/983)and the pa-tients aged between 14 and 60 years old(103/985)(x2=108.840,P＜0.001).The proportion of infections was higher among the patients with the burn wound depth no less than grade Ⅲ(146/458)than among the patients with the burn wound depth no less than grade Ⅱ(251/1664)(x2=66.600,P＜0.001).The proportion infections was higher among the patients with burn wounds in limbs(370/1881)than among the patients with burn wounds in other sites(1153/1987)(x2=47.244,P＜0.001).The isolation rates of methicillin-resistant Staphy-lococcus epidermidis and carbapenem-resistant Pseudomonas aeruginosa strains showed downward trends from 2014 to 2023,the isolation rates of carbapenem-resistant Klebsiella pneumoniae and the third generation cephalo-sporins-resistant Escherichia coli showed upward trends,however,there were no significant differences.CONCLUSIONS The patients with no less than 60 years of age,no lower than grade Ⅲ of burn wound depth and burn wounds in limbs are more likely to have burn wound infections.S.aureus is the predominant species of pathogens causing the infections.The isolation rates of carbapenem-resistant K.pneumoniae strains and the third generation cephalosporins-resistant E.coli strains show upward trends.It is necessary to take targeted prevention and treatment measures for the burn wound infections.

Objective:To observe the impact of upper limb resistance exercise on the exercise tolerance, muscle strength and life quality of patients with chronic obstructive pulmonary disease (COPD) so as to provide a reference for optimizing their rehabilitation plans.Methods:Fifty-eight COPD patients were randomly divided into an observation group and a control group, each of 29. Both groups were given routine pulmonary rehabilitation training (including lip retraction and abdominal breathing) for 12 weeks, while the observation group also performed upper limb resistance exercises. Before and after the intervention, both groups were evaluated using the 6-minute walk test (6MWT), St. George′s Respiratory Questionnaire (SGRQ) and the modified Medical Research Council Dyspnea Scale (mMRC). Lung function, respiratory muscle strength and upper limb muscle strength were also measured.Results:After the intervention there was a significant increase in the average 6MWT distance, maximum inspiration pressure, maximum expiratory pressure, and upper limb muscle strength among the observation group. In the control group, maximum inspiration pressure and the average the dyspnea mMRC score had improved. The observation group showed a significant decrease in the average heart rate after the 6MWT, and in average dyspnea mMRC and SGRQ scores. So after the intervention there were significant differences between the groups in terms of 6MWT distance (312.3±50.2m), maximum inspiratory pressure (96.8±11.3cmH 2O), maximum expiratory pressure (88.6±11.3cmH 2O), heart rate after the 6MWT (113.8±4.9beats/min) and SGRQ score. Conclusions:Adding upper limb resistance exercise to routine pulmonary rehabilitation can further improve the exercise tolerance, respiratory muscle strength, upper limb muscle strength and life quality of COPD patients. Therefore, such therapy is worthy of clinical promotion and application.

Objective To explore the diagnostic efficacy of digital tomosynthesis(DTS)and kidney-ureter-bladder(KUB)X-ray plain filmin for urinary calculi.Methods A total of 140 patients with urinary calculi were randomly divided into observation group and control group,with 70 cases in each.The observation group underwent bowel preparation(BP)before DTS,while the control group did not.KUB,DTS and unenhanced multidetector computed tomography(UMDCT)were performed in both groups,and the three images were assessed and compared by three physicians.Results The X-ray plain filmin detection rate of stones≤5 mm in the observation group was significantly higher than that in the control group(85.46%vs 33.33%,χ2=30.75,P<0.01),and the detec-tion rate of stones>5 mm in the observation group was also significantly higher than that in the control group(100%vs 58.44%,χ2=43.12,P<0.01).The DTS detection rate of stones≤5 mm in the observation group was significantly higher than that in the control group(90.91%vs 55.56%,χ2=17.44,P<0.01),but there was no significant difference in the detection rate of stones>5 mm between the two groups(100%vs 96.10%,P>0.05).The effective dose(ED)differed significantly among X-ray plain filmin,DTS and UMDCT(P<0.001).Except for DTS,there were significant differences in imaging sensitivity between the two groups(P<0.05).Conclusion DTS is an appropriate examination method for patients with urinary calculi,which can improve the diag-nostic rate of urinary calculi and reduce the radiation dose for patients.The detection rate of stones≤5 mm in DTS is affected by BP,but the detection rate of stones>5 mm is unaffected by BP.The diagnostic sensitivity of DTS is unaffected by BP.

Objective:To conduct a scoping review on the critical values for lifestyle risk factors in young and middle-aged patients with prediabetes progressing to diabetes, so as to provide a reference for clinical screening, prevention, intervention, and patient self-management.Methods:Guided by the scoping review methodology and framework developed by Arksey et al., research questions were identified. Through systematic searches of Chinese and English literature databases, studies on risk factors in young and middle-aged patients with prediabetes progressing to diabetes published from the establishment of the database to August 11, 2024 were screened. Studies examining critical values for lifestyle risk factors were selected for data extraction, summary of findings, and qualitative analysis.Results:A total of 19 articles were ultimately included. Lifestyle risk factors encompassed diet, exercise, smoking, drinking, and step count. Specific indicators included daily sugar intake >25 grams, weekly exercise time <150 min, daily exercise time <30 min, weekly drinking ≥3 times with ≥180 ml of clear liquor per session, and daily step count <5 000 steps.Conclusions:There are different characteristics and critical values of the influence of various factors on the progress of diabetes. Future research should further standardize criteria and conduct large-scale, multicenter, long-term follow-up studies to establish optimal critical values for lifestyle factors, thereby providing evidence for diabetes screening, prevention, and intervention.

X-ray is usually used to determine anatomy and localization during conventional permanent pacemaker implantation.But X-ray exposure might induce radiation injury to fetus.In this paper,we reported 2 cases successful double cavity permanent pacemaker implantation in pregnant women woman at 13 weeks of gestation under the guidance of transthoracic echocardiography.The postoperative pacing parameters were good,the whole process was finished with zero radiation,and there were complications during pregnancy.Both cases resulted in full-term pregnancies and the natural delivery of healthy newborns.Pacemaker electrodes were in normal position as confirmed by post-delivery X-ray examinations.

Objective:To investigate level and influencing factors of information overload of intensive care unit (ICU) patients′ decision-making agents in order to provide positive clinical interventions for improving their information overload.Methods:During March 2023 to February 2024, 302 ICU patients′ decision-making agents from the Second Affiliated Hospital of Naval Medical University of the People′s Liberation Army of China were cross-sectional surveyed by Basic Information Questionnaire, Information Overloading Scale, Decision Participation Expectancy Scale, Multidimensional Perceived Social Support Scale, State Trait Anxiety Inventory, Vickers Forest Physician Trust Scale, Decision Preparation Scale, Decision Fatigue Scale and Information Literacy Scale through convenience sampling methods.Results:In the valid 297 questionnaires, there were 172 males and 125 females in ICU patients′ decision-making agents aged 28-69(47.94 ± 8.71) years. The score of information overload was (19.65 ± 7.71), the score of perceived social support was (52.34 ± 7.87), the score of state anxiety was (60.88 ± 6.16), the score of trait anxiety was (60.09 ± 5.49), the score of physician trust was (35.34 ± 4.30), the score of preparation of decision was (27.90 ± 3.01), the score of decision fatigue was (20.61 ± 3.30), and the score of information literacy was (56.18 ± 11.46) in ICU patients′ decision-making agents. Linear regression analysis showed that age, educational level, having a common decision-maker, times of making medical decisions, type of participating in medical decision (cooperative type and proactive type), perceived social support, state anxiety, physician trust, preparation for decision making, decision fatigue and information literacy were all significant influencing factors of information overload of ICU patients′ decision-making agents ( t values were -6.76 to 7.57, all P<0.05). Conclusions:The level of information overload of ICU patients′ decision-making agents was above average. Therefore, while educating them about patients′ illness situation and inviting them to participate in decision-making, ICU medical staff should pay attention on their level of information overload, and then select simply easy communication methods and content to help them quickly understand information and make decisions according to their characteristics and information processing ability.

Objective To investigate the expression pattern of IQGAP2 in renal cell carcinoma tissues and cell lines,and to analyze its effects on the proliferation and migration of renal cell carcinoma cells.Methods Firstly,GEO database was used to screen differentially expressed genes between renal cell carcinoma tissues,and GEPIA,TIMER2.0 were used to analyze the expression level of IQGAP2 in renal cell carcinoma tissue.Subse-quently,knockdown(siRNA)and overexpression plasmids of IQGAP2 were constructed and transfected into ACHN and 786-O cell lines to perform a series of functional experiments to evaluate the effect of IQGAP2 on the malignant biological behavior of renal carcinoma cells.qRT-PCR and Western Blot were used to detect the expres-sion of EMT(epithelial-mesenchymal transition)related proteins after knockdown and overexpression of IQGAP2.Results In renal cell carcinoma tissues,the relative expression of IQGAP2 was significantly lower than in adja-cent normal tissues(P<0.001).Transfection of si-IQGAP2 in ACHN and 786-O cells effectively downregulated the mRNA and protein expression levels of IQGAP2(P<0.01),while transfection with an overexpression plasmid significantly upregulated its mRNA and protein expression(P<0.001).Further studies revealed that overexpression of IQGAP2 significantly inhibited the proliferation(P<0.05)and migration(P<0.01)of ACHN and 786-O cells,whereas knockdown of IQGAP2 enhanced their proliferation(P<0.05,P<0.001)and migration(P<0.01).Through qRT-PCR and Western blot analyses of EMT-related proteins,it was found that reduced expression of IQGAP2 promoted the epithelial-mesenchymal transition(EMT)process in renal cancer cells.Conclusions The expression of IQGAP2 is low in renal cell carcinoma tissues and cells,and the decrease of the expression level can promote the EMT process of renal cell carcinoma cells,and then enhance the proliferation and migration of renal cell carcinoma cells.IQGAP2 plays an important tumor suppressor role in renal cell carcinoma.

Objective:To investigate devices for radiodiagnosis used in medical institutions in Beijing, China, as well as radiation workers and the devices′ application frequencies, in order to provide data support for determining radiation protection measures and allocating resources for clinical radiodiagnosis.Methods:In October 2023, questionnaires were distributed to the members of the Radiation Technology Branch of the Beijing Medical Association who work in medical institutions at different levels across varying districts of Beijing. The collected data included information about devices for radiodiagnosis and radiation workers, as well as the application frequencies of various medical X-ray imaging devices during 2018-2022, in 38 medical institutions of Level 3 Grade A, Level 3, and Level 2 in 14 municipal districts of Beijing. Then, the collected data were organized using the Microsoft Power BI software to form report models, followed by the statistical analysis of data on the devices, radiation workers, and application frequencies were using the RStudio software.Results:The 38 medical institutions in Beijing possess 591 devices for radiodiagnosis and 2 018 staff in the departments of radiology, including 1 037 radiologic technologists and 738 physicians, with 1.77 technologists and 1.26 physicians arranged for a single device on average. From 2018 to 2022, among all examinations of radiodiagnosis, computed tomography (CT) scans showed the highest frequencies, with total and average annual growth rates of 138.06% and 108.40%, respectively. Specifically, chest CT scans exhibited total and average annual growth rates of 225.20% and 122.50%, respectively. X-ray imaging ranked second in application frequency, with total average annual growth rates of 70.20% and 91.53%, respectively. Notably, chest X-ray imaging showed total and average annual growth rates of 63.89% and 89.41%, respectively.Conclusions:From 2018 to 2022, X-ray imaging examinations displayed significantly fluctuating frequencies with an overall decline trend in the 38 medical institutions. In contrast, the CT scans showed increased frequencies, with chest CT scans displaying an increased frequency and proportion. This necessitates ensuring the justification of CT scans.