Objective To investigate the dietary structure and nutritional metabolism indicators in patients with type 2 diabetic nephropathy and to analyze the relationship with renal injury. Methods From January 2022 to February 2024, 296 patients with type 2 diabetic nephropathy were included in the hospital for investigation. According to the measurement results of 24h urinary protein quantification, these patients were divided into mild, moderate and severe renal injury groups. The diet, nutritional metabolism and renal injury indicators were compared, and the correlation was analyzed. Results The total energy intake, protein, fat and carbohydrate energy supply ratio were decreased with the aggravation of renal injury while the levels of hemoglobin (Hgb), total protein (TP), globulin (GLB), albumin (ALB), triglyceride (TG) and high density lipoprotein cholesterol (HDL-C) were enhanced (P<0.05), and the total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) were manifested as severe injury group>moderate injury group>mild injury group (P<0.05). Total intake, carbohydrate energy supply ratio, Hgb, TP, GLB, ALB, TG and HDL-C were positively correlated with 24h urinary protein quantification, and the other indicators were negatively correlated with 24h urinary protein quantification (P<0.05). Conclusion The patients with type 2 diabetic nephropathy generally have unreasonable dietary structure and poor nutritional metabolism, both of which are associated with the degree of renal injury. It is recommended to strengthen the diet management, optimize the energy supply ratio, monitor the biochemical indicators and adjust the treatment regimen.

Objective:To construct and validate a prognostic prediction model for patients with ovarian metastases from colorectal cancer after radical resection.Methods:A retrospective case series analysis was conducted on the clinical and pathological data of 81 patients with colorectal cancer and ovarian metastases who underwent radical resection for ovarian metastases at the Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, between January 2014 and December 2023. The patients were all female, with an age ( M(IQR)) of 49(13) years (range: 22 to 79 years). The primary tumor was located in the colon in 60 cases (74.1%) and in the rectum in 21 cases (25.9%). Univariate and multivariate Cox regression analyses were used to identify independent risk factors affecting prognosis. A risk scoring system was constructed, and patients were assigned to high-risk and low-risk groups based on their risk scores. The predictive performance of the scoring system was assessed, and 5-fold cross-validation was performed to evaluate the model′s stability on the internal dataset. Results:Among the 81 patients with ovarian metastases, a high proportion had T4 stage (58 cases, 71.6%), lymph node positivity (68 cases, 84.0%), and colon cancer (60 cases, 74.1%). Preoperative imaging suggested unilateral ovarian metastasis in 15 patients (23.4%), but pathological examination after bilateral oophorectomy confirmed bilateral ovarian metastases. Among the 17 patients who initially underwent unilateral oophorectomy, 11 developed contralateral ovarian metastases at varying times postoperatively. Univariate Cox proportional hazards regression analysis revealed that positive lymph node ratio ( HR=2.68,95% CI:1.41 to 5.09, P=0.003), N stage ( HR=2.07,95% CI:1.08 to 3.95, P=0.028),maximum diameter of metastatic tumors ( HR=2.27,95% CI:1.04 to 4.96, P=0.040),and peritoneal metastasis or ascites at the time of ovarian metastasis ( HR=2.04,95% CI:1.02 to 4.08, P=0.043) were significantly associated with overall survival in patients with ovarian metastasis from colorectal cancer. Multivariate regression analysis identified that positive lymph node ratio ( HR=3.34,95% CI:1.08 to 10.34, P=0.037) and maximum diameter of metastatic tumors ( HR=2.65,95% CI:1.19 to 5.88, P=0.017) were independent prognostic factors for overall survival following radical oophorectomy in patients with ovarian metastasis from colorectal cancer. Based on the regression coefficients from the multivariate analysis for variables (ovarian metastatic tumor diameter ≥6 cm, positive lymph node ratio ≥0.3,and presence of peritoneal metastasis or ascites), a risk scoring system was developed. Using the optimal cutoff value (154 points) for the risk score,patients were divided into high-risk (19 cases) and low-risk (62 cases) groups. Kaplan-Meier survival curves demonstrated that the high-risk group had significantly lower median overall survival (27 months) and median disease-free survival (22 months) compared to the low-risk group (median overall survival 90 months,median disease-free survival not reached; both P<0.01). Receiver operating characteristic curve analysis showed that the area under the curve(AUC) for predicting 1-,3-,and 5-year overall survival was 0.731(95% CI:0.563 to 0.899), 0.703(95% CI:0.573 to 0.833), and 0.776(95% CI: 0.657 to 0.894), respectively. The AUC for predicting 1-,3-, and 5-year disease-free survival was 0.724(95% CI:0.397 to 0.993),0.710(95% CI:0.514 to 0.906),and 0.688(95% CI:0.478 to 0.898),respectively,indicating good performance of the model.The decision curve analysis showed that the model has good clinical net benefit and the results of the 5-fold cross-validation showed that the model demonstrated stability in the internal dataset. Conclusions:When performing radical resection for ovarian metastasis from colorectal cancer,bilateral oophorectomy should be considered to minimize the risk of postoperative recurrence. Patients with ovarian metastasis from colorectal cancer,characterized by a metastatic tumor diameter ≥6 cm,a positive lymph node ratio ≥0.3,and the presence of peritoneal metastasis or ascites, tend to have a poorer prognosis. Based on these findings,a clinical prognostic scoring system for radical resection of ovarian metastasis from colorectal cancer has been developed to stratify patients into different risk groups and may assist in postoperative risk assessment and management.

Objectives:To investigate the clinical value of cardiac magnetic resonance imaging(CMR)feature-tracking strain analysis in risk stratification of diabetic heart failure with preserved ejection fraction(HFpEF).Methods:In this retrospective study,a total of 215 patients with diabetic HFpEF who underwent CMR at Chinese Academy of Medical Sciences Fuwai Hospital from January 2012 to December 2018 were included.Myocardial strain parameters were calculated using CMR feature-tracking technology.Patients were followed up by medical records or telephone calls.Composite endpoint event,all-cause death or heart failure hospitalization during follow-up were recorded.Patients were divided into event group and event-free group.Univariable and multivariable Cox proportional hazard regression analyses were performed to determine the risk factors for the outcomes in diabetic HFpEF.The effects of hypertension and obesity on the prognosis of diabetic HFpEF patients and whether they affect the prognostic value of CMR feature-tracking strain analysis were also analyzed.Results:During a follow-up of(7.1±1.8)years,93(43.3%)patients had endpoint events(event group),including 28 all-cause deaths and 65 heart failure hospitalization.Compared with the event-free group(n=122),patients in the event group had significantly lower left ventricular ejection fraction,higher prevalence and extent of late gadolinium enhancement,and significantly reduced global longitudinal strain(GLS),global circumferential strain,global radial strain,and global systolic longitudinal strain rate(all P<0.05).The absolute GLS value was significantly lower in event group than in event-free group,regardless of the presence of hypertension and obesity.Multivariate Cox regression analysis showed that estimated glomerular filtration rate(HR=0.983,95%CI:0.972-0.993,P=0.001),left atrial volume index(HR=1.015,95%CI:1.005-1.026,P=0.004),and GLS(HR=1.142,95%CI:1.060-1.231,P<0.001)were independent risk factors for adverse cardiovascular events in diabetic HFpEF patients.However,adjusted N-terminal pro-brain natriuretic peptide was not an independent prognostic factor.The cut-offvalue of GLS to predict outcome was-14.09%from ROC curve analysis.The Kaplan-Meier curve showed that in patients with and without hypertension and obesity,patients with the GLS>-14.09%had lower event-free survival compared to patients with GLS≤-14.09%(all P<0.05),and the ability of GLS to predict adverse outcomes was not affected by hypertension and obesity.Conclusions:GLS obtained by CMR feature-tracking strain analysis is an independent predictor of adverse outcomes in diabetic HFpEF,and its ability to predict adverse outcomes is independent of hypertension and obesity.

Objective To evaluate the test-retest reliability of the ballistic push-up(BPU)test and establish predictive models for upper-limb strength and explosive power in young males.Methods A total of 71 male college students performed assessments of upper-limb bench press 1 repetition maximum(1RM)strength,bench press explosive power,and two BPU tests with a 48-hour interval.BPU test data were recorded using a three-dimensional(3D)force platform and motion capture system to calculate concentric metrics such as peak force(PF)and mean velocity(MV).The intraclass correlation coefficient(ICC)was used to examine the retest reliability of the BPU test.The Pearson correlation coefficient was used to evaluate the correlation of the BPU metrics with upper-limb strength and explosive power.Predictive models for upper-limb strength and explosive power were created using stepwise regression analysis.Results BPU metrics showed a good test-retest reliability(ICC=0.764-0.935).PF and MV,along with body weight(BW),were effective predictors of bench press 1RM in young males:bench press 1RM=0.129PF-16.772[R2=0.790,standard error of the estimate(SEE)=8.17 kg];bench press 1RM=1.511BW+87.15 MV-110.136(R2=0.767,SEE=8.60 kg).PF and BW were also predictors of bench press explosive power:bench press explosive power=2.755BW+0.287PF-17.351(R2=0.620,SEE=46.1 W).Conclusions The BPU test demonstrates a good test-retest reliability,and PF and MV from the BPU test can be used to predict upper-limb strength and explosive power in young males.

Objective:To assess the humanistic caring ability of clinical interns, analyze its influencing factors, explore the correlation between humanistic caring ability and narrative ability, and provide a basis for formulating narrative medical education scheme for clinical interns.Methods:A total of 163 clinical interns from the Class of 2020 completing internships at a Grade A tertiary hospital in Zhuhai were enrolled as research subjects using convenience sampling. A questionnaire survey was conducted using a baseline demographic survey, a humanistic caring ability inventory, and a medical narrative ability scale. Pearson correlation analysis and multiple linear regression analysis were conducted to explore the influencing factors for humanistic caring ability and its correlation with narrative ability.Results:The overall score of humanistic caring ability was (187.52±20.30). There were significant differences between groups in self-evaluation of humanistic caring ability, degree of satisfaction with the major, and relationship with classmates ( P<0.05). There was a positive correlation between narrative ability and caring ability in both total score and individual dimensions ( r=0.600, P<0.01). After adjusting for demographic differences, relationship with classmates ( β=0.138, P=0.042), attentive listening ( β=0.354, P<0.01), and reflective representation ( β=0.259, P=0.008) exhibited a significant positive impact on humanistic caring ability. However, this impact was not observed for the understanding-response dimension. Conclusions:The humanistic caring ability of clinical interns is low and their medical narrative ability is positively correlated with their humanistic caring ability. Therefore, narrative medical education should focus on training medical students' attentive listening and reflective representation to enhance humanistic literacy and promote their career development.

Objective To optimize the extraction process of chlorogenic acid and three other organic acids from Picris hieracioides L.with deep eutectic solvents using response surface methodology.Methods By comparing the extraction rate of organic acids in seven deep eutectic solvents,the best solvent combinations were identified,and the optimal extraction process of organic acids from Picris hieracioides L.was obtained by optimizing the liquid/feed ratio,extraction temperature,extraction time and other parameters using the response surface method on the basis of a one-way experiment.Results The deep eutectic solvent with 30%water content(choline chloride∶urea=1∶2)was effective in extracting organic acids from Picris hieracioides L.The optimal extraction process optimized by response surface method was:extraction temperature 30℃,extraction time 30 min,liquid-solid ratio 20∶1(mL·g-1),the extraction rate of organic acids under this condition was 1.092 9%.Conclusion The deep eutectic solvent optimized through response surface methodology is an efficient,green and eco-friendly extraction method.This study provides a theoretical foundation for the subsequent development and utilization of Picris hieracioides L..

The “Technical Guideline for Epidemic Prevention and Control Disinfection in Large-Scale Events”(hereinafter referred to as “the Guideline”), organized and compiled by the National Disease Control and Prevention Administration, was officially released in April 2024. This guideline aims to ensure the effective implementation of large-scale group activities, mitigate the impact of infectious disease outbreaks on such events, and maintain hygiene and safety standards at event venues. During the compilation process, data were systematically collected in alignment with epidemic prevention requirements and disinfection principles, incorporating research findings from domestic and international disinfection practices. Information was gathered through field investigations, expert consultations in epidemiology and disinfection, and roundtable discussions with representatives from organizations responsible for disinfection operations at large-scale events, thereby ensuring the scientific rigor and practical applicability of the content. The Guideline provides comprehensive technical disinfection guidance for relevant authorities and event organizers, addressing critical aspects such as disinfection protocols, operational principles, emergency response strategies, and technical specifications. By standardizing hygiene assurance measures for large-scale events, including considerations of participant demographics, venue characteristics, and event scale, the guideline establishes a framework to proactively minimize the risk of infectious disease transmission.

Objective:To analyze the clinicopathological factors affecting the prognosis of patients after curative resection of lung metastases (LMs) from colorectal cancer (CRC) and to construct a clinical risk scoring (CRS) model.Methods:This study retrospectively collected clinicopathological data and follow-up information on 132 patients who underwent radical resection of LMs from CRC at the Cancer Hospital of the Chinese Academy of Medical Sciences between January 2010 and December 2020. We analyzed the clinicopathological factors influencing patient prognosis using univariate and multivariate Cox proportional hazards regression models, and we developed a risk stratification model for prognostic prediction.Results:The median follow-up duration for the cohort of 132 patients was 54.2 months. During this period, 61 patients (46.2%) experienced recurrence or distant metastasis, resulting in a 5-year DFS rate of 54.1%. Additionally, 33 patients (25.0%) died, corresponding to a 5-year overall survival (OS) rate of 76.7%. Univariate Cox proportional hazards regression model analysis indicated that ten clinicopathological factors were significantly associated with OS (all P＜0.05). These factors include the total number of lymph nodes (LNs) dissected from the primary tumor (PT) <16, the number of negative LNs from the PT <13, pN(+) of the PT, logarithmic odds of positive lymph nodes (LODDS) of the PT ≥-1.1, lymph nodes ratio (LNR) of the PT ≥0.02, preoperative carcinoembryonic antigen (CEA) level before LMs resection ≥10 ng/ml, the presence of hilar/mediastinal LN metastasis, the number of LMs ≥2, the maximum diameter of LMs ≥2.5 cm, and the necessity for hilar/mediastinal lymphadenectomy. Multivariate Cox proportional hazards regression analysis identified the number of negative LNs <13 ( HR=3.01, 95% CI: 1.28-7.03, P=0.011), pN(+) of the PT ( HR=5.04, 95% CI: 1.51-16.84, P=0.009), preoperative CEA level before LMs resection ≥10 ng/ml ( HR=5.39, 95% CI: 1.80-16.19, P=0.003), the number of LMs ≥2 ( HR=2.47, 95% CI: 1.09-5.60, P=0.030), and the necessity for hilar/mediastinal lymphadenectomy ( HR=2.74, 95% CI: 1.15-6.52, P=0.023) as independent prognostic risk factors. Patients were categorized based on independent risk factors, revealing statistically significant differences in OS across the groups with CRS scores of ≤2, 3～4, and ≥5 ( P＜0.001). Conclusions:Independent risk factors associated with LMs from CRC patients include the number of negative LNs <13, pN(+) of the PT, preoperative CEA level before LMs resection ≥10 ng/ml, the number of LMs ≥2, and the necessity for hilar/mediastinal lymphadenectomy. Patients scoring 3 or higher on the CRS model may warrant cautious assessment for the appropriateness of direct surgical treatment.

Objective:To establish a fluorescent quantitative RT-PCR assay based on N_sgRNA of SARS-CoV-2 and preliminarily apply it on real samples.Methods:Recombinant plasmid, specific primers and probes of N_sgRNA were designed and synthesized based on Wuhan-Hu-1/2019_MN908947 and synthesis mechanism of subgenomic RNA (sgRNA). Using recombinant plasmid as amplification templates, the optimal reaction conditions and reaction system were screened according to the Ct value, fluorescence intensity, and shape of amplification curve and was evaluated for sensitivity, reproducibility, and specificity. Meanwhile, the possibility of practical application of the method was explored by testing 172 clinical samples and 256 municipal wastewater samples. Results:A qRT-PCR assay for N_sgRNA in SARS-CoV-2 was initially established. The detection limit of the assay was 20 copies/mL, and the variation coefficients of in-batch (0.002%~0.767%) and batch to batch repetition (0.016%~0.752%) were less than 1%. Only N_sgRNA recombinant plasmid was detected in the specificity assay. So the method is more highly sensitive, specific and reproducible. The RatiosgRNA/ gRNA of clinical samples HK.3, EG.5.1, JN.1 and their sub-lineages and their corresponding urban sewage samples in epidemic period were significantly different ( P<0.05). There is a strong correlation between the median of RatiosgRNA/ gRNA in clinical samples and sewage samples in the same period (correlation coefficient r=1.000, P=0.010). Conclusions:In this study, a qRT-PCR method for detecting N_sgRNA of SARS-CoV-2 was established and the method has the characteristics of higher sensitivity, stronger specificity and better repeatability, and it can be used to detect SARS-CoV-2 infectivity.

Objective:To investigate the prevalence of and risk factors associated with Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT) and high-risk human papillomavirus (HPV) coinfections among patients with newly diagnosed syphilis at a hospital in Nanjing. Methods:A cross-sectional study was conducted on patients with newly diagnosed syphilis at the STD Clinic, Hospital of Dermatology, Chinese Academy of Medical Sciences in Nanjing, China from May 2023 to April 2024. Urethral, cervical or rectal swabs were collected according to the gender and types of sexual behavior of the patients. Screening tests for CT, NG and HPV infections were then performed by nucleic acid amplification testing. High-risk HPV testing was performed only in female patients. Univariate analysis was carried out to investigate risk factors associated with CT infection. The chi-square test, chi-square test with continuity correction, or Fisher's exact test was chosen based on the sample size and expected values.Results:A total of 111 newly diagnosed syphilis patients with test specimens were collected, including 71 males (64%) and 40 females (36%), and their ages ranged from 16 to 87 years; there were 82 patients with early syphilis and 29 with late latent syphilis; the number of sexual partners in the past 3 months ranged from 0 to 3. Among the 60 male patients with early syphilis, 1 (1.7%) was co-infected with NG, and 12 (20%) with CT; among the 16 men who have sex with men, 7 (43.8%) were co-infected with CT, while 5 (11.4%) of the 44 heterosexual patients were co-infected with CT, showing a significant difference in CT infection rates between the two groups ( χ2 = 5.80, P = 0.016). Among the 22 female patients with early syphilis, 1 (4.5%) was co-infected with NG, and 8 (36.4%) with CT; among the 12 female patients aged < 25 years, 8 (66.7%) were infected with CT, while none of the 7 patients aged 25-44 years or the 3 patients aged ≥ 45 years were infected with CT, showing a significant difference in CT infection rates among the 3 age groups ( P = 0.005) ; among the 16 female patients with 1 sexual partner in the past 3 months, 3 were infected with CT, while 5 were infected with CT in the 6 female patients with 2-3 sexual partners in the past 3 months, with a significant difference in CT infection rates between the two groups ( P = 0.011). Out of the 40 female patients with syphilis, 16 (40%) were co-infected with high-risk HPV; the HPV infection rates did not differ among different age groups (age groups of < 25 years, 25-44 years, ≥ 45 years: 8/14, 2/9, 6/17, respectively; P = 0.265) . Conclusion:The CT infection rate was relatively high in patients with newly diagnosed early syphilis, and a relatively high infection rate of high-risk HPV was observed in female patients with syphilis aged < 25 years.