Objective:To discuss the effect of long non-coding RNA(lncRNA)DUXAP8 in exosomes(Exo)derived from the lung cancer A549 cells on the growth and immune escape of the lung cancer cells,and to clarify the mechanism.Methods:The human lung cancer cell line A549 was cultured,and its exosomes were extracted and identified.The A549 cells were treated with PKH67-labeled Exo to observe the uptake of Exo by A549 cells.Real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the expression level of lncRNA DUXAP8 in A549 cells before and after Exo treatment.The A549 cells were divided into control group(no treatment),Exo group(A549 cells treated with Exo),Exo+sh-NC group(A549 cells treated with Exo and then transfected with sh-NC),and Exo+sh-DUXAP8 group(A549 cells treated with Exo and then transfected with sh-DUXAP8).RT-qPCR method was used to detect the expression level of lncRNA DUXAP8 in A549 cells in various groups;colony formation assay was used to detect the colony formation abilities of the A549 cells in various groups;5-ethynyl-2'-deoxyuridine(EdU)staining method was used to detect the proliferation abilities of the A549 cells in various groups.After co-culturing A549 cells in various groups with human peripheral blood lymphocytes,flow cytometry was used to detect the percentages of activated CD8+T lymphocytes in the human peripheral blood lymphocytes in various groups;3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT)method was used to detect the killing rates of human peripheral blood lymphocytes on the A549 cells in various groups.Results:The diameter of Exo vesicles was 50-150 nm,and the exosome-specific marker proteins cluster of differentiation 63(CD63),cluster of differentiation 9(CD9),tumor susceptibility gene 101(TSG101),and heat shock protein 70(HSP70)were positively expressed,indicating successful exosome extraction.A549 cells efficiently took up PKH67-labeled Exo.The RT-PCR results showed that compared with A549 cells cultured alone,the expression level of lncRNA DUXAP8 in the A549 cells was increased after treatment with Exo derived from A549 cells(P<0.05).compared with control group,the expression level of lncRNA DUXAP8 in the A549 cells in Exo group was increased(P<0.05);compared with Exo group,the expression level of lncRNA DUXAP8 in the A549 cells in Exo+sh-DUXAP8 group was decreased(P<0.05),while there were no significant difference in the expression level of IncRNA DUXAP8 in the cells in Exo+sh-NC group(P>0.05).The colony formation assay results showed that compared with control group,the number of colony formation of the A549 cells in Exo group was increased(P<0.05);compared with Exo group,the number of colony formation of the A549 cells in Exo+sh-DUXAP8 group was decreased(P<0.05),while there was no significant difference in the number of colony formation of the A549 cells in Exo+sh-NC group(P>0.05).The EdU staining results showed that compared with control group,the EdU-positive rate of the A549 cells in Exo group was increased(P<0.05);compared with Exo group,the EdU-positive rate in A549 cells in Exo+sh-DUXAP8 group was decreased(P<0.05),while there was no significant difference in the EDU-positive rate in the cells in Exo+sh-NC group(P>0.05).The flow cytometry results showed that compared with control group,the percentage of activated CD8+T lymphocytes in the human peripheral blood lymphocytes in Exo group was decreased(P<0.05);compared with Exo group,the percentage of activated CD8+T lymphocytes in the human peripheral blood lymphocytes in Exo+sh-DUXAP8 group was increased(P<0.05),while there was no significant difference in the percentage of activated CD8+T lymphaytes in Exo+sh-NC group(P>0.05).The MTT assay results showed that compared with control group,the killing rate of human peripheral blood lymphocytes on the A549 cells in Exo group was decreased(P<0.05);compared with Exo group,the killing rate of human peripheral blood lymphocytes on A549 cells in Exo+sh-DUXAP8 group was increased(P<0.05),while no significant difference was observed in Exo+sh-NC group(P>0.05).Conclusion:The lncRNA DUXAP8 in exosomes derived from the lung cancer A549 cells promotes the proliferation of lung cancer cells and tumor immune escape.

The intestinal flora is a vast and complex microbial system，and its dysregulation may be associated with the occurrence and progression of various diseases.Nephrotic syndrome is a kidney disease characterized by massive proteinuria，hypoalbuminemia，edema，and hyperlipidemia.Some studies have found alterations in the intestinal flora of patients with nephrotic syndrome.Short-chain fatty acids produced by intestinal flora metabolism，particularly butyrate，may influence the occurrence and progression of nephrotic syndrome by regulating immune responses and inflammatory processes through their effects on the differentiation and function of regulatory T cells.These findings provide insights for exploring the pathophysiology of nephrotic syndrome and developing novel therapeutic strategies.

Childhood primary renal tubular diseases are chronic kidney diseases characterized by impaired renal tubular reabsorption. Primary renal tubular disease has diverse clinical manifestations and lacks of specificity. Laboratory tests are limited，making it prone to missed diagnosis and misdiagnosis. Based on the current knowledge of renal tubular diseases，authors propose early warning signals of renal tubular diseases such as family history of primary tubular diseases，unexplained polyhydramnios during pregnancy，polydipsia，polyuria，delayed growth and development or rickets，decreased muscle strength and tone，unexplained electrolyte disturbance，hyperuricemia，acid-base disturbance，positive urine sugar test，renal tubular proteinuria，urinary imaging examination suggesting kidney stones，calcium deposition，renal cysts and early onset of eye，ear，joint and neuron injury.Meanwhile，some universal management strategies for primary renal tubular disease are proposed，emphasizing the importance of multidisciplinary collaboration，genetic testing and individualized intervention to improve the long-term prognosis of childhood primary renal tubular diseases.

Hydroxychloroquine is a classical antimalarial agent that has been widely used in the treatment of autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis due to its notable anti-inflammatory and immunomodulatory effects. In recent years，increasing attention has been paid to the therapeutic potential of hydroxychloroquine in immune-related kidney diseases，including lupus nephritis，IgA nephropathy，and renal ischemia-reperfusion injury. Although clinical studies have shown encouraging results，the underlying mechanisms of hydroxychloroquine remain incompletely understood. Emerging evidence suggests that hydroxychloroquine may exert renal protective effects through multiple immunoregulatory pathways. These include inhibition of lysosomal acidification and autophagy，modulation of innate immune signaling via Toll-like receptors，suppression of NLRP3 inflammasome activation，and reduction of NADPH oxidase activity and oxidative stress. Moreover，hydroxychloroquine can downregulate the production of pro-inflammatory cytokines such as IL-6，tumor necrosis factor-alpha（TNF-α），and interferon-α（IFN-α），contributing to a reduction in renal inflammation. Additional mechanisms involve the modulation of the Th17/Treg cell balance and the inhibition of neutrophil extracellular trap formation，which further supports its role in modulating immune responses，attenuating renal inflammation，and preserving kidney function. This article provides a concise review of the mechanisms of hydroxychloroquine in immune-related renal diseases.

Crystalline nephropathy is a kidney disorder characterized by crystal deposition in the renal tubules and interstitium，leading to renal dysfunction. Clinical manifestations include polydipsia，polyuria，renal function abnormalities，with or without crystalluria. The pathogenesis involves direct and indirect cytotoxicity caused by crystal deposition，inflammatory kidney injury，tubular obstruction，oxidative stress and inflammatory responses，which further promote renal fibrosis. It represents a significant cause of both acute and chronic renal failure. In adults，it is primarily induced by medications and secondary factors，while it is relatively rare and mainly caused by genetic and metabolic disorders in children. Diagnosis relies on clinical presentation，urinalysis，and medical imaging，while confirmatory diagnosis requires renal biopsy. Currently，due to the limitid awareness of pediatric crystalline nephropathy，it is essential to enhance pediatrician' understanding of this disease for early and precise diagnosis and treatment，thereby improving prognosis and reducing the risk of end-stage renal disease.

In recent years, research on the quality and safety detection of bear bile powder has mainly involved three aspects. First, the identification of active components and substitutes. Quantitative analysis of bile acids and other components is performed using HPLC, HPLC-tandem mass spectrometry, and other techniques, combined with near-infrared spectroscopy, X-ray diffraction, and polymerase chain reaction to identify adulteration. Isotope fingerprint analysis and glycosylation modification detection are used to distinguish natural products from biosynthetic substitutes, revealing significant differences in δ13C values and the proportion of specific glycosylation modifications between natural bear bile powder and synthetic products. Second, the detection of veterinary drug residues, mainly based on ultra-high performance liquid chromatography-tandem mass spectrometry, which can screen over 100 types of residues, but targeted purification strategies are needed to address interference from the bile acid matrix. Thirdly, heavy metal detection, mainly using inductively coupled plasma mass spectrometry and atomic absorption spectrometry, has revealed that contamination is associated with the breeding environment, with significant regional differences. Related detection technologies are gradually evolving from single-target analysis to multi-modal and intelligent approaches. Existing research faces issues, such as matrix effect interference, lack of international standards, and ethical controversies. It is suggested that future efforts should focus on the interdisciplinary application of detection technologies, develop rapid detection methods such as non-invasive monitoring and microfluidic chips, promote the standardization and equivalence evaluation of synthetic alternatives, and establish a full-chain quality control system integrating spatially resolved mass spectrometry imaging, artificial intelligence, and big data.

Objective To explore and analyze the characteristics and transmission routes of carbapenem-resistant Klebsiella pneumoniae(CRKP)strains in intensive care unit(ICU).Methods From January to October 2023,17 clinical infection isolates(clinical infection group),5 active screening isolates(active screening group),and 7 envi-ronmental isolates(environmental group)of CRKP in the liver surgery ICU of a hospital were selected and analyzed by whole-genome sequencing.The differences in resistance genes,virulence genes,and sequence typing(ST)were compared,and transmission routes were analyzed based on the phylogenetic tree.Results 29 strains of CRKP car-ried 4-18 resistance genes and 52-98 virulence genes,respectively.There were no statistically significant diffe-rences in genotype distribution of resistance genes,the number of virulence genes,and gene types among three groups of CRKP(all P＞0.05).ST showed that 29 CRKP strains mainly consisted of two categories:ST11 and ST15.Based on the phylogenetic tree constructed from the core genome,there were 7 highly homologous groups of CRKP,among which 4 groups had clear epidemiological associations.Conclusion CRKP in ICU carries more re-sistance and virulence genes,and some strains are highly homologous in ST and phylogenetic tree,which may lead to cross transmission.In the future,prevention and control measures should be strengthened to reduce the trans-mission of CRKP.

Objective:To investigate the effects of apical periodontitis of mandibular primary molars on the development of mandibu-lar permanent premolars in children in Guangzhou.Methods:335 children aged 4-9 years with apical periodontitis of mandibular pri-molar at one side and normal healthy homologous tooth at another side were included and divided into 2 groups:Group A(n=200)in-cluded the first mandibular premolars and group B(n=135)included the second mandibular premolars.Subgroup A1 and B1 were the apical periodontitis groups,subgroup A2 and B2 were the normal healthy groups.The degree of root destruction of primary teeth,the degree of destruction and development of the dental follicle of permanent teeth,the mesial and distal direction changes,and the eruption height were observed and measured on the panoramic raidiographs,data were statistically analyzed.Results:In the 7-year-old children of A1 and the 6-year-old of B1 groups,the development degree of successor permanent teeth was lower than that of group A2 and group B2 of the same age children respectively(P＜0.05).In the 6-7-year-old children of group A1,the permanent teeth development of boys was slower than that of the girls(P＜0.05).There was no gender difference in dental follicle destruction and malposition of the perma-nent teeth in both A1 and B1 groups(P＞0.05).The proportion of malposition of the successor permanent teeth in group A1 increased with the primary teeth damage degree increace(P＜0.05),while the proportion of malposition of the successor permanent teeth in group B1 showed no significant difference(P＞0.05).Positive correlation between the damage degree of primary teeth and dental follicle of per-manent teeth was observed(rA1=0.41,rB1=0.21,P＜0.05).In boys aged 7-8 years,the succesor permanent teeth eruption in group A1 was higher than that in group A2(P＜0.05),and there was no significant difference between group B1 and group B2(P＞0.05).Conclusion:In the later stages of root stabilization of primary molars,periapical inflammation of primary teeth may cause developmen-tal delay of the succesor permanent teeth,and the delay degree is higher in boys than in girls.With the deterioration of the periapical tissue of primary teeth,the destruction of the dental follicle of permanent teeth may deepen,and the mandibular first premolar is more likely to have abnormal eruption.

Cross-border teaching provides new opportunities for college students to gain diverse insights amid the globalization and internationalized education, In July 2024, guided by the Chinese Association for Science and Technology, the Chinese Nutrition Society and the Hong Kong Nutrition Association collaborated to host a three-week clinical nutrition internship at Peking Union Medical College Hospital for five college students from Hong Kong SAR, China. This program included participating in outpatient rounds, attending in inpatient nutrition management, and attending lectures, aiming to enhance students' professional skills and clinical experience. Cultural exchange and value-based education also enriched students' social responsibility and cultural understanding. The Hong Kong students also brought diverse cultural backgrounds and inputs, enabling multidimensional communication during the training. Post-internship feedback survey showed that the students found the inernship valuable for their career development and hoped for more learning opportunities. This cross-border high-quality internship program fostered skill enhancement, cultural exchange between young students in Beijing and Hong Kong and contributed to advancement of clinical nutrition.

Anhedonia is one of the core features of major depressive disorder (MDD) and is associated with poor functional outcomes in MDD patients. Psychosocial functional recovery is an important goal for achieving MDD remission. Although longitudinal studies have found association between anhedonia and impaired psychosocial function, there is still a lack of neurobiological biomarkers that can indicate this relationship. In this review, brain structural and functional changes associated with anhedonia and impaired psychosocial function in MDD patients are reviewed from the perspective of magnetic resonance imaging. It finds that anhedonia and psychosocial dysfunction in MDD may share common neuroimaging changes, manifested in abnormal brain regions such as the nucleus accumbens, caudate nucleus, putamen nucleus, orbitofrontal cortex, insula, amygdala, anterior cingulate cortex, dorsolateral prefrontal cortex, superior parietal lobe, inferior frontal gyrus and temporal lobe. These findings help to better understand the pathophysiology of the disease and offer potential insights for developing new treatment strategies.