Renal Fanconi syndrome (FS) is a rare renal manifestation of primary Sjögren's syndrome (pSS). This study aims to analyze the clinical and prognostic characteristics of patients with pSS-associated renal FS (pSS-FS) and provide insights for clinical management.

ObjectiveTo explore the epidemiological characteristics of poisoning cases in Qingpu District, Shanghai, and to provide a scientific basis for the prevention and control of poisoning within the district. MethodsA retrospective study was conducted to collect the information of 3 415 poisoning cases admitted to sentinel hospitals from 2018 to 2024. Descriptive statistical analyses were performed regarding the causes of poisoning, types of toxicants, gender and age distribution, and temporal distribution. Chi-square tests were used to analyze differences among groups. ResultsMales accounted for 64.30% of the poisoning cases, and the 20‒39 years old group (51.27%) constituted the largest proportion. The top three causes of poisoning were alcohol abuse (61.00%), suicide (15.20%), and accidental ingestion (9.93%). The distribution of poisoning causes varied significantly by gender and age groups (P<0.001). Among cases aged 10 years old and below, the main causes of poisoning were accidents/disasters and accidental ingestion; among cases aged 20 to 69 years old, alcohol abuse was the primary cause; among cases aged 11 to 19 years old and 70 years old and above, suicide was the primary cause of poisoning. The categories of toxic subtances included alcohol (61.41%), drugs (21.93%), pesticides or rodenticides (6.21%), toxic gases or liquids (5.68%), and venomous animals (3.95%). The composition of toxic subtance categories differed by gender (χ²=714.8, P<0.001): males were primarily poisoned by alcohol (78.32%), while females were primarily poisoned by drugs (45.53%). Poisoning occurred most frequently in January, July, and August. Alcohol poisoning peaked in January; pesticide or rodenticide poisoning peaked in June‒July; toxic gas or liquid poisoning (CO accounted for 69.59%) peaked in December and January; venomous animal poisoning (bee stings accounted for 97.78%) peaked from June to August. There were 8 deaths for the poisoning cases, with a case fatality rate of 0.23%. ConclusionThe situation of poisoning in this district was relatively severe. Prevention and control measures targeting the characteristics of poisoning in different populations and the distinct peak periods should be implemented to reduce the incidence of poisoning in the district.

Objective To summarize the current status and trends of clinical research on gallbladder cancer (GBC) from 2016 to 2026. Methods Literature of GBC clinical research published from 2016 to 2026 was collected from the Web of Science Core Collection. VOSviewer 1.6.21 software was applied to perform cluster and chronological analyses on countries, academic institutions, authors, and keywords of the included publications, alongside cluster analysis on co-citation references. The visualization maps were generated to analyze collaborative networks among countries, academic institutions, and researchers, and to predict the future research hot spots and directions. Results A total of 411 publications in English were included. From 2016 to 2026, the amount of literature on GBC clinical research has shown a fluctuating upward trend, with publications concentrated mainly in professional journals in the field of oncology. China ranks first globally in the publication output, but its average citation is lower than that of United Kingdom and Germany. Institutions of publications exhibit distinct regional clustering characteristics, with close collaboration within regions but a need for strengthened cross-regional collaboration. Keyword analysis reveals that research hot spots are shifting from traditional surgical treatment toward systemic therapy, immunotherapy, and precision medicine, which may represent future development directions. Conclusions Clinical research on GBC has flourished from 2016 to 2026, with global publication output showing a fluctuating upward trend. China leads in publication amount, but the quality of articles and citation counts still need improvement. To foster continued development and transformation in GBC, it is necessary to strengthen cross-regional international collaboration, promote the integration of precision medicine and systemic therapy, and emphasize patient-centered research strategies.

Ferroptosis of chondrocytes is a significant contributor to osteoarthritis(OA),for which there is still a lack of safe and effective therapeutic drugs targeting ferroptosis.Here,we screen for anti-ferroptotic drugs in Food and Drug Administration(FDA)-approved drug library via a high-throughput manner in chondrocytes.We identified a group of FDA-approved anti-ferroptotic drugs,among which vitamin K showed the most powerful protective effect.Further study demonstrated that vitamin K effectively inhibited ferroptosis and alleviated the extracellular matrix(ECM)degradation in chondrocytes.Intra-articular injection of vitamin K inhibited ferroptosis and alleviated OA phenotype in destabilization of the medial meniscus(DMM)mouse model.Mechanistically,transcriptome sequencing and knockdown experiments revealed that the anti-ferroptotic effects of vitamin K depended on growth arrest-specific 6(Gas6).Furthermore,exogenous expression of Gas6 was found to inhibit ferroptosis through the AXL receptor tyrosine kinase(AXL)/phosphatidylinositol 3-kinase(PI3K)/AKT serine/threonine kinase(AKT)axis.Together,we demonstrate that vitamin K inhibits ferroptosis and alleviates OA progression via enhancing Gas6 expression and its downstream pathway of AXL/PI3K/AKT axis,indicating vitamin K as well as Gas6 to serve as a potential therapeutic target for OA and other ferroptosis-related diseases.

Objective To explore and identify the nutritional/inflammatory indicator with the highest predictive potential for overall survival(OS)in postoperative tumor patients so as to provide guidance for postoperative rehabilitation of tumor patients.Methods Data from 3 191 surgical patients were collected,including 15 nutritional/inflammatory indicators.The maximum selection rank statistic method was used to calculate the optimal cut-off values for continuous indicators.The Kaplan-Meier method was used to assess OS,and Cox proportional hazards models were used to analyze the association between the aforementioned 15 indicators and survival.The predictive value of these 15 indicators was evaluated with receiver operating characteristic(ROC)curves and C-index.Results Multivariate analysis showed that all 15 indicators were significantly associated with poorer OS in surgical patients(P＜0.05 for all).Time-dependent area under the curve(AUC)and C-index analysis indicated that 3 indicators with the highest predictive potential in OS in postoperative tumor patients were the nutritional risk index(NRI)(C-index:0.597),C-reactive protein-to-albumin ratio(CAR)(C-index:0.587),and C-reactive protein-to-lymphocyte ratio(CLR)(C-index:0.587).The optimal cut-off value for NRI was determined to be 104.31(i.e.,NRI＜104.31 suggests malnutrition)with the maximum selection rank statistic method,the optimal cut-off value for CAR to be 0.05(i.e.,CAR≥0.05 suggests a strong inflammatory response,often accompanied by malnutrition),and the optimal cut-off value for CLR to be 1.18(i.e.,CLR≥1.18 suggests a strong inflammatory response).Subgroup analysis indicated that NRI,CAR,and CLR had good correlation with tumor staging,and there were significant differences between tumor node metastasis(TNM)Ⅲ/Ⅳ stage patients and TNM Ⅰ/Ⅱ stage patients when there was a strong inflammatory response or malnutrition.Conclusion In postoperative tumor patients,NRI,CLR,and CAR have high prognostic value.Combining these with the patient's clinical stage,it enables more precise guidance for clinical diagnosis and treatment strategies.

Objective:To analyze the current research hotspots and trends of traditional Chinese medicine (TCM) treatment for neurogenic bladder (NB).Methods:The Chinese and English articles on TCM treatment of neurogenic bladder were searched in CNKI, Wanfang Database, PubMed, and Web of Science from the inception to May 31, 2024, using the terms "neurogenic bladder" "intervention" "treatment" "clinical" "Chinese medicine" "electroacupuncture" "acupuncture", and "moxibustion". VOSviewer and Citespace bibliometric software were used to analyze the publication trend, authors, research institutions, source journals and keywords of these articles.Results:A total of 776 Chinese articles and 253 English articles on the diagnosis and treatment of NB by traditional Chinese medicine were retrieved, the number of publications was increasing every year. Most Chinese papers came from Shandong University of Traditional Clinese Medicine, and most English papers came from Sun Yat-sen University. Some authors and institutions had formed networks of cooperation. Most papers were published in the journal of Traditional Chineses Medicine Clinical Research (in Chinese) and Neural Regeneration Research (in English). This study generated 244 Chinese core key words with 14 clustering networks, and 233 English core key words with 10 clustering networks. The main symptoms of NB are uroschesis and urinary incontinence. NB are primarily caused by spinal cord injury, diabetes mellitus and stroke. The main treatment methods of TCM for NB are electroacupuncture, acupuncture and percutaneous acupoint electrical stimulation. The research on NB mechanisms focuses on the apoptosis, regeneration and plasticity of spinal neurons, the activation of the bladder autophagy signaling pathway, the expression of proteins related to the contractile function of the forced muscles. Conclusion:The research quantity and quality of traditional Chinese medicine in diagnosis and treatment NB have increased in recent years, and the mechanism and treatment of NB are the research hotspots; however, the extension and depth of researches are limited, and the institutional cooperations are insufficiente.

Objective:To explore the surgical efficacy of cervical cerclage with cervical length (CL) <10 mm and emergency cerclage.Methods:From January 2013 to June 2022, a total of 98 singleton pregnant women who underwent ultrasound-indicated cervical cerclage because of CL<10 mm in the second trimester and underwent emergency cervical cerclage because of cervical dilation found by physical examination in Peking University First Hospital were enrolled. The differences in clinical data between the <34 weeks delivery group (25 cases) and the ≥34 weeks delivery group (73 cases) were compared. Meanwhile, according to different cervical status, they were divided into CL<10 mm group (43 cases) and cervical dilatation group (55 cases), and the cervical dilatation group was further divided into cervical dilatation <4 cm group and cervical dilatation ≥4 cm group. The clinical data and pregnancy outcomes of pregnant women with different cervical status were compared.Results:(1) There were significant differences in the proportion of preoperative CL<10 mm and the degree of preoperative cervical dilation between the <34 weeks delivery group and the ≥34 weeks delivery group (all P<0.05). (2) After cervical cerclage, compared with women in the cervical dilatation group, the prolonged gestational age in the CL<10 mm group was longer [(10.5±4.6) vs (14.3±3.4) weeks], the gestational age at delivery was later (median: 35.7 vs 38.0 weeks), the preterm birth rates before 37 and 34 weeks were lower, the late abortion rate was lower [9% (5/55) vs 0 (0/43)], and the newborn birth weight was higher, the differences were statistically significant (all P<0.05). (3) Compared with the cervical dilation ≥4 cm group, the prolonged gestational age of the cervical dilatation <4 cm group was longer [(7.5±5.3) vs (11.1±4.2) weeks], the gestational age at delivery was later (median: 29.2 vs 36.0 weeks), and the birth weight of the newborn was higher (all P<0.05). The late abortion rate of cervical dilatation <4 cm group was lower than that of cervical dilatation ≥4 cm group [7% (3/45) vs 2/10; P=0.220]. Conclusions:Timely cervical cerclage in individuals with CL<10 mm could reduce preterm birth rate before 34 weeks gestation, and the pregnancy outcome is better than that of individuals with cervical dilation. Moreover, the pregnancy outcome of cervical cerclage in women with cervical dilation <4 cm is significantly better than that in women with cervical dilatation ≥4 cm.

Objective:To explore the clinical efficacy of periosteal induction technique combined with transfer of sural neurovascular flap in treatment of post-traumatic osteomyelitis of calcaneus with soft tissue defect.Methods:Clinical data, from January 2017 to December 2022, of 17 patients in the Army Institute for Traumatic Orthopaedics, the 920th Hospital of Joint Service Force of the Chinese People’s Liberation Amy with post-traumatic calcaneal osteomyelitis combined with soft tissue defect were retrospectively studied. The patients were 11 males and 6 females, with 46.5 (17-68) years in average. All patients received surgical treatment with periosteal induction technique in 2 phased surgies. Thorough debridement, antibiotics blended bone cement filling and wound coverage with sural neurovascular flap were carried out in phase-I surgery; The phase-II surgery were performed at 6-8 weeks after infection control to remove bone cement and then to transfer bone grafts for periosteal induction. After surgery, flap healing and infection control were observed. The infection control, pain improvement, recovery of ankle function and improvement of quality of life were evaluated by comparison of following parameters before and after surgery per phase: infection indicators [white blood cell count (WBC), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)], Visual Analogue Scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, and MOS 36-item Short form Health Survey (SF-36, Boston Institute of Health, USA).Results:All 17 patients completed the two-phased surgical treatment, with an average interval of 9.4 (8-16) weeks between phase-I and phase-II surgery. All patients were included in the postoperative follow-up of 25.8 (13-40) months. After debridement in phase-I surgery, the sizes of soft tissue defect were found at 3.0 cm×2.0 cm-6.0 cm×8.0 cm. All flaps survived from the reconstructive surgery of sural neurovascular flap. Postoperative distal flap necroses occurred to 4 patients but all healed after further debridement. Recurrence of postoperative infection occurred to 2 patients and the infection control was achieved after the phase-I rescue surgery. Good outcomes without recurrence of infection were achieved after phase-II surgery. The postoperative follow-up at 1 year after phase-II surgery showed a statistically significant improvement of infection in blood indicators and reductions in VAS score, AOFAS ankle-hindfoot score and SF-36 score in comparison with those before surgery ( P<0.05). In addition to WBC, there were also significant differences in pairwise comparisons between each group at different time points ( P<0.05). Conclusion:In the treatment of post-traumatic calcaneal osteomyelitis with soft tissue defect, a combination of periosteal induction technique and sural neurovascular flap is beneficial to infection control, bone defect reconstruction, recovery of ankle function and improvement of quality of life.

The construction of an information system for equipment budget management in public hospitals is an important measure to strengthen comprehensive budget management, serving as an important foundation for promoting the development of clinical disciplines and enhancing operational management. Since September 2023, a tertiary public hospital had explored the construction of equipment budget management informatization. This practice had established a supporting budget management information system, which included an equipment demand reserve library and a general use product library, linked performance evaluation indicators, implemented visualizing real-time project progress, and strengthened data governance. A series of measures had been taken to move management to equipment demand research, expand the time window for departments to fill in budget requirements, simplify the department application process, and achieve a closed-loop management of the entire chain of department equipment demand research, budget approval, and execution, ensuring the rationality and accuracy of the budget. By the end of 2024, the budget management information system had covered 87 departments and included 30 000 sets of equipment applications, providing detailed data support and critical management references for demand departments, equipment management departments, and hospital decision-makers, while improving the quality and efficiency of in-hospital equipment management. This practice could provide references for other public hospitals in China to optimize their equipment budget management.

Objective:To analyze the serological and molecular characteristics of rare A el and B el subtypes in the ABO blood group system, and to explore their genotype-phenotype correlation and the potential clinical significance. Methods:From January 1st, 2021, to January 1st, 2025, 289, 815 samples subjected to ABO blood grouping in Henan Provincial People′s Hospital were selected. Samples demonstrating discrepancies between forward and reverse typing, or consistent typing but with abnormal agglutination degree were included. Those affected by underlying diseases, transplantation, age-related and other interferences were excluded. A total of 169 suspected ABO subgroup samples were identified. Sanger sequencing of exons 1-7 and relevant regulatory regions of the ABO gene was performed. Protein structure modeling and mutation effect analysis for two'el′ subtype glycosyltransferases (GTs) were conducted using SWISS-MODEL and PyMOL.Results:A total of 12 Ael, 6 B el, and 2 AB el subtypes were identified. Serological analysis revealed that all 18 A el/B el samples exhibited O phenotype in forward typing. Among them, A el subtypes showed weaker agglutination in reverse typing with A 1c than with Bc (>2+), while the opposite pattern was observed in B el subtypes. The two AB el samples were typed as A in forward typing, with agglutination ranging from 0-1+with Bc in reverse typing. Genetic analysis indicated that AEL.02 (c.646T>A, p.Phe216Ile) was the predominant allele in A el samples accounting for 7 cases. Also, we found an AEL.02-like variant (lacking c.681G>A), AEL.10 (c.963insC), and carrying a compound variant of c.322C>T (p.Gln108Ter) and c.296C>T (p.Thr99Ile). Among B el samples, BEL.03 (c.502C>T, p.Arg168Trp) accounted for 4 cases, one of which lacked the c.297A>G mutation, and novel mutations such as c.145_146dupCG were detected. Structural simulation demonstrated that AEL.02 and BEL.03 disrupted the hydrogen-bonding network within the active centers of GTA and GTB, respectively, and these mutations probably significantly impaired the structural stability of the corresponding GTs. Additionally, the c.296C>T mutation also markedly affected GTA structural stability. Conclusion:A el/B el subtypes are prone to mis-identify routine blood types. Their molecular mechanisms involved a variety of functional variantions, and integrating molecular detection is crucial for achieving accurate sub-typing and transfusion safety.