Objective:To analyze the clinical application of protocol biopsy (PB) during postoperative follow-up in recipients of allogeneic kidney transplantation.Methods:A prospective observational cohort study was conducted. Recipients who underwent allogeneic kidney transplantation at the Second Affiliated Hospital of Nanjing Medical University between January 2022 and September 2024 and received PB at 3 months (±1 week) and/or 12 months (±4 weeks) post-transplantation in the Department of Nephrology were enrolled. The implementation, complications, and pathological results of PB were summarized. The safety and diagnostic efficacy of PB were analyzed.Results:A total of 143 allogeneic kidney transplant recipients were included, and 200 PB procedures were performed. The overall implementation rate of protocol biopsy (PB) was 84.1% (143/170). Among them, 170 recipients completed 3-month follow-up, and 136 PBs were performed at 3 months (±1 week) post-transplantation, with an implementation rate of 80.0%. Seventy-nine recipients completed 12-month follow-up, and 64 PBs were performed at 12 months (±4 weeks), with an implementation rate of 81.0%. One major PB-related complication occurred (0.5%), presenting as gross hematuria and diagnosed as a transplant renal arteriovenous fistula. At 3 months post-transplantation, 58 biopsies (42.6%) showed pathological abnormalities, including rejection in 12 cases (8.8%), borderline changes in 18 cases (13.2%), BK virus nephropathy (BKVN) in 10 cases (7.4%), calcineurin inhibitor (CNI) nephrotoxicity in 13 cases (9.6%), and recurrent kidney disease in 5 cases (3.7%). At 12 months post-transplantation, 22 biopsies (34.4%) revealed pathological abnormalities, including rejection in 13 cases (20.3%), borderline changes in 4 cases (6.3%), BKVN in 3 cases (4.7%), CNI nephrotoxicity in 1 case (1.6%), and recurrent disease in 1 case (1.6%).Conclusions:Protocol kidney allograft biopsy after allogeneic kidney transplantation is highly safe and feasible in clinical practice. PB provides significant diagnostic value for the early detection of subclinical rejection and BKVN, thereby supporting its clinical utility in postoperative monitoring and management.

Polypoid choroidal vasculopathy(PCV)is associated with poor visual prognosis in its natural course and is more prevalent in Asian populations. Despite advancements in optical coherence tomography(OCT)and OCT angiography(OCTA)that have significantly improved morphological diagnostic capabilities, imaging biomarkers are limited by temporal resolution constraints and fail to elucidate molecular mechanisms underlying vascular angiogenesis, inflammation, genetic factors, and extracellular matrix(ECM)remodeling. This review synthesizes current research on molecular biomarkers associated with PCV, focusing on its core pathological mechanisms. These biomarkers provide crucial insights into disease pathogenesis to inform precision prevention, dynamic disease monitoring, and therapeutic response prediction. Furthermore, this article proposes the integration of multi-omics data(genomics, proteomics, and radiomics)to establish a multimodal hierarchical diagnostic-therapeutic model. This framework will guide risk stratification, real-time disease assessment, and personalized treatment strategies, advancing the development of a precision medicine framework for PCV management.

Objective:To investigate the relationship between CXCL6 expression and prostate cancer,as well as its effects on the malignant progression of PC-3 cells and the underlying mechanisms.Methods:Multiple databases were used to analyze CXCL6 expression in prostate cancer.And survival analysis,GO,and KEGG enrichment analysis were conducted.According to the concentration of CXCL6,PC-3 cells were divided into 0,100 and 200 ng/ml CXCL6 groups.The effects of up-regulated CXCL6 expression on PC-3 cell proliferation,migration,apoptosis,cycle,and related genes were investigated using CCK-8,EdU assay,scratch test,flow cytometry,and prostate cancer-targeted PCR array.Results:Database analysis revealed that CXCL6 was significantly down-regulated in prostate cancer(P＜0.05),and patients with low CXCL6 expression had a worse prognosis(P＜0.05).In prostate cancer,proteins associated with CXCL6 expression included CXCL1 and CXCL2,and related genes included MIR325 and RASSF6.GO analysis indicated that differentially expressed genes(DEGs)of CXCL6 were primarily enriched in processes such as response to chemokines and the tubular endoplasmic reticulum network(P＜0.05).KEGG analysis showed that DEGs were mainly enriched in signaling pathways such as the Hippo signaling pathway(P＜0.05).CCK-8,EdU assay,scratch test,and flow cytometry results demonstrated that compared with the 0 ng/ml CXCL6 group,the 100 and 200 ng/ml CXCL6 groups exhibited significantly reduced proliferation and migration rates(P＜0.05),significantly increased apoptosis rate(P＜0.05).And the proportion of S-phase cells in the 200 ng/ml CXCL6 group was lower compared to the 0 ng/ml CXCL6 group(P＜0.05).PCR array results showed that compared with the 0 ng/ml CXCL6 group,the expression of genes such as CDH1 and HAL was increased in the 200 ng/ml CXCL6 group,while the expression of genes such as CD5L and EDNRB was decreased.Conclusion:CXCL6 plays a significant role in the malignant progression of PC-3 cells,and its mechanism may be associated with the methylation of promoters of genes such as RASSF1,RARB,and CDH1.

Objective:To investigate the relationship between CXCL6 expression and prostate cancer,as well as its effects on the malignant progression of PC-3 cells and the underlying mechanisms.Methods:Multiple databases were used to analyze CXCL6 expression in prostate cancer.And survival analysis,GO,and KEGG enrichment analysis were conducted.According to the concentration of CXCL6,PC-3 cells were divided into 0,100 and 200 ng/ml CXCL6 groups.The effects of up-regulated CXCL6 expression on PC-3 cell proliferation,migration,apoptosis,cycle,and related genes were investigated using CCK-8,EdU assay,scratch test,flow cytometry,and prostate cancer-targeted PCR array.Results:Database analysis revealed that CXCL6 was significantly down-regulated in prostate cancer(P＜0.05),and patients with low CXCL6 expression had a worse prognosis(P＜0.05).In prostate cancer,proteins associated with CXCL6 expression included CXCL1 and CXCL2,and related genes included MIR325 and RASSF6.GO analysis indicated that differentially expressed genes(DEGs)of CXCL6 were primarily enriched in processes such as response to chemokines and the tubular endoplasmic reticulum network(P＜0.05).KEGG analysis showed that DEGs were mainly enriched in signaling pathways such as the Hippo signaling pathway(P＜0.05).CCK-8,EdU assay,scratch test,and flow cytometry results demonstrated that compared with the 0 ng/ml CXCL6 group,the 100 and 200 ng/ml CXCL6 groups exhibited significantly reduced proliferation and migration rates(P＜0.05),significantly increased apoptosis rate(P＜0.05).And the proportion of S-phase cells in the 200 ng/ml CXCL6 group was lower compared to the 0 ng/ml CXCL6 group(P＜0.05).PCR array results showed that compared with the 0 ng/ml CXCL6 group,the expression of genes such as CDH1 and HAL was increased in the 200 ng/ml CXCL6 group,while the expression of genes such as CD5L and EDNRB was decreased.Conclusion:CXCL6 plays a significant role in the malignant progression of PC-3 cells,and its mechanism may be associated with the methylation of promoters of genes such as RASSF1,RARB,and CDH1.

Objective:To analyze the clinical application of protocol biopsy (PB) during postoperative follow-up in recipients of allogeneic kidney transplantation.Methods:A prospective observational cohort study was conducted. Recipients who underwent allogeneic kidney transplantation at the Second Affiliated Hospital of Nanjing Medical University between January 2022 and September 2024 and received PB at 3 months (±1 week) and/or 12 months (±4 weeks) post-transplantation in the Department of Nephrology were enrolled. The implementation, complications, and pathological results of PB were summarized. The safety and diagnostic efficacy of PB were analyzed.Results:A total of 143 allogeneic kidney transplant recipients were included, and 200 PB procedures were performed. The overall implementation rate of protocol biopsy (PB) was 84.1% (143/170). Among them, 170 recipients completed 3-month follow-up, and 136 PBs were performed at 3 months (±1 week) post-transplantation, with an implementation rate of 80.0%. Seventy-nine recipients completed 12-month follow-up, and 64 PBs were performed at 12 months (±4 weeks), with an implementation rate of 81.0%. One major PB-related complication occurred (0.5%), presenting as gross hematuria and diagnosed as a transplant renal arteriovenous fistula. At 3 months post-transplantation, 58 biopsies (42.6%) showed pathological abnormalities, including rejection in 12 cases (8.8%), borderline changes in 18 cases (13.2%), BK virus nephropathy (BKVN) in 10 cases (7.4%), calcineurin inhibitor (CNI) nephrotoxicity in 13 cases (9.6%), and recurrent kidney disease in 5 cases (3.7%). At 12 months post-transplantation, 22 biopsies (34.4%) revealed pathological abnormalities, including rejection in 13 cases (20.3%), borderline changes in 4 cases (6.3%), BKVN in 3 cases (4.7%), CNI nephrotoxicity in 1 case (1.6%), and recurrent disease in 1 case (1.6%).Conclusions:Protocol kidney allograft biopsy after allogeneic kidney transplantation is highly safe and feasible in clinical practice. PB provides significant diagnostic value for the early detection of subclinical rejection and BKVN, thereby supporting its clinical utility in postoperative monitoring and management.

Objective To investigate the impact and mechanism of Liraglutide on autophagy and apoptosis of human podocyte induced by high glucose.Methods Human podocytes were cultured in vitro,and grouped into normal control group(NC group),high glucose group(HG group),25 nmol/L Liraglutide group(HG+Lir 25 group),50 nmol/L Liraglutide group(HG+Lir 50 group),Liraglutide+LY294002 group(HG+Lir+LY294002 group),and Liraglutide+3-MA group(HG+Lir+3-MA group).The podocyte activity was detected by CCK-8.The apoptosis rate and morphology of podocytes were detected by flow cytometry and Hoechst 33342 staining.The expression of autophagic body and autophagic marker LC3 protein in podocyteswas observed by transmission electron microscopy and immunofluorescence staining.Western blot was applied to detect the expression of apoptosis,autophagy and phosphoinositol 3-kinase(PI3K)/protein kinase B(Akt)/mammalian target of rapamycin(mTOR)pathway related proteins in podocytes.Results Compared with NC group,the activity of podocytes and the expression of Bcl-2,Bcl-2/Bax,LC3 Ⅱ/LC3 Ⅰ,p-PI3K/PI3K,p-Akt/Akt proteins in HG group were decreased(P＜0.05),while the apoptosis rate and the expression of Bax,p62,p-mTOR/mTOR proteins were increased in HG group(P＜0.05).There were many podocytes with pyknotic nuclei,the number of autophagic bodies and the number of green fluorescent spots of LC3 protein were decreased in HG group.Compared with HG group,the activity of podocyte increased,and the expression of Bcl-2,Bcl-2/Bax,LC3 Ⅱ/LC3 Ⅰ,p-PI3K/PI3K,p-Akt/Akt protein increased(P＜0.05),while the apoptosis rate and the expression of Bax,p62,p-mTOR/mTOR protein decreased(P＜0.05)in HG+Lir 25 group and HG+Lir 50 group.The number of podocytes with karyopyknosis was reduced,the number of autophagosomes and the number of green fluorescent spots of LC3 protein were increased in HG+Lir 25 group and HG+Lir 50 group,and the above changes indexes were more obvious in the HG+Lir 50 group group.Compared with HG+Lir 50 group,PI3K/Akt/mTOR pathway could be regulated,and reduce the improvement of Liraglutide on podocyte viability,apoptosis and autophagy induced by high glucose in HG+Lir+LY294002 group and HG+Lir+3-MA group.Conclusion Liraglutide may promote the autophagy of human podocyte induced by high glucose and inhibit its apoptosis through PI3K/Akt/mTOR pathway.

Objective To investigate the clinical efficacy of dot matrix laser combined with subcutaneous separation in the treatment of depressed acne scar.Methods A total of 86 patients with depressed acne scar admitted to the Second Affiliated Hospital of Nanchang University from February 2022 to August 2023 were selected and divided into dot matrix group and combined group according to random number table method,with 43 cases in each group.The patients in dot matrix group were treated with dot matrix laser,and the patients in combined group were treated with dot matrix laser combined with subcutaneous separation.The visual analogue scale(VAS)score,echelle d'evaluation clinique des cicatrices d'acne(ECCA)score,pigmentation area,scar area,treatment satisfaction and adverse reactions were compared between two groups.Results There was no significant difference in VAS scores between two groups after the first treatment and the second treatment(P>0.05).Three months after treatment,the ECCA score of combined group was significantly lower than that of dot matrix group,and the pigmentation area and scar area were significantly smaller than those of dot matrix group(P<0.05).The total satisfaction of patients in combined group was significantly higher than that in dot matrix group(χ2=4.746,P=0.029).There was no significant difference in the occurrence of adverse reactions between two groups(χ2=0.453,P=0.501).Conclusion Dot matrix laser combined with subcutaneous separation in the treatment of depressed acne scar can effectively promote scar repair,reduce skin pigmentation area and scar area,and do not increase pain,with good safety and high patient satisfaction.

Objective:To develop a self-directed learning feedback system for patients with post-stroke dysphagia (PSD) and analyze its effectiveness.Methods:From November 2022 to July 2023, convenience sampling was used to select 108 PSD patients from the Neurological Disease Center of Taiyuan Central Hospital as the research subject. The patients were divided into a control group and an experimental group using a random number table method, with 54 cases in each group. The control group received routine nursing upon discharge, while the experimental group was treated intervention measures through the self-directed learning feedback system. The self-efficacy, quality of life, swallowing function, and psychological status of two groups of patients were compared before intervention and one and three months after intervention, respectively.Results:A total of 52 patients in the experimental group and 50 patients in the control group completed the study. Repeated measures analysis of variance showed that the self-efficacy and quality of life scores of both groups improved with the extension of intervention time, and the self-efficacy and quality of life scores of the experimental group were higher than those of the control group at one and three months after intervention, with statistical differences ( P<0.01). After one and three months of intervention, the severity scores of dysphagia in the experimental group were lower than those in the control group, and the differences were statistically significant ( P<0.01). As the intervention time extended, the psychological status scores of the experimental group were lower than those of the control group at different time periods, and the differences were statistically significant ( P<0.05) . Conclusions:The application of self-directed learning feedback system in the rehabilitation of PSD patients at home can improve their self-efficacy, quality of life and swallowing function, and relieve negative emotions, which is worthy of further promotion.

Objective To investigate the knowledge,attitude and behavior of pediatric ICU nurses on preventing unplanned extubation(UEX).Methods The pre-test paper was prepared by the combination of literature review and expert consultation.The convenience sampling method was used to select 237 pediatric ICU nurses from four tertiary hospitals(including one children's hospital and three general hospitals)to con-duct a survey.The project analysis and reliability and validity test of the pre-test questionnaire were carried out to form a formal questionnaire.Results The questionnaire included 41 items,including 13 items of knowl-edge dimension,nine items of attitude dimension and 19 items of behavior dimension.The average content va-lidity index of knowledge,attitude and behavior dimensions was 0.921,0.996 and 0.998,respectively,and the content validity index of each item was 0.852-1.000.The Cronbach's α coefficients of knowledge,behavior and attitude were 0.911,0.946 and 0.944 respectively,and the total Cronbach's α coefficient of the question-naire was 0.953.The split-half reliability of knowledge,behavior and attitude dimensions was 0.710,0.931 and 0.859,and the total split-half reliability of the questionnaire was 0.695.Conclusion The questionnaire of knowledge,attitude and behavior of pediatric ICU nurses in preventing tracheal intubation UEX has good reli-ability and validity,and can be used as an evaluation tool for pediatric ICU nurses'cognition and behavior compliance in preventing tracheal intubation UEX.

Circadian rhythm disruption is a universal phenomenon that is associated with a combination of internal and external factors, with internal factors referring to disturbances in the intrinsic regulatory mechanisms of sleep-wake behavior, and external factors including changes in sleep habits, severe sleep deprivation, shift work, social jet lag, prolonged exposure to nighttime light, and late nighttime eating. Shift work, as a common occupational factor, can lead to disruption of the central/ peripheral biological clock which regulates the expression of almost the entire genome, and the disruption of the biological clock can lead to genetic variants, hormonal secretion abnormalities, insulin resistance, oxidative stress, and systemic inflammation, which are risk factors for obesity. In the context of rapid advancement of global economy and industrialization, the prevalence of simple obesity in the traditional cognitive category is increasing in a linear trend, while the incidence of abdominal obesity, which is closely related to metabolic disorders, is also showing an increasing trend. In recent years, the mechanism of circadian rhythm disorder and obesity associated with shift work has attracted much attention, and this article summarized the latest research progress, aiming to provide a basis for the prevention and treatment of obesity caused by circadian rhythm disruption due to shift work.