Objective To analyze the epidemiological characteristics of statutory infectious diseases in Yichang City from 2015 to 2023 and evaluate the effectiveness of non-pharmaceutical interventions (NPIs) in infectious disease prevention and control, and to provide a basis for formulating prevention and control strategies. Methods Descriptive epidemiological methods were used to analyze annual incidence rates. SARIMA and SARIMA intervention models were constructed to predict the incidence rates of infectious diseases. Interrupted time series analysis (ITS) was applied to assess the control effectiveness. Results The average annual incidence rate from 2015 to 2023 was 787.47/100 000, with the top five diseases being influenza, hand-foot-and-mouth disease, hepatitis B, tuberculosis, and diarrheal diseases. The average incidence rate from 2015 to 2019 (654.31/100 000) was significantly higher than that from 2020 to 2022 (489.01/100 000) (χ²= 3 499.6, P < 0.05). The total incidence rate in 2023 (2 396.51/100 000) was significantly higher than the average annual incidence rates from 2015-2019 (χ²= 108 186.1, P < 0.05) and 2020-2022 (χ²= 112 869.4, P < 0.05). SARIMA model results indicated that the actual incidence rate from 2020 to 2022 decreased by 73.49% compared to the predicted rate without intervention, with the highest decline observed in respiratory infectious diseases (79.57%). The SARIMA-intervention model showed a 55.48% relative decrease in the total incidence rate for 2023, with the largest reduction in respiratory infectious diseases (63.28%) and a slight increase in intestinal infectious diseases (5.48%). Conclusion NPIs effectively reduce the incidence of statutory infectious diseases in the short term, especially for acute respiratory and intestinal infectious diseases. However, long-term effectiveness faces challenges, necessitating the development of differentiated prevention and control strategies.

Objective To investigate the therapeutic efficacy of the combination of upper limb rehabilitation robots(ULRR)and ultrasound-guided extracorporeal shock wave(ESW)in the treatment of mild to moderate rotator cuff injuries.Methods A total of 90 patients with mild to moderate rotator cuff injuries,who were admitted to the Second Affiliated Hospital of Anhui Medical University between January 2023 and March 2024,were selected and randomly assigned to three groups:Group A(basic rehabilitation),Group B(basic rehabilitation+ESW),and Group C(basic rehabilitation+ESW+ULRR),with 30 patients in each group.Before and after treatment,shoulder pain was assessed using the visual analogue scale(VAS).Proprioception was evaluated based on shoulder joint position reproduction error.The integral electromyography(iEMG)and root mean square(RMS)values of the median tract,supraspinatus,infraspinatus,and deltoid muscles on the affected side were measured using surface electromyography(sEMG).The active range of motion(AROM)for external rotation,abduction,and forward flexion of the affected shoulder was measured using a standard goniometer.Overall shoulder function was evaluated using the Constant-Murley Shoulder Score(CMS).The clinical efficacy rate and patient satisfaction levels were compared among the three groups.Results After treatment,the VAS score and shoulder position reproduction deviation angle in all three groups significantly decreased.Additionally,the iEMG and RMS values of the middle deltoid,supraspinatus,and infraspinatus muscles;the AROM of shoulder external rotation,abduction,and forward flexion;and the CMS scores(including pain,activities of daily living,active range of motion,and muscle strength)all showed significant improvement.Furthermore,the degree of improvement in all evaluated parameters in Group C was significantly greater than that observed in Groups A and B(P<0.05).Moreover,Group C demon-strated a significantly higher clinical response rate and greater patient satisfaction compared to Groups A and B(P<0.05).Conclusion For patients with mild to moderate rotator cuff injuries,the integration of an upper limb rehabilitation robot with extracorporeal shock wave therapy demonstrates superior therapeutic outcomes,effectively alleviating pain,enhancing motor function and proprioception,and increasing overall patient satisfaction.

AIM:To investigate the function of mitochondrial reactive oxygen species(mtROS)/nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)signaling pathway in modulating macrophage polarization in liver fibrosis resulting from iron overload.METHODS:Thirty-two male C57BL/6 mice were randomly allocated into four groups:control group,model group(iron dextran,50 mg/kg),MitoTEMPO(3 mg/kg)group,and MCC950(10 mg/kg)group,comprising eight mice per group.All mice,with the exception of the control group,were administered daily in-traperitoneal injections of iron dextran for a duration of seven consecutive weeks,whereas the control group received equiv-alent volumes of normal saline.Starting in week four,the MitoTEMPO and MCC950 cohorts received their designated treatments through intraperitoneal injection three times weekly.Serum alanine aminotransferase(ALT)and aspartate ami-notransferase(AST)concentrations were assessed through biochemical analysis.Liver tissues were analyzed utilizing HE,Masson,Sirius red and immunohistochemical staining.The concentrations of mtROS were evaluated utilizing the MitoSOX Red probe.Cytokines and polarization markers,such as interleukin-1β(IL-1β),IL-18,IL-6,tumor necrosis factor-α(TNF-α),inducible nitric oxide synthase(iNOS),IL-10,and arginase-1(Arg-1),were quantified via ELISA.Western blot analysis was performed to quantify the protein expression levels of Arg-1,iNOS,NLRP3,apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC),and caspase-1.The mRNA expression of NLRP3,ASC,and caspase-1 was assessed using RT-qPCR.Immunofluorescence double labeling was employed to identify M1 and M2 macrophages.RESULTS:(1)In comparison to the control group,the model group demonstrated notable inflammatory cell infiltration,pronounced fibrous tissue hyperplasia,significant disruption of hepatic lobular architecture,and the develop-ment of pseudo-lobules in certain areas.Serum ALT and AST levels were markedly elevated(P<0.01),as were the mRNA and protein expression levels of NLRP3,ASC,caspase-1,and mtROS(P<0.01).Iron overload resulted in markedly ele-vated serum iron,ferritin,total liver iron,and ferrous iron concentrations(P<0.01).Markers indicative of M1 macrophage polarization,including IL-6,TNF-α,and iNOS,exhibited upregulation(P<0.01),whereas M2 markers such as IL-10,Arg-1,and CD206 were significantly downregulated(P<0.01).(2)Compared with model group,inhibiting mtROS or NL-RP3 substantially reduced inflammation and fibrous tissue hyperplasia.ALT and AST levels were markedly diminished(P<0.01),as were the areas of positive staining for α-smooth muscle actin and collagen type Ⅰ(P<0.01).Markers of iron over-load,such as serum iron,ferritin,total liver iron,and ferrous iron,were significantly ameliorated(P<0.01).M1 polariza-tion markers were significantly downregulated(P<0.01).CONCLUSION:The mtROS/NLRP3 signaling pathway facili-tates liver fibrosis caused by iron overload by enhancing macrophage polarization to the M1 phenotype.

Objective To investigate the effect of joint end micro fracture treatment combined with arthroscopy on the long-term effect of ankle joint fusion and the effects on perioperative oxidative stress and complications.Methods 108 patients with end-stage ankle arthritis with internal and external inversion angles with ≤20° matching baseline data from February 2021 to April 2023 were selected.Among them,54 patients underwent arthroscopic ankle fusion as arthroscopic group,54 patients were treated with joint end microfracture combined with arthroscopic ankle joint fusion as improved group.The surgical indexes,perioperative oxidation indexes[malondialdehyde(MDA),total oxidation state(TOS),oxidative stress index(OSI)before surgery,1 d after surgery and 3 d after surgery]and antioxidant indexes[glutathione peroxidase(GSH-Px),superoxide dismutase(SOD),total antioxidant capacity(TAC)before surgery,1 d after surgery and 3 d after surgery]of the two groups were compared.Visual analogue scale(VAS score),American Orthopaedic Foot and Ankle Society(AOFAS score),before surgery,6 months after surgery and 1 year after surgery,excellent and good rate and complications were compared between the two groups,and fusion time and AOFAS score at 1 year after surgery of patients with different internal and external inversion angles were compared between the two groups.Results The intraoperative blood loss in the improved group was less than that in the arthroscopic group,postoperative hospital stay in the improved group was shorter than that in the arthroscopic group,the differences were statistically significant(P＜0.05).The MDA,TOS and OSI levels in the improved group were lower than those in the arthroscopic group on day 1 and day 3 after operation,the differences were statistically significant(P＜0.05).The GSH-Px,SOD and TAC levels in the improved group were significantly higher than those in the arthroscopic group at 1 and 3 days after surgery,the differences were statistically significant(P＜0.05).The VAS score and AOFAS score at 6 months and 1 year after surgery in the improved group were not significantly different from those in the arthroscopic group(P＞0.05).Comparison of the excellent rate of patients in the two groups,the difference was not statistically significant(P＞0.05).The total complication rate of the improved group was significantly lower than that of the arthroscopic group,the difference was statistically significant(P＜0.05).There was no significant difference in AOFAS scores between patients with 10°～20° and patients with＜10° at 1 year after surgery(P＞0.05).The fusion time of patients with internal and external inversion angles 10°～20° was longer than that of patients with＜10°(P＜0.05).Conclusion Joint end microfracture treatment combined with arthroscopy ankle fusion for end-stage ankle arthritis with ≤20° internal and external varus can avoid bone grafting and osteotomy with satisfactory efficacy,and has advantages in reducing intraoperative bleeding and complications,alleviating perioperative oxidative stress,and accelerating postoperative recovery.However,when internal and external varus malformations are obvious,the time of osseous fusion can be prolonged.

Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.

Objective:To investigate the characteristics of metabolic indicators in patients with allergic rhinitis (AR) and the potential relationship between AR and metabolic syndrome (MetS).Methods:A total of 179 patients with MetS admitted to the Dahua Hospital in Xuhui District, Shanghai, from June 2021 to May 2024 were retrospectively included. They were divided into an AR group (69 cases) and a non-AR group (110 cases) based on the presence of AR. Clinical data including demographic information, metabolic indicators, and immunological test results were collected. Multivariate logistic regression analysis was used to identify clinical risk factors associated with MetS complicated with AR, and a nomogram prediction model was constructed. The model′s discriminative ability, calibration, and clinical predictive performance were evaluated using receiver operating characteristic (ROC) curves, consistency index (C-index), and decision curve analysis.Results:The AR group had a significantly higher proportion of males, fasting C-peptide levels, total cholesterol, low-density lipoprotein cholesterol, CD4/CD8 ratio, immunoglobulin M, immunoglobulin E, CD3 cell count, CD4 cell count, and interleukin-6 levels compared to the non-AR group, while hip circumference was significantly lower (all P<0.05). Logistic regression analysis showed that male sex ( OR=2.156, P=0.042), total cholesterol ( OR=1.504, P=0.003), fasting C-peptide ( OR=3.342, P=0.016), CD4 cell count ( OR=1.002, P=0.011), and interleukin-6 ( OR=1.124, P=0.002) were risk factors for AR in MetS patients, while hip circumference ( OR=0.956, P=0.026) was a protective factor. The area under the ROC curve of the nomogram model was 0.771(95% CI: 0.698-0.841), and the C-index was 0.769(95% CI: 0.732-0.806), indicating good predictive ability and consistency of the model. Conclusions:The occurrence of AR is closely associated with multiple metabolic indicators, suggesting that AR may not only be a local inflammatory condition but also involve systemic metabolic abnormalities. The nomogram model based on these risk factors can be used for individualized risk assessment and early intervention.

ObjectiveTo investigate the triglyceride-glucose (TyG) index and the level of serum homocysteine (Hcy) in association with the incidence of stroke in type 2 diabetes mellitus (T2DM) patients. MethodsBased on the chronic disease risk factor surveillance cohort in Pudong New Area, Shanghai, excluding those with stroke in baseline survey, T2DM patients who joined the cohort from January 2016 to October 2020 were selected as the research subjects. During the follow-up period, a total of 318 new-onset ischemic stroke patients were selected as the case group, and a total of 318 individuals matched by gender without stroke were selected as the control group. The Cox proportional hazards regression model was used to adjust for confounding factors and explore the serum TyG index and the Hcy biochemical indicator in association with the risk of stroke. ResultsThe Cox proportional hazards regression results showed that after adjusting for confounding factors, the risk of stroke in T2DM patients with 10 μmol·L⁻¹-¹ and Hcy>15 μmol·L⁻¹ was 1.532 times (95%CI: 1.017‒2.309 times, P=0.041) and 1.738 times (95%CI: 1.119‒2.699 times, P=0.014) higher respectively, compared to T2DM patients with Hcy≤10 μmol·L⁻¹. T2DM patients with TyG>9.074 had 1.396 times higher risk of stroke (95%CI: 1.091‒1.787, P=0.008) compared to those with TyG≤9.074. The study found that urea and α1-antitrypsin (α1-AT) were independent risk factors for the incidence of stroke in T2DM patients. For every unit increase in urea andα1-AT, the risk of stroke in T2DM patients increased by 233.6% (HR=3.336, 95%CI: 1.588‒7.009, P=0.001) and 11.3% (HR=1.113, 95%CI: 1.028‒1.205, P=0.008), respectively. Cumulative risk curves showed that Hcy>10 μmol·L⁻¹ and TyG>9.074 accelerated the time to stroke occurrence in T2DM patients. ConclusionElevated levels of Hcy>10 μmol·L⁻¹ and a higher TyG index are risk factors for stroke in T2DM patients. Effective interventions for Hcy and TyG should be conducted for diabetic patients to reduce the incidence of stroke.

Clathrin-mediated endocytosis (CME) is a critical process by which cells internalize macromolecular substances and initiate vesicle trafficking, serving as the foundation for many cellular activities. Central to this process are clathrin-coated structures (CCSs), which consist of clathrin-coated pits (CCPs) and clathrin plaques. While clathrin-coated pits are well-established in the study of endocytosis, clathrin plaques represent a more recently discovered but equally important component of this system. These plaques are large, flat, and extended clathrin-coated assemblies found on the cytoplasmic membrane. They are distinct from the more typical clathrin-coated pits in terms of their morphology, larger surface area, and longer lifespan. Recent research has revealed that clathrin plaques play roles that go far beyond endocytosis, contributing to diverse cellular processes such as cellular adhesion, mechanosensing, migration, and pathogen invasion. Unlike traditional clathrin-coated pits, which are transient and dynamic structures involved primarily in the internalization of molecules, clathrin plaques are more stable and extensive, often persisting for extended periods. Their extended lifespan suggests that they serve functions beyond the typical endocytic role, making them integral to various cellular processes. For instance, clathrin plaques are involved in the regulation of intercellular adhesion, allowing cells to better adhere to one another or to the extracellular matrix, which is crucial for tissue formation and maintenance. Furthermore, clathrin plaques act as mechanosensitive hubs, enabling the cell to sense and respond to mechanical stress, a feature that is essential for processes like migration, tissue remodeling, and even cancer progression. Recent discoveries have also highlighted the role of clathrin plaques in cellular signaling. These plaques can serve as scaffolds for signaling molecules, orchestrating the activation of various pathways that govern cellular behavior. For example, the recruitment of actin-binding proteins such as F-actin and vinculin to clathrin plaques can influence cytoskeletal dynamics, helping cells adapt to mechanical changes in their environment. This recruitment also plays a pivotal role in regulating cellular migration, which is crucial for developmental processes. Additionally, clathrin plaques influence receptor-mediated signal transduction by acting as platforms for the assembly of signaling complexes, thereby affecting processes such as growth factor signaling and cellular responses to extracellular stimuli. Despite the growing body of evidence that supports the involvement of clathrin plaques in a wide array of cellular functions, much remains unknown about the precise molecular mechanisms that govern their formation, maintenance, and turnover. For example, the factors that regulate the recruitment of clathrin and other coat proteins to form plaques, as well as the signaling molecules that coordinate plaque dynamics, remain areas of active research. Furthermore, the complex interplay between clathrin plaques and other cellular systems, such as the actin cytoskeleton and integrin-based adhesion complexes, needs further exploration. Studies have shown that clathrin plaques can respond to mechanical forces, with recent findings indicating that they act as mechanosensitive structures that help the cell adapt to changing mechanical environments. This ability underscores the multifunctional nature of clathrin plaques, which, in addition to their role in endocytosis, are involved in cellular processes such as mechanotransduction and adhesion signaling. In summary, clathrin plaques represent a dynamic and versatile component of clathrin-mediated endocytosis. They play an integral role not only in the internalization of macromolecular cargo but also in regulating cellular adhesion, migration, and signal transduction. While much has been learned about their structural and functional properties, significant questions remain regarding the molecular mechanisms that regulate their formation and their broader role in cellular physiology. This review highlights the evolving understanding of clathrin plaques, emphasizing their importance in both endocytosis and a wide range of other cellular functions. Future research is needed to fully elucidate the mechanisms by which clathrin plaques contribute to cellular processes and to better understand their implications for diseases, including cancer and tissue remodeling. Ultimately, clathrin plaques are emerging as crucial hubs that integrate mechanical, biochemical, and signaling inputs, providing new insights into cellular function and the regulation of complex cellular behaviors.

This study employed bioinformatics to screen the feature genes related to efferocytosis in diabetic kidney disease(DKD) and explores traditional Chinese medicine(TCM) regulating these feature genes. The GSE96804 and GSE30528 datasets were integrated as the training set, and the intersection of differentially expressed genes and efferocytosis-related genes(ERGs) was identified as DKD-ERGs. Subsequently, correlation analysis, protein-protein interaction(PPI) network construction, enrichment analysis, and immune infiltration analysis were performed. Consensus clustering was conducted on DKD patients based on the expression levels of DKD-ERGs, and the expression levels, immune infiltration characteristics, and gene set variations between different subtypes were explored. Eight machine learning models were constructed and their prediction performance was evaluated. The best-performing model was evaluated by nomograms, calibration curves, and external datasets, followed by the identification of efferocytosis-related feature genes associated with DKD. Finally, potential TCMs that can regulate these feature genes were predicted. The results showed that the training set contained 640 differentially expressed genes, and after intersecting with ERGs, 12 DKD-ERGs were obtained, which demonstrated mutual regulation and immune modulation effects. Consensus clustering divided DKD into two subtypes, C1 and C2. The support vector machine(SVM) model had the best performance, predicting that growth arrest-specific protein 6(GAS6), S100 calcium-binding protein A9(S100A9), C-X3-C motif chemokine ligand 1(CX3CL1), 5'-nucleotidase(NT5E), and interleukin 33(IL33) were the feature genes of DKD. Potential TCMs with therapeutic effects included Astragali Radix, Trionycis Carapax, Sargassum, Rhei Radix et Rhizoma, Curcumae Radix, and Alismatis Rhizoma, which mainly function to clear heat, replenish deficiency, activate blood, resolve stasis, and promote urination and drain dampness. Molecular docking revealed that the key components of these TCMs, including β-sitosterol, quercetin, and sitosterol, exhibited good binding activity with the five target genes. These results indicated that efferocytosis played a crucial role in the development and progression of DKD. The feature genes closely related to both DKD and efferocytosis, such as GAS6, S100A9, CX3CL1, NT5E, and IL33, were identified. TCMs such as Astragali Radix, Trionycis Carapa, Sargassum, Rhei Radix et Rhizoma, Curcumae Radix, and Alismatis Rhizoma may provide a new therapeutic strategy for DKD by regulating efferocytosis.
Humans ; Computational Biology ; Diabetic Nephropathies/physiopathology* ; Protein Interaction Maps ; Medicine, Chinese Traditional ; Drugs, Chinese Herbal ; Phagocytosis/genetics* ; Efferocytosis

OBJECTIVE: To investigate the predictive role of the modified Endothelial Activation and Stress Index (mEASIX) in the efficacy of chimeric antigen receptor T-cell (CAR-T) therapy and cytokine release syndrome (CRS). METHODS: The clinical data of 70 relapsed and refractory (R/R) B-cell tumor patients who were treated with CAR-T therapy from September 1, 2018 to February 28, 2023 in the Department of Hematology, Affiliated Hospital of Xuzhou Medical University, were retrospectively analyzed. The value of log-2 mEASIX before conditioning (-7 d) was calculated, and the patients were divided into a low-mEASIX group (42 patients) and a high-mEASIX group (28 patients) based on the cut-off value of 5.443 determined by the receiver operating characteristic (ROC) curve. Eventually, the predictive role of mEASIX before conditioning on the efficacy of CAR-T cell therapy and CRS was analyzed. RESULTS: The high-mEASIX group exhibited significantly worse median overall survival (OS) and median progression-free survival (PFS) in comparison to the low mEASIX group (OS: 3.2 months vs not reached, P < 0.01; PFS: 1.3 months vs 6.0 months, P =0.009). The incidence of grade ≥2 CRS in the high-mEASIX group was substantially higher than that in the low-mEASIX group (57.1% vs 19.0%, P =0.007). The degree of remission after CAR-T therapy (P =0.001), whether CRS occurs or not (P =0.041), the lactate dehydrogenase (LDH) level before conditioning (P =0.046), and the mEASIX score before conditioning (P =0.047) were independent influencing factors for the OS of patients receiving CAR-T cell therapy. CONCLUSION The mEASIX score before conditioning can predict OS and the incidence of grade ≥2 CRS in patients with relapsed and refractory B-cell tumors who receive CAR-T cell therapy.
Cytokine Release Syndrome/therapy* ; Immunotherapy, Adoptive/methods* ; Humans ; Lymphoma, B-Cell/therapy* ; Retrospective Studies ; Hematology ; China ; Receptors, Chimeric Antigen/blood* ; Predictive Value of Tests