This article reviews the diagnosis, therapeutic approaches, and subsequent care for a patient with a complex, long-standing history of encapsulating peritoneal sclerosis (EPS). A 40-year-old male, who had been on peritoneal dialysis (PD) for 11 years, encountered refractory peritonitis, leading to the removal of PD catheter and the subsequent diagnosis of EPS. The patient was transitioned to hemodialysis (HD) and prescribed tamoxifen to mitigate peritoneal fibrosis. After 4 months on HD, the patient underwent a kidney transplant, but acute rejection episode caused the transplanted kidney to fail 3 months postoperatively, necessitating a return to HD. Over the past 7 years, the patient has been repeatedly hospitalized due to recurrent bowel obstructions and infected abdominal fluid accumulation. A multidisciplinary approach, including anti-infective therapy, gastrointestinal intervention, nutritional support, and psychological care, has been instrumental in managing symptoms, and sustaining life. This case underscores the importance of recognizing EPS in long-term PD patients with peritonitis. While discontinuing PD, switching to HD, or receiving kidney transplantation do not halt the progression of EPS, optimized comprehensive management can extend the patient's survival.

OBJECTIVES: To analyze the global disease burden of cervical cancer and the association between screening coverage and the quality of disease management. METHODS: The data of global burden of cervical cancer 2021 and the data of cervical cancer screening 2019 were obtained from IHME Global Burden of Disease (GBD) and the WHO global health observatory, respectively. The age-standardized disease burden index was calculated, the quality of care index (QCI) was determined with principal component analysis, and the correlation between QCI and cervical cancer screening coverage was examined with linear regression analysis by regions and populations. RESULTS: The burden of cervical cancer and the quality of management exhibited significant variability across countries with differing levels of social development. The indicators of cervical cancer burden in China were close to the average level of countries with higher socio-demographic index (SDI). The global QCI was 22.22 (10.50, 35.43), and that of China was 26.30. The global screening coverage rate for cervical cancer was 42% (12%, 86%) and that in China was 31%. After adjusting for the social development level of countries, the coverage level of cervical cancer screening was associated with QCI (β=0.27, P<0.01), with no difference between low and high SDI countries (P>0.05). The association was significantly stronger among 25-30 years old women (β=1.48, P<0.05). CONCLUSIONS There are discrepancies in both the disease burden of cervical cancer and the quality of disease management among countries with different socioeconomic levels, and there is still considerable room for improvement in China. Expanding coverage of cervical cancer screening may be an effective strategy to enhance the management quality of cervical cancer, particularly among younger women where the screening benefits are most pronounced.
Humans ; Uterine Cervical Neoplasms/prevention & control* ; Female ; Early Detection of Cancer ; Global Burden of Disease ; China/epidemiology* ; Mass Screening ; Quality of Health Care ; Disease Management ; Adult ; Middle Aged

This article reviews the diagnosis, therapeutic approaches, and subsequent care for a patient with a complex, long-standing history of encapsulating peritoneal sclerosis (EPS). A 40-year-old male, who had been on peritoneal dialysis (PD) for 11 years, encountered refractory peritonitis, leading to the removal of PD catheter and the subsequent diagnosis of EPS. The patient was transitioned to hemodialysis (HD) and prescribed tamoxifen to mitigate peritoneal fibrosis. After 4 months on HD, the patient underwent a kidney transplant, but acute rejection episode caused the transplanted kidney to fail 3 months postoperatively, necessitating a return to HD. Over the past 7 years, the patient has been repeatedly hospitalized due to recurrent bowel obstructions and infected abdominal fluid accumulation. A multidisciplinary approach, including anti-infective therapy, gastrointestinal intervention, nutritional support, and psychological care, has been instrumental in managing symptoms, and sustaining life. This case underscores the importance of recognizing EPS in long-term PD patients with peritonitis. While discontinuing PD, switching to HD, or receiving kidney transplantation do not halt the progression of EPS, optimized comprehensive management can extend the patient's survival.

Objective To investigate the relationship between the expression of matrix metalloproteinase(MMP)-2,MMP-9,MMP-13 and disease activity in pemphigus patients.Methods A total of 60 pemphigus patients treated in the dermatology department of the hospital from January 2021 to January 2023 were select-ed as the study group,and another 60 healthy volunteers who underwent physical examination in the same pe-riod were recruited as the control group.The levels of MMP-2,MMP-9 and MMP-13 in serum and the expres-sion of MMP-2,MMP-9 and MMP-13 in peripheral blood mononuclear cells were compared between the two groups,and the relationship between the expression of MMP-2,MMP-9 and MMP-13 in peripheral blood mononuclear cells of patients with pemphigus was analyzed.Pemphigus patients were divided into acute phase group(n=22),chronic phase group(n=23)and stable phase group(n=15)according to their disease activi-ty.The expression of MMP-2,MMP-9 and MMP-13 in peripheral blood mononuclear cells of the three groups were compared,as well as the correlation between the three indexes and disease activity.Receiver operating characteristic(ROC)curve was plotted for analysis.Results The levels of MMP-2,MMP-9 and MMP-13 in serum and the expression of MMP-2,MMP-9 and MMP-13 in peripheral blood mononuclear cells in the study group were higher than those in the control group,with statistical significance(P＜0.05).The expression of MMP-2,MMP-9 and MMP-13 in peripheral blood mononuclear cells in severe patients were higher than those in moderate and mild patients,and the difference was statistically significant(P＜0.05).The expression of MMP-2,MMP-9 and MMP-13 and disease activity scores of mononuclear cells in acute attack group were higher than those in chronic attack group,and the differences were statistically significant(P＜0.05).The ex-pression of MMP-2,MMP-9 and MMP-13 in peripheral blood mononuclear cells were positively correlated with disease activity(rMMP-2=0.545,rMMP-9=0.592,rMMP-13=0.580,P＜0.05).ROC curve analysis showed that compared with the single diagnostic efficacy of MMP-2,MMP-9 and MMP-13 expression in peripheral blood mononuclear cells,the three combined diagnostic efficacy was better.Conclusion The expression of MMP-2,MMP-9 and MMP-13 in peripheral blood mononuclear cells of pemphigus patients is related to the disease activity,and these three indicators can be used as reference indicators for the diagnosis of pemphigus disease activity.

Objective:To investigate the effect and mechanism of esophageal squamous cell carcinoma exosomal miR-181b-5p to the polarization of M2 macrophages.Methods:Extracted and identified exosomes from esophageal squamous cell carcinoma,and detected the expression of miR-181b-5p in esophageal squamous cell carcinoma cells and their exosomes by qRT-PCR.M0 type macro-phages were divided into PBS group,HEEC exo group,Eca-109 exo group,miR-NC exo group,miR-181b-5p exo group,miR-NC group,miR-181b-5p mimic group,si-NC group,si-PTEN group,miR-181b-5p exo+PTEN group.qRT-PCR was used to detect the expressions of CD163,CD206,iNOS and TNF-α in each group.The targeting relationship between miR-181b-5p and PTEN were veri-fied by double luciferase reporter gene experiment.Results:miR-181b-5p was significantly overexpressed in esophageal squamous cell carcinoma cells TE-13,TE-12,TE-10,Eca-109,KYSE30 and their exosomes(P<0.001).Compared with miR-NC group,the expression of CD163 and CD206 in cells were significantly upregulated in the miR-181b-5p mimic group,as well as the expressions of iNOS and TNF-α were significantly downregulated(P<0.001).The results of double luciferase reporter genes showed that PTEN was the target gene of miR-181b-5p.Compared with si-NC group,the expressions of CD163 and CD206 in cells were significantly upregu-lated in the si-PTEN group,as well as the expressions of iNOS and TNF-α were significantly downregulated(P<0.001).Compared with PBS group,the expressions of CD163 and CD206 in cells were significantly upregulated in the Eca-109 exo group,as well as the expressions of iNOS and TNF-α were significantly downregulated(P<0.001).Compared with miR-NC exo group,the expressions of CD163 and CD206 in cells were significantly upregulated in the miR-181b-5p exo group,as well as the expressions of iNOS and TNF-α were significantly downregulated(P<0.001).Compared with miR-181b-5p exo group,the expressions of CD163 and CD206 in cells were significantly downregulated in the miR-181b-5p exo+PTEN group,as well as the expressions of iNOS and TNF-α were significantly upregulated(P<0.001).Conclusion:Exosomal miR-181b-5p inhibits PTEN expressions to promote M2 macrophage polarization.

Objective:To investigate the effect of de novo designed epidermal growth factor receptor(EGFR)binding protein EGn and fibroblast growth factor receptor(FGFR)Ⅲc binding protein FG2 on pancreatic cancer cells.Methods:EGn and FG2 sequences were obtained from an existing study,and the proteins were amplified and expressed in Escherichia coli BL21(DE3)followed by purification through Ni-NTA affinity chromatography and size exclusion chromatography.The purified protein was tested with SDS-PAGE followed by Coomassie Brilliant Blue staining for purity evaluation.The expression level of EGFR and FGFR2 Ⅲc in PANC-1,MIA PaCa-2 and BxPC-3 cells was compared using Western blotting and real-time fluorescence quantitative PCR.The binding of EGn and FG2 in different pancreatic cancer cell lines was assessed by flow cytometry.The effect of EGn and FG2 on the phosphorylation of the target receptors or the down-stream extracellular signal-regulated kinase(ERK)molecules was analyzed by Western blotting.The effect of EGn and FG2 on the proliferation of PANC-1 and MIA PaCa-2 cells was evaluated by CCK-8 assay and colony formation assay.The effect of EGn and FG2 on the migration of PANC-1 cells was examined by Transwell assay.Results:EGn and FG2 proteins were successfully purified and can specifically bind to pancreatic cancer cell lines expressing target receptors,with the binding efficiency positively correlated with target receptor expression levels.EGn and FG2 can competitively inhibit the down-stream signaling of target receptors in PANC-1 cells,and significantly suppress the proliferation and migration of PANC-1 cells(P<0.05).However,their inhibitory effects on the down-stream signaling or proliferation in MIA PaCa-1 and BxPC-3 cells were relatively limited.Conclusion:EGn and FG2 demonstrate inhibitory effects on the proliferation and migration of PANC-1 cells with high expression of EGFR and ectopic high-expression of FGFR2 Ⅲc,indicating their potential therapeutic efficacy in pancreatic cancer and supporting the potential application of de novo designed binding proteins in targeted therapy for pancreatic cancer.

Objective:To investigate the effect of de novo designed epidermal growth factor receptor(EGFR)binding protein EGn and fibroblast growth factor receptor(FGFR)Ⅲc binding protein FG2 on pancreatic cancer cells.Methods:EGn and FG2 sequences were obtained from an existing study,and the proteins were amplified and expressed in Escherichia coli BL21(DE3)followed by purification through Ni-NTA affinity chromatography and size exclusion chromatography.The purified protein was tested with SDS-PAGE followed by Coomassie Brilliant Blue staining for purity evaluation.The expression level of EGFR and FGFR2 Ⅲc in PANC-1,MIA PaCa-2 and BxPC-3 cells was compared using Western blotting and real-time fluorescence quantitative PCR.The binding of EGn and FG2 in different pancreatic cancer cell lines was assessed by flow cytometry.The effect of EGn and FG2 on the phosphorylation of the target receptors or the down-stream extracellular signal-regulated kinase(ERK)molecules was analyzed by Western blotting.The effect of EGn and FG2 on the proliferation of PANC-1 and MIA PaCa-2 cells was evaluated by CCK-8 assay and colony formation assay.The effect of EGn and FG2 on the migration of PANC-1 cells was examined by Transwell assay.Results:EGn and FG2 proteins were successfully purified and can specifically bind to pancreatic cancer cell lines expressing target receptors,with the binding efficiency positively correlated with target receptor expression levels.EGn and FG2 can competitively inhibit the down-stream signaling of target receptors in PANC-1 cells,and significantly suppress the proliferation and migration of PANC-1 cells(P<0.05).However,their inhibitory effects on the down-stream signaling or proliferation in MIA PaCa-1 and BxPC-3 cells were relatively limited.Conclusion:EGn and FG2 demonstrate inhibitory effects on the proliferation and migration of PANC-1 cells with high expression of EGFR and ectopic high-expression of FGFR2 Ⅲc,indicating their potential therapeutic efficacy in pancreatic cancer and supporting the potential application of de novo designed binding proteins in targeted therapy for pancreatic cancer.

BACKGROUND: The clinical importance of hypokalemia is likely underrecognized in Chinese dialysis patients, and whether its clinical effect was mediated by serum albumin is not fully elucidated. This study aimed to explore the association between serum potassium and mortality in dialysis patients of a Chinese nationwide multicenter cohort, taking albumin as a consideration. METHODS: This was a prospective nation-wide multicenter cohort study. Restricted cubic splines were used to test the linearity of serum potassium and relationships with all-cause (AC) and cardiovascular (CV) mortality and a subsequent two-line piecewise linear model was fitted to approach the nadir. A mediation analysis was performed to examine relations of albumin to potassium and mortalities. RESULTS: A total of 10,027 patients were included, of whom 6605 were peritoneal dialysis and 3422 were hemodialysis patients. In the overall population, the mean age was 51.7 ± 14.8 years, 55.3%(5546/10,027) were male, and the median dialysis vintage was 13.60 (4.70, 39.70) months. Baseline serum potassium was 4.30 ± 0.88 mmol/L. After a median follow-up period of 26.87 (14.77, 41.50) months, a U-shape was found between potassium and mortality, and a marked increase in risk at lower potassium but a moderate elevation in risk at higher potassium were observed. The nadir for AC mortality risk was estimated from piecewise linear models to be a potassium concentration of 4.0 mmol/L. Interestingly, the significance of the association between potassium and mortality was attenuated when albumin was introduced into the extended adjusted model. A subsequent significant mediation by albumin for potassium and AC and CV mortalities were found ( P < 0.001 for both), indicating that hypokalemia led to higher mortality mediated by low serum albumin, which was a surrogate of poor nutritional status and inflammation. CONCLUSIONS Associations between potassium and mortalities were U-shaped in the overall population. The nadir for AC mortality risk was at a potassium of 4.0 mmol/L. Serum albumin mediated the association between potassium and AC and CV mortalities.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; East Asian People ; Hypokalemia/etiology* ; Kidney Failure, Chronic/mortality* ; Potassium/blood* ; Prospective Studies ; Renal Dialysis ; Serum Albumin/analysis*

Objective:To investigate the relationship between histone deacetylase (HDAC) gene polymorphism and type 2 diabetes mellitus (T2DM) in Bai and Han populations in Dali of Yunnan province.Methods:A total of 148 patients with T2DM of Bai and Han nationalities who received treatment in Dali Bai Autonomous Prefecture People's Hospital from May 2019 to March 2021 were included in the T2DM group. An additional 100 healthy controls of Bai and Han nationalities who concurrently received physical examination in the same hospital from May 2019 to December 2020 were included in the normal control group. The susceptibility genes of T2DM were detected using the Taqman MGB probe method. The susceptibility gene loci were amplified using polymerase chain reaction. The whole sequence of susceptibility gene was sequenced.Results:There were no significant differences in the distribution frequencies of rs2530223 genotype, rs11741808 genotype, rs2547547 genotype, and rs1741981 genotype between Bai and Han populations (all P > 0.05). There was a significant difference in blood lipid level between four loci ( t = -1.06, -0.19, 0.39, -2.12, -2.04, 0.16, 1.47, < 0.01, -0.16, -3.17, -2.93, 0.69, -2.58, -2.33, all P < 0.05). There was a significant difference in homeostasis model assessment of insulin resistance between different states (all P < 0.05). The frequency distributions of each genotype and each allele did not differ significantly between healthy control people of Bai nationality and T2DM patients of Bai nationality and between healthy control people of Han nationality and T2DM patients of Han nationality (all P > 0.05). Logistic regression analysis showed that the polymorphism was not an independent risk factor for T2DM. Conclusion:The relationships between HDAC gene polymorphism and T2DM, obesity and dyslipidemia differ between Bai and Han populations.

Objective: To explore the role of miR-30b in the trigeminal ganglion( TG) of trigeminal neuralgia( TN) model rats. Methods: An infraorbital nerve-chronic constriction injury( ION-CCI) model of TN was produced in the rat. Von Frey hair was used to determine the time-course of changes in mechanical pain threshold.qRT-PCR and Western blot were used to detect the expression of miR-30b and activating transcription factor 3( ATF3) in the TG. In addition,miR-30b agomir and agomir NC were injected into ION-CCI rats by the infraorbital foramen injection. The mechanical pain threshold and the expression changes of ATF3 were determined after intervention. Results: Compared with the sham-operated group,the ION-CCI group had a decreased mechanical pain threshold 2 days after surgery,reached the lowest observed level by day 12,and this threshold reduction lasted more than 28 days( P<0. 05). Compared with the sham-operated group,the ION-CCI group had a lower miR-30b expression and a higher ATF3 expression in postoperative TG( P<0. 05). After the overexpression of miR-30b in ION-CCI group,the mechanical pain threshold increased,and the expression of ATF3 decreased in TG( P<0. 05). Conclusion These results suggest that miR-30b may participate in the regulation of TN. miR-30b may be a potential therapeutic target for TN.