Objective: To investigate the trends in incidence and mortality of lung cancer in Huangpu District, Shanghai Municipality from 2002 to 2019, so as to provide the evidence for formulating lung cancer prevention and control measures. Methods: Data of lung cancer incidence and mortality among residents in Huangpu District from 2002 to 2019 were collected through the Shanghai Cancer Registration and Reporting Management System. The crude incidence and mortality of lung cancer was calculated, and standardized by the data from the Chinese Fifth National Population Census in 2000 (Chinese-standardized rate) and the Segi's world standard population in 1960 (world-standardized rate). The trends in incidence and mortality of lung cancer among residents by age and gender were evaluated using annual percent change (APC). Results: A total of 12 965 cases of lung cancer were reported in Huangpu District from 2002 to 2019, and the crude incidence rate was 80.66/105, the Chinese-standardized incidence rate was 34.54/105, and the world-standardized incidence rate was 31.30/105, all showing upward trends (APC=4.588%, 2.933% and 3.247%, all P<0.05). A total of 10 102 deaths of lung cancer were reported, and the crude mortality rate was 62.30/105, showing an upward trend (APC=0.959%, P<0.05); the Chinese-standardized mortality was 25.93/105, and the world-standardized mortality was 22.05/105, both showing downward trends (APC=-1.282% and -1.263%, both P<0.05). The crude incidence and mortality rates of lung cancer in males were higher than those in females (101.39/105 vs. 60.52/105, 85.45/105 vs. 39.87/105, both P<0.05). The crude incidence and mortality rates of lung cancer showed upward trends with age (both P<0.05), reaching their peaks in the age groups of 80-<85 years (341.37/105) and 85 years or above (355.97/105), respectively. Conclusions The incidence of lung cancer showed an upward trend, while the mortality showed a downward trend in Huangpu District from 2002 to 2019. Elderly men were the high-risk group for lung cancer incidence and mortality.

Objective Through the combined detection method,we tried to find more sensitive biomarkers for the diagnosis of acute TBI,which might provide the exact diagnosis,treatment and monitoring indicators for the clinic.Methods A total of 156 patients with acute TBI admitted to the Emergency Traumatic Center of Yan'an Hospital of Kunming from October 2022 to June 2023 were collected and included the normal and fracture control groups.Peripheral blood samples of the enrolled patients were collected and monitored,S100β and IL-6 were tested and clinical data such as hs-CRP was collected immediately upon admission,then statistical analysisanalysis was conducted.Results Peripheral blood in patients with acute TBI,The levels of S100β,IL-6 and hs-CRP significantly increased,and the area under the ROC curve for diagnosing acute TBI was 0.944,0.915,and 0.897.The combined detection of the three indicators showed an area under the ROC curve of up to 0.975.Person correlation analysis found a positive correlation between the three indicators,especially S100β with IL-6,The correlation coefficient between them is 0.715.Binary logistic regression analysis found that S100β,IL-6 and hs-CRP are independent risk factors for acute TBI.Conclusions The combined detection of S100β,IL-6 and hs-CRP can effectively improve the sensitivity of acute TBI diagnosis.The mutual promotion of S100β and IL-6 may aggravate the secondary craniocerebral injury caused by inflammatory mechanism,and early targeted treatment may improve the prognosis.

Objective:To compare the clinical outcomes between percutaneous Kirschner wire leverage plus plaster fixation and elastic intramedullary nailing in the treatment of radial neck fractures in children.Methods:A retrospective study was conducted to analyze the 60 children with radial neck fracture who had been treated by percutaneous Kirschner wire leverage plus plaster fixation at Department of Pediatric Orthopedics, Children's Hospital of Soochow University from January 2016 to July 2023 (set as an internal fixation-free group). They were 30 males and 30 females (34 left and 26 right sides) with an age of (7.7±3.0) years. At the same time, another cohort of 60 patients were chosen as an intramedullary nailing group who had been treated by percutaneous Kirschner wire leverage plus elastic intramedullary nailing and matched in age and gender with those in the internal fixation-free group. The preoperative fracture angulation, operative time, hospitalization time, fracture angulation on the first postoperative day, fracture angulation at 1 month postoperatively, rate of angulation loss after reduction, Mayo elbow performance score (MEPS) at the last follow-up and complications were compared between the 2 groups.Results:There was no significant difference between the 2 groups in their preoperative general data, showing comparability ( P<0.05). The 120 pediatric patients were followed up for (7.5±3.2) months. The operative time [(27.4±15.0) min] and hospitalization time [(3.4±1.9) d] in the internal fixation-free group were significantly shorter than those in the intramedullary nailing group [(45.4±13.5) min and (4.4±1.3) d] ( P<0.05). The preoperative fracture angulation (50.8°±1.9°), fracture angulation on the first postoperative day (11.3°±1.2°), fracture angulation at 1 month postoperatively (12.1°±1.3°), rate of angulation loss after reduction (2.9%±0.5%), and MEPS at the last follow-up [(90.4±2.0) points] in the internal fixation-free group showed no significant differences from those in the intramedullary nailing group [49.5°±1.7°, 11.1°±1.2°, 13.3°±1.5°, 3.9%±1.4%, and (90.2±2.3) points] ( P>0.05). None of the patients in the internal fixation-free group developed pin-tail irritation sign or premature epiphyseal closure after surgery, whereas 3 patients in the intramedullary nailing group developed pin-tail irritation sign and 2 ones premature epiphyseal closure after surgery, showing a significant difference in the complication rate between the 2 groups [0 (0/60) versus 8.3% (5/60)] ( P<0.05). Conclusions:Percutaneous Kirschner wire leverage plus plaster fixation and close elastic intramedullary nailing can both achieve satisfactory outcomes in the treatment of radial neck fractures in children. However, percutaneous Kirschner wire leverage plus plaster fixation needs shorter operative time and hospitalization time, leads to fewer complications, and requires no reoperation to remove internal fixation.

Objective This study investigated the protective effects of Corni Fructus ethanol extract on β-amyloid protein 25-35 (Aβ25-35)-induced Alzheimer's disease (AD) mice by regulating histone lysine-specific demethylase 1 (LSD1) / postsynaptic density protein 95 (PSD95) on synapses and neuroinflammation. Methods Specifically, according to the body weight, 40 C57BL/6N mice were randomized into four groups: the sham operation group, the model group, the low-dose (0.1mg/g) and the high-dose (0.3 mg/g) Corni Fructus ethanol extract groups. Aβ25-35 was injected into the hippocampus of mice in three groups except for the sham operation group to established AD model. All mice were orally administered with either Corni Fructus ethanol extract or vehicle by gavage for 7 days before molding and continued 5 days after surgery for a total of 60 days. Morris water maze, Y maze and open field tests were performed to evaluate the recognition memory and space exploration ability of mice. The expression of LSD1, PSD95, synaptophysin (SYN), interleukin-1β (IL-1β), tumor necrosis factor-α(TNF-α) and H3K9me2 level were measured by Western blotting. Chromatin immunoprecipitation (CHIP) combined with qPCR was used to detect H3K9me2 modification of PSD95 promoter region and mRNA levels of PSD95. The correlation between the expression of H3K9me2 and PSD95 and the expression of IBA1 in the hippocampus were detected by immunofluorescence assay.Results The result showed that Corni Fructus ethanol extract significantly reversed Aβ25-35-induced learning and memory impairment in AD mice. Compared with the model group, Corni Fructus ethanol extract demonstrated shorter escape latency, increased number and time of autonomous activities and the rate of autonomous alternation. Moreover, it increased the expression of LSD1 in hippocampus of AD mice(P<0.05), and reduced H3K9me2 modification level in the promoter region of PSD95 gene, and then promoted the mRNA transcription and protein expression of PSD95. Immunofluorescence staining indicated the reduction of H3K9me2 modification level in hippocampus was accompanied by the enhancement of PSD95 expression. Corni Fructus ethanol extract could also inhibit the activation of microglia and reduce the expression of proinflammatory factors IL-1β and TNF-α.Conclusion Corni Fructus ethanol extract may regulate PSD95 gene transcription by up-regulating the expression of LSD1 and reducing the H3K9me2 modification level in its promoter region, thereby increasing the expression of PSD95, a key protein in synaptic plasticity regulation, which alleviate neuroinflammatory response, improve learning and memory dysfunction in AD model mice, and thus play a protective role in Aβ25-35-induced nerve damage.

Objective:To explore the predictive value of the change rate of parathyroid hormone (PTH) after total thyroidectomy (TT) for hypoparathyroid function.Methods:A total of 182 patients with thyroid tumor who underwent TT from Jan. 2018 to Jun. 2023 in the Department of Otolaryngology, Head and Neck Surgery, Second Hospital of Shanxi Medical University were retrospectively selected as the study objects. The clinical and surgical data of the patients were collected, and the key factors associated with postoperative hypoparathyroidism were screened by multi-factor analysis. The change rate of serum PTH was calculated during perioperative period (before operation, at the end of operation, 1 and 3 days after operation). Receiver operator curve (ROC) was used to analyze the predictive value of PTH change rate in all patients.Results:Whether temporary hypoparathyroidism (THP) or permanent hypoparathyroidism (PHP), both were closely related to TT+ bilateral central lymph node dissection ( χ2=33.764, 9.235, P < 0.05) and parathyroid resection ( χ2=6.512, 58.999, P < 0.05). The change rate of PTH in HP patients was significantly higher than that in normal patients ( F=15.993, 16.830, 19.024, P < 0.05), and on the first and third day after surgery, the change rate of PTH in PHP patients was significantly higher than that in THP patients ( t=7.955, 9.023, P < 0.05). The predicted area under curve (AUC) of THP or PHP in different patient populations is different with the change rate of PTH in different periods. For patients with TT+ bilateral central lymph node dissection and parathyroidectomy, the change rate of PTH at the end of surgery was significantly higher than the change rate of PTH at 3 days after surgery for the AUC with PHP ( Z=5.433, 4.923, P < 0.05) . Conclusion:Perioperative PTH has good predictive value for THP and PHP in TT patients, especially in TT+ bilateral central lymph node dissection and parathyroidectomy.

Objective To study the role and mechanisms of equilibrative nucleotide transporter 1(ENT1)on Alzheimer's disease(AD)by constructing ENT1 overexpression and knockdown plasmids.Methods Molecular cloning was used to construct the ENT1 overexpression(pAAV-ENT1-mCherry)and knockdown(pAAV-ENT1shRNA-ZsGreen)plasmids.The overexpression plasmids and the knockdown plasmids were transfected into N2A cells(mouse Neuro A2 cells)and N2A-APP cells(N2A cells stably expressing human APP695).The expression of ENT1 and inflammatory factors at mRNA and protein levels were detected by real-time qPCR and Western blotting,respectively,and the change in cell viability were measured with CCK-8 assay.Results Sequencing and real-time qPCR indicated that ENT1 overexpression and knockdown plasmids were successfully constructed.CCK-8 assay showed that ENT1 overexpression significantly reduced the cell survival rate within 24 h(P＜0.05),while its knockdown increased the cell survival rate(P＜0.01).Real-time qPCR displayed that overexpression of ENT1 enhanced the expression levels of inflammatory factors,such as IL-1β,TNF-α,C1q-a and C1q-b in N2A cells(P＜0.05),while ENT1 knockdown reversed the above changes in inflammatory factors in N2A-APP cells(P＜0.05).Conclusion Knockdown of ENT1 attenuates pathological changes in AD by reducing the inflammatory response.ENT1 may be a potential target in the pathological mechanism of AD.

Objective To investigate the effect of probiotics in patients with chronic heart failure (CHF) and its impact on intestinal microecology. Methods A total of 112 patients with CHF were selected as research subjects and randomly divided into study group and control group, with 56 patients in each group. The control group received angiotensin-converting enzyme inhibitors (ACEI) combined with angiotensin Ⅱ receptor blockers (ARB) for treatment, while the study group received bifidobacterium viable capsules on the basis of treatment in the control group. The levels of myocardial fibrosis markers[type Ⅰ collagen precursor C-propeptide (PⅠCP), type Ⅲ collagen precursor N-propeptide (PⅢNP), PⅠCP/PⅢNP, type Ⅰ collagen carboxyl-terminal peptide (ⅠCTP)], cardiac function indicators[leftventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular end-systolic volume (LVESV)], intestinal flora abundance, plasma trimethylamine oxide (TMAO) levels, and serum tumor necrosis factor-α(TNF-α) and interleukin-1β(IL-1β) levels were measured in both groups. The therapeutic effects, drug safety, re-hospitalization rate, and mortality rate within 3 months after discharge were observed in both groups. Results The total effective rate in the study group was 71.43 %, which was higher than 51.79 % in the control group (P < 0.05). After treatment, the LVEF in the study group was higher than that in the control group, while LVEDD, LVESD, and LVESV were lower than those in the control group (P < 0.05). After treatment, the PⅠCP/PⅢNP in the study group was higher than that in the control group, while the ⅠCTP level was lower than that in the control group (P < 0.05). After treatment, the abundances of Proteobacteria, Actinobacteria, Firmicutes, and Fusobacteria in the study group were lower than those in the control group, while the abundance of Bacteroidetes was higher than that in the control group (P < 0.05). After treatment, the levels of TMAO, TNF-α, and IL-1β in the study group were lower than those in the control group (P < 0.05). No serious adverse reactions occurred in either group after treatment. Within 3 months after discharge, the re-hospitalization rate in the study group was 12.50 %, which was lower than 30.36 %in the control group (P < 0.05). The mortality rates in the study group and the control group were 1.79 % and 7.14 %, respectively, but no statistically significant difference was observed(P>0.05). Conclusion The combination of probiotics with ACEI and ARB can effectively reduce myocardial fibrosis in patients with CHF and improve intestinal microecology and prognosis.

OBJECTIVE: To assess the clinical efficacy and health economic value of non-invasive prenatal testing (NIPT) for the prenatal screening of common fetal chromosomal aneuploidies. METHODS: 10 612 pregnant women from October 2017 to December 2019 presented at the antenatal screening clinic of the General Hospital of Tianjin Medical University were selected as the study subjects. Results of NIPT and invasive prenatal diagnosis and follow-up outcome for the 10 612 pregnant women were retrospectively analyzed and compared. Meanwhile, NIPT data for two periods were analyzed for assessing the health economic value of NIPT as the second- or first-tier screening strategy for the prenatal diagnosis of fetal trisomies 21, 18 and 13. RESULTS: The NIPT was successful in 10 528 (99.72%) subjects, with the sensitivity for fetal trisomies 21, 18 and 13 being 100%, 92.86% and 100%, and the positive predictive value (PPV) being 89.74%, 61.90% and 44.44%, respectively. The PPV of NIPT for sex chromosome aneuploidies was 34.21%. Except for one false negative case of trisomy 18, the negative predictive value for trisomy 21, trisomy 13 and other chromosomal abnormalities were 100%. For pregnant women with high risk by serological screening, advanced maternal age or abnormal ultrasound soft markers, NIPT has yielded a significantly increased high risk ratio. There was no statistical difference in the PPV of NIPT among pregnant women from each subgroup. NIPT would have higher health economic value as a second-tier screening until 2019, while compared to 2015 ~ 2017, its incremental cost-effectiveness ratio as a first-tier screening had declined clearly. CONCLUSION The screening efficacy of NIPT for trisomies 21, 18 and 13 for a mixed population is significantly better than conventional serological screening, but it is relatively low for sex chromosomal abnormalities. NIPT can also be recommended for populations with relatively high risks along with detailed pre- and post-test genetic counselling. From the perspective of health economics, except for open neural tube defects, it is possible for NIPT to replace the conventional serological screening in the future as its cost continues to decrease.
Pregnancy ; Female ; Humans ; Trisomy/genetics* ; Retrospective Studies ; Prenatal Diagnosis/methods* ; Down Syndrome/genetics* ; Aneuploidy ; Chromosome Aberrations ; Trisomy 18 Syndrome/genetics* ; Sex Chromosome Aberrations ; Fetus

Objective:To report a case of acute kidney injury caused by rhabdomyolysis and summarize its etiology, pathogenesis, and treatment strategy.Methods:The clinical data of a case of rhabdomyolysis complicated by acute kidney injury admitted to Affiliated Huadu Hospital of Southern Medical University on August 30, 2020, were collected, including clinical manifestation, auxiliary examination, and disease outcome. Referring to the previous literature reports of rhabdomyolysis complicated by acute kidney injury, this paper discusses its etiology, monitors and analyzes some indicators such as serum creatinine, blood urea nitrogen, creatine kinase, myoglobin, and 24-hour urine volume during the treatment, and summarizes the clinical diagnosis and treatment ideas of the disease.Results:This case developed an intestinal infection after an unclean diet, which induced rhabdomyolysis and acute kidney injury. Renal pathology after renal biopsy showed that renal biopsy result was consistent with an acute tubulointerstitial injury caused by myoglobin tubular nephropathy. The biochemical indexes such as creatine kinase and myoglobin decreased rapidly after ordinary hemodialysis, but the levels of serum creatinine and blood urea nitrogen did not decrease markedly, and there was continuous oliguria. After switching to hemodialysis filtration and continuous intensive dialysis treatment, the levels of serum creatinine and blood urea nitrogen decreased rapidly, the amount of urine increased gradually, and finally, the renal function recovered.Conclusion:For acute kidney injury caused by rhabdomyolysis, early sufficient blood purification can accelerate the clearance of myoglobin, promote the recovery of the injured kidney, and improve the prognosis of the disease.

Objective:To investigate the characteristics of cardiac structure and function changes in maintenance hemodialysis (MHD) patients.Methods:The information of 363 MHD patients with dialysis age ≥3 months who were registered in Huadu District People′s Hospital of Guangzhou City before January 2020 was collected, and the echocardiographic screening was performed to analyze the changes in cardiac structure and function.Results:The most common abnormal changes of heart structure and function in MHD patients were valve regentation (69.7%), left ventricular hypertrophy (LVH) (51.8%), left ventricular diastolic dysfunction (29.8%), valve calcification (11.6%), and left ventricular systolic dysfunction (10.2%). With the increase of age, the left ventricular ejection fraction of MHD patients decreased, and the proportion of left ventricular diastolic dysfunction, left atrial enlargement and pulmonary hypertension increased (all P<0.05). Among 363 MHD patients, 188(51.8%) had LVH. It was found that LVH patients had higher average single ultrafiltration volume, higher brain natriuretic peptide (BNP) level, more type 2 diabetes, lower left ventricular ejection fraction (all P<0.05), and were more prone to chest tightness, chest pain, post activity shortness of breath, heart failure and other symptoms compared with the non-LVH patients (all P<0.05). Conclusions:Most MHD patients have different degrees of cardiac structural changes. Early intervention, reduction of single ultrafiltration volume and control of blood glucose are beneficial to improve the dialysis quality of MHD patients and reduce the occurrence of cardiovascular events.