ObjectiveTo analyze the epidemiological and clinical characteristics of the 21 confirmed monkeypox cases in a district of Chengdu City, and to provide scientific guidance for the prevention and control of subsequent monkeypox epidemics. MethodsData of confirmed monkeypox cases residing in this district were collected from the Disease Control and Prevention Information System of China. A retrospective descriptive epidemiological analysis was used to analyze the demographic, distributional and behavioral characteristics of the cases. ResultsThe first confirmed case of monkeypox was reported on July 5, 2023. Up to April 30, 2025, a total of 21 confirmed cases of monkeypox have been reported. All cases were male, with a mean age of (30.9±6.2) years. The highest proportion of cases(47.62%) was in the 30‒40 years age group. The majority were men who have sex with men (MSM) population (90.48%, 19/21). The results showed that 19.05% of cases were co-infected with HIV, and 19.05% had a history of syphilis infection. Within 21 days prior to symptom onset, 19 cases (90.48%) self-reported engaging in male-to-male sexual contact, among whom 10 cases (52.63%) reported having taken protective measures, while 9 cases (47.37%) did not take safety precautions. Thirteen cases (61.90%) had no travel history to areas with reported monkeypox cases during the 21 days before symptom onset. The predominant manifestation was exanthem (100%, 21/21), followed by fever (57.14%, 12/21) and lymphadenectasis (47.62%, 10/21). Among febrile cases, 50.00% (6/12) had low-grade fever (37.3‒38.0 ℃). All cases were identified through active medical consultation. The median interval from symptom onset to the first medical visit was 3 (2, 6) days, with a maximum interval of 14 days. The median interval from symptom onset to laboratory confirmation was 7 (5, 9) days. Six cases (28.57%) had two or more visits to the hospital, with bacterial infection being the primary initial diagnosis. ConclusionMonkeypox prevention and control efforts in a district of Chengdu City should prioritize MSM population and young and middle-aged adults aged 30 to <40 years. It is recommended to establish an integrated monkeypox epidemic prevention and control network by leveraging existing HIV/AIDS prevention and control network. Concurrently, accelerating the deployment of the national intelligent infectious disease monitoring and early warning front-end software will strengthen early detection capabilities and be beneficial for the overall effectiveness of epidemic prevention and control efforts.

This paper summarizes professor YANG Chunbo's clinical experience in treating refractory constipation （RC） complicated with melanosis coli （MC） from the perspective of damp-heat theory. Internal accumulation of damp-heat is considered as the core pathogenesis of this condition， and the therapeutic principles should focus on clearing， transforming， tonifying， and resolving. Self-formulated Qinghua Beverage （清化饮） is developed to clear and transform damp-heat， regulate qi， and soothe collaterals. In clinical practice， RC complicated with MC is classified into damp-heat with qi stagnation syndrome and damp-heat with stasis obstruction syndrome. Qinghua Beverage is used as the base prescription with modifications according to syndrome differentiation. For damp-heat with qi stagnation syndrome， medicinals that promote qi movement and unblock the bowels， activate blood and clear collaterals are added， while for damp-heat with stasis obstruction syndrome， herbs that resolve stasis and unblock collaterals are incorporated， with simultaneous consideration of nourishing blood and supporting collaterals.

Latent autoimmune diabetes in adults (LADA) is a type of mixed diabetes in WHO2019 Diabetes classification. LADA has both type 1 diabetes and type 2 diabetes genetic susceptibility genes. It is difficult to distinguish LADA from type 1 diabetes mellitus and type 2 diabetes mellitus. This paper systematically reviewed the genetic background and immune characteristics of LADA, providing new ideas for the study of LADA and theoretical support for the precise diagnosis and treatment of LADA and immune intervention strategies.

Objective:To explore the serum miRNA-144-5p (miR-144-5p) level in liver cancer patients and its relationship with clinical characteristics, as well as the target genes of miR-144-5p and the possible pathogenic mechanisms.Methods:The morning fasting serum samples were retrospectively collected from 100 newly diagnosed liver cancer patients (liver cancer group) before any treatment in Shanxi Province Cancer Hospital from June 2019 to June 2020, as well as 100 healthy individuals (healthy control group) during physical examinations in the same period. The real-time fluorescence quantitative polymerase chain reaction method was used to measure the transcription level expression of miR-144-5p in serum. The high and low expressions of miR-144-5p in patients were determined based on the median relative expression level of miR-144-5p; the distribution differences between patients with high and low expressions of miR-144-5p among different clinical pathological features were compared. The online tools miRDB, TargetScan 8.0 and miRWalk were used to predict potential target genes for miR-144-5p, and Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed through a bioinformatics platform, and complementary sequences between miR-144-5p and target genes were analyzed using RNA22 software.Results:The median age of the liver cancer group was 54 years old, ranging from 38 to 74 years old, including 80 males (80.0%) and 20 females (20.0%); the median age of the healthy control group was 46 years old, ranging from 34 to 66 years old, including 69 males (69.0%) and 31 females (31.0%); there was no statistically significant difference in age and gender composition between the two groups (both P > 0.05). The median transcription level relative expression of miR-144-5p in liver cancer patients was lower than that in the healthy control group [ M ( Q1, Q3)] [0.311 (0.066, 2.270) vs. 1.067 (0.263, 3.620)], and the difference was statistically significant ( Z = -4.16, P < 0.001). The proportion of patients with low expression of miR-144-5p was higher in the group with maximum diameter of tumor > 5 cm compared to the group with maximum diameter of tumor ≤5 cm [59.3% (35/59) vs. 36.6% (15/41)] and in the group with metastasis compared to the group without metastasis [60.4% (29/48) vs. 40.4% (21/52)], and the differences were statistically significant (both P < 0.05). There was no statistically significant difference in the distribution of patients with high and low expressions of miR-144-5p among different subgroups based on gender, age >55 years, presence of hepatitis, cirrhosis, alpha fetoprotein >400 μ g/L, and differentiation degree (all P > 0.05). According to predictions, there were 34 miR-144-5p target genes shared by the three bioinformatics online tools. GO and KEGG enrichment analyses showed that these target genes were associated with ubiquitination, primarily enriched in the ubiquitin-mediated proteolysis pathway (hsa04120) and the mTOR signaling pathway (hsa04150). RNA22 software analysis showed that miR-144-5p mainly had complementary sequences with 3' untranslated regions of UBR5 and UBE4A genes. Conclusions:The serum miR-144-5p level in liver cancer patients is relatively low, and its expression level may be related to tumor size and metastasis. miR-144-5p may affect the occurrence and development of liver cancer by regulating ubiquitination level through target genes such as UBR5 and UBE4A.

Objective:To explore the prognosis of patients with gastric cancer peritoneal metastasis (PM) receiving programmed cell death-1 (PD-1) antibody therapy, and investigate the biomarkers that affect the prognosis of anti-PD-1 therapy.Methods:This restrospecific study collected the clinic-pathological data of 56 patients with peritoneal metastasis of gastric cancer who received first-line treatment in the Nanjing Drum Town Hospital from March 2020 to September 2023, among which 41 had received anti-PD-1 immunotherapy and 15 hadn't. The relationship between overall survival (OS) and anti-PD-1 immunotherapy was evaluated by Kaplan-Meier analysis. The relationship between baseline peripheral blood indicators and treatment response of patients with anti-PD-1 treatment was analyzed using unpaired t-test. Subsequently, the Cox proportional risk regression model was used to explore the clinical prognostic factors that may affect anti-PD-1 immunotherapy by univariate and multivariate analysis. The clinical prognostic factors included baseline data and baseline peripheral blood indexes such as anti-PD-1 treatment lines, Eastern Cooperative Oncology Group performance status (ECOG PS), combined positive score (CPS), expression of human epidermal growth factor receptor 2 (Her-2), EBER status, pathological types, other metastatic lesions, ascites content before immunotherapy, with or without abdominal drainage during anti-PD-1 treatment, blood lipid indicators, inflammatory indicators, and tumor indicators. Results:Kaplan-Meier survival statistics showed similar OS (15.9 vs. 15.2 months, P=0.600) in patients with anti-PD-1 therapy compared to those without anti-PD-1 therapy. Patients with baseline high-density lipoprotein (HDL) ≥0.97 mmol/L ( n=22) demonstrated a significantly longer median OS compared to those with HDL＜0.97 mmol/L (15.2 vs. 13.5 months; P=0.018). Similarly, the cohort with apolipoprotein A1 (ApoA1) levels ≥0.86 g/L ( n=21) showed superior survival outcomes, with a median OS of 17.7 months versus 12.3 months in the ApoA1＜0.86 g/L group ( n=20; P=0.006). In contrast, elevated baseline alpha-fetoprotein (AFP) levels ( n=2) were associated with markedly reduced survival (median OS: 5.7 vs. 15.2 months in normal AFP group, n=37; P=0.005). Notably, elevated pretreatment ApoA1 levels correlated with enhanced immunotherapy response ( P=0.017). Multivariate Cox regression analysis revealed that ApoA1 deficiency (≥0.86 g/L) independently predicted better OS following PD-1 antibody therapy ( HR=0.35, 95% CI: 0.12-0.98, P=0.046) in gastric cancer patients with PM. Conclusions:In our study, it is first proposed that ApoA1 could be a significant predictor of the survival advantages of immunotherapy in gastric cancer patients with PM.

Objective To observe the value of whole-brain CT perfusion(CTP)parameters at different time and clinical data for predicting delayed cerebral ischemia(DCI)and 3-month poor prognosis in patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods Totally 127 aSAH patients were retrospectively enrolled.Clinical and CTP data within 24 h of symptom onset and during DCI time window(DCITW)were collected.The patients were divided into DCI group(n=34)and non-DCI group(n=93)based on DCI occurred or not during hospitalization,also into poor outcome group(modified Rankin scale[mRS]≥3,n=36)and good outcome group(mRS≤2)based on 3-month's follow-up.Multivariate logistic regression was performed to select independent predictive factors among variates being significantly different between groups.Then receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the predictive performance of logistic regression model.Results Patients'age,modified Fisher score(mFS),subarachnoid hemorrhage early brain edema score(SEBES)and mean flow extraction product(mFEP)within 24 h of onset were all identified as independent predictive factors of DCI,and the AUC of their combination for predicting DCI during hospitalization was 0.817.Patients' age and mFS within 24 h of onset,alternatively,World Federation of Neurosurgical Societies(WFNS)grade and mFEP during DCITW were all independent predictive predictors of 3 months' prognosis,and the combination of the latter two showed better predictive performance(AUC=0.922)tahn the former two(AUC=0.822,P＜0.05).Conclusion Whole-brain CTP parameters combined with clinical data within 24 h of onset of aSAH could be used to predict the occurrence of DCI during hospitalization,whole-brain CTP parameters during DCITW could be used to predict 3 months'poor prognosis.

Objective:To clarify the effects of simple subtalar fusion on distribution of plantar pressures.Methods:A retrospective study was conducted to analyze the 19 patients who had undergone simple subtalar fusion between January 2006 and December 2020 at Department of Orthopedics, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine. There were 13 males and 6 females with an age of (42.1±11.8) years and a duration of disease of 1.7 (1.0, 2.0) years. Another 14 normal subjects were recruited as normal controls [7 males and 7 females, with an age of (25.0±1.9) years]. The data of plantar pressure distribution were detected and analyzed by a Belgian Footscan? plantar pressure tester. The affected and healthy sides of the patients were compared with those of the normal group to analyze the peak pressures on different foot regions.Results:There was no significant difference in height or weight between the patients and the normal subjects ( P>0.05). The peak pressures on the first to the third metatarsal region of the forefoot and the medial region of the hindfoot of the affected foot were significantly lower than those of the normal foot in the patients ( P<0.05). The peak pressure on the forefoot region of a normal foot appeared in the third metatarsal region. In the patients, the peak pressure on the forefoot region of a healthy side shifted inward and appeared in the second metatarsal region, but the peak pressure on the forefoot region of an affected side shifted laterally and appeared in the fourth metatarsal region. The peak pressure on the midfoot of an affected side [(4.38±2.17) N/cm 2] was significantly higher than that on a healthy side [(3.04±1.80) N/cm 2] in the patients ( P=0.035). The peak pressures on the medial and lateral hindfoot regions of a healthy side were (7.12±1.91) N/cm 2 and (7.98±2.03) N/cm 2, respectively, showing no significant difference ( P=0.086). The peak pressure on the lateral hindfoot region of an affected side [(10.77±4.21) N/cm 2] was significantly higher than that on the medial hindfoot region [(8.71±2.89) N/cm 2] ( P=0.009). The peak plantar pressures on the affected side shifted to the lateral side in the patients. Conclusions:Subtalar fusion can exert significant effects on the distribution of plantar pressures. Specifically, the plantar pressures shift to the lateral side of an affected foot during all the gait stages while the plantar pressures on the healthy forefoot may compensate by transferring to the medial side in the patients.

Objective:To evaluate the safety and efficacy of early precise lower limb weight-bearing functional rehabilitation after open reduction and internal fixation of ankle fractures.Methods:A restropective multi-center study was conducted to enroll the eligible 120 patients with malleolar fracture who received the same surgical treatment from March 2023 to December 2023 at the trauma centers in 7 tertiary hospitals according to the inclusion criteria. They were assigned into a study group ( n=60) for precise lower limb weight-bearing functional rehabilitation with the assistance of intelligent lower limb walking rehabilitation crutches and a control group ( n=60) for conventional weight-bearing functional rehabilitation which was gradually increased according to their own feelings under the protection of a walking boot. All the 60 patients in the study group completed their final follow-ups. They were 25 males and 35 females, with an age of (43.8±16.6) years and a body mass index of (25.3±2.3) kg/m 2. Only 51 patients in the control group completed their final follow-ups. They were 27 males and 24 females, with an age of (45.1±16.4) years and a body mass index of (24.7±2.3) kg/m 2. When their incisions healed and their sutures were removed 2 weeks after operation, the patients were guided to start lower limb weight-bearing functional rehabilitation, and exercises for foot and ankle joint mobility and lower limb muscles. The end point of follow-up was 12 weeks after operation. The 2 groups were compared in terms of the crutch-off rates, thigh circumferences, calf circumferences, dorsiflexions, plantarflexions, ankle swellings, American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores, and visual analog scale (VAS) pain scores at 6 and 12 weeks after operation. The complications were also recorded in the 2 groups. Results:No statistically significant differences were observed in the baseline characteristics between the 2 groups, indicating comparability ( P>0.05). At 6 and 12 weeks after operation, the crutch-off rates [41.7% (25/60) and 100.0% (60/60)], dorsiflexions (69.3%±21.6% and 82.9%±26.3%) and AOFAS ankle-hindfoot scores [(68.5±7.6) points and (96.9±3.7) points] in the study group were significantly better than those in the control group [13.7% (7/51) and 39.2% (20/51), 61.5%±16.5% and 72.0%±14.3%, (61.9±9.3) points and (90.1±7.2) points] ( P<0.05). At 6 weeks after operation, the thigh circumference (97.4%±1.9%), calf circumference (97.3%±1.9%), and plantarflexion (76.6%±19.8%) in the study group were significantly higher than those in the control group (95.9%±2.5%, 94.6%±3.2%, and 63.9%±16.9%) ( P<0.05). There were no significant differences between the 2 groups in ankle swelling at 6 or 12 weeks after operation, or thigh or calf circumference, plantarflexion, or VAS pain score at 12 weeks after operation ( P>0.05). No wound complications, secondary fracture displacement, or loosening of internal fixation occurred in either group during the follow-up period. There were no cases of nonunion or delayed union. Conclusions:Early lower limb weight-bearing functional rehabilitation after open reduction and internal fixation of ankle fractures demonstrates good safety. Precise weight-bearing rehabilitation accelerates functional recovery of the ankle, enabling earlier return to normal daily activities.

Latent autoimmune diabetes in adults (LADA) is a type of mixed diabetes in WHO2019 Diabetes classification. LADA has both type 1 diabetes and type 2 diabetes genetic susceptibility genes. It is difficult to distinguish LADA from type 1 diabetes mellitus and type 2 diabetes mellitus. This paper systematically reviewed the genetic background and immune characteristics of LADA, providing new ideas for the study of LADA and theoretical support for the precise diagnosis and treatment of LADA and immune intervention strategies.

The struggle between healthy qi and pathogenic factors runs through the whole process of the formation and development of diabetic cardiomyopathy(DCM),and autophagy is the main regulator of cardiac homeostasis and function.Based on the theory of healthy qi and pathogenic factors,the autophagy state of DCM was understood.In the early stage of DCM,it is mainly characterized by deficiency of healthy qi and supplemented by pathogenic excess.In the middle stage,it is characterized by deficiency of healthy qi and pathogenic excess.In the late stage,it is mainly characterized by pathogenic excess and supplemented by deficiency of healthy qi.TCM clinical practice adheres to the principle of"strengthening the healthy qi and eliminating pathogenic factors",which aims to restore the dynamic balance of autophagy in the body by adjusting the balance between healthy qi and pathogenic factors,and ultimately improve the prognosis of DCM.This article took the theory of healthy qi and pathogenic factors as the starting point,and elaborated on the role of autophagy in the development of DCM from macro and micro perspectives.It explored Chinese materia medica intervention plans for different stages of DCM,providing theoretical reference for the regulation of autophagy in DCM by TCM.