Objective:To investigate the current application of blood purification in the treatment of acute poisoning within Jiangsu Province and to evaluate the impact of extracorporeal blood purification on the clinical outcomes of critically poisoned patients.Methods:This multicenter, cross-sectional real-world observational study followed patients presenting with poisoning to the emergency departments of nine hospitals in Jiangsu Province between June 2015 and May 2019. Data were collected on demographic characteristics, vital signs within the first hour of emergency presentation, treatment modalities, length of hospital stay, and survival outcomes. Clinical data from patients who underwent extracorporeal blood purification were compared with those who did not, using the Wilcoxon rank-sum test and Chi-square test.Results:A total of 4 178 poisoning cases were included between June 2015 and May 2019. Among them, 21.7% (908/4 178) received blood purification therapy, while 78.3% (3 270/4 178) did not. Hemoperfusion (90.4%) was the most frequently employed method, followed by continuous renal replacement therapy (CRRT) (4.4%). In combined blood purification modalities, 4.8% underwent hemoperfusion combined with CRRT, 0.1% received hemoperfusion with plasma exchange, and another 0.1% underwent hemoperfusion combined with both CRRT and plasma exchange. Among patients who underwent blood purification, pesticide poisoning was the most prevalent (76.3%), with the most common toxic agents being paraquat (23.7%), dichlorvos (8.7%), methamidophos (5.2%), omethoate (4.0%), and glyphosate (3.7%). Compared to the non-blood purification group, patients in the blood purification group were more likely to present within the first hour with a low Glasgow Coma Scale (GCS) score (3-8) (22.6% vs. 9.7%, P <0.05), low mean arterial pressure (8.0% vs. 3.2%, P <0.05), longer hospital stays [5(3,9) days vs. 2(1,4) days, P <0.05] and a higher in-hospital mortality rate (21.1% vs. 5.3%, P <0.05). Follow-up via telephone 28 days after discharge revealed a survival rate of 78.9%, with a mortality rate of 21.1% in the blood purification group. Conclusions:Hemoperfusion is the most commonly utilized blood purification technique for treating poisoning in Jiangsu Province, with pesticides being the primary toxic agents treated. Although the mortality rate is higher in the blood purification group, the intervention may still contribute to improved patient outcomes.

Gastroesophageal reflux disease （GERD） is a prevalent chronic digestive disorder， affecting about 20% of the population. In addition to the typical symptoms of acid regurgitation and pyrosis， GERD can lead to chronic esophageal mucosal inflammation， thereby increasing the risk of esophageal carcinoma. Proton pump inhibitors （PPIs） have emerged as the primary pharmacological intervention due to their efficacy in reducing gastric acid production. However， the long-term use of PPIs is associated with various complications， including malabsorption of nutrients， heightened susceptibility to enteric infections， and an elevated risk of fractures. These concerns have driven the pursuit of safer and more efficacious therapeutic alternatives by both patients and healthcare providers. Recent studies have highlighted the role of persistent inflammation triggered by irritation of the esophageal epithelial cells in the pathogenesis of GERD. Such inflammation not only exacerbates mucosal damage but also contributes to the chronicity and complexity of the disease. Consequently， the development of novel anti-inflammatory therapeutic strategies has become a focus in contemporary research. Chinese herbal medicine prescriptions， with distinctive anti-inflammatory and antioxidant properties， offer a promising avenue for the management of GERD. These prescriptions， composed of a variety of herbal medicines， are prescribed in accordance with the traditional Chinese medicine （TCM） principle of harmonizing Qi， blood， and Yin-Yang， thereby addressing the underlying disease processes. Among the numerous Chinese herbal medicine prescriptions for GERD， ingredients such as Coptidis Rhizoma， Bupleuri Radix， Euodiae Fructus， Glycyrrhizae Radix et Rhizoma， and Atractylodis Macrocephalae Rhizoma are commonly utilized for their effects of inhibiting inflammation， modulating immune functions， and alleviating oxidative stress. Despite the potential in treating GERD， concrete evidence-based medical proof of these prescriptions remains limited. This review summarizes the anti-inflammatory mechanisms and prospects of Chinese herbal medicines in treating GERD， providing an outlook on the value of these medicines in the anti-inflammatory management of GERD.

China prospective multicenter birth cohort (Prospective Omics Health Atlas birth cohort, POHA birth cohort) study was officially launched in 2022. This study, in collaboration with 12 participating units, aims to establish a high-quality, multidimensional cohort comprising 20 000 naturally conceived families and assisted reproductive families. The study involves long-term follow-up of parents and offspring, with corresponding biological samples collected at key time points. Through multi-omics testing and analysis, the study aims to conduct multi-omics big data research across the entire maternal and infant life cycle. The goal is to identify new biomarkers for maternal and infant diseases and provide scientific evidence for risk prediction related to maternal diseases and neonatal health.

BACKGROUND: Maturity-onset diabetes of the young (MODY) is the most common monogenic diabetes. The aim of this study was to assess the prevalence of MODY in phenotypic type 2 diabetes (T2DM) among Chinese young adults. METHODS: From April 2015 to October 2017, this cross-sectional study involved 2429 consecutive patients from 46 hospitals in China, newly diagnosed between 15 years and 45 years, with T2DM phenotype and negative for standardized glutamic acid decarboxylase antibody at the core laboratory. Sequencing using a custom monogenic diabetes gene panel was performed, and variants of 14 MODY genes were interpreted as per current guidelines. RESULTS: The survey determined 18 patients having genetic variants causing MODY (6 HNF1A , 5 GCK , 3 HNF4A , 2 INS , 1 PDX1 , and 1 PAX4 ). The prevalence of MODY was 0.74% (95% confidence interval [CI]: 0.40-1.08%). The clinical characteristics of MODY patients were not specific, 72.2% (13/18) of them were diagnosed after 35 years, 47.1% (8/17) had metabolic syndrome, and only 38.9% (7/18) had a family history of diabetes. No significant difference in manifestations except for hemoglobin A1c levels was found between MODY and non-MODY patients. CONCLUSION The prevalence of MODY in young adults with phenotypic T2DM was 0.74%, among which HNF1A -, GCK -, and HNF4A -MODY were the most common subtypes. Clinical features played a limited role in the recognition of MODY.
Humans ; Diabetes Mellitus, Type 2/diagnosis* ; Cross-Sectional Studies ; Mutation ; Prevalence ; Phenotype

Objective: To investigate the role of p38 MAPK pathway in IL-1β induced inflammatory secretory properties mesenchymal stem cells(SFMSCs) from human synovial fluid of temporomandibular joint. Methods: In vitro cultured hSFMSCs were divided into control group and IL-1β treated group(10 ng/ml IL-1β for 2 h), the activation of p38 MAPK was examined with western blot. Then, the gene expression and the secretion of IL-6 and IL-8 in control group, IL-1β treated group and p38 MAPK inhibitor pre-treated group(pretreatment with SB-203580 10 μmol/L prior to the addition of 10 ng/ml IL-1β) were examined by RT-PCR and cytometric bead array(CBA). Results: It was observed that the protein level of p-p38 MAPK, the secretion of IL-8 and IL-6 were increased in IL-1β treated group, and suppressed in p38 MAPK inhibitor pre-treated group. Conclusion: p38 MAPK pathway of SFMSCs might play a role in IL-6 and IL-8 secretion by SFMSCs in inflammatory environment.

Objective: To present the evolutionary path of Chinese Medical Ethics, analyze the development vein of periodical, explore the journal' s research focuses, and provide reference for related personnel to understand the development of the current research status in the field through visualization technology. Methods:Using biblio-metric method,taking "China National Knowledge Infrastructure" as source of data collection, we used the visual-ization software CiteSpace to draw scientific knowledge maps and analyzed literatures published from 1990 to 2014 in Chinese Medical Ethics. Results:The annualvolume of journal articles fluctuated upwards,with peaks in 1992, 2000 and 2009, and of which the most was in 2009, with 393 articles. "Medical Ethics" and "Doctor-patient Relationship" were hotwords in this field. The publications of domestic and foreign scholars promoted the interna-tional exchange and the development of Chinese medical ethics, and the most productive institutions were often col-leges or universities. Conclusion:Chinese Medical Ethics has effectively promoted the development of bioethics in China, more and more scholars are involved in the relative research of medical ethics, and the old, middle and young scientists and research teams inherit, cooperate and develop with each other. The cross-regional, inter-a-gency and interdisciplinary collaboration remains very limited, whichwill become the important factorinfluencingthe development of the field of Chinese medical ethics in the future.

Objective: To analyze related factors on the number of mesenchymal stem cells in the synovial fluid of the temporomandibular joint (TMJ) and provide an research basis for understanding of the source and biological role of mesenchymal stem cells derived from synovial fluid in TMJ. Methods: One hundred and twenty-two synovial fluid samples from 91 temporomandibular disorders (TMD) patients who visited in Department of TMJ Center, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University from March 2013 to December 2013 were collected in this study, and 6 TMJ synovial fluid samples from 6 normal volunteers who were studying in the North Campus of Sun Yat-sen University were also collected, so did their clinical information. Then the relation between the number of mesenchymal stem cells derived from synovial fluid and the health status of the joints, age of donor, disc perforation, condylar bony destruction, blood containing and visual analogue scale score of pain were investigated using Mann-Whitney U test and Spearman rank correlation test. Results: The number of mesenchymal stem cells derived from synovial fluid had no significant relation with visual analogue scale score of pain (r=0.041, P=0.672), blood containing (P=0.063), condylar bony destruction (P= 0.371). Linear correlation between the number of mesenchymal stem cells derived from synovial fluid and age of donor was very week (r=0.186, P=0.043). The number of mesenchymal stem cells up-regulated when the joint was in a disease state (P=0.001). The disc perforation group had more mesenchymal stem cells in synovial fluid than without disc perforation group (P=0.042). Conclusions The number of mesenchymal stem cells derived from synovial fluid in TMJ has no correlation with peripheral blood circulation and condylar bony destruction, while has close relation with soft tissue structure damage of the joint.

Objective To explore the relationship between apolipoprotein E gene polymorphism and cerebral infarction in Taishun county.Methods Determination of 112 cases of Taishun Siqian cerebral infarction patients and healthy persons 88 cases of ApoE gene polymorphism,and the cerebral infarction patients were admitted to the hospital for different period of time after the NIHSS score.Results The cerebral infarction group and the control group were ApoE -/3 genotype most were 70.5%(79 /112)and 63.6%(56 /88),both had significant difference(P >0.05);The cerebral infarction group and the control group in terms of ApoE -up to 3,respectively 82.1%(92 /112)and 75.6%(66.5 /88),both had no significant difference (P >0.05).The cerebral infarction group epsilon 4 to 9.8%(11 /112),and was significantly higher than that of the control group 4.0%(3.5 /88);E2 was 6.2% (7 /112), which was significantly lower than that of the control group [19.3% (17 /88)],the differences were significant (χ2 =6.189,7.970,all P <0.05).Carrying ApoE -4 of the cerebral infarction patient each time period at the time of admission,admission 7d and 14d NIHSS scores were not carrying epsilon 4 patients increased significantly (t =7.853,6.185,5.165,allP <0.05);and at each time point carrying epsilon 2 gene in patients with and without carry-ing epsilon 2 patients NIHSS scores had no significant difference (P >0.05 ).Conclusion Cerebral infarction patients ApoE gene polymorphism and disease progression and prognosis are closely related,ApoE -4 Taishun Siqian cerebral infarction patients predisposing factors.At the same time,the detection of apoE genotype and NIHSS score is helpful to the prognosis of the patients.

A method for simultaneous determination of PCDDs, dl-PCBs, BFRs and PBDD/Fs in flue gas from stationary source was developed. The sample was extracted by Soxhlet apparatus with toluene, and followed by purification through sulfuric acid partition and multi-layer silica gel column separation. The target compounds were then all separated by passing through the active carbon-dispersed silica gel column and reversal eluting. Gas chromatography coupled with a thermostable capillary column ( short length, thin stationary phase film) was operated at pulse injection mode. High resolution mass spectrometry set at low-electron-energy ionization was used for quantification. The high- and low-brominated compounds were determined simultaneously. The detection limits of this method were 0. 081-1. 2 pg for PCDD/Fs, 0. 10-0. 32 pg for dl-PCBs, 0. 14-12 pg for PBDEs, 0. 26-16 pg for new BFRs, 0. 44-3. 6 pg for tetra- to hepta-BDD/Fs and 8. 2-12 pg for OBDD/F. Recoveries ( RSDs) in spiked flue gas samples were 88%-115%(2. 9%-6. 1%) for PCDD/Fs, 84%-118% (3. 2%-10%) for dl-PCBs, 71%-135% (2. 1%-18%) for PBDEs, 71%-114% (2. 9%-7. 4%) for new BFRs, 83%-127% (5. 2%-10%) for tetra-to hepta-BDD/Fs and 52%-149% ( 23%-24%) for OBDD/F. All quality control data fell within the acceptable range specified in analysis standards for flue gas.