The level of urinary albumin is a critical indicator for the early diagnosis and management of chronic kidney disease (CKD). However, existing methods for detecting albumin are not conducive to point-of-care testing due to the complexity of reagent addition and incubation processes. This study presents a smartphone-integrated handheld automated biochemical analyzer (sHABA) designed for point-of-care testing of urinary albumin. The sHABA features a pre-loaded, disposable reagent cassette with reagents for the albumin assay arranged in the order of their addition within a hose. The smartphone-integrated analyzer can drive the reagents following a preset program, to enable automatic sequential addition. The sHABA has a detection limit for albumin of 5.9 mg/L and a linear detection range from 7 to 450 mg/L. The consistency of albumin level detection in 931 urine samples using sHABA with clinical tests indicates good sensitivity (95.78%) and specificity (90.16%). This research advances the field by providing an automated detection method for albumin in a portable device, allowing even untrained individuals to monitor CKD in real time at the patient's bedside. In the context of promoting tiered diagnosis and treatment, the sHABA has the potential to become an essential tool for the early diagnosis and comprehensive management of CKD and other chronic conditions.

Objective:To explore the standardized performance of a FISH probe before clinical detection.Methods:The probe sensitivity and specificity of ETV6/RUNX1 were analyzed via interphase and metaphase FISH in 20 discarded healthy bone marrow samples. The threshold system of the probe was established using an inverse beta distribution, and an interpretation standard was established. Finally, a parallel-controlled polymerase chain reaction detection study was conducted on 286 bone marrow samples from patients at our hospital. The clinical sensitivity, specificity, and diagnostic coincidence rate of ETV6/RUNX1 FISH detection were analyzed, and the diagnostic consistency of the two methods was analyzed by the kappa test.Results:The probe sensitivity and specificity of the ETV6/RUNX1 probe were 98.47% and 100%, respectively. When 50, 100, and 200 cells were counted, the typical positive signal pattern cutoffs were 5.81%, 2.95%, and 1.49%, respectively, and the atypical positive signal pattern cutoffs were 13.98%, 9.75%, and 6.26%, respectively. The clinical sensitivity of FISH was 96.1%, clinical specificity was 99.6%, diagnostic coincidence rate was 99.00%, diagnostic consistency test kappa value was 0.964, and P value was <0.001.Conclusion:For FISH probes without a national medical device registration certificate, standardized performance verification and methodology performance verification can be performed using laboratory developed test verification standards to ensure a reliable and accurate reference basis for clinical diagnosis and treatment.

Coronary artery bypass grafting (CABG) is one of the most effective revascularization treatments for coronary heart disease. Secondary prevention strategies, which rely on antiplatelet and lipid-lowering drugs, are crucial after CABG to ensure the durability of revascularization treatment effects and prevent adverse cardiovascular and cerebrovascular events in the medium to long term. Previous research conducted by Professor Zhao Qiang's team from Ruijin Hospital of Shanghai Jiao Tong University, known as the DACAB study, indicated that dual antiplatelet therapy (DAPT, specifically ticagrelor+aspirin) after CABG can enhance venous graft patency. However, it remains uncertain whether DAPT can further improve the medium to long-term clinical outcomes of CABG patients. Recently, the team reported the medium to long-term follow-up results of the DACAB study, termed the DACAB-FE study, finding that DAPT administered after CABG can reduce the incidence of major cardiovascular events over five years and improve patients' medium to long-term clinical outcomes. This article will interpret the methodological highlights and significant clinical implications of the DACAB-FE study.

Objective To explore the characteristics of blood vitamins A, B2, B6, B12, D, E, K1, K2 and folic acid and their correlation with severity in patients with metabolic-related fatty liver disease (MAFLD). Methods　From September to December 2022, a total of 473 cases of residents were recruited through community MAFLD screening activities and their health information was obtained through questionnaire survey and physical examination. The severity of hepatic steatosis was determined with FibroScan, and vitamin concentrations were determined with liquid chromatography-tandem mass spectrometry. Two independent samples' t-tests were used to assess the differences between the two groups, and univariate chi-square tests and multivariate logistic regression analysis were used to explore the related factors of MAFLD. Results　Of the 473 inhabitants, 195 (41.23%, 195/473) met the diagnostic criteria for MAFLD, including mild 43 (22.05%, 43/195) cases of fatty liver, 88 (45.13%, 88/195) cases of moderate fatty liver, and 64 (32.82%, 64/195) cases of severe fatty liver. Using healthy residents collected during the same period as controls, the overall mean of vitamins A, E, K1, and K2 in the MAFLD group was higher than that of the healthy group, with a statistical difference (P<0.05). Furthermore, the concentrations of vitamins A, E, K1 and K2 increased with the severity of fatty liver [R=0.149, P=0.004; R=0.245, P<0.001; R=0.110, P=0.032; R=0.129，P=0.012]. There were statistically significant differences (P<0.05) in the blood levels of vitamin A and E between patients with moderate or severe fatty liver and the healthy population. The blood vitamins K1 and K2 in severe fatty liver patients were also different from those of healthy people (P<0.05). However, there was no significance between folic acid, vitamin D, B2, B6, B12, and MAFLD (P>0.05). Through univariate chi-square analysis and multivariate logistic regression analysis, it was found that male [Wald=5.789, P=0.034，OR=1.598(1.037-2.463)] and vitamin E≥8.13 μg/mL[Wald=14.632，P<0.001，OR=2.378(1.522-3.674)] were risk factors for moderate and severe MAFLD. Conclusions The concentrations of vitamin A, E, and K in the blood are increased in patients with MAFLD compared to the healthy population, and they are positively correlated with the severity of MAFLD. ale gender and high levels of vitamin E may be related to moderate to severe MAFLD.

OBJECTIVE To establish a rapid and accurate PCR method for detecting 24 strains of Burkholderia cepacia complex(Bcc) by comparing three detection methods of loop-mediated isothermal amplification(LAMP), SYTO 9 dye method based on polymerase chain reaction(PCR) and TaqMan probe real-time fluorescent quantitative PCR method( TaqMan probe method). METHODS According to the molecular biological information of 24 strains of Bcc in the NCBI database, multiple candidate sequence fragments unique to Bcc were screened out, and specific primer and probe that could simultaneously detect 24 strains of Bcc were designed. At the same time, the detection methods of LAMP, SYTO 9 dye method based on PCR and Taqman probe were explored, and the optimal annealing temperature was optimized and screened. The 39 experimental strains were used to verify the Bcc detection method. RESULTS LAMP method could not effectively detect Bcc, SYTO 9 dye method and TaqMan probe method could effectively detect more than 20 strains of Bcc, while TaqMan probe method had higher amplification effect, better detection sensitivity, repeatability and stability, which could meet the requirements of this study. CONCLUSION In this study, a TaqMan probe method for rapid detection of Bcc was established. Compared with LAMP method and SYTO 9 dye method, this method has the advantages of fast, simple and high sensitivity, and provides technical support for the rapid detectionof Bcc.

Objective:To investigate the effects of glycopyrrolate on intestinal spasm and hemodynamics in painless colonoscopy.Methods:A total of 100 patients who were scheduled to undergo painless colonoscopy were selected as the study subjects and randomly divided into two groups by a computerized number method. Ten patients in both groups dropped out because of disruption of the study protocol, and 45 patients from each group were included in the final analysis. Before anesthesia induction, patients in group glycopyrrolate (group G) were injected with 0.2 mg glycopyrrolate, while those in congtrol group (group C) were injected with an equal amount of saline. The heart rate, systolic blood pressure, and diastolic blood pressure were recorded at T 0 (baseline period), T 1 (after anesthesia induction), T 2 (colonoscopy over sigmoid colon), T 3 (colonoscopy over the liver region), T 4 (after the end of examination), and T 5 (at the awakening phase), and the degree of intestinal spasm was assessed intraoperatively using the Likert′s four-point scale. The numerical rating scale (NRS) was used to assess preoperative and postoperative pain. The incidence of adverse events was recorded. Results:The general data at baseline were not statistically different between the two groups ( P>0.05). During the procedure, patients in group G had lower intraoperative intestinal spasm scores than those in group C ( P=0.028). Intraoperative hypotension and bradycardia occurrence were lower in group G than in group C ( P<0.05), and intraoperative norepinephrine use was also lower than in the group C ( P=0.034). Postoperative visual analog scale pain scores were lower in group G ( P=0.047), but patients who used glycopyrrolate had a higher proportion of dry mouth ( P=0.035). Conclusion:During painless colonoscopy, preoperative administration of glycopyrrolate significantly improved intraoperative hemodynamic fluctuations, reduced the incidence of hypotension and bradycardia, and relieved postoperative pain. However, glycopyrrolate use resulted in the risk of dry mouth.

Objective:To explore the clinical characteristics and influencing factors intracranial hemorrhagic lesions in patients with intracranial venous sinus thrombosis (CVST).Methods:The 108 patients with CVST from January 2013 to December 2020 in the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed. Among them, 46 patients had intracranial hemorrhagic lesions (hemorrhagic lesion group), and 62 patients did not have intracranial hemorrhagic lesions (non hemorrhagic lesion group). The general medical history data, laboratory examination results, imaging examination results, National Institutes of Health stroke scale (NIHSS) score within 24 hours of admission and modified Rankin scale (mRS) score (2 to 6 scores indicating poor prognosis) at discharge (or on the 30th day of hospitalization) were recorded. Multivariate Logistic regression analysis was used to analyze the independent risk factors of intracranial hemorrhagic lesions in patients with CVST and the independent risk factors of prognosis in patients CVST combined with intracranial hemorrhagic lesions.Results:The NIHSS score, neutrophil to lymphocyte ratio (NLR), high sensitivity C-reactive protein (hs-CRP) and the proportions of changes in consciousness, epileptic seizures, poor prognosis, oral contraceptives, congenital protein C or S deficiency in hemorrhagic lesion group were significantly higher than those in non hemorrhagic lesion group: 4 (0, 10) scores vs. 0 (0, 5) scores, 4.62 (2.50, 8.58) vs. 3.46 (2.01, 5.00), 13.1 (5.6, 56.7) mg/L vs. 7.5 (2.8, 18.0) mg/L, 47.8% (22/46) vs. 29.0% (18/62), 39.1% (18/46) vs. 21.0% (13/62), 39.1% (18/46) vs. 21.0% (13/62), 32.6% (15/46) vs. 8.1% (5/62), 30.4% (14/46) vs. 12.9% (8/62), and there were statistical differences ( P<0.01 or <0.05). The incidences of straight sinus and multiple venous sinus thrombosis in hemorrhagic lesion group were significantly higher than those in non hemorrhagic lesion group: 43.5% (20/46) vs. 24.2% (15/62) and 82.6% (38/46) vs. 58.1% (36/62), and there were statistical differences ( P<0.05 or <0.01). Multivariate Logistic regression analysis result showed that the oral contraceptives, multiple venous sinus thrombosis and the elevated hs-CRP, NLR were independent risk factors of intracranial hemorrhagic lesions in patients with CVST ( OR = 6.950, 5.182, 1.026 and 1.137; 95% CI 1.453 to 33.243, 1.076 to 24.960, 1.007 to 1.046 and 1.004 to 1.287; P<0.05 or <0.01). Among 46 patients with CVST combined with intracranial hemorrhagic lesions, 28 patients had a good prognosis, and 18 patients had a poor prognosis. The NIHSS score, NLR, hs-CRP and the proportions of oral contraceptives, congenital protein C or S deficiency, changes in consciousness and epileptic seizures in patients with poor prognosis were significantly higher than those in patients with good prognosis: 9 (4, 28) scores vs. 0 (0, 6) scores, 7.43 (3.86, 12.99) vs. 3.3 (1.97, 6.77), 127.0 (96.5, 168.0) mg/L vs. 11.5 (3.3, 33.5) mg/L, 10/18 vs. 17.9% (5/28), 10/18 vs. 14.3% (4/28), 12/18 vs. 35.7% (10/28) and 11/18 vs. 25.0% (7/28), and there were statistical difference ( P<0.01 or <0.05). Multivariate Logistic regression analysis result showed that the elevated hs-CRP was the independent risk factor of prognosis in patients CVST combined with intracranial hemorrhagic lesions ( OR = 1.046, 95% CI 1.007 to 1.086, P<0.05). Conclusions:The patients with CVST combined with intracranial hemorrhagic lesions have more severe clinical symptoms, and the changes in consciousness, epileptic seizures, poor short-term prognosis are more common. The oral contraceptives, multiple venous sinus involvement and elevated NLR, hs-CRP are independent risk factors in patients with CVST combined with intracranial hemorrhagic lesions; moreover, the elevated hs-CRP is an independent risk factor for poor short-term prognosis in patients with CVST combined with intracranial hemorrhagic lesions.

Studies have shown that m6A modifying enzymes regulated the expression of related factors by m6A methylation modification,and then participated in the regulation of adipogenesis,adipocyte hypertrophy,adipose tissue browning and thermogenesis.This article reviews the research progress of m6A methylation modification on the regulation of adipose tissue metabolism.

Multiple signaling pathways are involved in the regulation of cell proliferation and differentiation in odontogenesis and dental tissue renewal, but the details of these mechanisms remain unknown. Here, we investigated the expression patterns of a transcription factor, Krüppel-like factor 6 (KLF6), during the development of murine tooth germ and its function in odontoblastic differentiation. KLF6 was almost ubiquitously expressed in odontoblasts at various stages, and it was co-expressed with P21 (to varying degrees) in mouse dental germ. To determine the function of Klf6, overexpression and knockdown experiments were performed in a mouse dental papilla cell line (iMDP-3). Klf6 functioned as a promoter of odontoblastic differentiation and inhibited the proliferation and cell cycle progression of iMDP-3 through p21 upregulation. Dual-luciferase reporter assay and chromatin immunoprecipitation showed that Klf6 directly activates p21 transcription. Additionally, the in vivo study showed that KLF6 and P21 were also co-expressed in odontoblasts around the reparative dentin. In conclusion, Klf6 regulates the transcriptional activity of p21, thus promoting the cell proliferation to odontoblastic differentiation transition in vitro. This study provides a theoretical basis for odontoblast differentiation and the formation of reparative dentine regeneration.
Animals ; Cell Differentiation/physiology* ; Cell Proliferation ; Mice ; Odontoblasts/metabolism* ; Odontogenesis ; Tooth Germ

Objective:To evaluate the safety and effectiveness of primary percutaneous coronary intervention using the transradial approach in patients with acute ST-segment elevation myocardial infarction (STEMI) based on electrocardiography results.Methods:The clinical data of 298 patients with STEMI who had indications of emergency coronary angiography and percutaneous coronary intervention who received treatment in The Second People's Hospital of Shantou between January 2015 and June 2019 were retrospectively included in this study. These patients were assigned into traditional transfemoral intervention (TTFI, n = 56), traditional transradial intervention (TTRI, n = 167), and single transradial intervention (STRI, n = 75) groups. Door-to-balloon (D2B) time, needle-to-balloon (N2B) time, hospital days, and the incidence of major adverse cardiac events within 1 year after treatment were compared among the three groups. Results:The D2B time in the STRI, TTFI and TTRI groups was (67.6 ± 2.1) minutes, (73.3 ± 15.3) minutes, and (77.4 ± 16.7) minutes, respectively. There was a significant difference in D2B time among the three groups ( F = -2.24, P = 0.013). The D2B time was significantly shorter in the STRI group than in the TTFI and TTRI groups ( t = -1.84, -1.84, both P = 0.033). The N2B time in the STRI, TTFI and TTRI groups was (7.6 ± 2.1) minutes, (15.3 ± 6.5) minutes, and (14.1 ± 5.7) minutes, respectively. There was a significant difference in N2B time among the three groups ( F = -4.34, all P < 0.001). The N2B time was significantly shorter in the STRI group than in the TTFI and TTRI groups ( t = -2.06, P = 0.020; t = -3.12, P < 0.001). The proportion of patients with D2B time less than 90 minutes in the STRI group was 74.7% (56/75), which was significantly higher than that in the TTRI [46.1% (77/167)] and TTFI [51.8% (29/56)] groups ( χ2 = 4.07, P < 0.001). The incidence of major adverse cardiac events within 1 year after treatment in the TTFI, TTRI, and STRI groups was 16.1% (9/56), 13.2% (22/167), and 9.3% (7/75), respectively. The incidence of major adverse cardiac events within 1 year after treatment was significantly lower in the STRI group than in the TTFI and TTRI groups ( χ2 = 5.67, P < 0.05). Conclusion:STRI is safe and effective for STEMI and is expected to improve long-term prognosis.