Objective: To compare the biological characteristics of human induced pluripotent stem cell-derived platelet exosomes (hiPSC-Plt-Exos) with those of conventional apheresis platelet exosomes (Plt-Exos), specifically focusing on their differential abilities to enhance the proliferation and migration of human umbilical cord mesenchymal stem cells (hUC-MSCs). Methods: Exosomes were isolated from hiPSC-derived Plt and apheresis Plt concentrate using size exclusion chromatography. These exosomes were then characterized through nanoparticle tracking analysis (NTA), transmission electron microscopy (TEM), and Western blotting. Co-culture experiments into hUC-MSCs were conducted with hiPSC-Plt-Exos and apheresis Plt-Exos, respectively. Their effects on the proliferation and migration of hUC-MSCs were assessed via cell proliferation assays and scratch tests. Results: hiPSC-Plt-Exos and apheresis Plt-Exos exhibited comparable particle sizes, morphological features (such as the characteristic cup-shaped structure), and surface markers (including CD9 and HSP70). Notably, hiPSC-Plt-Exos demonstrated a significantly greater ability to enhance the proliferation and migration of hUC-MSCs compared to apheresis Plt-Exos (P<0.05). These differences provide critical comparative data for their application in various clinical contexts. Conclusion: This study establishes a theoretical foundation for developing precise therapeutic strategies based on hiPSC-Plt-Exos. Furthermore, it underscores the necessity of selecting the appropriate type of exosomes according to the specific disease microenvironment to achieve optimal therapeutic outcomes.

Objective To research the correlation between triglyceride-glucose index(TyG)and the risk of colorectal polyps with different pathological types.Methods According to inclusion and exclusion criteria,453 patients who underwent fiberoptic colonoscopy at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from May 2022 to December 2023 were selected.Based on colonoscopy results,patients were divided into non-colorectal polyp group and a colorectal polyp group.The polyp group was further classified according to pathological results into non-adenomatous polyps,adenomatous polyps,and colorectal cancer groups.A retrospec-tive analysis was conducted on the general data of the study subjects,including relevant test indicators such as blood glucose and lipids.Logistic regression analysis was employed to identify risk factors associated with the occurrence of colorectal polyps.Receiver operating characteristic(ROC)curves were constructed to evaluate the predictive role of the TyG index in the development of colorectal polyps,and the TyG levels among different pathological types of colorectal polyps were compared.Results Patients in the polyp group exhibited high-er age,male proportion,body mass index(BMI),glycosylated hemoglobin(HbA1c),triglycerides(TG),lipoprotein(a),and TyG in-dex compared to the non-polyp group.After adjusting for confounding factors,Logistic regression analysis indicated a correlation between the TyG index and the occurrence of colorectal polyps(P＜0.05).The area under the curve(AUC)for the TyG index predicting the development of colorectal polyps was 0.756(95％CI:0.702-0.809,P＜0.001).The TyG index level in the non-colorectal polyp group was lower than that in the non-adenomatous polyp,adenomatous polyp,and colorectal cancer groups,with statistically significant differences(P＜0.05).Pairwise comparisons also showed statistically significant differences(P＜0.05).Conclusion The TyG in-dex may be correlated with the occurrence of colorectal polyps.There are significant differences in the TyG index levels among different pathological types of colorectal polyps.

Objective To explore the correlation between high-sensitivity C-reactive protein(hs-CRP)-to-lymphocyte ratio(CLR)and the severity of coronary heart disease,as well as the degree of coronary artery lesions.Methods A total of 603 patients who underwent coronary angiography in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2022 to November 2023 were conducted on the retrospective analysis.All patients were divided into non-coronary heart disease group,stable an-gina pectoris(SAP)group,and acute coronary syndrome(ACS)group according to clinical classification.Basing on the Gensini score for coronary arteries,the extent of stenosis in patients'coronary arteries was classified into mild(0-31 points),moderate(31-61 points),and severe(≥61 points)groups.Differences in CLR and neutrophil-to-lymphocyte ratio(NLR)among groups were com-pared.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of CLR,NLR,and troponin Ⅰ for ACS.Spearman correlation analysis was used to evaluate the correlation between CLR,NLR and the degree of coronary stenosis.Results The CLR in the ACS group was higher than that in the SAP group,which was in turn higher than that in the non-coronary heart disease group,the differences were statistically significant(P＜0.05).The troponin Ⅰ and NLR in the ACS group were significantly higher than those in the SAP group(P＜0.05),but there was no statistical significance between the SAP group and non-coronary heart disease group(P＞0.05);the area under the curve(AUC)of CLR,NLR and troponin Ⅰ in predicting ACS were 0.787,0.730 and 0.837,re-spectively(P＜0.001).At the optimal cut-off value,the sensitivity and specificity of CLR were 75.5％and 71.6％.In the mild,moderate,and severe coronary lesion groups,with the degree of coronary stenosis worsened,levels of NLR and CLR increased correspond-ingly,and the differences were statistically significant(P＜0.05);Spearman correlation analysis demonstrated a positive correlation be-tween CLR,NLR and the degree of coronary stenosis in coronary heart disease patients(rCLR=0.308,rNLR=0.247,P＜0.001).Conclusion Levels of CLR have a positive correlation with the severity of disease and the degree of coronary artery lesions in coronary heart disease patients.Compared with NLR and troponin Ⅰ,it can better reflect the differences between stable-phase coronary heart dis-ease patients and non-coronary heart disease patients,and has a higher sensitivity in predicting ACS patients,providing clinical value for early diagnosis and condition evaluation in coronary heart disease patients.

Objective To research the correlation between triglyceride-glucose index(TyG)and the risk of colorectal polyps with different pathological types.Methods According to inclusion and exclusion criteria,453 patients who underwent fiberoptic colonoscopy at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from May 2022 to December 2023 were selected.Based on colonoscopy results,patients were divided into non-colorectal polyp group and a colorectal polyp group.The polyp group was further classified according to pathological results into non-adenomatous polyps,adenomatous polyps,and colorectal cancer groups.A retrospec-tive analysis was conducted on the general data of the study subjects,including relevant test indicators such as blood glucose and lipids.Logistic regression analysis was employed to identify risk factors associated with the occurrence of colorectal polyps.Receiver operating characteristic(ROC)curves were constructed to evaluate the predictive role of the TyG index in the development of colorectal polyps,and the TyG levels among different pathological types of colorectal polyps were compared.Results Patients in the polyp group exhibited high-er age,male proportion,body mass index(BMI),glycosylated hemoglobin(HbA1c),triglycerides(TG),lipoprotein(a),and TyG in-dex compared to the non-polyp group.After adjusting for confounding factors,Logistic regression analysis indicated a correlation between the TyG index and the occurrence of colorectal polyps(P＜0.05).The area under the curve(AUC)for the TyG index predicting the development of colorectal polyps was 0.756(95％CI:0.702-0.809,P＜0.001).The TyG index level in the non-colorectal polyp group was lower than that in the non-adenomatous polyp,adenomatous polyp,and colorectal cancer groups,with statistically significant differences(P＜0.05).Pairwise comparisons also showed statistically significant differences(P＜0.05).Conclusion The TyG in-dex may be correlated with the occurrence of colorectal polyps.There are significant differences in the TyG index levels among different pathological types of colorectal polyps.

Objective To explore the correlation between high-sensitivity C-reactive protein(hs-CRP)-to-lymphocyte ratio(CLR)and the severity of coronary heart disease,as well as the degree of coronary artery lesions.Methods A total of 603 patients who underwent coronary angiography in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2022 to November 2023 were conducted on the retrospective analysis.All patients were divided into non-coronary heart disease group,stable an-gina pectoris(SAP)group,and acute coronary syndrome(ACS)group according to clinical classification.Basing on the Gensini score for coronary arteries,the extent of stenosis in patients'coronary arteries was classified into mild(0-31 points),moderate(31-61 points),and severe(≥61 points)groups.Differences in CLR and neutrophil-to-lymphocyte ratio(NLR)among groups were com-pared.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of CLR,NLR,and troponin Ⅰ for ACS.Spearman correlation analysis was used to evaluate the correlation between CLR,NLR and the degree of coronary stenosis.Results The CLR in the ACS group was higher than that in the SAP group,which was in turn higher than that in the non-coronary heart disease group,the differences were statistically significant(P＜0.05).The troponin Ⅰ and NLR in the ACS group were significantly higher than those in the SAP group(P＜0.05),but there was no statistical significance between the SAP group and non-coronary heart disease group(P＞0.05);the area under the curve(AUC)of CLR,NLR and troponin Ⅰ in predicting ACS were 0.787,0.730 and 0.837,re-spectively(P＜0.001).At the optimal cut-off value,the sensitivity and specificity of CLR were 75.5％and 71.6％.In the mild,moderate,and severe coronary lesion groups,with the degree of coronary stenosis worsened,levels of NLR and CLR increased correspond-ingly,and the differences were statistically significant(P＜0.05);Spearman correlation analysis demonstrated a positive correlation be-tween CLR,NLR and the degree of coronary stenosis in coronary heart disease patients(rCLR=0.308,rNLR=0.247,P＜0.001).Conclusion Levels of CLR have a positive correlation with the severity of disease and the degree of coronary artery lesions in coronary heart disease patients.Compared with NLR and troponin Ⅰ,it can better reflect the differences between stable-phase coronary heart dis-ease patients and non-coronary heart disease patients,and has a higher sensitivity in predicting ACS patients,providing clinical value for early diagnosis and condition evaluation in coronary heart disease patients.

This study aimed at conducting retrospective analysis of the clinical symptoms and genetic mutations in 20 children with Gitelman syndrome treated at the Affiliated Children′s Hospital of Nanjing Medical University from August 2015 to November 2022 and also explored the molecular mechanism of the pathogenic high-frequency mutation D486N in the Chinese population.

【Objective】 To analyze the data of clinical blood transfusion quality control supervision in Shanghai, so as to provide reference for the improvement of clinical blood transfusion quality management in hospitals at all levels. 【Methods】 The data of clinical blood transfusion quality control supervision in hospitals at all levels from 2016 to 2021 were retrospectively analyzed to obtain the characteristics and indicators in the quality management. 【Results】 The overall level of clinical blood transfusion quality management in Shanghai steadily improved from 2016 to 2021 (F=3.82, P<0.01), and the management level of different hospitals varied significantly (F=9.00, P<0.01). In 2021, the full compliance rates of housing facilities, instruments and equipment, diagnostic reports and medical record writing among the third-level indicators of clinical blood transfusion quality management in hospitals at all levels were as follows: 86.49%(32/37), 100% (37/37)and 43.24%(16/37) for tertiary comprehensive hospitals; 61.11%(11/18), 88.89%(16/18) and 50.00% (9/18)for tertiary specialized hospitals; 60.87%(14/23), 78.26%(18/23)and 47.83%(11/23) for secondary comprehensive hospitals, ; 60.00%(9/15), 66.67%(10/15), 40.00%(6/15) for secondary specialized hospitals; 52.38%(11/21), 38.10%(8/21), 42.86%(9/21) for private hospitals. 【Conclusion】 The characteristics of clinical blood transfusion quality management in hospitals at all levels in Shanghai differed significantly, with different strengths and weaknesses. Hospitals should improve blood transfusion management in terms of housing facilities, personnel management, system process as well as diagnostic reports and medical record writing, in order to enhance the clinical blood transfusion quality management.

Humans ; East Asian People ; Surveys and Questionnaires ; Vitiligo/epidemiology*

The study utilized a cross-sectional design. Data was retrieved from the American Academy of Family Physicians fellowship training directory, including program names, areas of focus, program length, and program descriptions. The collected data was categorized and analyzed based on areas of focus and training duration. The program descriptions were also analyzed qualitatively using Nvivo12 software. A total of 532 programs were included in the study:295 programs (55.5%) were ACGME-certified, while 237 programs (44.5%) were not. The majority of programs, 468 (87.9%), were clinically oriented, while 64 programs (12.1%) were non-clinical. Among ACGME-certified programs, the largest number of programs were in sports medicine (121 programs), followed by geriatrics (52 programs). Among non-certified programs, the largest number of programs was in obstetrics (66 programs), accounting for 27.8% of all non-certified programs. Qualitative research found that fellowship programs were diverse, reflecting the societal demands of healthcare service. Moreover, a significant emphasis was placed on empowering teaching and research abilities.The family medicine fellowship programs in the United States cover a wide range of disciplines and meet both the professional interests of doctors and the needs of patients. As China continues to implement its tiered medical system, it can learn from the experience of the United States and develop general practice subspecialty training programs, thereby improving the service capacity of general practitioners and improve the quality of healthcare.

Objective:To investigate the relationship between white blood cells, neutrophil-lymphocyte ratio(NLR), platelet-lymphocyte ratio(PLR) and monocyte-lymphocyte ratio(MLR) with patients suffering from first episode depression.Methods:This retrospective study was conducted among inpatients of Hebei General Hospital from January 2021 to December 2021.Ultimately, 193 patients with first-episode depression were enrolled.According to the score of Hamilton depression scale-24 (HAMD-24), the patients were divided into mild-moderate depression group(20≤HAMD-24<35 score, n=98) and severe depression group (HAMD-24 score ≥35, n=95). White blood cells and the counts of each cell subtype were detected and the NLR, MLR and PLR were calculated.SPSS 25.0 statistical software was used to analyze the data.Mann-Whitney U test was used to compare differences in the two groups and Binary Logistic regression analyses were performed to recognize the predictive factors of the severity of first episode depression. Results:(1) The white blood cells and NLR in the severe depression group were significantly higher than those in the mild-moderate depression group (white blood cells: 5.77(2.05)×10 9/L vs 5.11(1.31)×10 9/L; NLR: 1.86 (1.04) vs 1.57(0.55), P<0.05). There were no significant differences in PLR and MLR between the two groups ( P>0.05). (2)Multiple regression analysis of NLR, white blood cells and HAMD-24 score showed that there were significant differences in the effect of different white blood cells and NLR levels on HAMD-24 score( B=1.398, P=0.003; B=2.624, P=0.001). (3)Binary Logistic regression revealed that white blood cell count and NLR were risk factors for the severity of depression patients( OR were 1.612 and 2.336, respectively, P<0.05). Conclusion:The results suggest that white blood cells and NLR may be relate with the severity of first episode depression.