OBJECTIVES: To investigate the causal relationship between Helicobacter pylori (Hp) infection and immune thrombocytopenia (ITP) using Mendelian randomization (MR), as well as the association between Hp infection and chronic ITP (cITP) through a clinical study. METHODS: The datasets from genome-wide association studies were used to select the single nucleotide polymorphism loci significantly associated with Hp infection as genetic instrumental variables. The MR analysis model was used to investigate the causal relationship between ITP and Hp infection. A retrospective analysis was conducted on the medical data of 316 children with newly diagnosed ITP at the First Affiliated Hospital of Xinjiang Medical University from January 2020 to December 2023. The children were followed up for 1 year, and a multivariate logistic regression analysis was used to investigate the risk factors for cITP. RESULTS: The inverse variance weighted analysis revealed that Hp infection was significantly associated with an increased risk of ITP (OR=1.280, 95%CI: 1.098-1.492, P=0.002). There was no heterogeneity or pleiotropy in this MR study (P>0.05), and the model was stable. The "leave-one-out" sensitivity analysis verified the reliability of the results. The multivariate logistic regression analysis demonstrated that Hp infection was an independent risk factor for progression to cITP (OR=7.916, 95%CI: 3.327-18.832, P<0.001). CONCLUSIONS Hp infection is a risk factor for the onset of ITP and is an independent risk factor for cITP in children.
Humans ; Helicobacter Infections/complications* ; Purpura, Thrombocytopenic, Idiopathic/etiology* ; Child ; Male ; Female ; Helicobacter pylori ; Prognosis ; Child, Preschool ; Logistic Models ; Retrospective Studies ; Risk Factors ; Polymorphism, Single Nucleotide ; Adolescent ; Infant

Colorectal cancer (CRC) poses a severe global health challenge with high incidence and mortality rates. USP37 has been identified as the bona fide deubiquitinase of SND1, playing a critical role in stabilizing SND1, thereby augmenting its oncogenic potential. The interaction between USP37 and SND1 was confirmed through extensive proteomics, ubiquitinomics, and interactomics, underscoring their synergistic effects on CRC proliferation and metastasis. Additionally, CDK1 has emerged as a pivotal regulator of USP37, phosphorylating it at threonine 631 rather than serine 628, enhancing its deubiquitinase activity, and consequently stabilizing SND1 to drive CRC malignancy further. Histological analyses of human CRC samples linked the upregulation of CDK1 and USP37 with increased SND1 levels and poor patient prognosis. High-throughput virtual screening and subsequent experimental validation identified Dacarbazine as a pharmacological inhibitor of USP37, and its inhibition disrupted SND1 stability, hindering CRC cell proliferation and metastasis. This study reveals a novel and promising molecular mechanism driving CRC progression through the CDK1-USP37-SND1 axis, highlighting the clinical importance of targeting this pathway to improve patient outcomes.

The aim of this updated guideline is to provide comprehensive recommendations for the management of gout in patients with common comorbidities, such as chronic kidney disease(CKD), cardiovascular disease(CVD), diabetes, osteoarthritis(OA), and gastrointestinal disorders. This guideline was developed by a multidisciplinary expert panel consisting of specialists in endocrinology, rheumatology, nephrology, cardiology, gastroenterology, and methodology. The development process adhered to standard methodologies, including PICO(population, intervention, comparator, and outcomes) question deconstruction, systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation(GRADE) for evidence and recommendation evaluation, Delphi voting, and expert consensus. The guideline presents 26 evidence-based recommendations addressing 7 clinical questions for patients with hyperuricemia and gout in the context of comorbidities. Key recommendations include the maintenance of strict serum urate targets, particularly for patients with CKD stage≥3, chronic gouty arthritis, and OA, in order to prevent disease progression. In patients with CVD or diabetes, intra-articular triamcinolone is preferred over systemic glucocorticoids. Prioritized anti-inflammatory treatments for patients with CKD, gastrointestinal diseases and OA are recommended. The guideline also introduces emerging therapies, such as interleukin-1 inhibitors and selective urate transport inhibitors, as potential treatment options for refractory cases. The update offers a comprehensive, patient-centered approach to managing gout, particularly in individuals with associated comorbidities. Multidisciplinary collaboration and emerging new treatments and evidence ensure the optimization of the recommendations.

OBJECTIVE To collect the data regarding postoperative pneumonia(POP)in recent ten years,analyze the epidemiological rules and understand the distribution of major pathogens causing the POP so as to lay solid foundation for fully implementing' Infection Control in Surgery' initiative.METHODS The clinical data were col-lected from the patients who received surgical procedures in Chongqing University Fuling Hospital from 2015 to 2024.The difference in the incidence of POP between the sexes and among the departments and incidence trends a-mong the age groups and the years as well as the distribution of major pathogens were retrospectively analyzed.RESULTS The total incidence of POP was 1.41％in 2015-2024,2.82％in 2015,showing a year by year downward trend from 2021 to 2024(x2=284 906,P＜0.001).The incidence of POP of the male was 2.42％,higher than 0.70％of the female(P＜0.001).The incidence of POP was 0.29％in the 1 day to 19-year-old age group,2.84％in the 60-year-old age group,and the incidence showed an upward trend with the increase of age(x2=451.053,P＜0.001).The incidence of POP varied in the departments(P＜0.001),with the highest(20.24％)in the neurosurgery department,the lower(0.05％and 0.06％)in the gynecology department and oph-thalmology department.Of the isolated pathogens causing POP,Acinetobacter baumannii accounted for 25.48％,Klebsiella pneumoniae 22.82％,Pseudomonas aeruginosa 14.35％.The percentage of the A.baumannii strains was highest in all the years except for the percentage of K.pneumoniae in 2015 and 2018.CONCLUSIONS The in-cidence of hospital-associated POP is relatively low.The population of advanced age and male is at high risk of POP.POP is highly prevalent in neurosurgery department.The gram-negative bacteria are dominant among the pathogens causing the POP.

Aim To investigate the changes in hepatic lactylation during liver regeneration and its impact on regeneration.Methods A partial hepatectomy(PHx)mouse model was used to study liver regenera-tion.Sodium oxamate was administered intraperitoneal-ly to inhibit lactate dehydrogenase,and blood and liver tissues were collected at different time points post-sur-gery.The histopathological status was observed using HE staining.Proliferating cell nuclear antigen(PC-NA)levels were detected by immunohistochemistry.Lactylation was assessed using immunofluorescence.Liver LDH enzyme activity,lactate levels and serum alanine aminotransferase(ALT)and aspartate trans-aminase(AST)levels were measured using assay kits.Results After PHx,the liver volume of mice gradual-ly increased,returning to preoperative size on day 7.PCNA levels peaked at 48 hours post-surgery.Liver tissue lactate levels increased to approximately 1.5 times the preoperative level at 12 hours post-surgery and remained elevated until day 7.The lactylation lev-el in hepatocytes peaked at 24 hours post-surgery,gradually declined after 48 hours,and returned to pre-operative levels on day 7.Compared to the PHx group,the sodium oxamate(750 mg·kg-1)+PHx group showed significantly reduced lactylation levels in hepa-tocytes and a smaller liver regeneration volume on day 7.Conclusion Lactylation regulates hepatocyte pro-liferation and promotes liver regeneration after PHx.

Objective To summarize the imaging characteristics of occult rib fracture(ORF),analyze the causes of missed diagnosis and misdiagnosis of ORF,and explore strategies to improve the detection rate of ORF.Methods A total of 142 patients with rib fractures who underwent multi spiral computed tomography(MSCT)were selected.The initial examination was conducted within 1 week after the injury,and follow-up examinations were performed at multiple time points after 1 week post-injury.A retrospective analysis was conducted to review the fracture detection and locations during the follow-up period.The time of fracture edge sclerosis or callus growth was observed in the young group(17 cases),middle-aged group(64 cases),and elderly group(61 cases).Results The anterior segment of the ribs was the predilection site for occult fractures,with 199 cases(53.4％).The missed diagnosis rates of fracture were higher for fractures near the costal cartilage segment and the posterior segment of the ribs,with missed diagnosis rates of 49.4％and 58.8％,respectively.Compared with the number of rib fractures identified in the initial examination,there was a statistically significant difference in the number of rib fractures at 3-6 weeks after injury(P＜0.05).The time of local sclerosis or callus growth in the young,middle-aged and elderly groups was(18.76±3.849)d,(26.14±6.597)d,and(37.69±5.726)d,respectively,with statistically significantl differences between the groups(P＜0.05).Conclusion MSCT has certain limits in diagnosing ORF in the short term after injury.Primarily observing the predilection sites and missed sites of occult fractures,systematically recognizing the imaging characteristics of ORF,and adopting the optimal detection-time window for patients of different age groups can reduce the missed diagnosis rate and misdiagnosis rate of ORF and improve the detection rate of fractures.This provides accurate and objective basis for clinical and forensic identification,with significant clinical importance and application value.

Purpose To investigate the role of secreted protein acidic and rich in cysteine(SPARC)expression in the diagnosis and differential diagnosis of mesothelioma.Methods Immunohistochemical EnVision two-step method was used to detect SPARC expression in 40 cases of mesothelioma,4 cases of well-differentiated mesothelial tumour(WDPMT),40 cases of poorly differentiated squamous cell carcinoma of the lung,40 cases of poorly differentiated ad-enocarcinoma of the lung,20 cases each of low-grade and high-grade serous carcinoma of the ovary.The sensitivity and specificity of SPARC,Calretinin,D2-40,and WT-1 expression in mesothelioma were compared and analyzed.Results SPARC showed diffuse strong positive expression in mesothelioma(37/40 cases),medium positive expression in WDPMT(3/4 cases),and focal weak positive expression in a few cases of poorly differentiated squamous cell carcino-ma of the lung(1/40 cases),poorly differentiated adenocarcinoma of the lung(2/40 cases),low-grade serous carci-noma of the ovary(0/20 cases),and high-grade serous carcinoma of the ovary(1/20 cases).In 40 mesotheliomas,the sensitivity of SPARC was 92.5％,and the specificity of SPARC in control tumors(squamous carcinoma of the lung,adenocarcinoma of the lung,and serous carcinoma of the ovary)was 96.7％.Conclusion SPARC is widely expressed in mesotheliomas,with a sensitivity similar to that of Calretinin,D2-40,and WT-1,but with a much higher specificity than other mesothelial markers.It is of great significance in distinguishing between mesothelioma and pulmo-nary poorly differentiated carcinoma and ovarian serous carcinoma.

Aim To investigate the changes in hepatic lactylation during liver regeneration and its impact on regeneration.Methods A partial hepatectomy(PHx)mouse model was used to study liver regenera-tion.Sodium oxamate was administered intraperitoneal-ly to inhibit lactate dehydrogenase,and blood and liver tissues were collected at different time points post-sur-gery.The histopathological status was observed using HE staining.Proliferating cell nuclear antigen(PC-NA)levels were detected by immunohistochemistry.Lactylation was assessed using immunofluorescence.Liver LDH enzyme activity,lactate levels and serum alanine aminotransferase(ALT)and aspartate trans-aminase(AST)levels were measured using assay kits.Results After PHx,the liver volume of mice gradual-ly increased,returning to preoperative size on day 7.PCNA levels peaked at 48 hours post-surgery.Liver tissue lactate levels increased to approximately 1.5 times the preoperative level at 12 hours post-surgery and remained elevated until day 7.The lactylation lev-el in hepatocytes peaked at 24 hours post-surgery,gradually declined after 48 hours,and returned to pre-operative levels on day 7.Compared to the PHx group,the sodium oxamate(750 mg·kg-1)+PHx group showed significantly reduced lactylation levels in hepa-tocytes and a smaller liver regeneration volume on day 7.Conclusion Lactylation regulates hepatocyte pro-liferation and promotes liver regeneration after PHx.

OBJECTIVE To collect the data regarding postoperative pneumonia(POP)in recent ten years,analyze the epidemiological rules and understand the distribution of major pathogens causing the POP so as to lay solid foundation for fully implementing' Infection Control in Surgery' initiative.METHODS The clinical data were col-lected from the patients who received surgical procedures in Chongqing University Fuling Hospital from 2015 to 2024.The difference in the incidence of POP between the sexes and among the departments and incidence trends a-mong the age groups and the years as well as the distribution of major pathogens were retrospectively analyzed.RESULTS The total incidence of POP was 1.41％in 2015-2024,2.82％in 2015,showing a year by year downward trend from 2021 to 2024(x2=284 906,P＜0.001).The incidence of POP of the male was 2.42％,higher than 0.70％of the female(P＜0.001).The incidence of POP was 0.29％in the 1 day to 19-year-old age group,2.84％in the 60-year-old age group,and the incidence showed an upward trend with the increase of age(x2=451.053,P＜0.001).The incidence of POP varied in the departments(P＜0.001),with the highest(20.24％)in the neurosurgery department,the lower(0.05％and 0.06％)in the gynecology department and oph-thalmology department.Of the isolated pathogens causing POP,Acinetobacter baumannii accounted for 25.48％,Klebsiella pneumoniae 22.82％,Pseudomonas aeruginosa 14.35％.The percentage of the A.baumannii strains was highest in all the years except for the percentage of K.pneumoniae in 2015 and 2018.CONCLUSIONS The in-cidence of hospital-associated POP is relatively low.The population of advanced age and male is at high risk of POP.POP is highly prevalent in neurosurgery department.The gram-negative bacteria are dominant among the pathogens causing the POP.

Objective To summarize the imaging characteristics of occult rib fracture(ORF),analyze the causes of missed diagnosis and misdiagnosis of ORF,and explore strategies to improve the detection rate of ORF.Methods A total of 142 patients with rib fractures who underwent multi spiral computed tomography(MSCT)were selected.The initial examination was conducted within 1 week after the injury,and follow-up examinations were performed at multiple time points after 1 week post-injury.A retrospective analysis was conducted to review the fracture detection and locations during the follow-up period.The time of fracture edge sclerosis or callus growth was observed in the young group(17 cases),middle-aged group(64 cases),and elderly group(61 cases).Results The anterior segment of the ribs was the predilection site for occult fractures,with 199 cases(53.4％).The missed diagnosis rates of fracture were higher for fractures near the costal cartilage segment and the posterior segment of the ribs,with missed diagnosis rates of 49.4％and 58.8％,respectively.Compared with the number of rib fractures identified in the initial examination,there was a statistically significant difference in the number of rib fractures at 3-6 weeks after injury(P＜0.05).The time of local sclerosis or callus growth in the young,middle-aged and elderly groups was(18.76±3.849)d,(26.14±6.597)d,and(37.69±5.726)d,respectively,with statistically significantl differences between the groups(P＜0.05).Conclusion MSCT has certain limits in diagnosing ORF in the short term after injury.Primarily observing the predilection sites and missed sites of occult fractures,systematically recognizing the imaging characteristics of ORF,and adopting the optimal detection-time window for patients of different age groups can reduce the missed diagnosis rate and misdiagnosis rate of ORF and improve the detection rate of fractures.This provides accurate and objective basis for clinical and forensic identification,with significant clinical importance and application value.