Objective By population survey,to explore the epidemiological characteristics of gastric precancerous lesions in Lishui District of Nanjing and provide objective basis for the prevention and treatment of early gastric cancer.Methods From July 2021 to December 2022,21 977 patients who received endoscopy and/or 13C-UBT in Lishui District People's Hospital and 6 medical community units in Nanjing City were retrospectively analyzed for demography characteristics,detection rate of gastric precancerous lesions,and H.Pylori infection rate.Results(1)590 cases of gastric precancerous lesions were detected(detection rate 2.68%);(2)The total detection rate of precancerous lesions and three pathological types in males were all higher than those in females(all P<0.001);(3)The minimum age for the total detection rate of precancerous lesions in males and the mini-mum age for each pathological type were lower than in females(P<0.001,0.009,0.005,0.002);(4)The popu-lation total H.pylori infection rate was 23.10%,the H.pylori infection rate in patients with precancerous lesions was higher than that in non-precancerous lesions(P<0.001),both H.pylori infection rate of male and female in precancerous lesions were all higher than those of non-precancerous lesions of the same sex(all P<0.001),in addition,the H.pylori infection rate of male whether in precancerous or non-precancerous lesions was higher than that of female(all P<0.001);(5)The precancerous lesions detection rate in male,female,and the overall age range of 20～29 to 70～79 years is positively correlated with age growth(P<0.001),and rapidly decreases after the age of 79,the of H.pylori infection rate was also positively correlated with age growth(P<0.001),and the trend of age change(P<0.001)was parallel to the precancerous lesions detection rate.Conclusions The detec-tion rate of gastric precancerous lesions in this region is above the average level in China;the total H.pylori infec-tion rate is at a relatively low level in China;the H.pylori infection rate is parallel to the age trend of the detection rate of gastric precancerous lesions,and increases with age.

Objective:To evaluate the diagnostic efficacy and practicality of the Jaundice color card (JCard) as a screening tool for neonatal jaundice.Methods:Following the standards for reporting of diagnostic accuracy studies (STARD) statement, a multicenter prospective study was conducted in 9 hospitals in China from October 2019 to September 2021. A total of 845 newborns who were admitted to the hospital or outpatient department for liver function testing due to their own diseases. The inclusion criteria were a gestational age of ≥35 weeks, a birth weight of ≥2 000 g, and an age of ≤28 days. The neonate′s parents used the JCard to measure jaundice at the neonate′s cheek. Within 2 hours of the JCard measurement, transcutaneous bilirubin (TcB) was measured with a JH20-1B device and total serum bilirubin (TSB) was detected. The Pearson′s correlation analysis, Bland-Altman plots and the receiver operating characteristic (ROC) curve were used for statistic analysis.Results:Out of the 854 newborns, 445 were male and 409 were female; 46 were born at 35-36 weeks of gestational age and 808 were born at ≥37 weeks of gestational age. Additionally, 432 cases were aged 0-3 days, 236 cases were aged 4-7 days, and 186 cases were aged 8-28 days. The TSB level was (227.4±89.6) μmol/L, with a range of 23.7-717.0 μmol/L. The JCard level was (221.4±77.0) μmol/L and the TcB level was (252.5±76.0) μmol/L. Both the JCard and TcB values showed good correlation ( r=0.77 and 0.80, respectively) and agreements (96.0% (820/854) and 95.2% (813/854) of samples fell within the 95% limits of agreement, respectively) with TSB. The JCard value of 12 had a sensitivity of 0.93 and specificity of 0.75 for identifying a TSB ≥205.2?μmol/L, and a sensitivity of 1.00 and specificity of 0.35 for identifying a TSB ≥342.0?μmol/L. The TcB value of 205.2?μmol/L had a sensitivity of 0.97 and specificity of 0.60 for identifying TSB levels of 205.2 μmol/L, and a sensitivity of 1.00 and specificity of 0.26 for identifying TSB levels of 342.0 μmol/L. The areas under the ROC curve (AUC) of JCard for identifying TSB levels of 153.9, 205.2, 256.5, and 342.0 μmol/L were 0.96, 0.92, 0.83, and 0.83, respectively. The AUC of TcB were 0.94, 0.91, 0.86, and 0.87, respectively. There were both no significant differences between the AUC of JCard and TcB in identifying TSB levels of 153.9 and 205.2 μmol/L (both P>0.05). However, the AUC of JCard were both lower than those of TcB in identifying TSB levels of 256.5 and 342.0 μmol/L (both P<0.05). Conclusions:JCard can be used to classify different levels of bilirubin, but its diagnostic efficacy decreases with increasing bilirubin levels. When TSB level are ≤205.2 μmol/L, its diagnostic efficacy is equivalent to that of the JH20-1B. To prevent the misdiagnosis of severe jaundice, it is recommended that parents use a low JCard score, such as 12, to identify severe hyperbilirubinemia (TSB ≥342.0 μmol/L).

Polycystic kidney disease (PKD) is a hereditary kidney disease characterized by the formation of numerous cysts in the kidneys, which progressively impairs renal function over time. PKD is primarily divided into two types: autosomal dominant polycystic kidney disease (ADPKD) and autosomal recessive polycystic kidney disease (ARPKD), with ADPKD being more prevalent. Current treatments primarily focus on symptom relief and disease progression delay, lacking a curative approach. However, the development of gene editing technologies such as clustered regularly interspaced short palindromic repeats (CRISPR) and CRISPR-associated protein 9 (CRISPR-Cas9) and adeno-associated virus (AAV) vectors has offered new therapeutic possibilities for ADPKD and ARPKD. These include approaches like antisense oligonucleotides (ASO), adenovirus-mediated gene knockdown, CRISPR- Cas9, Pkd1 gene enhancement therapy, and the use of induced pluripotent stem cells (iPSCs), which have shown potential efficacy in animal models and early clinical studies. Despite facing technological challenges, ethical and legal issues, and high costs, gene therapy presents an unprecedented hope for PKD treatment. Future interdisciplinary collaboration and international cooperation are essential for developing more effective treatment strategies for PKD patients.

Objective:To explore the role and mechanism of C3a-C3a receptor (C3aR) in the progression of autosomal dominant polycystic kidney disease (ADPKD).Methods:Renal tissues of ADPKD patients and PKD1 knockout mice were collected. Then the expression of C3a-C3aR, Ki67 and F4/80 in renal tissues was observed. Macrophages were stimulated with lipopolysaccharide (LPS) and interleukin 4 respectively. The expression of C3aR, TNF-α, typing markers and related signal pathway proteins was detected in each group. PKD1 knockout mice were treated with C3aR inhibitor SB290157 (1 mg/kg). Renal pathology, cyst-related indicators and renal function were observed. Results:The expression of C3a and C3aR in ADPKD was up-regulated (both P<0.05); C3aR and F4/80 were co-located in the kidney of polycystic kidney disease (PKD) mice, indicating that C3aR was mainly expressed on membrane of macrophages. In vitro, the expression of C3aR was up-regulated in M1 macrophages ( P<0.05). After the stimulation of C3a, the expression of iNOS, TNF-α and IL-6 mRNA in M1 macrophages were up-regulated (all P<0.05), as well as the secretion of TNF-α, indicating that C3a not only affected the expression of inflammatory factors of M1 macrophages, but also affected the inflammatory microenvironment. In addition, C3a significantly activated Akt in M1 macrophages ( P<0.05). Compared with the control group, the treatment group showed a decrease in C3a-C3aR as well as serum BUN, Scr, cyst index, and two kidneys weight/body weight (2KW/BW) (all P<0.05), and ADPKD related pathway protein expression such as p-ERK and p-P65 was significantly down-regulated (all P<0.05). Conclusions:The increased C3a in polycystic kidney tissue causes infiltration and activation of macrophages through C3aR, and then promotes ADPKD progression. The mechanism may be mediated by Akt activation and increased TNF-α production. C3aR antagonist is a potential research direction in the treatment of ADPKD.

Objective To explore the expression difference of cytokines related to nuclear factor kappa B (NF-κB) signaling pathway among different traditional Chinese medicine (TCM) syndromes in the patients with diabetic nephropathy (DN).Methods Serum tumor necrosis factor-α (TNF-α),interleukin-1 (IL-1),interleukin-6 (IL-6) and interleukin-8 (IL-8) in 146 patients with DN and 62 individuals undergoing healthy physical examination in the control group were measured.Results The levels of serum TNF-α,IL-1,IL-6 and IL-8 in various DN groups were significantly higher than those in the control group (P＜0.05).The levels of serum TNF-α,IL-1,IL-6 and IL-8 were significantly different among groups of different TCM syndromes (P＜0.05).With the progression of DN,all cytokines levels showed a gradually increasing trend,moreover the increased extents and time were different in different TCM syndrome types of DN.Conclusion The levels of serum TNF-α,IL-1,IL-6 and IL-8 related to NF-κB signaling pathway are correlated with different TCM syndromes types and may play a role in the occurrence and progression of different TCM syndrome types of DN.

Objective To compare and evaluate the performance and applications of three assays in preliminary screening of dengue infections.Methods This study was designed as a retrospective study.Clinical data were obtained from 2 137 borderline cases from September to October in 2014 and 2015.Markers of dengue infections of serum samples were detected by NS1 antigen captured ELISA, dengue NS1 detect rapid test and dengue IgM detect rapid test, respectively.Chi square test was used to compare the preliminary screening value of these 3 methods.Forty-eight diagnosed patients were also examined in the 1st-3rd day, 4th-5th day, 6th-7th days and 14th day after infection to access the sensitivities and specificities of three assays.Results Nine hundred and fifty-seven ( 57.2%) cases in 2014 and 48 ( 10.4%) cases in 2015 were diagnosed to be Dengue fever of 2 137 borderline cases.The overall sensitivity of NS1-ELISA was superior to NS1 and IgM rapid detect test (χ2 =40.865,P<0.001;χ2 =151.383,P<0.001).No significant differences were found in specificity between three assays(χ2 =0.661,P=0.416;χ2 =0.548,P=0.459; χ2 =2.397,P=0.122).The NS1 detecting assays were sensitive in 7 days after infection, but the sensitivity of IgM detecting assay increased over time.Conclusions NS1 detecting assays had good sensitivities and specificities, which can be used as an important method in preliminary screening of dengue infection.ELISA or rapid test can be selected according to epidemic situation.

Objective To investigate the change of peripheral blood CD4+CD25+ regulatory T cells (Tr) in patients with idiopathic thrombocytopenic purpura (ITP), and to analyze its role in the pathogenesis of ITP.Methods Anticoagulated venous blood was collected from ITP patients (ITP group,n=35) and healthy controls (healthy control group,n=35). T lymphocytes were isolated and purified with human CD3+ T cell enrichment columm. The percentage of peripheral blood CD4+CD25+ regulatory T cells was detected by immunofluorescence staining (PE-anti-CD4 monoclone antibody and FITC-CD25 monoclone antibody) and bicolor flow cytometry by CD25/CD4 gating.Results The number and constituent ratio of CD4+CD25+T cell were significantly lower in ITP group than those of healthy control group (P<0.05).Conclusion There is peripheral blood celluar immunological function disorder in ITP patients, and decrease of CD4+CD25+ T cell population may be involved in the pathogenesis of ITP.

ObjectiveTo evaluate the reliability of the Cybex 6000 isokinetic dynamometer in measuring the shoulder extensor contracted concentrically and eccentrically.Methods15 male subjects with no previous shoulder injuries were studied. The extensor muscles groups of asymmetrical shoulder were tested at 60°/s, 120°/s, and 180°/s respectively. Variables studied included peak torque (PT), average power (AP) and total work (TW). The interclass correlation coefficient (ICC) was used to determine the reliability.ResultsHigh test-retest reliability, ICC ranging from 0.86 to 0.97, was demonstrated for all tests.ConclusionThe Cybex 6000 isokinetic dynamometer shows a good reliability in measuring the shoulder extensor isokinetic contracted concentrically and eccentrically.

To evaluate the influence of combined endurance and strength training on the knee flexors and extensors strength of Chinese army male recruits. At the beginning and end of their 4 weeks′ combined endurance and strength training, twenty recruits received isokinetic dynamometer test for flexors and extensors of both knees with the Cybex 6000 isokinetic dynamometer. after training, there was a significant increase in the peak torque values, torque acceleration energy, and endurance ratio of flexors of both knees at two angular velocities (60?/s,180?/s). Meanwhile, the torque acceleration energy and endurance ratio were increased in the extensors of both knees at two angular velocities . It suggested that four weeks of combined endurance and strength training for the recruits is effective in terms of increasing muscular strength, explosive force and muscular endurance of knee flexors and extensors. More loads should be applied to strengthen the strength of the extensors.

Objective To study the adaptability of rat' skeletal muscle to medium load on endurance training. Methods 40 male Wistar rats were used in an upward-slope running with medium load. Then the ultrastructural changes of the soleus muscle and IGF-1 expression in different training stages were observed. Results The pathologic change of muscular tissues suggested that there was kinesic injury in rat soleus muscle, and the injury happened most seriously in the third week, when muscle structure experienced a relative 'fragile' period. At the same time, there was an obvious increase of IGF-1 in muscular tissues, which indicated that the muscle started to repair of itself immediately after injury. The abnormity rate of Z-cure and IGF-1 level began to decline gradually after 4 weeks, meanwhile the pathologic change reduced. Conclusion After been injured, the pathologic changes of muscle underwent a course of going serious then reducing accompanied with the reparation. The fact indicated that rat skeletal muscle showed a good adaptability to the injury accumulation.