Objective:To analyze the interference of an exogenous glucose test on urinary creatinine-related renal injury biomarkers in patients with chronic kidney disease (CKD).Methods:This cross-sectional study enrolled CKD patients who visited Peking University First Hospital between October 2023 and March 2024. The patients (age: 50±18 years) included 90 males and 70 females. Fresh morning urine samples were collected, totaling 160 samples. Each urine sample was divided into 5 aliquots,each containing 225 μl. One aliquot received 75 μl of deionized water as the control. The other aliquots received 75 μl of glucose solutions at concentrations of 120, 480, 960, and 1200 mmol/L, resulting in final glucose concentrations of 30, 120, 240, and 300 mmol/L in the urine samples, respectively. Urinary creatinine in each sample was measured using both the enzymatic method and the picric acid (Jaffe) method. The following ratios were calculated: urinary albumin-to-creatinine ratio (uACR), urinary protein-to-creatinine ratio (uPCR), urinary transferrin-to-creatinine ratio (uTRF/uCr), urinary α1-microglobulin-to-creatinine ratio (uA1M/uCr), urinary immunoglobulin G-to-creatinine ratio (uIgG/uCr), and urinary N-acetyl-β-D-glucosaminidase-to-creatinine ratio (uNAG/uCr).Results:Under high glucose concentrations, significant differences ( P<0.05) were observed between the enzymatic method and the picric acid method in measuring urinary creatinine-related renal injury biomarkers. At glucose concentrations of 30, 120, 240, and 300 mmol/L, the mean percentage biases for creatinine measured by the enzymatic method were -0.19%, -0.27%, -0.20%, and -0.21%, respectively. The mean percentage biases for creatinine measured by the picric acid method were 0.78%, 1.26%, 1.35%, and 1.38%, respectively, showing an increasing deviation between the results before and after glucose addition as the glucose concentration rose. For uACR measurement, the mean absolute biases using the enzymatic method were -0.01, 1.27, 0.95, and 1.10 mg/g at the respective glucose concentrations. Using the picric acid method, the mean absolute biases for uACR were -11.69, -14.98, -16.91, and-18.51 mg/g. The biases of the picric acid method were significantly higher than the those of the enzymatic method, and the absolute value of the mean biases increased with rising glucose concentration. For uPCR, uTRF/uCr, uA1M/uCr, uNAG/uCr, and uIgG/uCr, the deviations measured by the enzymatic method were consistently smaller than those measured by the picric acid method. Conclusions:The measurement of creatinine and related renal injury biomarkers by the enzymatic method is less affected by glucose concentration. In contrast, the measurement results obtained using the picric acid method are significantly affected by glucose concentration.

As the chip of synthetic biology, enzymes play a vital role in the bio-manufacturing industry. The development of diverse functional enzymes can provide a rich toolbox for the development of synthetic biology. This article reports the construction of an artificial enzyme with the introduction of a non-natural cofactor. By introducing the 4-dimethylaminopyridine (DMAP) cofactor into the optimal protein skeleton via covalent bonds based on a click-chemistry strategy, we successfully constructed a novel artificial enzyme with the DMAP cofactor as the catalytic center. The artificial enzyme successfully catalyzed an unnatural asymmetric Morita-Baylis- Hillman (MBH) reaction between cycloketenone and p-nitrobenzaldehyde, with a conversion rate of 90% and enantioselectivity (e.e.) of 38%. This study not only provides an effective strategy for the design of new artificial enzymes but also establishes a theoretical basis for the development of unnatural biocatalytic MBH reactions.
Biocatalysis ; 4-Aminopyridine/chemistry* ; Enzymes/metabolism* ; Coenzymes/chemistry* ; Benzaldehydes/chemistry* ; Protein Engineering/methods* ; Click Chemistry

Gastroesophageal reflux disease (GERD), a common chronic disease of the digestive system, has a severe impact on the quality of life of patients and simultaneously increases the medical burden. The symptoms of GERD are diverse and atypical, and diagnosis requires a comprehensive assessment of symptoms, endoscopic findings, reflux monitoring, and therapeutic responses. Lifestyle interventions and pharmacological treatment remain the preferred basic treatment modalities for GERD, which have a favorable relieving effect on most of the population. Patients who do not respond to conservative treatment can undergo endoscopic anti-reflux surgery and surgical procedures. For patients with concomitant esophageal hiatal hernia, esophageal hiatal hernia repair can be performed simultaneously. With the high prevalence of obesity and the popularization of bariatric surgery, GERD in the obese population and those after bariatric surgery has gradually received more attention. This article summarizes the current status of the diagnosis and treatment of GERD and prospects the new technologies and research directions in the future.

Objective To investigate the predictive value of serum complement C1q tumor necrosis factor-related protein 3(CTRP3)and chitinase protein-40(YKL-40)in the prognosis of implants in patients with dentition defect after implant restoration.Methods A total of 98 patients with dentition defect were selected as the observation group,and 98 healthy people were selected as the control group.Based on the prognosis of the implant,patients were assigned into the good prognosis group(67 cases)and the poor prognosis group(31 cases).Enzyme linked immunosorbent assay was applied to detect serum levels of CTRP3 and YKL-40.Multivariate Logistic regression analysis was performed to analyze factors influencing the prognosis of implant defects.The receiver operating characteristic(ROC)curve was used to evaluate the efficacy of serum CTRP3 and YKL-40 levels in predicting implant prognosis.Results Compared with the control group,the serum CTRP3 level was prominently lower in the study group,and the serum YKL-40 level was prominently higher(P＜0.05).Compared with the good prognosis group,the proportion of smoking patients and the serum YKL-40 level were prominently higher in the poor prognosis group,and the serum CTRP3 level was prominently lower(P＜0.05).Elevated serum YKL-40 level and smoking history were risk factors for poor implant prognosis in patients,while elevated serum CTRP3 level was the protective factor(P＜0.05).ROC curve analysis showed that the combination of serum CTRP3 and YKL-40 levels was superior to any single indicator in predicting the poor prognosis of implants in patients with dentition defect.Conclusion Serum CTRP3 level is decreased and serum YKL-40 level is increased in patients with dental defect,both of which are potential factors affecting poor implant prognosis.The combination of the two is more effective in predicting implant prognosis in patients with dental defect.

Objective To evaluate the efficacy,safety and economy of vonoprazan in the treatment of post-endoscopic submucosal dissection(ESD)ulcer by rapid health technology assessment method,and to provide reference for clinical treatment decision.Methods PubMed,Cochrane Library,Embase,ScienceDirect,CNKI,WanFang Data databases and the official website of health technology assessment(HTA)agency were electronically searched to collect HTA reports,systematic reviews/Meta-analysis and pharmacoeconomic studies of vonoprazan in the treatment of post-ESD ulcer from inception to July 31,2024.Two researchers independently screened literature,extracted data,and comprehensively analyzed the results of the included literature on the basis of literature quality evaluation.Results A total of 8 studies were included,all were systematic reviews/Meta-analysis.In terms of effectiveness,compared with proton pump inhibitors(PPI),vonoprazan significantly increased the overall ulcer healing rate after ESD and more rapid reduction of ulcer area(P<0.05).The results of subgroup analysis showed that there was no significant difference in ulcer healing rate between vonoprazan and PPI treatment at 4 or 8 weeks after ESD(P>0.05).Vonoprazan significantly increased the rate of postoperative ulcer reduction in H.pylori positive patients compared with PPI(P<0.05).In terms of safety,compared with PPI,vonoprazan reduced the incidence of overall adverse events rate(P<0.05).The difference in the incidence of delayed bleeding and ulcer perforation between vonoprazan and PPIs showed no statistically significant difference.(P>0.05).Conclusion Vonoprazan demonstrated favorable efficacy and safety in the treatment of ESD ulcers,and further economic studies are warranted.

Background and Aims:Gastroesophageal reflux disease(GERD)is a common complication following sleeve gastrectomy(SG),particularly in patients with concomitant hiatal hernia,where symptoms tend to be more persistent and refractory,significantly impairing postoperative quality of life.This study aimed to evaluate the efficacy of laparoscopic hiatal hernia repair combined with gastroesophageal fixation in SG patients with severe GERD and hiatal hernia,providing clinical reference for revisional surgical strategies.Methods:The clinical data of 9 patients with severe GERD after SG who underwent laparoscopic hiatal hernia repair and gastroesophageal fixation at Huashan Hospital,Fudan University,between January 2023 and June 2024 were retrospectively analyzed.GerdQ scores,proportion of endoscopically confirmed reflux esophagitis,and proton pump inhibitor(PPI)usage were compared before and after surgery.Surgical parameters and follow-up outcomes were also recorded.Results:All patients successfully completed the surgery without major intraoperative complications,and the mean postoperative hospital stay was 5.22 d.After a mean follow-up period of 15.27 months,the GerdQ score significantly decreased from 11.67±2.00 to 7.22±1.48.The proportion of patients with GerdQ score≥8 decreased from 100.00％to 44.44％,and the rate of endoscopically confirmed GERD dropped from 88.89％to 11.11％;PPI use also significantly declined,with all differences reaching statistical significance(all P＜0.05).Conclusion:Laparoscopic hiatal hernia repair combined with gastroesophageal fixation can effectively alleviate reflux symptoms in SG patients with coexisting hiatal hernia,demonstrating favorable short-term efficacy and high safety.This approach may be a preferable surgical option for selected patients.

Objective To investigate the predictive value of serum complement C1q tumor necrosis factor-related protein 3(CTRP3)and chitinase protein-40(YKL-40)in the prognosis of implants in patients with dentition defect after implant restoration.Methods A total of 98 patients with dentition defect were selected as the observation group,and 98 healthy people were selected as the control group.Based on the prognosis of the implant,patients were assigned into the good prognosis group(67 cases)and the poor prognosis group(31 cases).Enzyme linked immunosorbent assay was applied to detect serum levels of CTRP3 and YKL-40.Multivariate Logistic regression analysis was performed to analyze factors influencing the prognosis of implant defects.The receiver operating characteristic(ROC)curve was used to evaluate the efficacy of serum CTRP3 and YKL-40 levels in predicting implant prognosis.Results Compared with the control group,the serum CTRP3 level was prominently lower in the study group,and the serum YKL-40 level was prominently higher(P＜0.05).Compared with the good prognosis group,the proportion of smoking patients and the serum YKL-40 level were prominently higher in the poor prognosis group,and the serum CTRP3 level was prominently lower(P＜0.05).Elevated serum YKL-40 level and smoking history were risk factors for poor implant prognosis in patients,while elevated serum CTRP3 level was the protective factor(P＜0.05).ROC curve analysis showed that the combination of serum CTRP3 and YKL-40 levels was superior to any single indicator in predicting the poor prognosis of implants in patients with dentition defect.Conclusion Serum CTRP3 level is decreased and serum YKL-40 level is increased in patients with dental defect,both of which are potential factors affecting poor implant prognosis.The combination of the two is more effective in predicting implant prognosis in patients with dental defect.

Objective To evaluate the efficacy,safety and economy of vonoprazan in the treatment of post-endoscopic submucosal dissection(ESD)ulcer by rapid health technology assessment method,and to provide reference for clinical treatment decision.Methods PubMed,Cochrane Library,Embase,ScienceDirect,CNKI,WanFang Data databases and the official website of health technology assessment(HTA)agency were electronically searched to collect HTA reports,systematic reviews/Meta-analysis and pharmacoeconomic studies of vonoprazan in the treatment of post-ESD ulcer from inception to July 31,2024.Two researchers independently screened literature,extracted data,and comprehensively analyzed the results of the included literature on the basis of literature quality evaluation.Results A total of 8 studies were included,all were systematic reviews/Meta-analysis.In terms of effectiveness,compared with proton pump inhibitors(PPI),vonoprazan significantly increased the overall ulcer healing rate after ESD and more rapid reduction of ulcer area(P<0.05).The results of subgroup analysis showed that there was no significant difference in ulcer healing rate between vonoprazan and PPI treatment at 4 or 8 weeks after ESD(P>0.05).Vonoprazan significantly increased the rate of postoperative ulcer reduction in H.pylori positive patients compared with PPI(P<0.05).In terms of safety,compared with PPI,vonoprazan reduced the incidence of overall adverse events rate(P<0.05).The difference in the incidence of delayed bleeding and ulcer perforation between vonoprazan and PPIs showed no statistically significant difference.(P>0.05).Conclusion Vonoprazan demonstrated favorable efficacy and safety in the treatment of ESD ulcers,and further economic studies are warranted.

Background and Aims:Gastroesophageal reflux disease(GERD)is a common complication following sleeve gastrectomy(SG),particularly in patients with concomitant hiatal hernia,where symptoms tend to be more persistent and refractory,significantly impairing postoperative quality of life.This study aimed to evaluate the efficacy of laparoscopic hiatal hernia repair combined with gastroesophageal fixation in SG patients with severe GERD and hiatal hernia,providing clinical reference for revisional surgical strategies.Methods:The clinical data of 9 patients with severe GERD after SG who underwent laparoscopic hiatal hernia repair and gastroesophageal fixation at Huashan Hospital,Fudan University,between January 2023 and June 2024 were retrospectively analyzed.GerdQ scores,proportion of endoscopically confirmed reflux esophagitis,and proton pump inhibitor(PPI)usage were compared before and after surgery.Surgical parameters and follow-up outcomes were also recorded.Results:All patients successfully completed the surgery without major intraoperative complications,and the mean postoperative hospital stay was 5.22 d.After a mean follow-up period of 15.27 months,the GerdQ score significantly decreased from 11.67±2.00 to 7.22±1.48.The proportion of patients with GerdQ score≥8 decreased from 100.00％to 44.44％,and the rate of endoscopically confirmed GERD dropped from 88.89％to 11.11％;PPI use also significantly declined,with all differences reaching statistical significance(all P＜0.05).Conclusion:Laparoscopic hiatal hernia repair combined with gastroesophageal fixation can effectively alleviate reflux symptoms in SG patients with coexisting hiatal hernia,demonstrating favorable short-term efficacy and high safety.This approach may be a preferable surgical option for selected patients.

Objective:To analyze the interference of an exogenous glucose test on urinary creatinine-related renal injury biomarkers in patients with chronic kidney disease (CKD).Methods:This cross-sectional study enrolled CKD patients who visited Peking University First Hospital between October 2023 and March 2024. The patients (age: 50±18 years) included 90 males and 70 females. Fresh morning urine samples were collected, totaling 160 samples. Each urine sample was divided into 5 aliquots,each containing 225 μl. One aliquot received 75 μl of deionized water as the control. The other aliquots received 75 μl of glucose solutions at concentrations of 120, 480, 960, and 1200 mmol/L, resulting in final glucose concentrations of 30, 120, 240, and 300 mmol/L in the urine samples, respectively. Urinary creatinine in each sample was measured using both the enzymatic method and the picric acid (Jaffe) method. The following ratios were calculated: urinary albumin-to-creatinine ratio (uACR), urinary protein-to-creatinine ratio (uPCR), urinary transferrin-to-creatinine ratio (uTRF/uCr), urinary α1-microglobulin-to-creatinine ratio (uA1M/uCr), urinary immunoglobulin G-to-creatinine ratio (uIgG/uCr), and urinary N-acetyl-β-D-glucosaminidase-to-creatinine ratio (uNAG/uCr).Results:Under high glucose concentrations, significant differences ( P<0.05) were observed between the enzymatic method and the picric acid method in measuring urinary creatinine-related renal injury biomarkers. At glucose concentrations of 30, 120, 240, and 300 mmol/L, the mean percentage biases for creatinine measured by the enzymatic method were -0.19%, -0.27%, -0.20%, and -0.21%, respectively. The mean percentage biases for creatinine measured by the picric acid method were 0.78%, 1.26%, 1.35%, and 1.38%, respectively, showing an increasing deviation between the results before and after glucose addition as the glucose concentration rose. For uACR measurement, the mean absolute biases using the enzymatic method were -0.01, 1.27, 0.95, and 1.10 mg/g at the respective glucose concentrations. Using the picric acid method, the mean absolute biases for uACR were -11.69, -14.98, -16.91, and-18.51 mg/g. The biases of the picric acid method were significantly higher than the those of the enzymatic method, and the absolute value of the mean biases increased with rising glucose concentration. For uPCR, uTRF/uCr, uA1M/uCr, uNAG/uCr, and uIgG/uCr, the deviations measured by the enzymatic method were consistently smaller than those measured by the picric acid method. Conclusions:The measurement of creatinine and related renal injury biomarkers by the enzymatic method is less affected by glucose concentration. In contrast, the measurement results obtained using the picric acid method are significantly affected by glucose concentration.