ObjectiveTo explore the effects of genetic variation of obesity-related biological pathways and gene-obesity interactions on the incidence of gastric cancer, so as to better understand the pathogenesis of gastric cancer and help identify high-risk populations for individualized prevention of gastric cancer. MethodsA case-control study based on the Shanghai Suburban Adult Cohort and Biobank study (SSACB) was conducted on the cases with gastric cancer. A total of 267 cases with gastric cancer and 267 healthy controls matched 1∶1 by age and gender using propensity score were included in the study. After genome-wide genotyping, quality control and imputation, 19 250 single nucleotide polymorphism (SNP) sites from 115 genes in 4 obesity-related biological pathways were extracted. Univariate and multivariate logistic regression analyses were used to evaluate the association between these SNP sites and the risk of gastric cancer, and false positive report probability (FPRP) was used for multiple test correction.Data from Biobank Japan (BBJ) and FinnGen public accessible databases were used to validate significant SNP sites. For validated sites, expression quantitative trait loci (eQTL) analysis and differentially expressed genes analysis were further performed. Additive and multiplicative interactions were used to evaluate the gene-obesity interactions on the incidence of gastric cancer. Additive interaction evaluation indicators included relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI), while multiplicative interaction evaluation indicators include OR_GxE and P_inter. ResultsA total of 41 SNP sites were significantly associated with the onset of gastric cancer (P_adj<0.05, FPRP_0.1<0.1), among which 7 groups of haplotype blocks were formed. ACACB/ rs2268401 [SSACB: P=0.005, BBJ: P=0.049], HRAS/ rs12785860 (SSACB: P<0.001, FinnGen: P=0.045), and PTPN1/ rs6095985 (SSACB: P<0.001, FinnGen: P=0.023) were significantly associated with the risk of gastric cancer after validation in different populations. Among which, the G allele of HRAS/ rs12785860 was correlated with the downregulation of HRAS mRNA expression (P<0.001), and the expression level of HRAS in gastric cancer tissues was higher than that in adjacent normal tissues (P<0.001). Additionaly, JAK1/rs11208559 showed a positive additive interaction with waist circumstance (WC) on the risk of gastric cancer [RERI=2.29(0.06~4.53), AP=0.57(0.23~0.90), SI=4.03(2.20~5.87)]. ConclusionObesity-related biological pathway SNP sites and their haplotypes are associated with the risk of gastric cancer, suggesting that genetic variations in obesity pathways may affect gastric cancer. The HRAS/ rs12785860 is significantly associated with downregulation of HRAS gene expression, which may serve as a potential genetic marker for gastric cancer. JAK1/rs11208559 interacts with obesity additively on the risk of gastric cancer. Individuals with GC+CC genotypes and pre-central or central obesity have an increased risk of gastric cancer, providing clues and evidences for individualized prevention of gastric cancer.

Medical therapy and surgical intervention are the two primary approaches for treating myocardial bridge.However,there remains controversy regarding the use of coronary artery bypass grafting(CABG)and myocardial bridge unroofing.Here,we report a case of myocardial infarction following CABG in a patient with a myocardial bridge.The patient was admitted to Lanzhou First Peopie's Hospital with persistent chest pain,chest tightness,and shortness of breath lasting 2 hours.Physical examination revealed no significant abnormalities.Electrocardiography(ECG)indicated extensive anterior wall myocardial infarction.Laboratory findings showed myoglobin levels of 140.1 ng/ml and troponin Ⅰ levels of 2.59 ng/ml,with no other significant abnormalities.The initial diagnosis was acute extensive anterior wall myocardial infarction.Emergency coronary angiography revealed a myocardial bridge in the mid-segment of the left anterior descending artery(LAD).Emergency CABG using the left internal mammary artery to the LAD was performed,leading to symptomatic improvement,and the patient was discharged in stable condition.However,the patient experienced a recurrent myocardial infarction seven years post-surgery and received secondary preventive medical therapy.The patient is currently under ongoing follow-up care.CABG is an effective treatment for myocardial bridge.However,based on the case reported in this study,we recommend careful evaluation of whether a patient may benefit from CABG.

Objective To explore the value of cardiopulmonary and additional ultrasound(CLAUS)protocol and point-of-care ultrasound rapid management(POCURM)protocol in etiological diagnosis of acute respiratory distress in critically ill patients in the emergency room.Methods A total of 242 patients with acute respiratory distress admitted to Jinhua City Central Hospital from January 2022 to January 2024 were selected as the research subjects.According to the final diagnosis after discharge,they were divided into cardiogenic group(n=144)and pulmonary group(n=98).Compare the CLAUS findings of two groups and accuracy of two protocols in diagnosing etiology of acute respiratory distress.Results The history of heart disease in cardiogenic group was higher than that in pulmonary group,and difference was statistically significant(P＜0.05).The lung disease history of patients in cardiogenic group was lower than that in pulmonary group,and difference was statistically significant(P＜0.05).The proportion of pleural smoothness/slight thickening,sliding presence/slight weakening,left heart dysfunction,right heart dysfunction,and B-line pulmonary ultrasound scores in cardiogenic group were higher than those in pulmonary group,and differences were statistically significant(P＜0.05).The sensitivity,specificity of POCURM protocol for diagnosing acute respiratory distress were 90.28％,91.84％.The sensitivity,specificity of CLAUS protocol for diagnosing acute respiratory distress were 96.53％,97.96％.Conclusion CLAUS regimen can effectively diagnose specific causes of acute respiratory distress in patients,with higher accuracy than POCURM regimen.

Objective To investigate the relationship between serum CXC chemokine ligand 1(CXCL1)and positive regulatory zone zinc finger protein 5(PRDM5)levels and lymph node metastasis of progressive gastric cancer and to analyze their predictive value for patients'prognosis.Methods 203 patients with progressive gastric cancer diagnosed in our hospital from June 2020 to March 2023 were selected and divided into the lymph node metastasis group(n=90)and the no-lymph node metastasis group(n=113)based on the presence or absence of lymph node metastasis,and the differences in the general information of the two groups were analyzed and compared,and the diagnostic value of CXCL1 and PRDM5 in lymph node metastasis of progressive gastric cancer was analyzed by plotting the ROC curve.Logistic regression was used to analyze the risk factors of lymph node metastasis in patients with progressive gastric cancer.Follow up for 2 years,draw Kapan Meier curves to compare the prognosis of patients with advanced gastric cancer lymph node metastasis at different levels of CXCL1 and PRDM5.Results The CXCL1 level in the lymph node metastasis group was higher than that in the no-lymph node metastasis group,and its PRDM5 level was lower than that in the no-lymph node metastasis group(P<0.05).The AUCs for diagnosing lymph node metastasis of progressed gastric cancer were 0.755 and 0.844 for CXCL1 and PRDM5,respectively,and the AUC for the combination of the two was 0.898(95%CI 0.848～0.936).The sensitivity and specificity were 88.89%and 77.88%,respectively(P<0.05).Tumor size,differentation degree,serum CEA,serum CA19-9,CXCL1,and PRDM5 levels were all risk factors for lymph node metastasis in patients with progressive gastric cancer(P<0.05).The survival time of patients with CXCL1>96.13 pg/mL is(15.13±0.85)months,while the survival time of patients with CXCL1≤96.13 pg/mL is(19.06±0.66)months.The survival time of patients with CXCL1≤96.13 pg/mL is longer than that of patients with CXCL1>96.13 pg/mL(P<0.05).The survival time of patients with PRDM>100.85 pg/mL is(18.62±0.69)months,while the survival time of patients with PRDM≤100.85 pg/mL is(14.60±0.78)months.The survival time of patients with PRDM>100.85 pg/mL is longer than that of patients with PRDM≤100.85 pg/mL(P<0.05).Conclusion The abnormal expression of CXCL1 and PRDM5 is related to lymph node metastasis in patients with progressive gastric cancer,and the combined detection of the two is of high value in the assessment of lymph node metastasis and prognosis in patients with progressive gastric cancer.

Objective To investigate the relationship between serum CXC chemokine ligand 1(CXCL1)and positive regulatory zone zinc finger protein 5(PRDM5)levels and lymph node metastasis of progressive gastric cancer and to analyze their predictive value for patients'prognosis.Methods 203 patients with progressive gastric cancer diagnosed in our hospital from June 2020 to March 2023 were selected and divided into the lymph node metastasis group(n=90)and the no-lymph node metastasis group(n=113)based on the presence or absence of lymph node metastasis,and the differences in the general information of the two groups were analyzed and compared,and the diagnostic value of CXCL1 and PRDM5 in lymph node metastasis of progressive gastric cancer was analyzed by plotting the ROC curve.Logistic regression was used to analyze the risk factors of lymph node metastasis in patients with progressive gastric cancer.Follow up for 2 years,draw Kapan Meier curves to compare the prognosis of patients with advanced gastric cancer lymph node metastasis at different levels of CXCL1 and PRDM5.Results The CXCL1 level in the lymph node metastasis group was higher than that in the no-lymph node metastasis group,and its PRDM5 level was lower than that in the no-lymph node metastasis group(P<0.05).The AUCs for diagnosing lymph node metastasis of progressed gastric cancer were 0.755 and 0.844 for CXCL1 and PRDM5,respectively,and the AUC for the combination of the two was 0.898(95%CI 0.848～0.936).The sensitivity and specificity were 88.89%and 77.88%,respectively(P<0.05).Tumor size,differentation degree,serum CEA,serum CA19-9,CXCL1,and PRDM5 levels were all risk factors for lymph node metastasis in patients with progressive gastric cancer(P<0.05).The survival time of patients with CXCL1>96.13 pg/mL is(15.13±0.85)months,while the survival time of patients with CXCL1≤96.13 pg/mL is(19.06±0.66)months.The survival time of patients with CXCL1≤96.13 pg/mL is longer than that of patients with CXCL1>96.13 pg/mL(P<0.05).The survival time of patients with PRDM>100.85 pg/mL is(18.62±0.69)months,while the survival time of patients with PRDM≤100.85 pg/mL is(14.60±0.78)months.The survival time of patients with PRDM>100.85 pg/mL is longer than that of patients with PRDM≤100.85 pg/mL(P<0.05).Conclusion The abnormal expression of CXCL1 and PRDM5 is related to lymph node metastasis in patients with progressive gastric cancer,and the combined detection of the two is of high value in the assessment of lymph node metastasis and prognosis in patients with progressive gastric cancer.

OBJECTIVE To explore the effectiveness and possible mechanism of Shangke Lengtong Patch in treating knee osteo-arthritis with cold-dampness arthralgia obstruction.METHODS A total of 70 patients who met the inclusion criteria of knee osteoar-thritis with cold-dampness arthralgia obstruction in the Orthopedics Department of Affiliated Hospital of Nanjing University of Chinese Medicine from November to December 2024 were randomly divided into an experimental group and a control group,with 35 cases in each group.During the treatment,1 case dropped out of the experimental group,3 cases dropped out of the control group,and 1 case was discontinued.The experimental group was treated with Shangke Lengtong Patch,and the control group was treated with Compound Nanxing Zhitong Ointment.The WOMAC scores and TCM syndrome scores of the two groups before and after treatment were compared to comprehensively evaluate the clinical efficacy.The changes in the expression levels of CGRP,substance P,HMGB1,IL-1β,CX-CL12,and CXCR4 in the serum of the two groups were detected by ELISA.RESULTS After 3,7,and 14 d of treatment,the WOMAC scores and TCM syndrome scores of the two groups were significantly reduced(P<0.05,P<0.01),and the score of aggrava-ted cold in the experimental group was better than that in the control group at 7 d of treatment(P<0.05);after 14 d of treatment,the expression levels of CGRP,substance P,HMGB1,IL-1β,CXCL12,and CXCR4 in the serum of the two groups were significantly re-duced(P<0.05),and there was no statistical difference between the two groups.CONCLUSION Shangke Lengtong Patch can sig-nificantly relieve the pain symptoms of knee osteoarthritis patients with cold-dampness arthralgia obstruction and improve the joint func-tion of patients.It may improve synovial inflammation by inhibiting the HMGB1/CXCL12/CXCR4 pathway,thereby exerting a thera-peutic effect.

Objective:To investigate the disparities in breast cancer burden and changing epidemiological trends between China and the United States(US)from 1990 to 2021 and identify the key driving factors.Methods:The Global Burden of Disease database(1990-2021)was utilized to analyze breast cancer incidence,mortality,and disability adjusted life years(DALYs)in China and the US;we also assessed the as-sociations with risk factors(e.g.,obesity and smoking)through regression models and spatiotemporal analysis.Results:China's breast can-cer age-standardized incidence rate(ASIR)surged from 9.08/100,000 in 1990 to 19.36/100,000 in 2021,whereas the US ASIR declined from 44.37/100,000 to 37.49/100,000.Regarding the age-standardized mortality rate(ASMR),China saw a marginal reduction from 4.70/100,000 to 4.40/100,000,whereas the US experienced a significant decline from 13.03/100,000 to 9.28/100,000,narrowing the mortality gap from 2.8-fold to 2.1-fold.Key risk factors contributing to mortality and DALYs included smoking,exposure to secondhand smoke,low physical activity,high red meat and alcohol intake,elevated fasting blood glucose levels,and high body mass index.The rising cancer incidence in China is associated with the westernization of lifestyles and changes in fertility patterns,whereas the United States has achieved a dual de-cline in both incidence and mortality rates through widespread screening and control of hormone replacement therapy.Conclusions:Both the incidence and mortality rates of breast cancer in China rank among the highest globally,with incidence rates still increasing,indicating severe issues in prevention and control.In contrast,although the incidence rate in the US is higher than that in China,it shows a declining trend.To alleviate the growing burden of breast cancer,China must further enhance the intensity and coverage of breast cancer screening.

Objective:To investigate the role of umbilical cord mesenchymal stem cell (MSC) -derived nanovesicles in hair regeneration.Methods:(1) Nanovesicles were prepared by continuously extruding umbilical cord MSCs through polycarbonate membranes, and were identified using transmission electron microscopy and nanoparticle tracking analysis. (2) Six C57BL/6 female mice with full-thickness skin wounds were randomly divided into a nanovesicle group (subcutaneously injected with nanovesicles once at the wound margin) and a control group (subcutaneously injected with an equal volume of phosphate-buffered saline [PBS] at the wound margin) ; skin samples were collected on day 16 for hematoxylin-eosin (HE) staining to assess wound healing and hair follicle regeneration. (3) Human hair follicle dermal papilla cells (DPCs) were isolated using a two-step enzyme method; the uptake of PKH26-pre-labeled nanovesicles by DPCs was observed by fluorescence microscopy; the proliferative activity of DPCs co-cultured with nanovesicles was evaluated using cell counting kit-8 (CCK8) and 5-ethynyl-2'-deoxyuridine (EdU) assays. (4) Six healthy C57BL/6 female mice were randomly divided into two groups after anesthesia, and subcutaneously injected with either fluorescent dye DIR-pre-labeled nanovesicles or PBS; an in vivo imaging system was used to observe the uptake and metabolism of nanovesicles in the mouse skin. (5) Twenty-four C57BL/6 female mice with depilated backs were randomly divided into a nanovesicle group (subcutaneously injected with nanovesicles on days 0, 8, and 15) and a control group (subcutaneously injected with an equal volume of PBS at the same time points) ; skin samples were collected on days 4, 18, and 21 for HE staining to analyze differences in hair follicle cycling; transcriptome sequencing was performed on skin samples collected on day 4. Statistical analyses were conducted using the t test. Results:(1) Transmission electron microscopy showed that nanovesicles exhibited a spherical membranous structure with diameters of 141.3 ± 60.0 nm. (2) In 6 C57BL/6 female mice with full-thickness skin wounds, the wound area on day 12 was significantly smaller in the nanovesicle group (1.27 ± 0.50 mm 2) than in the control group (4.13 ± 1.03 mm 2, t = 4.34, P = 0.012). (3) Fluorescence microscopy revealed that nanovesicles were taken up by DPCs within 20 hours; the absorbance of DPCs was significantly higher in the nanovesicle group than in the control group ( t = 20.23, P < 0.001), and the percentage of EdU-positive cells was also significantly higher in the nanovesicle group (49.62% ± 6.45%) than in the control group (37.58% ± 3.42%, t = 3.69, P = 0.006). (4) In vivo imaging of the 6 C57BL/6 female mice showed strong fluorescence in the back of mice in the nanovesicle group on day 0, which markedly decreased by day 8, while no fluorescence was observed in the control group throughout the experiment. (5) Hair follicle cycle experiments on the 24 C57BL/6 female mice with depilated backs showed that the hair follicle length on day 4 after depilation was significantly longer in the nanovesicle group (368.00 ± 63.17 μm) than in the control group (266.90 ± 34.41 μm, t = 9.87, P < 0.001), and the hair bulb diameter was also significantly longer in the nanovesicle group (54.83 ± 10.32 μm) than in the control group (39.12 ± 7.54 μm, t = 16.02, P < 0.001) ; on day 18, the nanovesicle group showed a significantly higher hair follicle density (19.12 ± 0.90) compared with the control group (11.07 ± 1.51, t = 7.92, P = 0.001) ; on day 21, 46.13% ± 8.64% of hair follicles in the nanovesicle group remained in the anagen phase Ⅵ to the catagen phase Ⅱ, and 46.24% ± 3.29% were in the catagen phases Ⅲ to Ⅳ, while 78.89% ± 18.36% of hair follicles in the control group were in the telogen phases Ⅶ to Ⅷ. Transcriptome sequencing showed that differentially expressed genes in the nanovesicle group were significantly positively enriched in the keratinization process (NES = 2.23, P < 0.001) . Conclusion:Umbilical cord MSC-derived nanovesicles could promote the proliferation of DPCs, advance the entry of hair follicles into the anagen phase, delay their entry into the catagen phase, and induce hair regeneration.

Objective:To understand the status and influencing factors of social isolation in elderly individuals with chronic diseases.Methods:A multi-stage sampling method was used to select elderly individuals from eight communities or villages in Hefei from July to September 2022. The study employed a general information survey, the Lubben Social Network Scale (LSNS-6) , the Geriatric Depression Scale (GDS-15) , the Social Support Rating Scale (SSRS) , and the Personal Social Capital Scale 16 (PSCS-16) . Binary Logistic regression analysis was used to explore the factors influencing social isolation in elderly individuals with chronic diseases.Results:A total of 1 133 elderly individuals were surveyed, among which 538 had chronic diseases. Among the 538 elderly individuals with chronic diseases, 209 were socially isolated, resulting in a social isolation rate of 38.8%. Binary Logistic regression analysis revealed that living area, fear of falling, depression, social capital, and social support were significant factors influencing social isolation ( P<0.05) . Conclusions:The social isolation rate among elderly individuals with chronic diseases is high. Special attention should be given to elderly individuals living in rural areas, those who fear falling, and those experiencing depression. Additionally, improving social capital and social support can help alleviate social isolation in these elderly individuals.

[Objective] To investigate the infection status and characteristics of HEV among voluntary blood donors in Ningbo, and to provide a basis for improving the blood screening strategy. [Methods] A total of 12 227 blood samples from voluntary blood donors in Ningbo from June 2022 to May 2023 were tested for HEV serology, enzymology, and nucleic acid testing. Furthermore, HEV gene sequencing was performed for genotyping analysis, and donors with reactive nucleic acid testing results were followed up to confirm their infection status. [Results] The reactivity rate of HEV Ag, anti-HEV IgM and anti-HEV IgG was 0.098%, 0.899% and 29.198%, respectively. There was no difference in the reactivity of anti-HEV IgM and anti-HEV IgG between genders, donation frequencies and donation types (P>0.05). The reactivity rate increased significantly with age (P<0.05). The rate of ALT disqualification (ALT>50U/L) was significantly higher than that in non-reactive samples (P<0.05). The HEV Ag reactivity rate (0.098%) was not correlated with gender, donation frequency, donation type or age. One HEV RNA positive case was found, with a positive rate of 0.008%(1/12 227). It was confirmed to be hepatitis E virus genotype 3 by sequencing analysis. Apart from HEV Ag reactivity, all other blood safety screening items were non-reactive, suggesting this case might be in the acute infection phase. The follow-up results showed that all indicators of the donor's previous blood donation were non-reactive. [Conclusion] Pre-donation ALT detection can reduce the risk of transfusion-transmitted HEV (TT-HEV) to a certain extent, and the effective way to prevent TT-HEV is to detect HEV RNA and serology of donor blood.