Objective To investigate the species of sandflies and the prevalence of Leishmania infections in sandflies from selected areas of northern and northwestern China, so as to provide insights into identification of leishmaniasis vectors and assessment of epidemiological trends of leishmaniasis in China. Methods Sandfly samples were collected from Mentougou District of Beijing Municipality, Xiangning County in Linfen City of Shanxi Province, Ejin Banner in Alxa League of Inner Mongolia Autonomous Region, and Payzawat County of Karamay District of Karamay City, Gaochang District of Turpan City in Xinjiang Uygur Autonomous Region from July 2023 to July 2024. Approximately 100 intact female sandfly samples were randomly selected from each site and the species of sandflies was identified according to morphological characteristics and molecular assays. Female sandflies originating from the same habitat were grouped into pools of 10 individuals. Leishmania infection was detected using polymerase chain reaction (PCR) assay targeting the internal transcribed spacer 1 (ITS-1) gene, and the prevalence of Leishmania infection was calculated in sandflies from different sampling sites using the minimum infection rate (MIR) method. In addition, positive amplicons were sequenced and subjected to phylogenetic analysis. Results A total of 6 155 sandflies were collected from different environments at sampling sites across the six aforementioned regions from July 2023 to July 2024. Phlebotomus chinensis (96.00%) was the dominant sandfly species in Mentougou District, Beijing Municipality, with a small proportion of Ph. sergenti (4.00%), and only Ph. chinensis was found in Xiangning County, Linfen City, Shanxi Province. Ph. wui was the only sandfly species detected in Ejin Banner, Alxa League, Inner Mongolia Autonomous Region, and Payzawat County, Kashgar City, Xinjiang Uygur Autonomous Region, and Ph. caucasicus (97.70%) was the dominant sandfly species in Karamay District, Karamay City, Xinjiang Uygur Autonomous Region, with a small proportion of Ph. wui (2.30%), while Ph. alexandri was the only species in Gaochang District, Turpan City, Xinjiang Uygur Autonomous Region. A total of 40, 60, 34, 18, 18, and 22 pools of sandfly samples were tested from Mentougou District in Beijing Municipality, Xiangning County in Linfen City of Shanxi Province, Ejin Banner in Alxa League of Inner Mongolia Autonomous Region, Payzawat County in Kashgar City, Karamay District in Karamay City, and Gaochang District in Turpan City of Xinjiang Uygur Autonomous Region, respectively. L. infantum was detected in Ph. chinensis samples from Mentougou District in Beijing Municipality, and Xiangning County of Linfen City in Shanxi Province, with MIR of 0.25% to 1.00%, and L. donovani was detected in Ph. wui from Ejin Banner in Alxa League of Inner Mongolia Autonomous Region, and Payzawat County in Kashgar City of Xinjiang Uygur Autonomous Region, with MIR of 0.56% to 0.88%; however, no Leishmania infection was detected in Ph. caucasicus from Karamay District in Karamay City or Ph. alexandri from Gaochang District in Turpan City of Xinjiang Uygur Autonomous Region. Phylogenetic analysis showed that the Leishmania ITS-1 gene sequences obtained from Mentougou District in Beijing Municipality and Xiangning County in Linfen City of Shanxi Province were clustered into the same clade with the reference sequences of L. infantum ITS-1 gene, while the Leishmania ITS-1 gene sequences obtained from Ejin Banner in Alxa League of Inner Mongolia Autonomous Region and Payzawat County in Kashgar City of Xinjiang Uygur Autonomous Region were clustered into the same clade with the reference sequences of L. donovani ITS-1 gene. Conclusions There are variations in sandfly species in selected areas of northern and northwestern China, and variations in the species of Leishmania infecting sandflies. Improved surveillance of sandfly vectors and targeted control strategies with adaptations to geographical features and leishmaniasis vectors are recommended.

Diabetic cardiomyopathy is a distinct form of cardiomyopathy that can lead to heart failure, arrhythmias, cardiogenic shock, and sudden death. It has become a major cause of mortality in diabetic patients. The pathogenesis of diabetic cardiomyopathy is complex, involving increased oxidative stress, activation of inflammatory responses, disturbances in glucose and lipid metabolism, accumulation of advanced glycation end products (AGEs), abnormal autophagy and apoptosis, insulin resistance, and impaired intracellular Ca²⁺ homeostasis. Recent studies have shown that adenosine monophosphate-activated protein kinase (AMPK) plays a crucial protective role by lowering blood glucose levels, promoting lipolysis, inhibiting lipid synthesis, and exerting antioxidant, anti-inflammatory, anti-apoptotic, and anti-ferroptotic effects. It also enhances autophagy, thereby alleviating myocardial injury under hyperglycemic conditions. Consequently, AMPK is considered a key protective factor in diabetic cardiomyopathy. As part of diabetes prevention and treatment strategies, both pharmacological and exercise interventions have been shown to mitigate diabetic cardiomyopathy by modulating the AMPK signaling pathway. However, the precise regulatory mechanisms, optimal intervention strategies, and clinical translation require further investigation. This review summarizes the role of AMPK in the prevention and treatment of diabetic cardiomyopathy through drug and/or exercise interventions, aiming to provide a reference for the development and application of AMPK-targeted therapies. First, several classical AMPK activators (e.g., AICAR, A-769662, O-304, and metformin) have been shown to enhance autophagy and glucose uptake while inhibiting oxidative stress and inflammatory responses by increasing the phosphorylation of AMPK and its downstream target, mammalian target of rapamycin (mTOR), and/or by upregulating the gene expression of glucose transporters GLUT1 and GLUT4. Second, many antidiabetic agents (e.g., teneligliptin, liraglutide, exenatide, semaglutide, canagliflozin, dapagliflozin, and empagliflozin) can promote autophagy, reverse excessive apoptosis and autophagy, and alleviate oxidative stress and inflammation by enhancing AMPK phosphorylation and its downstream targets, such as mTOR, or by increasing the expression of silent information regulator 1 (SIRT1) and peroxisome proliferator-activated receptor‑α (PPAR‑α). Third, certain anti-anginal (e.g., trimetazidine, nicorandil), anti-asthmatic (e.g., farrerol), antibacterial (e.g., sodium houttuyfonate), and antibiotic (e.g., minocycline) agents have been shown to promote autophagy/mitophagy, mitochondrial biogenesis, and inhibit oxidative stress and lipid accumulation via AMPK phosphorylation and its downstream targets such as protein kinase B (PKB/AKT) and/or PPAR‑α. Fourth, natural compounds (e.g., dihydromyricetin, quercetin, resveratrol, berberine, platycodin D, asiaticoside, cinnamaldehyde, and icariin) can upregulate AMPK phosphorylation and downstream targets such as AKT, mTOR, and/or the expression of nuclear factor erythroid 2-related factor 2 (Nrf2), thereby exerting anti-inflammatory, anti-apoptotic, anti-pyroptotic, antioxidant, and pro-autophagic effects. Fifth, moderate exercise (e.g., continuous or intermittent aerobic exercise, aerobic combined with resistance training, or high-intensity interval training) can activate AMPK and its downstream targets (e.g., acetyl-CoA carboxylase (ACC), GLUT4, PPARγ coactivator-1α (PGC-1α), PPAR-α, and forkhead box protein O3 (FOXO3)) to promote fatty acid oxidation and glucose uptake, and to inhibit oxidative stress and excessive mitochondrial fission. Finally, the combination of liraglutide and aerobic interval training has been shown to activate the AMPK/FOXO1 pathway, thereby reducing excessive myocardial fatty acid uptake and oxidation. This combination therapy offers superior improvement in cardiac dysfunction, myocardial hypertrophy, and fibrosis in diabetic conditions compared to liraglutide or exercise alone.

ObjectiveTo investigate the core influencing factors for quality of life in patients with primary biliary cholangitis through a systematic review， and to provide an evidence-based basis for understanding such factors. MethodsThe databases including CNKI， Wanfang Data， CBM， VIP， PubMed， Embase， Web of Science， Ovid， Scopus， and Medline were searched for articles assessing the influencing factors for quality of life in patients with primary biliary cholangitis using PBC-40 scale published up to January 11， 2025. Quality assessment was conducted using the scale compiled by the Agency for Healthcare Research and Quality， and then a qualitative evaluation was performed for the basic situation of the studies included in the analysis. ResultsA total of 11 articles were included， and the results showed that age， sex， albumin， alkaline phosphatase， gamma-glutamyl transferase， direct bilirubin， total bilirubin， total bile acid， alanine aminotransferase， aspartate aminotransferase， body mass index， and high-density lipoprotein cholesterol were important influencing factors for quality of life in patients with primary biliary cholangitis. ConclusionInfluencing factors include demographic features， liver function parameters， and physical and metabolic indicators； however， due to the limited number of studies， more high-quality large-sample studies are needed in the future.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective:To investigate the effect of thrombocytopenia and coagulation dysfunction on bleeding complications in patients undergoing percutaneous liver biopsy.Methods:The clinical, laboratory, and demographic data of patients undergoing percutaneous liver biopsy at the First Affiliated Hospital of Air Force Medical University from January 2005 to January 2024 were retrospectively analyzed. The incidence of bleeding was recorded. Univariate and multivariate logistic regression analyses were used to assess the effects of thrombocytopenia and coagulation dysfunction on the risk of postoperative bleeding. Furthermore, we assessed the bleeding risk in patients with autoimmune hepatitis.Results:A total of 2 885 liver perforations were performed in 2 364 patients, 98.4% of whom had an autoimmune liver disease. There were 27 cases of postoperative bleeding (0.9%). The univariate logistic regression analysis showed that platelet count (PLT)( P<0.05, OR=0.975), coagulation dysfunction (international normalized ratio; INR)( P<0.05, OR=6.954), and cirrhosis ( P<0.05, OR=3.857) were associated with bleeding. The multivariate logistic regression analysis showed that PLT was an independent risk factor for bleeding ( P<0.05, OR=0.975). PLT scores of 40×10 9/L and 65×10 9/L can classify the bleeding risk of patients with thrombocytopenia into high, medium, and low risk. There was no difference in the risk of bleeding between the 40×10 9/L0.05, χ2=0.10). The risk of bleeding in the 31×10 9/L≤PLT≤40×10 9/L group was higher than that in the 40×10 9/L0.05, χ2=0.10). Furthermore, the bleeding cases were considered mild as the bleeding stopped after pressure hemostasis. Conclusions:PLT is an independent risk factor for bleeding after hepatocentesis. When the PLT is >40×10 9/L, hepatocentesis can still be performed safely with appropriate management measures.

Objective:To evaluate the quality of information on autoimmune liver disease in videos on the TikTok short video platform.Methods:The keyword "autoimmune liver disease" was used to search the top 200 videos on TikTok in the default sorting order. Using the DISCERN video quality assessment tool and the structured content integrity evaluation tool, we assessed the quality of the information in each video in relation to the pertinent disease guidelines. Furthermore, we investigated any relationships between the quality of the videos and their characteristics (likes, comments, retweets, days and duration of uploading).Results:A total of 140 videos were included, 96.4% of which were provided by medical professionals. The content completeness scores for each dimension were as follows: definition, 1.0 (0.0, 1.0); symptoms, 0.0 (0.0, 1.0); risk factors, 0.0 (0.0, 0.5); assessment, 0.5 (0.0, 1.5); management, 0.5 (0.0, 1.0); and outcome, 0.0 (0.0, 1.0). Furthermore, 91.4% of videos with DISCERN scores of ≤50 were of "fair" quality or below. Additionally, the difference in DISCERN scores between videos from different publishers was not statistically significant ( P>0.05). The number of likes, comments, favorites, retweets, and video duration had a strong positive correlation with the overall DISCERN score ( r=0.17, 0.18, 0.25, 0.26, 0.44, all P<0.05). Conclusions:The overall quality of videos related to autoimmune liver disease on the TikTok video platform is low. Therefore, publishers should focus on the comprehensiveness and accuracy of the information. Additionally, the TikTok platform should optimize its video review mechanism to provide the public with more accurate and reliable health information.

Objective:To explore the feasibility of joint screening of the two primary immunodeficiency diseases [severe combined immunodeficiency (SCID) and X-linked agammaglobulinemia(XLA)] and spinal muscular atrophy(SMA) in newborns by multiplex real-time quantitative PCR technology, and to provide evidence for early screening, diagnosis and treatment of children.Methods:Cross-sectional study. From July 2021 to January 2023, a total of 103 240 dry blood spots samples of newborns were collected which were delivered to Neonatal Disease Screening Center of Zhejiang by cold chain transportation. The concentrations of the T cell receptor excision ring (TREC), Kappa deletion of the recombinant excision loop (KREC), and exon 7 deletion of Survival Motor Neuron 1 (SMN1) gene in dry blood spots were simultaneously detected by multiplex real-time fluorescence quantitative PCR, taken ribonuclease P/MRP 30 000 subunits (RPP30) as an internal reference gene. The positive newborns were further diagnosed by other laboratory tests and gene sequencing was taken as gold standard. Children samples from 1 case of SCID, 3 cases of XLA and 2 cases of SMA were used for positive verification. The correlation between detected concentration of TREC/KREC and basic information in newborns were analyzed. The differences among groups for each factor were analyzed.Results:One case of SCID, 2 cases of XLA, 9 cases of SMA and 7 cases of other genetic diseases (4 cases of DiGeorge syndrome, 1 case of trisomy 21 syndrome, 1 case of Noonan syndrome and 1 case of super male syndrome) were identified by multiplex real-time fluorescence quantitative PCR. The positive predictive values of screening neonatal SCID, XLA and SMA were 2.44% (1/41), 2.78% (2/72) and 9/9 respectively. Taking the samples from clinically diagnosed 1 case of SCID, 3 cases of XLA and 2 cases of SMA as positive validation samples, which were all identified. The detected results of TREC/KREC correlated with time of blood collection, sex, weight, gestational age and delivery mode of newborns, whose r values were 0.162/0.187, 0.066/0.032, 0.045/0.042, ?0.015/?0.088 and 0.014/0.068 respectively (all P<0.05). Conclusions:Relying on current neonatal screening platform in Zhejiang, it is feasible to screen jointly two kinds of primary immunodeficiency diseases and spinal muscular atrophy in newborns by multiple real-time fluorescence quantitative PCR technology.

Objective:To investigate the endocardial myocardial biopsy and ultrastructural features of heart failure patients with reduced ejection fraction, to determine their histopathologic phenotype, and to explore the diagnostic utility of endomyocardial biopsy in such patients.Methods:A total of 35 patients with heart failure with reduced ejection fraction diagnosed at Beijing Anzhen Hospital and underwent endomyocardial biopsy were collected between January 2022 and December 2023. The clinical features, histopathological, and ultrastructural characteristics were analyzed and compared with 11 patients with heart failure with preserved ejection fraction.Results:The age ranged from 35-58 years, with median age of 51 years; there were 26 males and 9 females. Myocardial fibrosis and myocardial fiber disorders were the most common histopathologic changes [97.1% (34/35) and 74.3% (26/35), respectively]. Myocardial fibrosis was not statistically different between the heart failure with reduced ejection fraction group and the heart failure with preserved ejection fraction group [13.3% (5.7%-21.4%) vs. 13.2% (9.3%-34.2%), P=0.279]. Significant ultrastructural changes were dense mitochondrial proliferation, vacuolar degeneration, and disorganized arrangement of myocardial fibers with localized lysis and fracture. After endomyocardial biopsy, the etiology was identified in 11 patients (31.4%,11/35), with a prevalence of cardiac amyloidosis of 17.1% (6/35). Conclusions:Endomyocardial biopsy is useful for early diagnosis and precise treatment in patients presenting with heart failure with reduced ejection fraction. Histopathological and ultrastructural analyses can uncover potential treatments, and predict and improve prognosis by providing relevant information for understanding the pathogenesis and clinical evolution.