Objective:To investigate the correlation between insulin resistance surrogate indicators and early-stage kidney injury in type 2 diabetes mellitus(T2DM).Methods:A total of 918 T2DM patients hospitalized in the Endocrinology Department of Xinhua Hospital from January 2018 to December 2020 were selected, including 313 patients with early-stage kidney injury and 605 without. Differences in insulin resistance surrogate indicators, including triglyceride to high-density lipoprotein cholesterol ratio(TG/HDL-C), triglyceride glucose(TyG) index, and triglyceride glucose-body mass index(TyG-BMI), were compared between the two groups. Factors associated with early-stage kidney injury in T2DM were analyzed, and the impact of TG/HDL-C, TyG index, and TyG-BMI on early-stage kidney injury in T2DM were explored.Results:Compared with T2DM patients without early-stage kidney injury, those with early-stage kidney injury exhibited significantly elevated levels of TG/HDL-C, TyG index, and TyG-BMI( P< 0.001). TG/HDL-C, TyG index, TyG-BMI, age, duration of diabetes, systolic blood pressure, fasting insulin, and HbA 1C were identified as independent risk factors for early-stage kidney injury in T2DM. Compared to the Q1 quartile, the risk in the Q4 quartile was 3.168 times(95% CI 1.993-5.036) for TG/HDL-C, 2.714 times(95% CI 1.710-4.306) for TyG index, and 2.893 times(95% CI 1.820-5.598) for TyG-BMI. Conclusion:Insulin resistance surrogate indicators TG/HDL-C, TyG index, and TyG-BMI are significantly elevated in T2DM patients with early-stage kidney injury, serving as independent risk factors for early-stage renal impairment in T2DM.

AIM:To investigate the impact of mitochondrial carrier homologous protein 2(MTCH2)on the metastasis of oral squamous cell carcinoma and to elucidate its underlying mechanisms.METHODS:Human tongue squamous cell carcinoma CAL-27 cells were selected as the study model.An MTCH2 inhibition and overexpression model was established using small interfering RNA(siRNA)technology and overexpression plasmids.Based on the experimental design,cells were categorized into the following groups:siRNA negative control(siRNA-NC)group,MTCH2 siRNA(siRNA-MTCH2)group,empty vector(OE-NC)group,and MTCH2 overexpression(OE-MTCH2)group.Transwell as-says and wound healing assays were conducted to assess the invasion and migration capabilities of cells in each group.The morphological changes and distribution of actin microfilaments were examined using a red fluorescent probe.The mito-chondrial membrane potential was evaluated using a mitochondrial membrane potential detection kit.The levels of reactive oxygen species(ROS)were measured using a ROS detection kit.Adenosine triphosphate(ATP)production levels were assessed with an ATP detection kit.The protein expression levels of MTCH2 and matrix metalloproteinase 14(MMP14)were analyzed through cell fluorescence and Western blot techniques.RESULTS:The number of invasive cells in the siRNA-MTCH2 group was significantly reduced,and the cell migration rate was notably decreased.Conversely,the OE-MTCH2 group exhibited a significant increase in both the number of invasive cells and the cell migration rate(P<0.01).The fluorescence intensity of F-actin and MTCH2 in the siRNA-MTCH2 group was significantly diminished,while these in-tensities were markedly elevated in the OE-MTCH2 group(P<0.01).The ROS levels in the siRNA-MTCH2 group were significantly higher than those in the siRNA-NC group,whereas the levels of ATP and mitochondrial membrane potential were significantly lower.Conversely,the ROS levels in the OE-MTCH2 group were significantly lower than those in the OE-NC group,with corresponding increases in ATP levels and mitochondrial membrane potential(P<0.01).The expres-sion levels of MTCH2 and MMP14 proteins in the siRNA-MTCH2 group were significantly lower than those in the siRNA-NC group,while the OE-MTCH2 group showed significantly higher expression levels compared to the OE-NC group(P<0.01).CONCLUSION:The MTCH2 is associated with the development of oral squamous cell carcinoma and may facili-tate the metastasis of CAL-27 cells by regulating mitochondrial function and MMP14 protein expression.Therefore,MTCH2 may represent a novel therapeutic target for the treatment of oral cancer.

To perform the phylogenetic characterization of an isolated porcine rotavirus(PoRV)and investigate its pathogenicity in suckling mice and piglets.A G4P[23]genotype PoRV strain JSJR2023 was successfully isolated from the diarrheic piglet feces through propagation in MA104 cells.The viral proliferation kinetics were analyzed using TCID50 assays,followed by complete genome sequencing through Sanger sequencing platforms.Comprehensive genotyping and phylogenetic reconstruction were conducted using MEGA7.0 with maximum likelihood algorithms.Pathogenicity was assessed in the following animal models:5-day-old C57BL/6 mice and 3-day-old piglets.Multidimensional evaluation included clinical monitoring(diarrhea scoring,growth parameters),virological detection,and histopathological analysis of intestinal tissues.The virus strain JSJR2023 could replicate efficiently in MA104 cells,achieving peak titers of 107.5 TCID50/mL.Whole genome genotype analysis showed that the strain belonged to G4-P[23]-I5-R1-C1-M1-A8-N1-T1-E1-H1.Phylogenetic analysis indicated that the VP3 and NSP4 genes of JSJR2023 strain were most closedrelated to human species rotaviruses,suggesting genetic reassortment between human and porcine RV strains.The animal experiments in suckling mice showed that the JSJR2023 strain infection caused diarrhea symptoms,intestinal edema and congestion,and shedding of intestinal villus epithelial cells.The pathogenicity experiments in piglets showed that compared with the control group,the challenged group of pig-lets had severe diarrhea symptoms,accompanied by reduced appetite and listlessness.Post-mortem examination revealed that the intes-tines were significantly thinner,congested,and filled with yellow watery contents.The challenged piglets showed typical pathological changes such as thinning of the intestinal wall and shortening and shedding of intestinal villi.In conclusion,this study successfully iso-lated a human-porcine recombinant G4P[23]PoRV strain and established the infection models in suckling mice and piglets,providing important tools for investigating the pathogenic mechanism of PoRV,evaluating vaccines and developing antiviral drug.

Compared to traditional machine learning algorithms,which often suffer from low feature extraction efficiency,insufficient nonlinear pattern recognition capabilities and slow training speeds,the broad learning system(BLS)enhances the learning ability and efficiency by horizontally expanding the network structure.BLS offers advantages such as a simple structure,fast training speed,and strong generalization capabilities.While BLS has demonstrated potential in various fields,but its application in identification of complex samples has not been fully explored.This research investigated the feasibility of using BLS algorithm for identification of complex samples based on physicochemical indicators.Using the iris,wine,and breast cancer datasets,the length and width of petals and sepals of iris flowers,the physicochemical properties of wine,and the nuclear characteristics of breast cancer cells were used as input variables to establish BLS models for identifying iris species,wine varieties,and benign versus malignant nucleus.The model performance was evaluated by confusion matrices,accuracy,and runtime.Compared with partial least squares-discriminant analysis(PLS-DA),soft independent modeling of class analogies(SIMCA),and artificial neural networks(ANN),the results indicated that BLS demonstrated significant advantages in computational efficiency and recognition accuracy.Thus,BLS was an efficient and reliable method for identification of complex samples.

Objective:To investigate the correlation between insulin resistance surrogate indicators and early-stage kidney injury in type 2 diabetes mellitus(T2DM).Methods:A total of 918 T2DM patients hospitalized in the Endocrinology Department of Xinhua Hospital from January 2018 to December 2020 were selected, including 313 patients with early-stage kidney injury and 605 without. Differences in insulin resistance surrogate indicators, including triglyceride to high-density lipoprotein cholesterol ratio(TG/HDL-C), triglyceride glucose(TyG) index, and triglyceride glucose-body mass index(TyG-BMI), were compared between the two groups. Factors associated with early-stage kidney injury in T2DM were analyzed, and the impact of TG/HDL-C, TyG index, and TyG-BMI on early-stage kidney injury in T2DM were explored.Results:Compared with T2DM patients without early-stage kidney injury, those with early-stage kidney injury exhibited significantly elevated levels of TG/HDL-C, TyG index, and TyG-BMI( P< 0.001). TG/HDL-C, TyG index, TyG-BMI, age, duration of diabetes, systolic blood pressure, fasting insulin, and HbA 1C were identified as independent risk factors for early-stage kidney injury in T2DM. Compared to the Q1 quartile, the risk in the Q4 quartile was 3.168 times(95% CI 1.993-5.036) for TG/HDL-C, 2.714 times(95% CI 1.710-4.306) for TyG index, and 2.893 times(95% CI 1.820-5.598) for TyG-BMI. Conclusion:Insulin resistance surrogate indicators TG/HDL-C, TyG index, and TyG-BMI are significantly elevated in T2DM patients with early-stage kidney injury, serving as independent risk factors for early-stage renal impairment in T2DM.

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 explore the clinical characteristics and identification of the independent risk factors for disease progression in patients with anti-gp210 antibody-positive primary biliary cholangitis (PBC).Methods:A retrospective cohort study was performed. A total of 323 cases with PBC diagnosed in Tianjin Medical University General Hospital from January 2013 to June 2023 (125 patients with anti-gp210 antibody-positive and 198 patients with anti-gp210 antibody-negative) were included. Baseline and follow-up data were collected. The independent sample t-test and Mann-Whitney U rank sum test were used for comparison between groups of continuous data. The χ2 test was used to compare the data between groups for the count data. The Pearson test was used for correlation analysis between continuous variables. The Kaplan-Meier method was used to analyze the disease progression-free survival rate. The Cox regression model was used to analyze the risk factors for disease progression. Results:The male proportion (11.2% vs. 5.1%, P=0.040) and IgM level [3.29(1.88, 4.80) g/L vs. 2.56(1.44, 3.87) g/L, P=0.019] were significantly higher in patients with PBC with positive anti-gp210 antibodies than those of the negative group. Histopathological analysis showed that the Scheuer score [1(0,3) vs. 0(0,2)], bile duct inflammation [(2(1,3) vs. 1(1,2)] and bile duct reaction score [(2(1,3) vs. 1(1,2)] were higher in the positive group than those of the negative group ( P<0.05), and the maturity of the tertiary lymphoid structure was higher ( P=0.011). Kaplan-Meier analysis showed that the 5-year disease-free survival rate was significantly lower in patients with positive anti-gp210 antibodies than that of the negative group (55.8% vs. 79.7%, P=0.006) at a median follow-up of 3(2,6) years. Multivariate Cox regression analysis showed that γ-glutamyl transferase [ HR=1.002 (95% CI: 1.000～1.003)] and platelet count [ HR=0.993 (95% CI: 0.988～0.999)] were the independent influencing factors for disease progression in patients with anti-gp210 antibody-positive PBC ( P=0.002, 0.017). Conclusion:Patients with anti-gp210 antibody-positive PBC have more severe clinical pathological manifestations and a higher risk of disease progression. Higher levels of γ-glutamyl transferase and lower platelet counts during the first visit are independent risk factors for disease progression in patients with anti-gp210 antibody-positive PBC, which can be used as dynamic monitoring indicators for this population, suggesting the need for early intensive intervention.

Objective To investigate the functional changes of dendritic cells(DCs)in patients at different stages of hepatitis B virus(HBV)infection and analyze the mechanisms underlying DC dysfunction.Methods Single-cell RNA sequencing dataset GSE182159 was downloaded from the GEO database and classified into healthy control(HC),immune active(IA),and immune tolerant(IT)groups based on infection stage.Peripheral blood samples were collected from 7 IA patients,7 IT patients,and 12 healthy controls.Flow cytometry was used to isolate classical dendritic cells(cDC)and plasmacytoid dendritic cells(pDC).The expression levels of transcription factors in cDC and pDC were measured by quantitative real-time PCR(qRT-PCR).Bioinformatics analyses were per-formed using R and Python package.Results The proportions of DCs in IA and IT groups were higher than that in HC group.Func-tional enrichment analysis revealed that the differentially expressed genes(DEGs)of cDCs in the IA group were primarily enriched for the processes,such as inflammatory response,MHC classⅡantigen processing and presentation,cell migration,signal transduction,metabolism,and immune response.In contrast the IT group exhibited lower enrichment intensity and a significant reduction in interfer-on responses.The DEGs of pDC in the IA group were enriched in the processes of MHC-Ⅱantigen presentation,Fc receptor signal transduction,and metabolism,whereas those in the IT group were showed enrichment only in Fc receptor signal transduction and me-tabolism with a lower intensity.Both groups exhibited reduced synthesis of typesⅠandⅡinterferons in pDC,with the IT group showing a more pronounced downregulation.Cell-cell communication analysis demonstrated enhanced interactions between myeloid cells(except pDC)and T cells in the IA group,whereas the interactions between cDC/pDC and T cells in the IT group were reduced.Transcription factor analysis revealed that STAT2,STAT3,IRF1,and IRF5 were highly expressed in the IA group but their expression exhibited low-er expression levels in the IT group.In contrast,BHLHE40 was broadly upregulated in both cDC and pDC subsets within the IT group.The qRT-PCR results were consistent with the findings from the single-cell transcription factor analysis.Conclusion The IT phase of hepatitis B infection represents a critical period for cDC dysfunction,characterized by significant suppression of MHCⅡantigen presen-tation,metabolism,and interferon responsiveness.The functional impairment of pDC precedes that of cDC,as evidenced by a marked downregulation of interferon synthesis capacity observed during the IA phase.

Allergic rhinitis(AR)affects 10%-40%of the population in the world.Because CLOCK genes regulate the circadian rhythms of AR,the symptoms in parts of the patients are aggravated in the morning and evening and relieved at moon.Although lots of studies showed that traditional Chinese medicine is effective for AR,further explores are still needed to analyze the circadian rhythm of AR based on Chinese Chronological Medicine for controlling the circadian outbreak point of symptoms of AR in daily cycle.We supposed that Weiyang might play an important role for controlling the circadian rhythm of AR with closed similarities with the tidal variation of the expressions of CLOCK genes.Thus based on Weiyang theory,we tried to clarify the mechanism of circadian rhythm of AR and explore the relationship between Weiyang and the CLOCK genes so as to further expand the treatment methods of adjusting the circadian cycle of AR with TCM and improve the corresponding therapeutic efficacy.

Objective:To explore the short-term clinical effects of deep cervical lymph node-venous anastomosis in the treatment of Alzheimer’s disease (AD).Methods:A prospective exploratory study was conducted on the treatment of AD patients using the cervical deep lymph node-venous anastomosis technique in Scar and Wound Treatment Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, from September to October 2024. The patients underwent high-frequency ultrasound to locate deep cervical lymph nodes and the external jugular vein. Under general anesthesia, bilateral deep cervical lymph node-venous anastomoses were performed. Indocyanine green (ICG) lymphography was conducted via subcutaneous injection behind the ear to visualize lymph nodes in levels Ⅱ and Ⅲ. After making a skin incision along the posterior margin of the sternocleidomastoid muscle, the external jugular vein, internal jugular veins, and associated lymph nodes were exposed. Adjacent veins were selected for anastomosis of lymph node. Using microsurgical techniques, end-to-side or end-to-end anastomosis was completed for lymph nodes in levels Ⅱ and Ⅲ. Preoperative assessments included the mini-mental state examination (MMSE, a higher score indicates better cognitive function), Alzheimer’s disease assessment scale-cognitive subscale (ADAS-Cog, a higher score indicates greater impairment of cognitive function), Alzheimer’s disease cooperative study scale for activities of daily living (ADCS-ADL, a higher score indicates better ability to perform daily activity), and neuropsychiatric inventory (NPI, a higher score indicates more severe behavioral and emotional symptom). Postoperative follow-up included the same scales to observe changes in cognitive function, activities of daily living, and emotional communication.Results:Four patients (1 male, 3 females, aged 58-79 years) with AD were included. All were diagnosed based on cerebrospinal fluid biomarkers. All patients successfully underwent bilateral deep cervical lymph node-venous anastomoses. On average, 4.3 (2-7 per person) anastomoses were performed per patient. Surgical procedures lasted an average of 6.5 h (5.5-8.5 h) with minimal blood loss (less than 50 ml). Patients resumed normal activity within 6 hours postoperatively and were discharged after an average of 4.1 d (3.5-5.0 d). Postoperative complications included one case each of aspiration pneumonia, lower limb venous thrombosis, and transient delirium, all of whom resolved without long-term effects. Clinical symptoms, including memory decline, mood swings, and anxiety, showed varying degrees of improvement. Patients reported enhanced quality of life, emotional stability, and social engagement, confirming the procedure’s safety and potential cognitive benefits. At one month postoperatively, the MMSE scores of the four patients increased by an average of 0.8 points compared to preoperative levels. Additionally, the two patients who completed the ADAS-Cog assessments showed a decrease in their scores (reduced by 1.0 points and 11.3 points, respectively, compared to preoperative scores), indicating a certain degree of improvement in cognitive function during this period. The ADCS-ADL and NPI scores of four patients varied significantly, without showing any clear pattern.Conclusion:Lymphovenous anastomosis of the deep cervical lymph node-venous anastomosis may provide a new surgical intervention approach for AD, but further large-scale studies and long-term follow-up are needed to validate its safety and effectiveness.