Purpose: Combinations of immune checkpoint inhibitors (ICIs) and chemotherapy have become the standard first-line treatment for human epidermal growth factor receptor 2 (HER-2)-negative advanced gastric cancer. However, primary resistance remains a challenge, with no effective biomarkers available for its prediction. This retrospective study explores the relationship between the baseline inflammatory burden index (IBI) and primary resistance in such context. Materials and Methods: We analyzed 62 patients with HER-2-negative advanced gastric cancer who received ICIs and chemotherapy as their first-line treatment. The IBI was calculated as follows: C-reactive protein (mg/L) × neutrophil count (10 3 /mm 3 )/lymphocyte count (10 3 /mm 3 ). Based on disease progression within 6 months, patients were categorized into the primary resistant or the control group. We compared baseline characteristics and IBI scores between the groups and assessed the predictive value of the IBI using the receiver operating characteristic curve. Both univariate and multivariate binary logistic regression analyses were conducted to identify factors influencing primary resistance. Results: Nineteen patients were included in the primary resistance group, and forty-three patients were included in the control group. The IBI was significantly higher in the resistant group compared to the control group (P<0.01). The area under the curve for the IBI was 0.82, indicating a strong predictive value. Multivariate analysis identified the IBI as an independent predictor of primary resistance (P=0.014). Conclusions The baseline IBI holds promise as a predictor of primary resistance to combined ICIs and chemotherapy in patients with HER-2-negative advanced gastric cancer.

Purpose: Combinations of immune checkpoint inhibitors (ICIs) and chemotherapy have become the standard first-line treatment for human epidermal growth factor receptor 2 (HER-2)-negative advanced gastric cancer. However, primary resistance remains a challenge, with no effective biomarkers available for its prediction. This retrospective study explores the relationship between the baseline inflammatory burden index (IBI) and primary resistance in such context. Materials and Methods: We analyzed 62 patients with HER-2-negative advanced gastric cancer who received ICIs and chemotherapy as their first-line treatment. The IBI was calculated as follows: C-reactive protein (mg/L) × neutrophil count (10 3 /mm 3 )/lymphocyte count (10 3 /mm 3 ). Based on disease progression within 6 months, patients were categorized into the primary resistant or the control group. We compared baseline characteristics and IBI scores between the groups and assessed the predictive value of the IBI using the receiver operating characteristic curve. Both univariate and multivariate binary logistic regression analyses were conducted to identify factors influencing primary resistance. Results: Nineteen patients were included in the primary resistance group, and forty-three patients were included in the control group. The IBI was significantly higher in the resistant group compared to the control group (P<0.01). The area under the curve for the IBI was 0.82, indicating a strong predictive value. Multivariate analysis identified the IBI as an independent predictor of primary resistance (P=0.014). Conclusions The baseline IBI holds promise as a predictor of primary resistance to combined ICIs and chemotherapy in patients with HER-2-negative advanced gastric cancer.

Purpose: Combinations of immune checkpoint inhibitors (ICIs) and chemotherapy have become the standard first-line treatment for human epidermal growth factor receptor 2 (HER-2)-negative advanced gastric cancer. However, primary resistance remains a challenge, with no effective biomarkers available for its prediction. This retrospective study explores the relationship between the baseline inflammatory burden index (IBI) and primary resistance in such context. Materials and Methods: We analyzed 62 patients with HER-2-negative advanced gastric cancer who received ICIs and chemotherapy as their first-line treatment. The IBI was calculated as follows: C-reactive protein (mg/L) × neutrophil count (10 3 /mm 3 )/lymphocyte count (10 3 /mm 3 ). Based on disease progression within 6 months, patients were categorized into the primary resistant or the control group. We compared baseline characteristics and IBI scores between the groups and assessed the predictive value of the IBI using the receiver operating characteristic curve. Both univariate and multivariate binary logistic regression analyses were conducted to identify factors influencing primary resistance. Results: Nineteen patients were included in the primary resistance group, and forty-three patients were included in the control group. The IBI was significantly higher in the resistant group compared to the control group (P<0.01). The area under the curve for the IBI was 0.82, indicating a strong predictive value. Multivariate analysis identified the IBI as an independent predictor of primary resistance (P=0.014). Conclusions The baseline IBI holds promise as a predictor of primary resistance to combined ICIs and chemotherapy in patients with HER-2-negative advanced gastric cancer.

Chronic obstructive pulmonary disease (COPD) is a chronic lung disease characterized by persistent airflow limitation, with vascular endothelial dysfunction being one of its key pathogenic mechanisms. Endothelial progenitor cells (EPCs), a class of progenitor cells capable of vascular repair and regeneration, play a crucial role in the pathogenesis of COPD. In COPD patients, the number and function of circulating EPCs are significantly reduced, which is closely associated with disease severity, lung function decline, acute exacerbations, nutritional status, and comorbidities. Environmental factors such as smoking, nicotine, electronic cigarettes, and particulate matter 2.5 (PM2.5) can markedly impair both the function and quantity of EPCs. The underlying mechanisms may involve the regulation of vascular endothelial growth factor/vascular endothelial growth factor receptor (VEGF/VEGFR), C-X-C motif chemokine ligand 12/C-X-C motif chemokine receptor 4 (CXCL12/CXCR4) signaling pathways, and various cytokine regulations. Moreover, animal studies have shown that intratracheal transplantation of EPCs can significantly improve lung function and pathological changes in emphysema models, suggesting that targeting EPCs may be a promising therapeutic strategy for COPD. Elucidating the molecular mechanisms of EPC mobilization, homing, and dysfunction, and evaluating the efficacy and safety of their clinical application, may offer new insights into the treatment of COPD and other chronic lung diseases.
Humans ; Pulmonary Disease, Chronic Obstructive/pathology* ; Endothelial Progenitor Cells/cytology* ; Animals ; Signal Transduction ; Vascular Endothelial Growth Factor A/metabolism*

Objective To investigate the relationship between the level of secretory curl related protein(SFRP)and the therapeutic effect of sodium hyaluronate in patients with knee osteoarthritis(KOA).Methods A total of 89 patients with KO A from May 2021 to June 2023 in Wenzhou Traditional Chinese Medicine Hospital were selected as observation group.All patients were treated with sodium hyaluronate.According to the treatment effect,they were divided into obvious/improved group and poor effect group.67 healthy examinees were selected as control group during the same period..The levels of SFRP1,SFRP2 and SFRP5 in each group were determined by enzyme linked immunosorbent assay,and the therapeutic effect of sodium hyaluronate in patients with KOA was analyzed by multivariate Logistic regression.Receiver operating characteristic(ROC)curve was drawn to analyze the evaluation efficiency of SFRP level in the treatment effect of patients with KOA.Results SFRP1,SFRP2 and SFRP5 in observation group were lower than those in control group(P＜0.05);89 patients were treated with sodium hyaluronate,and 67 patients showed good treatment outcomes(75.28％),and SFRP1,SFRP2 and SFRP5 in obvious/improved group were higher than those in poor effect group(P＜0.05).Multivariate results showed that SFRP1,SFRP2,SFRP5 and the Western Ontario and MeMaster Universities osteoarthritis index were the influential factors for the treatment effect of patients with KOA(P＜0.05).ROC curve results showed that the sensitivity and specificity of SFRP1,SFRP2 combined with SFRP5 in the treatment of KOA patients was higher than that of a single index(P＜0.05).Conclusion The levels of SFRP1,SFRP2 and SFRP5 are low in patients with KOA,and their expression levels are closely related to the therapeutic effect of sodium hyaluronate.The combined determination of different indicators can improve the sensitivity and specificity of prognosis.

Objective To analyze the correlation between NOD like receptor pyrin domain containing 3(NLRP3)inflammasome and pro-inflammatory factors interleukin(1L)-1 β and tumor necrosis factor(TNF)-α in the pathogenesis of acute gouty arthritis.Methods From June 2023 to July 2024,76 patients in Wenzhou Hospital of Traditional Chinese Medicine with acute gouty arthritis were selected as case group,and 53 healthy individuals as control group.The mRNA expression levels of NLRP3 inflammasome,apoptosis-associated speck-like protein(ASC),Caspase-1,IL-1β,IL-18,TNF-α were monitored using real-time fluorescence quantitative real-time fluorescence quantitative(PCR),and concentrations of these proteins were determined using enzyme-linked immunosorbent assay(ELISA).Results Age,gender,and other data were similar between both groups(P＞0.05).levels of uric acid,C-reactive protein(CRP),and erythrocyte sedimentation rate(ESR)in case group were higher than those in control group(P＜0.001).Expression of NLRP3,ASC,and Caspase-1 were also higher(P＜0.001).Serum levels of IL-1β,IL-18,and TNF-α were higher in case group(P＜0.05).NLRP3 inflammasome activity correlated positively with IL-1β and TNF-α.Multivariate Logistic regression showed uric acid,CRP,ESR,NLRP3,ASC,Caspase-1,IL-1 β,IL-18,and TNF-α were important factors for acute gouty arthritis attacks(P＜0.05).Conclusion By inhibiting activation of NLRP3 inflammasome or release of downstream inflammatory factors,inflammatory response of gouty arthritis can be effectively reduced,thereby alleviating symptoms and preventing joint damage.

Objective To analyze the correlation between NOD like receptor pyrin domain containing 3(NLRP3)inflammasome and pro-inflammatory factors interleukin(1L)-1 β and tumor necrosis factor(TNF)-α in the pathogenesis of acute gouty arthritis.Methods From June 2023 to July 2024,76 patients in Wenzhou Hospital of Traditional Chinese Medicine with acute gouty arthritis were selected as case group,and 53 healthy individuals as control group.The mRNA expression levels of NLRP3 inflammasome,apoptosis-associated speck-like protein(ASC),Caspase-1,IL-1β,IL-18,TNF-α were monitored using real-time fluorescence quantitative real-time fluorescence quantitative(PCR),and concentrations of these proteins were determined using enzyme-linked immunosorbent assay(ELISA).Results Age,gender,and other data were similar between both groups(P＞0.05).levels of uric acid,C-reactive protein(CRP),and erythrocyte sedimentation rate(ESR)in case group were higher than those in control group(P＜0.001).Expression of NLRP3,ASC,and Caspase-1 were also higher(P＜0.001).Serum levels of IL-1β,IL-18,and TNF-α were higher in case group(P＜0.05).NLRP3 inflammasome activity correlated positively with IL-1β and TNF-α.Multivariate Logistic regression showed uric acid,CRP,ESR,NLRP3,ASC,Caspase-1,IL-1 β,IL-18,and TNF-α were important factors for acute gouty arthritis attacks(P＜0.05).Conclusion By inhibiting activation of NLRP3 inflammasome or release of downstream inflammatory factors,inflammatory response of gouty arthritis can be effectively reduced,thereby alleviating symptoms and preventing joint damage.

Objective:Inhaler satisfaction is an important factor affecting inhaler adherence and the efficacy of inhalers in chronic airway diseases.Using a scientific and effective method to assess patients'satisfaction with inhalers is of great significance for improving clinical outcomes.The Feeling of Satisfaction with Inhaler-10(FSI-10)is specifically designed to assess patients'inhaler satisfaction in chronic airway diseases,but the application research on this scale is not available in China.This study aims to evaluate the reliability and validity of the Chinese version of FSI-10,describe the current status of inhaler satisfaction and discuss the associated variables in Chinese patients with chronic airway disease. Methods:Based on the English version of FSI-10,items of the Chinese version of FSI-10 were determined after forward-backward translation and cultural adaption.Totally,322 patients with chronic obstructive pulmonary disease(COPD)and asthma were enrolled from the Second Xiangya Hospital of Central South University from June to October 2022.We collected associated clinical variables and inhaler satisfaction using the Chinese version of FSI-10.The content validity of the scale was expressed by content validity index(CVI)and the construct validity was analyzed by exploratory factor analysis(EFA).The reliability of the scale was expressed by Cronbach's α coefficient,the split-half reliability and test-retest reliability.A multivariate logistic regression was conducted to examine variables related to inhaler satisfaction. Results:The reliability and validity analysis showed that the CVI was 0.983.One factor was extracted from the Chinese version of FSI-10 and the cumulative variance contribution rate was 73.114%.The Cronbach's α of the scale was 0.913,the Guttman's half-reliability coefficient was 0.905,and the test-retest reliability was 0.727(P<0.001).In addition,the total score of the scale for patients was 38.92±4.26 points and the proportion of high satisfaction(the score of FSI-10≥40)in patients with COPD was significantly lower than that in asthma patients(71.3%vs 87.9%,P<0.01).Older age(age≥70 years)was a risk factor of lower inhaler satisfaction and asthma diagnosis was a protective factor. Conclusion:The Chinese version of FSI-10 has good reliability and validity in patients with COPD and asthma,which may be further promoted and applied in patients with chronic airway disease in China.Doctors should regularly evaluate the inhaler satisfaction of patients with chronic airway diseases,especially for those elder or with severe symptoms and a long course of illness.

Objective:To estimate the incidence and risk factors of acute kidney injury (AKI) in preterm infants, and provide basis for better evaluation and treatment of renal function in preterm infants.Methods:All the hospitalized premature infants who were admitted to three research centers (Department of Neonatology at Beijing Children′s Hospital; Department of Neonatology at Beijing Obstetrics and Gynecology Hospital; Department of Neonatology at Shunyi Maternal and Children′s Hospital of Beijing Children′s Hospital)from January 1, 2017 to June 30, 2019 and had more than two serum creatinine values or urine output were included.The incidence of AKI in preterm infants was calculated and the difference among different gestational weeks was compared.Preterm infants were divided into AKI and non-AKI groups according to AKI diagnostic criteria, and the clinical characteristics between two groups were compared, and the risk factors of AKI in preterm infants were analyzed.Results:A total of 763 premature infants were included in the analysis.Twenty two cases were diagnosed with AKI.The incidence of AKI in premature infants was 2.9%.The incidence of AKI was 33.3% (3/9), 3.7% (5/134), and 2.3% (14/620) in the 24-27 + 6 weeks, 28-31 + 6 weeks, and 32-36 + 6 weeks gestational age, respectively, and the difference was statistically significant ( χ2=31.010, P<0.001). Preterm infants in AKI group had a higher proportion of males(77.3% vs. 53.3%), lower gestational weeks[29(27, 33) weeks vs.31(29, 33)weeks], higher proportions of infants with diabetic mothers(40.9% vs.19.4%), lower Apgar scores at 1 and 5 minutes[8(7, 10) vs.9(8, 10), 9(9, 10) vs.10(9, 10), respectively], higher proportions of invasive and noninvasive respiratory support(45.5% vs.11.3%, 63.6% vs.19.2%, respectively), longer duration of invasive respiratory support[260(136, 742)h vs.72(18, 160)h], longer hospital stays[66(19, 88)d vs.42(26, 58)d], and higher rates of sepsis (27.3% vs. 6.5%), respiratory distress syndrome(40.9% vs. 11.6%), and patent ductus arteriosus that requiring ibuprofen or surgical closure(13.6% vs. 3.0%), diuretic(27.3% vs. 3.9%), and vasoactive drug use (22.7% vs. 3.6%) than those in non-AKI group, and the differences were statistically significant(all P<0.05). Multivariate regression analysis showed that sepsis was an independent risk factor for AKI in preterm infants ( P=0.039, OR=3.498, 95% CI 1.065-11.490) after adjustment of gestational age and birth weight. Conclusion:The incidence of AKI is relatively high in preterm infants with gestational age<28 weeks.Compared with preterm infants without AKI, preterm infants with AKI have smaller gestational weeks and longer hospital stay.Sepsis is an independent risk factor for AKI in preterm infants.

In order to ensure the normal teaching order during the prevention and control of the COVID-19 epidemic, the second semester of the 2019-2020 academic year in Central South University was devoted to the online teaching. In response to the school's call, the diagnostics teaching team has applied the Tencent classroom software, WeChat mini programs, analog teaching software and digital curriculum platform to carry out online teaching activities. On the basis of summarizing the previous online teaching experience, we have made a preliminary discussion and reflection on the online teaching, which will provide ideas and directions for the reform of medical education.