Objective:To investigate the association between fibroblast growth factor 21(FGF21)and chronic kidney disease(CKD)in a prediabetic population by conducting a 4-year prospective cohort study among community-dwelling residents aged≥40 years in Guangzhou,China.Methods:A total of 1505 subjects who met the criteria for prediabetes and had complete baseline data were col-lected from the 2012 REACTION cohort,and they were followed up for 4 years to observe newly-onset CKD and the changes in urinary albumin-to-creatinine ratio(UACR)and estimated glomerular filtration rate(eGFR).Results:Among the 1 505 subjects with predia-betes,142 reached the diagnostic criteria for CKD during follow-up,yielding an overall incidence rate of 9.43%(95%CI=7.895%-10.902%).According to baseline serum FGF21 level,the subjects were divided into Q1-Q4 groups,with the lowest level of FGF21 in the Q1 group,and the Q4 group had a significantly higher eGFR than the other groups(P<0.05).After a mean follow-up time of 4 years,UACR was increased by 0.87 mg/g(P<0.001)and eGFR was reduced by 4.8 mL/(min·1.73 m2)(P<0.001).After stratification by FGF21 quartiles,there were differences in the declines of eGFR across groups,with the lowest degree of reduction in the Q2 group.In the multivariate regression model,the serum level of FGF21 was significantly negatively associated with the onset of CKD.When FGF21 was analyzed as a continuous variable in the multivariate lo-gistic regression analysis,FGF21 was still significantly negatively associated with the risk of CKD,which was consistent with the re-sults of the quartile-based analysis.However,restricted cubic spline curves showed an L-shaped non-linear relationship between FGF21 level and the risk of CKD,i.e.,the incidence rate of CKD de-creased with the increase in FGF21 level,but when FGF21 level reached a certain threshold,the risk of CKD no longer changed with FGF21.The linear regression analysis showed that FGF21 was positively associated with UACR and eGFR.Conclusion:In this pro-spective cohort study,FGF21 level might be potentially associated with the future risk of CKD among adults with prediabetes,while fur-ther studies are needed to clarify related mechanisms and clinical value.

Objective To design a novel bromodomain-containing protein 4(BRD4)and histone deacetylase(HDAC)dual-target inhibitor(11b),and to elucidate its therapeutic efficacy and mechanisms in suppressing prostate cancer through epigenetic regulation.Methods BRD4 and HDAC expression levels were assessed via immunohistochemistry(IHC)using prostate cancer tissue microarrays.The inhibitory activity of 11b was screened across three prostate cancer cell lines,with the half-maximal inhibitory concentration(IC50)determined by CCK-8 assay.Western blot was employed to analyze changes in the expression of target proteins,including BRD4,c-Myc proto-oncogene protein(c-Myc),and Ac-H3K27,with parallel comparisons to single-target agents,including suberoylanilide hydroxamic acid(SAHA),a HDAC inhibitor,and JQ-1,a BRD4 inhibitor.Cell invasion and proliferation were evaluated using Transwell and colony formation assays,and the autophagy mechanism was validated using 3-methyladenine(3-MA),an autophagy inhibitor.A PC-3 xenograft model was established in nude mice.Then,11b(7.5 mg/kg or 15 mg/kg),normal saline,SAHA,and JQ-1 were administered via intraperitoneal injection,and their tumor growth inhibition effects were observed.The percentage of target protein-positive cells and the expression levels of target genes were quantified via IHC and RT-PCR,respectively.Results BRD4 and HDAC expression levels were both higher in tumor tissues than those in normal tissues(P<0.01).11b exhibited the strongest inhibitory activity against PC-3 cells(IC50=8.28 μmol/L),outperforming SAHA(22.61 μmol/L)and JQ-1(22.09 μmol/L).Treatment with 11b reduced BRD4 and c-Myc expression by(41.58±3.28)%and(63.21±6.91)%,respectively(P<0.01),and increased the Ac-H3K27 level to 6.52-fold that of the negative control(NC)group(P<0.01),demonstrating greater modulation than either SAHA or JQ-1 did.The in vitro experiment showed that 8 μmol/L 11b treatment reduced PC-3 colony formation and migration by 97.5%and 96.3%,respectively(P<0.001),and co-treatment with 3-MA reversed its cytotoxic effects.The in vivo experiment showed that 11b at both 7.5 mg/kg and 15 mg/kg significantly reduced tumor volume and weight compared with the control,SAHA,and JQ-1 groups(all P<0.01),with the proportion of percentage of target protein-positive cells and the expression of target genes showing trends consistent with in vitro findings.Conclusion The dual-target inhibitor 11b exerts potent antitumor effects in prostate cancer by synergistically modulating the BRD4/HDAC pathways.11b demonstrates therapeutic efficacy superior to that of the single-target agents SAHA and JQ-1 in suppressing prostate cancer progression,highlighting its potential for clinical translation.

OBJECTIVE To provide reference for improving the disease diagnosis related groups （DRG） payment reform， promoting refined hospital operation and management and rational drug use. METHODS Taking the orthopedic department of our hospital （the Third Affiliated Hospital of Anhui Medical University） as the research object， based on evidence-based medicine， a medication clinical pathway （hereinafter referred to as medication pathway） for DRG diseases in this department was constructed and implemented. All patients who met the DRG disease were included in the medication path management， and the patients in the same DRG disease group were treated with the same treatment method. Segmented regression model （SRM） was adopted to analyze the effects of medication pathway on the medical service capacity， efficiency and quality of our hospital. RESULTS During the implementation of medication pathway， significant decreases were observed in average length of hospital stay， cost per hospitalization， the proportion of medication expenses， medication cost per hospitalization and defined daily dose； the proportion of medical service revenue and the qualified rate of medical orders significantly increased （P＜0.05）. After the implementation of medication pathway， the average length of hospital stay and defined daily dose continued to decrease， and the qualified rate of medical orders also continued to significantly increase （P＜0.05）. CONCLUSIONS The implementation of medication pathway enhances the quality of medical services， improves operational efficiency， reduces medical expenses， and contributes to the development of a refined hospital management system.

Objective To investigate the epidemiological characteristics of foodborne diseases in Liuzhou City, and to provide reference for formulating the prevention and control measures of foodborne diseases. Methods The surveillance data of foodborne diseases in 25 sentinel hospitals in Liuzhou City from 2018 to 2020 were collected for statistical analysis. Results From 2018 to 2020, a total of 9 317 cases of foodborne diseases were reported in Liuzhou City, and 2 158 samples were collected for pathogen detection. A total of 311 cases were detected positive , with a detection rate of 14.41%. Norovirus had the highest detection rate (8.63%), followed by Salmonella (4.08%) and Escherichia coli (3.10%). July to October was a period of high incidence of foodborne disease（ 41.17%）. The proportion of patients aged 60 and over was the highest (18.49%), followed by the age group of 30-39 (18.03%). Suspicious foods were mainly meat and meat products (22.35%) and aquatic animals and their products (13.89%). The suspicious eating places were mainly families (40.43%) and restaurants (13.63%). Conclusion The high incidence of foodborne diseases in Liuzhou occurs in summer and autumn. The main pathogens are Salmonella and norovirus. Infected patients are concentrated in the age group of 60 years and above and the age group of 30 to 39 years old. The family is the main place of foodborne disease, followed by the restaurants and hotels. Suspicious foods include mainly meat and meat products and aquatic animals and their products. It is necessary to strengthen monitoring ability and food safety education to reduce the occurrence of foodborne diseases.

Objectives: . A novel J-shaped anterolateral thigh (ALT) flap reconstruction technique was developed to simultaneously restore swallowing and speech functions in patients following total laryngopharyngectomy. This study aimed to assess the outcomes and surgical complications in patients who underwent J-flap reconstruction over time. Methods: . Patients who underwent J-shaped ALT flap phonatory tube reconstruction were enrolled. Surgical morbidities and outcomes were evaluated every 3 months post-surgery for a period of 12 months or until death. Results: . Of the 36 patients, 13 underwent circumferential pharyngeal wall resection (circumferential defect [CD] group), and 23 underwent partial resection (partial defect [PD] group). After 12 months, 97% of the patients were able to resume oral intake without the need for a nasogastric tube, and 50% achieved fluent speech using the reconstructed phonatory tube. The CD group experienced a higher rate of delayed healing than the PD group (30.8% vs. 0%, p=0.012). Additionally, the PD group showed significantly higher percentages of individuals consuming solid food at both the 3- and 12-month intervals than the CD group (81.0% vs. 23.1% and 78.9% vs. 40%, respectively). Conclusions . This study investigated the progression of speech and swallowing functions over time after reconstruction of the voice tube with a J-flap. Using a J-shaped ALT flap phonatory tube effectively restored both speech and swallowing functions, providing long-term benefits, regardless of whether the defect was circumferential or partial.

Objectives: . A novel J-shaped anterolateral thigh (ALT) flap reconstruction technique was developed to simultaneously restore swallowing and speech functions in patients following total laryngopharyngectomy. This study aimed to assess the outcomes and surgical complications in patients who underwent J-flap reconstruction over time. Methods: . Patients who underwent J-shaped ALT flap phonatory tube reconstruction were enrolled. Surgical morbidities and outcomes were evaluated every 3 months post-surgery for a period of 12 months or until death. Results: . Of the 36 patients, 13 underwent circumferential pharyngeal wall resection (circumferential defect [CD] group), and 23 underwent partial resection (partial defect [PD] group). After 12 months, 97% of the patients were able to resume oral intake without the need for a nasogastric tube, and 50% achieved fluent speech using the reconstructed phonatory tube. The CD group experienced a higher rate of delayed healing than the PD group (30.8% vs. 0%, p=0.012). Additionally, the PD group showed significantly higher percentages of individuals consuming solid food at both the 3- and 12-month intervals than the CD group (81.0% vs. 23.1% and 78.9% vs. 40%, respectively). Conclusions . This study investigated the progression of speech and swallowing functions over time after reconstruction of the voice tube with a J-flap. Using a J-shaped ALT flap phonatory tube effectively restored both speech and swallowing functions, providing long-term benefits, regardless of whether the defect was circumferential or partial.

Objectives: . A novel J-shaped anterolateral thigh (ALT) flap reconstruction technique was developed to simultaneously restore swallowing and speech functions in patients following total laryngopharyngectomy. This study aimed to assess the outcomes and surgical complications in patients who underwent J-flap reconstruction over time. Methods: . Patients who underwent J-shaped ALT flap phonatory tube reconstruction were enrolled. Surgical morbidities and outcomes were evaluated every 3 months post-surgery for a period of 12 months or until death. Results: . Of the 36 patients, 13 underwent circumferential pharyngeal wall resection (circumferential defect [CD] group), and 23 underwent partial resection (partial defect [PD] group). After 12 months, 97% of the patients were able to resume oral intake without the need for a nasogastric tube, and 50% achieved fluent speech using the reconstructed phonatory tube. The CD group experienced a higher rate of delayed healing than the PD group (30.8% vs. 0%, p=0.012). Additionally, the PD group showed significantly higher percentages of individuals consuming solid food at both the 3- and 12-month intervals than the CD group (81.0% vs. 23.1% and 78.9% vs. 40%, respectively). Conclusions . This study investigated the progression of speech and swallowing functions over time after reconstruction of the voice tube with a J-flap. Using a J-shaped ALT flap phonatory tube effectively restored both speech and swallowing functions, providing long-term benefits, regardless of whether the defect was circumferential or partial.

OBJECTIVE To study the variety included in the List of Overseas New Drugs Urgently Needed in Clinic in China and optimization strategy， in order to better meet the needs of patients. METHODS The release process of List of Overseas New Drugs Urgently Needed in Clinic， the characteristics and attributes of the new drugs urgently needed abroad， and the problems in the implementation process were all analyzed to put forward some suggestions for optimizing the List of Overseas New Drugs Urgently Needed in Clinic. RESULTS & CONCLUSIONS The release process of the List of Overseas New Drugs Urgently Needed in Clinic was roughly divided into incubation stage， preparation stage and implementation stage. The treatment fields of 3 batches of overseas new drugs urgently needed in clinic were relatively concentrated on endocrine and metabolic diseases，tumor and skin diseases. Of included 73 varieties， 50 varieties have been approved for market，and 26 varieties have been included in the medical insurance， 4 varieties were included in the Catalogue of Encouraged Generic Drugs. At present， there are still some problems in our country， such as the shortage monitoring system needs to be established and improved； the linkage with medical insurance is weakened； the encouragement of generic drugs is insufficient. It is necessary to strengthen the cooperation of monitored departments in the shortage of new overseas drugs，establish a medical insurance payment system oriented by clinical value， and improve the incentive mechanism to encourage the imitation of overseas new drugs urgently needed in clinic.

Purpose: Gastric cancer (GC) is the second most lethal cancer globally and is associated with poor prognosis. Fatty acid-binding proteins (FABPs) can regulate biological properties of carcinoma cells. FABP5 is overexpressed in many types of cancers; however, the role and mechanisms of action of FABP5 in GC remain unclear. In this study, we aimed to evaluate the clinical and biological functions of FABP5 in GC. Materials and Methods: We assessed FABP5 expression using immunohistochemical analysis in 79 patients with GC and evaluated its biological functions following in vitro and in vivo ectopic expression. FABP5 targets relevant to GC progression were determined using RNA sequencing (RNA-seq). Results: Elevated FABP5 expression was closely associated with poor outcomes, and ectopic expression of FABP5 promoted proliferation, invasion, migration, and carcinogenicity of GC cells, thus suggesting its potential tumor-promoting role in GC. Additionally, RNA-seq analysis indicated that FABP5 activates immune-related pathways, including cytokinecytokine receptor interaction pathways, interleukin-17 signaling, and tumor necrosis factor signaling, suggesting an important rationale for the possible development of therapies that combine FABP5-targeted drugs with immunotherapeutics. Conclusions These findings highlight the biological mechanisms and clinical implications of FABP5 in GC and suggest its potential as an adverse prognostic factor and/or therapeutic target.

Objective:To evaluate the clinical efficacy and safety of endoscopic submucosal dissection (ESD) for early colorectal cancer and its precancerous lesions by using novel lifting clip-assisted traction.Methods:From March to July 2021, 42 patients with colorectal lesions who received ESD at the Digestive Endoscopy Center of Shanghai Tenth People's Hospital were included in the retrospective study. Nineteen patients were enrolled as the observation group using the novel lifting clip, and 23 others in the control group without the help of an auxiliary method. The operation time, the hospital stay, hospital expenses and the incidence of complications of the two groups were compared.Results:All 42 patients successfully received ESD. The operation time of the observation group was significantly shorter than that of the control group [31.00 (21.00, 58.00) min VS 60.00 (30.00, 75.00) min, Z=-2.04, P=0.04]. The postoperative hospital stay of the observation group was significantly shorter than that of the control group [2.00 (1.00, 2.00) d VS 2.00 (2.00, 3.00) d, Z=-1.99, P=0.04]. The hospital cost was lower than that of the control group, but the difference was not statistically significant (19 331.42 ± 3 481.20 yuan VS 19 802.40 ± 2 548.50 yuan, t=-0.49, P=0.63). No intraoperative perforation occurred in either group. There was no significant difference in intraoperative blood loss between the observation group and the control group [0.00 (0.00, 5.00) mL VS 3.00 (0.00, 7.00) mL, Z=-1.42, P=0.16]. There was 1 case of postoperative abdominal pain in the observation group, 2 cases of postoperative abdominal pain and 1 case of fever in the control group. There was no significant difference in the overall incidence of postoperative complications between the observation group and the control group [5.3% (1/19) VS 13.0% (3/23), χ2=0.73, P=0.39]. Conclusion:The novel lifting clip-assisted colorectal ESD is safe and effective, which can significantly shorten the ESD operation time and postoperative hospital stay without increasing the economic burden of patients.