BACKGROUND: Approximately 40% of individuals with diabetes worldwide are at risk of developing diabetic kidney disease (DKD), which is not only the leading cause of kidney failure, but also significantly increases the risk of cardiovascular disease, causing significant societal health and financial burdens. This study aimed to describe the burden of DKD and explore its cross-country epidemiological status, predict development trends, and assess its risk factors and sociodemographic transitions. METHODS: Based on the Global Burden of Diseases (GBD) Study 2021, data on DKD due to type 1 diabetes (DKD-T1DM) and type 2 diabetes (DKD-T2DM) were analyzed by sex, age, year, and location. Numbers and age-standardized rates were used to compare the disease burden between DKD-T1DM and DKD-T2DM among locations. Decomposition analysis was used to assess the potential drivers. Locally weighted scatter plot smoothing and Frontier analysis were used to estimate sociodemographic transitions of DKD disability-adjusted life years (DALYs). RESULTS: The DALYs due to DKD increased markedly from 1990 to 2021, with a 74.0% (from 2,227,518 to 3,875,628) and 173.6% (from 4,122,919 to 11,278,935) increase for DKD-T1DM and DKD-T2DM, respectively. In 2030, the estimated DALYs for DKD-T1DM surpassed 4.4 million, with that of DKD-T2DM exceeding 14.6 million. Notably, middle-sociodemographic index (SDI) quintile was responsible for the most significant DALYs. Decomposition analysis revealed that population growth and aging were major drivers for the increased DKD DALYs in most regions. Interestingly, the most pronounced effect of positive DALYs change from 1990 to 2021 was presented in high-SDI quintile, while in low-SDI quintile, DALYs for DKD-T1DM and DKD-T2DM presented a decreasing trend over the past years. Frontiers analysis revealed that there was a negative association between SDI quintiles and age-standardized DALY rates (ASDRs) in DKD-T1DM and DKD-T2DM. Countries with middle-SDI shouldered disproportionately high DKD burden. Kidney dysfunction (nearly 100.0% for DKD-T1DM and DKD-T2DM), high fasting plasma glucose (70.8% for DKD-T1DM and 87.4% for DKD-T2DM), and non-optimal temperatures (low and high, 5.0% for DKD-T1DM and 5.1% for DKD-T2DM) were common risk factors for age-standardized DALYs in T1DM-DKD and T2DM-DKD. There were other specific risk factors for DKD-T2DM such as high body mass index (38.2%), high systolic blood pressure (10.2%), dietary risks (17.8%), low physical activity (6.2%), lead exposure (1.2%), and other environmental risks. CONCLUSIONS DKD markedly increased and varied significantly across regions, contributing to a substantial disease burden, especially in middle-SDI countries. The rise in DKD is primarily driven by population growth, aging, and key risk factors such as high fasting plasma glucose and kidney dysfunction, with projections suggesting continued escalation of the burden by 2030.
Humans ; Global Burden of Disease ; Risk Factors ; Male ; Female ; Disability-Adjusted Life Years ; Diabetic Nephropathies/epidemiology* ; Middle Aged ; Diabetes Mellitus, Type 2/epidemiology* ; Adult ; Diabetes Mellitus, Type 1/complications* ; Aged ; Adolescent ; Young Adult ; Quality-Adjusted Life Years

The continuous emergence of SARS-CoV-2 variants as well as other potential future coronavirus has challenged the effectiveness of current COVID-19 vaccines. Therefore, there remains a need for alternative antivirals that target processes less susceptible to mutations, such as the formation of six-helix bundle (6-HB) during the viral fusion step of host cell entry. In this study, a novel high-throughput screening (HTS) assay employing a yeast-two-hybrid (Y2H) system was established to identify inhibitors of HR1/HR2 interaction. The compound IMB-9C, which achieved single-digit micromolar inhibition of SARS-CoV-2 and its Omicron variants with low cytotoxicity, was selected. IMB-9C effectively blocks the HR1/HR2 interaction in vitro and inhibits SARS-CoV-2-S-mediated cell-cell fusion. It binds to both HR1 and HR2 through non-covalent interaction and influences the secondary structure of HR1/HR2 complex. In addition, virtual docking and site-mutagenesis results suggest that amino acid residues A930, I931, K933, T941, and L945 are critical for IMB-9C binding to HR1. Collectively, in this study, we have developed a novel screening method for HR1/HR2 interaction inhibitors and identified IMB-9C as a potential antiviral small molecule against COVID-19 and its variants.

Objective To calculate and analyze the research and development(R&D)efficiency,as well as the technological achievements transformation efficiency,of ten"Double First-Class"medical universities and ten medical universities in the accumulative science and technology evaluation metrics over the last five years,in order to make recommendations for improving technological achievements transformation management at these universities.Methods The study used both classic data envelopment analysis and super-effectiveness data envelopment analysis models to assess the effectiveness of the R&D stage and technological achievements transformation stage at the selected medical universities.Furthermore,the Malmquist model was used to measure the changes in the efficiency of the transformation of scientific and technological achievements of the medical universities as a whole.Results Among the 20 medical universities chosen,the output efficiency in the R&D stage was greater than that in the technological achievements transformation stage.Five medical universities were output-effective at the R&D stage,and two medical universities were in the technological achievements transformation stage.The overall efficiency of scientific and technological achievements transformation in medical universities was steadily improving.Conclusion Based on the current situation,medical universities in China should strengthen effective collaboration between industry,academia,and research,establish professional teams for technological achievements transformation,improve the technological achievements transformation management system,improve talent team construction,and increase technological achievements transformation efficiency.

Objective To investigate the value of serum lipoprotein-associated phospholipase A2(Lp-PLA2)for predicting high-risk coronary plaques in elderly males.Methods A retrospective study was conducted on 46 elderly males aged ≥60 years undergoing health check-ups and coro-nary computed tomography angiography in our hospital between May and July 2024.Their general clinical data were collected.Artificial intelligence software was used to analyze coronary calcium scores and plaque characteristics.The participants were divided into a high-risk plaque group(n=15)and a non-high-risk plaque group(n=31).The differences were compared between the two groups.Multivariate logistic regression analysis was used to identify the influencing factors for high-risk coronary plaques.ROC curve was plotted to determine the predictive value of serum Lp-PLA2 for high-risk plaques,and its AUC value was calculated.Results The high-risk plaque group had significantly larger proportions of smoking history and hyperlipidemia,and higher level of homocysteine and Lp-PLA2 than the non-high-risk plaque group(P＜0.05,P＜0.01).Multiva-riate logistic regression analysis indicated that Lp-PLA2 was an independent risk factor for high-risk coronary plaques(HR=1.030,95％CI:1.008-1.053,P＜0.05).ROC curve analysis revealed that the AUC value of Lp-PLA2 in predicting high-risk coronary plaques was 0.833(95％CI:0.694-0.927,P＜0.01),with a sensitivity of 93.3％,a specificity of 71.0％,a positive predictive value of 62.5％,and a negative predictive value of 100％.Conclusion Serum Lp-PLA2 is of signif-icant value in predicting high-risk coronary plaques in elderly men.

Objective:This article studies the abilities and quality that medical technical managers should possess and provides a reference for promoting the professional training and development of medical technical managers.Methods:The data were obtained through semi-structured interviews and literature collection. The interview subjects were 20 scientific researchers with transformation projects and 10 management staffs with technical manager certificates in medical colleges. The documents are 6 articles related to ″technical manager capabilities″ collected on open academic platforms. Grounded theory was used to code and analyze above data.Results:After three-level coding and combining with the iceberg competency model, the knowledge, skills, self-awareness, traits and motivation of medical technology managers were sorted out, totalling 5 core categories, 10 main categories, and 50 initial categories, to construct a competency model for medical technology managers.Conclusions:Based on the complex knowledge structure and high occupational requirements of medical technology managers, policy insights such as systematic knowledge training, raising skill requirements in practice, and enriching assessment standards and communication channels are proposed.

Screening carbonyl reductases with the ability to catalyze the reduction of complex carbonyl compounds is of great significance for the biosynthesis of R-tolvaptan(R-TVP). In this study, the target carbonyl reductase in the crude enzyme extract of rabbit liver was separated, purified, and identified by ammonium sulfate precipitation, gel-filtration chromatography, ion exchange chromatography, affinity chromatography, and protein mass spectrometry. With the rabbit liver genome as the template, the gene encoding the carbonyl reductase rlsr5 was amplified by PCR and the recombinant strain was successfully constructed. After RLSR5 was purified by affinity chromatography, its enzymatic properties were characterized. The results indicated that the gene sequence of rlsr5 was 972 bp, encoding a protein with a molecular weight of 40 kDa. RLSR5 was a dimeric protein, and each monomer was composed of a (α/β)₈-barrel structure. RLSR5 could asymmetrically reduce 7-chloro-1-[2-methyl-4-[(2- methylbenzoyl)amino]benzoyl]-5-oxo-2,3,4,5-tetrahydro-1H-1-benzazepine (prochiral ketone, PK) to synthesize R-TVP. The specific activity of the enzyme was 36.64 U/mg, and the optical purity of the product was 99%. This enzyme showcased the optimal performance at pH 6.0 and 30 °C. It was independent of metal ions, with the activity enhanced by Mn²⁺. This study lays a foundation for the biosynthesis of tolvaptan of optical grade.
Animals ; Rabbits ; Alcohol Oxidoreductases/biosynthesis* ; Recombinant Proteins/metabolism* ; Escherichia coli/metabolism* ; Liver/enzymology*

Objective This article focuses on the investment promotion policies at the municipal and district levels(park management committee level)of biomedical industrial parks in China at different development stages.It aims to reveal the characteristics and patterns of these policies,providing a reference for the formulation of development policies for biomedical industrial parks in China.Methods A total of 166 policies issued by three biomedical industrial parks(LifeBay,Nanjing Biotech and Pharmaceutical Valley and BioBay)from January 2013 to June 2023 were coded and quantitatively analyzed using a three-dimensional analytical framework of policy tool-development stage-issuing body.Results At the municipal level,the use of policy tools by administrative development is supply-oriented and environmental-oriented.At the district level,the types of policy tools used are closely related to the stage of the park.Start-up parks have a high proportion of supply-based policy tools,growth parks have a high proportion of demand-based policy tools,and mature parks have a high proportion of environmental policy tools.Conclusion Policy insights such as the strategic use of policy tools according to the development stage of the park,the optimization of the internal structure of the tools and the enhancement of the complementarity and coordination among the tools,and the use of policy tools to promote industrial agglomeration in line with local realities are put forward.

Objective:To sinicize the adolescent personality structure questionnaire(APS-Q), and to examine the psychometric properties of APS-Q among Chinese adolescents.Methods:APS-Q was sinicized and the Chinese version of APS-Q was used for investigation.A sample of 1 207 adolescents were investigated firstly and randomly divided into sample 1 ( n1=590) and sample 2 ( n2=617) for exploratory factor analysis and confirmatory factor analysis, respectively. Moreover, the sample 3 ( n3=420) was collected to conduct confirmatory factor analysis for the second time.Sample 4( n4=83) was used to assess the test-retest reliability of APS-Q. The Chinese big five personality inventory-15 (CBF-PI-15), generalized anxiety disorder-7 (GAD-7) and patient health questionnaire-9 (PHQ-9) were used as criterion tools. Both SPSS 21.0 and Mplus 7.4 software were used for the data analysis. Results:Item analysis showed that the CITCs for items 27, 31 and 35 were low.Exploratory factor analysis suggested that after deleting items 3, 4, 21, 22, 24, 25, 26, 27, 31 and 35, the revised APS-Q was consisted with 25 items, covering 6 dimensions, which were investment and goals, aggression, sense of self, relationship with family, relationship with friends, and self-acceptance, respectively. Confirmatory factor analysis supported the six-factor model fitted well (sample 2: χ2/ df=1.94, RMSEA=0.04, CFI=0.94, TLI=0.93, and SRMR=0.05; sample 3: χ2/ df=2.12, RMSEA=0.05, CFI=0.95, TLI=0.92, and SRMR=0.06). Multigroup CFA indicated that the six-factor structure of APS-Q had strict measurement invariance across sex. The scores of APS-Q were significantly correlated with big five personality, depression, and anxiety(all P<0.05). The total score of APS-Q demonstrated satisfactory internal consistency (α=0.90, ω=0.90, split-half reliability=0.82, MIC=0.27) and test-retest reliability ( r=0.84), while the subscale scores of APS-Q showed acceptable internal consistencies (α=0.71-0.82, ω=0.72-0.82, split-half reliabilities=0.60-0.79, MIC=0.36-0.52) and test-retest coefficients ( r=0.66-0.77). Conclusion:The Chinese version of APS-Q can be used as a reliable and valid measurement to assess personality function for Chinese adolescents.

Objective To investigate the relationship between metaphor comprehension and theory of mind in school-aged children with autism spectrum disorder(ASD).Methods A total of 50 children with ASD(ASD group)and 50 age-and gender-matched typically developing(TD)chil-dren(TD group)were recruited from special education institutions in Hangzhou between August,2023 and No-vember,2024.Metaphor comprehension was assessed using a visual picture paradigm,covering conceptual,shape,appearance and mixed metaphors.The theory of mind was assessed using unexpected content/place tasks.Results The total score of metaphor comprehension was lower in ASD group than in TD group(Z=-5.625,P<0.001),particularly for shape,appearance and mixed metaphors(|Z|>5.625,P<0.01);as well as the scores of theory of mind(|Z|>5.255,P<0.001).There was positive correlation between the total score of theory of mind and total score(r=0.352,P<0.05),shape score(r=0.299,P<0.05)and mixed score(r=0.330,P<0.05)of metaphor comprehension.Regression analyses showed that the total score of theory of mind positively predicted total score(β=0.310,P<0.05),shape score(β=0.103,P<0.05)and mixed score(β=0.330,P<0.05)of metaphor com-prehension.Conclusion Children with ASD delayed in metaphor comprehension,which associates with deficits in theory of mind.

Objective To investigate the correlation between blood glucose(BG)control and barrier dysfunction in diabetes mellitus(DM)patients with ulcerative colitis(UC).Methods A total of 120 patients with DM and UC admitted to the Department of Gastroenterology of our hospital between January 2021 and January 2024 were selected and divided into injury group(n=68)and non-injury group(n=52)according to the injury of intestinal barrier function.Pearson correlation analysis was used to analyze the correlation between hemoglobin A1c(HbA1c),fasting plasma glucose(FPG),2 hPG and D-lactic acid(D-LA),diamine oxidase(DAO),lipopolysaccharide(LPS),and Galectin-3.Logistic regression analysis was used to analyze the influencing factors for intestinal barrier dysfunction.Receiver operator characteristic(ROC)curve was drawn to analyze the diagnostic value of BG level for intestinal barrier dysfunction.Results The levels of HbA1c,FPG,2 hPG,D-LA,DAO,and LPS were higher in the injury group than in the non-injury group(P<0.05),and the level of Galectin-3 was lower in the injury group than in the non-injury group(P<0.05).Pearson correlation analysis showed that HbA1c,FPG,and 2 hPG levels were positively correlated with D-LA,DAO,and LPS(P<0.05),and negatively correlated with Galectin-3(P<0.05).Logistic regression analysis showed that HbA1c,FPG and 2 hPG were the influencing factors for intestinal barrier dysfunction.ROC curve analysis showed that the area under the curve of HbA1c,FPG and 2 hPG was 0.968,0.942 and 0.910 for predicting intestinal barrier dysfunction.Conclusions BG level affects the damage of intestinal barrier function,and the risk of intestinal barrier function damage can be reduced by strengthening BG control in clinical practice.