Immunoglobulin G4-related disease (IgG4-RD) is a rare systemic immune-mediated disorder characterized by infiltration of IgG4-positive plasma cells and multiorgan fibrosis. Among them, cases with multiple pancreatic cystic lesions as the prominent manifestation are relatively rare, and they are easily misdiagnosed as pancreatic tumors or pancreatitis in clinical practice. Herein, we report one patient with IgG4-RD admitted to Peking Union Medical College Hospital. The patient initially presented with multiple pancreatic cystic lesions and aneurysmal dilatation of the abdominal aorta, accompanied by markedly elevated serum IgG4 levels. Combined with pathological findings from submandibular gland biopsy, the diagnosis of IgG4-RD was ultimately established. After treatment with a regimen of glucocorticoids combined with cyclophosphamide, the patient′s condition improved. Meanwhile, we performed a literature review of cases with IgG4-RD-related pancreatic cystic lesions, aiming to improve clinicians′ understanding of this rare disease phenotype.

To develop a portable transport vehicle for single injured soldier in field warfare,so as to meet the target of completing emergency transshipment for single injured solider in both peacetime and wartime.The main body of the transport vehicle consists of a general stretcher and an additional wheel device.The stretcher provides a supporting platform for lying down and prone position of injured solider.The device of additional wheel is a foldable portable structure with two-wheels,which composed of 2 wheels,2 sets of frames,a crossbeam,connecting rods,buckles,and hooks.When transport task for injured solider needs to be performed,it can be connected to the stretcher to be expanded as a stretcher cart for transporting injured solider.In normal times,it can be folded for storage in a backpack.The use of the portable transport vehicle for single injured soldier in field warfare can reduce the number of personnel who carries out the stretcher from 2-3 person to 1 person,and can significantly reduce the frequency of transport,and shorten the overall time of transport,and remarkably improve efficiency of transport.Moreover,the scores of medical members for the performance of labor-saving and the recommendation level of transport vehicle in this study were higher than general stretcher,and the differences were significant(t=9.52,3.60,P<0.05).This transport vehicle has a reasonably structural design,favorable portability and safety.It can greatly improve the efficiency of transporting injured solider under limited conditions,and enhance the possibility that successfully rescue injured solider,and meet the requirement of grass-roots unit of army for practical combat in transporting injured solider,which is a suitable transport tool.

Objective:To analyze the iodine nutrition status and its related factors among adults aged 18 years and above in Zhejiang Province in 2022.Methods:A multistage stratified sampling method was used to select 4 320 adults aged 18 years and above from 16 on-site survey sites in Zhejiang Province for the study. A questionnaire was used to investigate the general demographic information and personal dietary characteristics of the study participants. Household edible salt and urine samples were collected to detect salt iodine content and urinary iodine level by using direct titration and cerium arsenate-catalyzed spectrophotometry, respectively, to evaluate the iodine nutritional status according to the standard. The multiple-ordered logistic regression model was used to analyze the factors influencing the urinary iodine concentration.Results:The age of the 4 320 study participants was (51.19±15.33) years, with males accounting for 44.44% (1 920). About 40.16% of adults (1 735) were from coastal areas and 56.37% (2 435) from urban areas. The salt iodine content, M ( Q1, Q3), of the 4 320 household edible salt samples was 21.10 (0.00, 24.16) mg/kg, including 1 662 non-iodized salt samples, 182 unqualified iodized salt samples and 2 476 qualified iodized salt samples. The rate of iodized salt coverage was 61.53%, and the rate of qualified iodized salt consumption was 57.31%. There was a statistically significant difference in the proportion of qualified iodized salt in adult households among different regions ( P<0.001), with the proportion of non-iodized salt gradually decreasing from coastal to inland areas ( χ 2trend=618.458, P<0.001). The urinary iodine concentration M ( Q1, Q3) was 137.60 (86.85, 210.60) μg/L in 4 320 adult urine samples, with the urinary iodine levels of<100, 100-199, 200-299, and≥300 μg/L accounting for 31.64% (1 367), 40.56% (1 752), 17.66% (763), and 10.14% (438), respectively. There was a nonlinear positive correlation between household salt iodine content and urinary iodine level in adults aged 18 years and above by using the χ 2 test for trend ( χ 2regression=231.10, P<0.001 and χ 2skew=28.81, P<0.001). Urinary iodine concentrations were higher in men than in women ( P=0.029) and higher in adults in rural areas than in urban areas ( P<0.001). There were statistically significant differences in the distribution of iodine nutritional status among adults of different ages, regions, and urban and rural areas (all P<0.001). The proportion of those with urinary iodine levels<100 μg/L gradually increased with age ( χ 2trend=37.493, P<0.001), and gradually decreased from coastal areas to inland areas ( χ 2trend=71.381, P<0.001). The results of the multiple-ordered logistic regression model analysis showed that compared with adults aged 18 to 44 years and male adults, those aged 45 to 59 years and female adults had lower urinary iodine levels, with OR (95% CI) of 0.75 (0.68-0.83) and 0.85 (0.76-0.95), respectively. Compared with adults in coastal and urban adults, those in sub-coastal, inland and rural adults had higher levels of urinary iodine, with OR (95% CI) of 1.89 (1.63-2.19), 2.02 (1.72-2.37) and 1.46 (1.28-1.66), respectively. Conclusion:The overall iodine nutrition level of adults aged 18 years and above in Zhejiang Province in 2022 is generally appropriate. However, there is a potential risk of iodine deficiency among adults in coastal areas.

Objective:To investigate the level of urinary serine protease(Corin) in early diabetic kidney disease(DKD) and its correlation with clinical stage.Methods:One hundred and seventy-three patients with type 2 diabetes mellitus(DM) from two tertiary A hospitals in Henan, diagnosed between April 2023 and December 2023 were selected as the research group, and 120 healthy subjects were selected as the control group. Basic clinical information and laboratory data were collected, and urinary Corin level was detected. DM patients were classified into G1-G5 stages based on estimated glomerular filtration rate(eGFR), and those in the early DKD stages(G1-G3) were further divided into A1-A3 subgroups based on urinary albumin/creatinine ratio(ACR). Spearman correlation analysis was performed to assess relationships between urinary Corin and other indicators, linear regression analysis identified factors influencing urinary Corin in early DKD patients, logistic regression analysis evaluated the risk factors for early DKD, and receiver operating characteristic(ROC) curve analysis determined the diagnostic value of urinary Corin in early DKD. Results:Urinary Corin levels were significantly higher in early DKD patients compared to healthy controls, with levels increasing as ACR rose( P<0.05). Urinary Corin was positively associated with serum creatinine( r=0.570), urea( r=0.458), cystatin C( r=0.693), ACR( r=0.616), urinary transferrin( r=0.448), urinary α1 microglobulin( r=0.507), urinary n-acetyl-β-D-glucosaminase( r=0.388) and A subgroup( r=0.692) while was negatively correlated with eGFR( r=-0.647), albumin( r=-0.312)(all P<0.05). eGFR was the only independent factor affecting urinary Corin. After adjusting for confounding factors in logistic regression analysis, urinary Corin was still an independent influencing factor for early DKD. ROC curve analysis indicated that urinary Corin had a diagnostic AUC of 0.842(95% CI 0.791-0.892, P<0.001), with a cut-off value of 2 226.04 pg/mL, sensitivity of 0.712, and specificity of 0.858 for early DKD diagnosis. Conclusions:Urinary Corin was elevated in early DKD patients and correlated with clinical stage. Urinary Corin is an independent factor of early DKD, and a reliable predictor of early DKD diagnosis.

BACKGROUND:Studies have reported that alendronate intake significantly increases bone mineral density in patients with osteoporosis. OBJECTIVE:To analyze and compare the changes in metabolites before and after alendronate intervention in ovariectomized rats by chromatography-mass spectrometry,and to further explore the specific mechanism and target of alendronate in the treatment of osteoporosis. METHODS:A total of 36 female Sprague-Dawley rats were randomly divided into model group,alendronate sodium group and sham operation group.The osteoporosis model was established by ovariectomy in the first two groups.Four weeks after modeling,the rats in the alendronate group were intragastrically given alendronate sodium,while those in the sham operation group and model group were given equal volume of normal saline.After 12 weeks of continuous gavage,the metabolites of the lumbar spine were analyzed by chromatography-mass spectrometry,and the common differential metabolites were obtained,which were analyzed by bioinformatics such as Kyoto Gene and Genome Encyclopedia pathway. RESULTS AND CONCLUSION:Totally 17 different metabolites were obtained in the three groups.The enrichment analysis of the Kyoto Encyclopedia of Genes and Genomes showed that alendronate sodium could regulate unsaturated fatty acid biosynthesis,linoleic acid metabolism and other pathways to protect ovariectomized rats.These results indicate that alendronate sodium may exert its anti-osteoporosis effect by interfering with unsaturated fatty acid bioanabolism and linoleic acid metabolism,so as to achieve the purpose of preventing osteoporosis

OBJECTIVES: To analyze the molecular mechanism of Xixian Pills for treatment of rheumatoid arthritis (RA). METHODS: Forty-eight rats were randomized into 6 groups (n=8), including a normal control group, a collagen-induced arthritis (CIA) model group, 3 Xixian Pills treatment (200, 400 and 800 mg/kg) groups, and a Tripterygium glycosides tablet (TGT) treatment group. In the latter 4 groups, the rats were treated with daily gavage of Xixian Pills or TGT 2 weeks after CIA modeling for 3 consecutive weeks. The differentially expressed proteins in high-dose Xixian Pills group and the model group compared with the normal control group were screened based on the tandem mass spectrometry tag (TMT) technology, and the core targets and signaling pathways were analyzed. The immune cell infiltration and gene expression data were analyzed using ggplot2 and tidyverse packages, and the correlation coefficients between the core targets and the immune cells were calculated. RESULTS: The CIA rats showed significantly increased serum levels of TNF-α and IL-6 and lowered serum IL-10 level. Treatments with high- and medium-dose Xixian Pills and TGT all significantly reduced serum TNF‑α and IL-6 and increased IL-10 levels in CIA rats. Proteomic analysis identified 160 differential proteins between the model group and high-dose Xixian Pills group, and the core targets included CCL5, STAT1, GZMB and IL7R. The areas under the ROC curve of CCL5 and STAT1 were both greater than 0.9. Immunohistochemical and immunofluorescence staining revealed increased levels of CCL5 and STAT1 in the ankle joints of CIA rats, which were significantly decreased after treatment with Xixian Pills. CONCLUSIONS Treatment with Xixian Pills offers protection of the joints in CIA rats possibly by inhibiting joint inflammation via regulating protein expressions of CCL5 and STAT1.
Animals ; Drugs, Chinese Herbal/pharmacology* ; Rats ; Arthritis, Rheumatoid/metabolism* ; Proteomics ; Tripterygium/chemistry* ; Arthritis, Experimental/metabolism* ; Tumor Necrosis Factor-alpha/blood* ; Interleukin-10/blood* ; Interleukin-6/blood* ; Male ; Rats, Sprague-Dawley ; Signal Transduction

OBJECTIVE: To investigate the therapeutic effects of Banxia Xiexin Decoction (BXD), a herbal medicine formula, on inflammation and the imbalance of the gut microbiota in a rat model of colorectal cancer (CRC) induced by azoxymethane (AOM) /dextran sulfate sodium (DSS). METHODS: A total of 75 male C57BL/6 mice were randomly divided into five groups: normal control group (NC), model group (MODEL), low-dose BXD treatment group (L-BXD), high-dose BXD treatment (H-BXD) group and MS treatment group (MS). BXD and MS were used in CRC mice at the doses of 3.915 g/kg, 15.66 g/kg, 0.6 g/kg for 3 weeks consecutively. Histopathological changes in the colon were observed using hematoxylin-eosin (HE) staining. The content of inflammatory factors in serum was detected by an enzyme-linked immunosorbent assay (ELISA), and the expression of mRNA and protein of genes related to immunity, apoptosis, inflammation, and inflammatory factors was evaluated. Changes in the intestinal flora of mouse fecal were determined based on high-throughput sequencing of the 16S rRNA microbial gene. RESULTS: Compared to the model group, the low-dose BXD and high-dose BXD groups decreased the number of colon tumors, reversed weight loss, and shortened colon length of mice. The pathological examination showed that BXD alleviated the malignancy of intestinal tumors. It also suppressed signal transducer and activator of transcription 3 (STAT3), matrix metalloproteinase-9 (MMP-9), and transforming growth factor beta 1 (TGF-β1) expression, while increasing the expression of the tight junction protein ZO-1 in colon tissues. Additionally, the levels of key pathway proteins involved in inflammation (phosphorylated-STAT3, Bcl-2, COX-2) and cell cycle regulatory molecules (c-Myc and PCNA) were reduced. According to 16S rRNA sequence analysis, BXD enhanced the relative abundance of potentially beneficial bacteria, while that of cancer-related bacteria decreased. CONCLUSION BXD plays a preventive role in developing colorectal cancer; its mechanisms are related to the inhibition of inflammation and tumor proliferation, as well as maintenance of intestinal homeostasis.

Objective:To explore the clinical characteristics and risk factors of acute kidney injury (AKI) in patients with diquat mixed with paraquat poisoning.Methods:We retrospectively analyzed the clinical data of 210 patients admitted to the department of emergency at our hospital with paraquat, diquat or mixed poisoning from January 20, 2016, to June 10, 2024. Based on the detection results of plasma toxicants, patients were categorized into three groups: the paraquat group (PQ group), and the diquat group (DQ group), the diquat-paraquat mixed group (mixed group). We compared clinical indices, occurrence, and severity of AKI among these groups. In the mixed group, patients were further divided into AKI and non-AKI subgroups based on the presence of AKI during hospitalization, and differences in clinical indices between these subgroups were analyzed. Univariate logistic regression and least absolute shrinkage and selection operator (Lasso) regressions were used to screen risk factors, and multivariate logistic regression was applied to establish the model. ROC curves were generated, and factors influencing AKI occurrence in the mixed group were identified.Results:A total of 88 patients were included in the PQ group, 28 in the DQ group, and 57 in the mixed group. Significant differences were observed among the three groups in terms of age, mortality rate, ingestion amount, body mass index(BMI), occurrence of AKI, the incidence of organ support therapy, SIRS score, PSS score, and APACHE Ⅱ score on admission ( P < 0.05). All three groups exhibited various degrees of AKI, with the mixed group showing a higher proportion and more severe conditions. In the mixed group, compared with the non-AKI group, the AKI group showed significantly higher values for age, number of deaths, ingestion amount, SIRS score, PSS score, APACHE Ⅱ score, plasma PQ concentration on admission, plasma DQ concentration on admission, white blood cell count (WBC), neutrophil count (NEUT), monocyte count (MONO), serum creatinine (SCr), procalcitonin (PCT), c-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood lactic acid (Lac), and cystatin C (CysC) ( P < 0.05). Conversely, the estimated glomerular filtration rate (eGFR) and partial pressure of carbon dioxide (PCO2) were significantly lower in the AKI group ( P < 0.05). Additionally, in the mixed group, SCr levels at various times post-poisoning were significantly higher compared with the non-AKI group ( P < 0.05), showing an increasing trend and peaking at 212.19 ± 101.67 μmol/L on the fifth day after poisoning. Age, ingestion amount, SIRS score on admission, WBC, MONO, and PCO 2 were extracted by Lasso-Logistic regression. Multivariate logistic regression identified ingestion amount and SIRS score on admission as the independent risk factors for the occurrence of AKI in the mixed group. The area under the ROC curve for ingestion amount and SIRS score on admission was 0.991 (95% CI: 0.976-1.000), the sensitivity was 0.940 and the specificity was 1.000. Conclusions:The diquat mixed with paraquat poisoning is associated with a higher incidence and greater severity of AKI compared with poisoning with either PQ or DQ alone. Additionally, ingestion amount and SIRS score on admission have been identified as independent risk factors for the occurrence of AKI in patients with the mixed poisoning. The combined assessment of these two factors improves AKI prediction in patients with the mixed poisoning.

Modern Chinese dental societies have been a crucial part of the progress of stomatology in China, serving as both witnesses and key drivers of its development. By reviewing historical materials related to these societies, this paper focuses on analyzing their establishment background, developmental stages, overall scale, and major activities. The findings reveal that dental societies exhibited regional, phased, professional, and academic characteristics. Furthermore, the study highlights their contributions to strengthening dental education, promoting standardization within the industry, facilitating academic exchanges, and advocating for the integration of oral and systemic health. This research enriches the study of modern Chinese stomatology history.

Patients with severe periodontal disease often involve multidisciplinary therapy.This paper reports a case of adult patients with severe periodontitis who was treated by orthodontics,restoration,and periodontics.The space between upper central incisors was closed,aesthetics and periodontal conditions were significantly improved.