Objective To analyze the burden of pressure ulcers and its changing trends among the general population(all age groups)and the elderly aged 65 years and above in China based on the global burden of disease(GBD)data from 1990 to 2021,predict the burden trends from 2022 to 2035,and address the public health issues of its unclear medium-and long-term trends and insufficient precise interventions in its prevention and control in order to provide support for formulating targeted prevention and control strategies.Methods The GBD database was used to extract the incidence,mortality and disability-adjusted life years(DALYs)of pressure ulcers in the general population and in the elderly aged 65 years and above in China from 1990 to 2021.Meanwhile,the age-standardized incidence rate(ASIR),mortality rate(ASMR),and disability-adjusted life rate(ASDR)of the general population were also extracted,and the age-standardized rate(ASRs)corresponding to the elderly population aged 65 years and above were estimated based on the GBD 2021 standard population.The average annual percentage changes(EAPCs)of ASRs were calculated to assess the trends.Bayesian age-period-cohort(BAPC)model was adopted to predict the ASRs and their changing trends of the general and elderly population from 2022 to 2035,respectively.Results From 1990 to 2021,the number of pressure ulcer cases in the general population of China increased from 163 508.67(95%CI:142 891.48～184 055.10)cases to 397 312.27(95%CI:360 058.44～444 875.78)cases,the number of deaths soared from 242.51(95%CI:125.26～702.84)cases to 3 131.54(95%CI:1 562.60～4 126.85)cases,and DALYs increased from 11 965.10(95%CI:7 820.54～21 703.78)to 61 933.91(95%CI:36 313.26～77 402.42).During the same period,the EAPCs of ASIR,ASMR and ASDR were 1.06(95%CI:0.84～1.28),3.63(95%CI:3.45～3.81),and 2.76(95%CI:2.60～2.92),respectively.In 2021,the number of male cases and DALYs were both higher than those of females,while the number of deaths was similar.The ASIR,ASMR and ASDR of the males were all higher than those of the females,and the growth rates of both genders were relatively fast.All indicators were increased significantly with age.It is predicted that by 2035,the ASIR,ASMR,and ASDR in the general Chinese population will continue to rise significantly.From 1990 to 2021,the number of pressure ulcer cases among the elderly(≥65 years old)in China increased from 42 334.95(95%CI:35 739.05～48 930.84)to 238 431.65(95%CI:212 539.53～264 323.77).The number of deaths rose from 204.97(95%CI:93.33～316.60)to 2 871.02(95%CI:2 334.39～3 407.66),and DALYs increased from 4 619.74(95%CI:2 990.73～6 248.76)to 43 968.28(95%CI:37 542.85～50 393.70).The EAPCs of ASIR,ASMR,and ASDR were 2.62(95%CI:2.44～2.80),3.54(95%CI:3.38～3.70),and 3.28(95%CI:3.14～3.42),all of which increased significantly.In 2021,the number of cases,deaths and DALYs among elderly men and women were similar,but the ASIR,ASMR and ASDR of men were all higher than those of women,and their growth rates were faster.It is projected that by 2035,the ASIR of the elderly population will significantly decline to 146.24(95%CI:140.35～152.14),with an EAPC of-0.57(95%CI:-0.64～-0.50),while the ASMR and ASDR will continue to rise and remain higher in males than in females.Conclusion From 1990 to 2021,the number of pressure ulcer cases,deaths and DALYs among the general population and the elderly in China increased significantly,and the ASRs rose rapidly.The burden of pressure ulcers increases significantly with age and is higher in men than in women.Predictions show that ASIR in the general population will continue to rise,while that in the elderly will slightly decline.However,the ASMR and ASDR will continue to increase.Countermeasures Continuously strengthen the prevention and control of pressure ulcers,implement precise intervention for the elderly,especially older men,promote standardized nursing guidelines,enhance training and resource input in primary medical care,and establish a national pressure ulcer monitoring system.

Circulating tumor DNA (ctDNA) is cell-free DNA released by tumors or circulating tumor cells, containing abundant tumor-specific information that can serve as biomarkers for cancer early screening, monitoring, prognosis, and prediction of treatment response. This is particularly attractive in the field of gastric cancer, where high-quality screening, monitoring, and prediction methods are currently lacking. Gastric cancer exhibits significant tumor heterogeneity, with large differences in genetic and epigenetic characteristics among different subgroups. Methylated ctDNA has high sensitivity and specificity, which can help clarify tumor genotyping and facilitate the formulation of precise diagnostic and therapeutic strategies. Furthermore, numerous studies have confirmed the unique advantages of methylated DNA in predicting treatment response, adjuvant therapy, and drug resistance assessment, which may be used in the future to enhance the efficacy of chemotherapy regimens and improve patient chemotherapeutic response, and even treat multidrug resistance. However, there are several challenges associated with methylated ctDNA, such as low sensitivity and specificity at single-target sites, limited association between some gastric cancer subtypes and ctDNA, off-target risks, and the lack of large-scale and high-quality clinical research evidence. This review mainly summarizes current research on the methylation status of ctDNA in gastric cancer and connects these findings to early screening, recurrence monitoring, and potential treatment opportunities for gastric cancer. With advances in technology and the deepening of interdisciplinary research, ctDNA detection will reveal more disease information and become an essential foundation for gastric cancer research and precision medicine treatment.

Objective To determine the expression and clinical significance of pseudogene FMO6P in gastric cancer,and explore its functions and underlying molecular mechanism in regulating the invasion and metastasis of gastric cancer cells.Methods The expression level of FMO6P in gastric cancer tissues and cell lines was detected by quantitative real time polymerase chain reaction(qRT-PCR).The migration and invasion abilities of gastric cancer cells were detected by transwell assay.The effect of FMO6P on the tumor formation and peritoneal dissemination of gastric cancer cells were evaluated by injecting FMO6P-overexpressing gastric cancer cells into the subcutaneous or peritoneal cavity of nude mice respectively.The expression levels of epithelial-mesenchymal transition(EMT)markers,including E-cadherin,N-cadherin,ZEB1,MMP2,and the activation of AKT/mTOR pathway in FMO6P-overexpressing or knockdown gastric cancer cells were measured by Western blot.Results The expression of FMO6P was significantly reduced in tumor tissues compared to its adjacent non-tumor tissues of gastric cancer,FMO6P expression level in tumor tissues was correlated with tumor size and TNM stage.Overexpression of FMO6P significantly inhibited the invasion and migration abilities of gastric cancer cells,while downregulation of FMO6P expression promoted the invasion and migration ability of gastric cancer cells.Overexpression of FMO6P in gastric cancer cells significantly inhibited the subcutaneous tumor formation and peritoneal dissemination of gastric cancer cells in nude mice.Moreover,overexpression of FMO6P promoted the expression of E-cadherin,and inhibited the expression of N-cadherin,ZEB1,and MMP2 in gastric cancer cells.The phosphorylation levels of AKT and mTOR were also downregulated in gastric cancer cells overexpressing FMO6P.Conclusions All these findings suggested that pseudogene FMO6P suppresses the invasion and migration potential of gastric cancer cells in vitro and in vivo,which is possibly through the inhibition of the AKT/mTOR signaling pathway.

Objective To observe the value of hemagglutinin occlusion of needle passage for preventing complications of pulmonary puncture biopsy.Methods Data of 155 patients with single pulmonary nodule who underwent CT-guided percutaneous lung puncture biopsy were retrospectively analyzed.The patients were divided into observation group(n=78,injected hemagglutinin when withdrawing the needle)and control group(n=77,directly withdrawn the needle).Chest CT examination was performed immediately after completion of the procedure.Pulmonary hemorrhage grades were evaluated,and the proportions of compressed lung area were measured and compared between groups.Results Puncture and sampling were successfully performed in all 155 patients,and definite pathological diagnose was acquired in 150 cases(150/155,96.77%).High-grade hemorrhage was detected in 20 cases(20/78,25.64%)of observation group and 38 cases(38/77,49.35%)of control group,while pneumothorax was noticed in 18 cases(18/78,23.08%)with lung compression area proportion of(0[0,0])in observation group,and in 31 cases(31/77,40.26%)with lung compression area proportion of 0[0,0.76%]in control group,respectively,in observation group were better than in control group(all P＜0.05).Conclusion Occlusion needle passage when withdrawing needle with hemagglutinin after pulmonary puncture biopsy could reduce the risk of hemorrhage and pneumothorax.

Circulating tumor DNA (ctDNA) is cell-free DNA released by tumors or circulating tumor cells, containing abundant tumor-specific information that can serve as biomarkers for cancer early screening, monitoring, prognosis, and prediction of treatment response. This is particularly attractive in the field of gastric cancer, where high-quality screening, monitoring, and prediction methods are currently lacking. Gastric cancer exhibits significant tumor heterogeneity, with large differences in genetic and epigenetic characteristics among different subgroups. Methylated ctDNA has high sensitivity and specificity, which can help clarify tumor genotyping and facilitate the formulation of precise diagnostic and therapeutic strategies. Furthermore, numerous studies have confirmed the unique advantages of methylated DNA in predicting treatment response, adjuvant therapy, and drug resistance assessment, which may be used in the future to enhance the efficacy of chemotherapy regimens and improve patient chemotherapeutic response, and even treat multidrug resistance. However, there are several challenges associated with methylated ctDNA, such as low sensitivity and specificity at single-target sites, limited association between some gastric cancer subtypes and ctDNA, off-target risks, and the lack of large-scale and high-quality clinical research evidence. This review mainly summarizes current research on the methylation status of ctDNA in gastric cancer and connects these findings to early screening, recurrence monitoring, and potential treatment opportunities for gastric cancer. With advances in technology and the deepening of interdisciplinary research, ctDNA detection will reveal more disease information and become an essential foundation for gastric cancer research and precision medicine treatment.

[摘 要] 目的：探讨肝内胆管癌（intrahepatic cholangiocarcinoma，ICCA）围手术期外周血中性粒细胞与淋巴细胞比率（neutrophil-to-lymphocyte ratio，NLR）和血小板与淋巴细胞比率（platelet-to-lymphocyte ratio，PLR）对患者预后的预测价值。方法：收集2015年1月至2018年1月在上海市松江区中心医院接受肝切除术治疗的ICCA患者97例作为ICCA组，选择同期在本院做健康体检的志愿者100例作为正常对照组。检测两组受试者术前1 d、术后3 d和7 d外周血的NLR、PLR，采用单因素、多因素分析ICCA患者术后随访期死亡的危险因素，采用Kaplan-Meier生存曲线分析术后3 d的NLR和PLR对ICCA患者术后生存时间的影响，采用受试者工作特征曲线（receiver operating characteristic curve，ROC）分析术后3 d的NLR和PLR水平对患者术后随访期死亡的预测价值。结果：ICCA组患者术前1 d、术后3和7 d外周血的NLR、PLR均高于正常对照组（均P<0.05），术前1 d和7 d外周血NLR、PLR差异无统计学意义（P>0.05），术后3 d外周血NLR、PLR水平最高（P<0.05）。多发肿瘤、合并淋巴结转移、TNM分期Ⅲ~Ⅳ、CA199水平增高、术后3 d的NLR和PLR较高分别是ICCA患者随访期死亡的独立危险因素（均P<0.05）。ROC曲线显示，术后3 d的NLR和PLR高低对ICCA患者术后生存时间具有预测价值。Kaplan-Meier生存曲线显示，低NLR[（50.32±3.69） vs （30.12±2.36）个月]和低PLR[（53.6±3.75） vs （37.6±2.96）个月]患者生存时间均长于高NLR和PLR的ICCA患者（均P<0.05）。结论：ICCA术后3 d的NLR和PLR异常增高是患者肝切除术后死亡的独立危险因素，其对患者生存时间具有早期预测价值。

Objective: To investigate the expression of Flotillin-2 (Flot-2) protein in gastric cancer tissues and its relationship with clinicopathological features and prognosis of gastric cancer (GC) patients. Methods: 112 samples of gastric cancer tissue and the corresponding paracancerous tissue that resected at the gastrointestinal surgery department of the Second Affiliated Hospital of Nanchang University between January 2009 andApril 2010 were collected for this study. The expression of Flot-2 protein in tumor tissues was detected by immunohistochemistry. The survival data were analyzed by Kaplan-Meier and Log-Rank test, and the survival curve was plotted. Spearman correlation analysis was used to examine the relationship between Flot-2 protein expression and clinicopathological characteristics and prognosis of GC patients. Results: In gastric cancer tissues, Flot-2 was primary stained in cytoplasm. Level of Flot-2 was significantly higher in gastric cancer tissues compared with that in paracancerous tissues (53.57% vs 46.43%, P<0.05). Expression of Flot-2 in tumor tissues was significantly associated with tumor size, depth of invasion, lymph node metastasis, distant metastasis and AJCC stage (all P<0.01), but not with gender, age, differentiation degree and tumor location (P>0.05). Moreover, survival analysis showed that the overall survival of patients with low Flot-2 expression was significantly higher than that of the patients with high level (P<0.01). Cox regression analysis indicated that distant metastasis, AJCC stage and Flot-2 expression were the independent risk factors for the prognosis of GC patients. Conclusion: Flot-2 protein was highly expressed in gastric cancer tissues and closely correlated with the poor prognosis of GC patients; Flot-2 is an independent risk factor for GC prognosis and may be served as a potential therapeutic target for gastric cancer.

Objective To investigate the effect of siRNA targeted against Bcl-xl on cell proliferation of rheumatoid arthritis (RA) and the effect on expres-ion of apoptosis relevant factors Bcl-xl,Bax,Caspase-3.Methods Human RA synovial cells were cultured and passed by tissue block collagenase digestion method.The siRNA plasmid targeting Bcl-xl gene was constructed by Bcl-xl cDNA sequence provided by gene banks,while single missense sequences were used as negative controls.LipofectamineTM 2000 was used to transfect synovial cells.The effect of Bcl-xl silencing on proliferation of synovial cells was evaluated by MTT at 24,48,72 hours after transfection.The expressions of Bcl-xl,Bax,Caspase-3 protein,synovial apoptosisrelated factors were determined by Western blotting after transfected at different time points.The average of multiple-sample average was analyzed by single-factor x2 test or LSD-t and Tamhane's T2 test was used for twotwo comparison.Results MTT result s showed that RNA interference that specifically silent Bcl-xl could obviously suppress the proliferation of sliding film cells,which was most eveident at 48 hours.This inhibition was gradually weakened with prolonged time,but when compared was the control group,differences was significant (P＜0.05).Western blotting results displayed that when compared to the control group,Bcl-xl protein expression obviously declined after transfection P＜0.01,which was the least at 48 h time point.Bax,Caspase3 protein expression were obviously increased when compared to the coutrol group.Conclusion The expression of Bcl-xl,a RA synovial cell anti-apoptotic factor,is significantly reduced by specific RNA interference silencing Bcl-xl,which may play an important role in inhibiting the excessive proliferation of synovial cells.

Objective To investigate the distribution and susceptibility patterns of common uropathogens causing community-acquired urinary tract infection (UTI) in Beijing.MethodsA total of 300non-duplicate isolates were randomly collected from 3 hospitals in Beijing between Jan,1 2010 and Mar,312011.Minimal inhibitory concentrations (MICs) were determined by the broth microdilution methods,which were performed and interpreted according to the guidelines established by the Clinical and Laboratory Standards Institute (CLSI).A panel of 8 antimicrobial agents were tested:amikacin,cefaclor,cefepime,cefoperazone/sulbactam,ciprofloxacin,levofloxacin,gentamicin and nitrofurantoin. Fosfomycin trometamol MICs were determined by the agar-dilution method in cation-adjusted MH agar supplemented with glucose 6-phosphate at a concentration of 25 mg/L as detailed in the guidelines issued by 2010 CLSI. All the Escherichia coli,Klebsiella pneumoniae and Proteus mirabilis strains were screened and confirmed by double-disk synergy test for extended-spectrum β-lactamase (ESBLs).Results Among the organisms cultured,E.coli wasthepredominantpathogen(65.0％ ), followedby Enterococcus(11.7％ ),Staphylococcus( 6.3％ ), Klebsiella pneumoniae( 5. 3％ ), Proteus mirabilis( 4. 7％ ), and Pseudomonas aeruginosa (3.0％).Lower susceptibility rates to ciprofloxacin and levofloxacin (31.4％ -47.4％ ) were observed among all the stains.Amikacin,cefoperazone/sulbactam,nitrofurantoin and fosfomycin trometamol were the most active drugs (92.1％,92.1％,88.4％ and 87.9％ susceptible strains,respectively) among the Gram-negative strains.Isolates of Staphylococcus were highly sensitive to amikacin ( 100.0％ ),cefoperazone/sulbactam (94.7％),nitrofurantoin ( 100.0％ ).Higher susceptibility rates to nitrofurantoin (91.4％) and fosfomycin trometamol (90.0％) were observed in Enterococcus.ESBLs-producing strains accounted for 52.3％ (102/195) in E.coli,43.8％ (7/16) in K.pneumoniae and 14.3％(2/14) in P.mirabilis,respectively.ConclusionsResistance is most common to ciprofloxacin and levofloxacin of all the stains.Currently,the most appropriate agents for the empirical management of uncomplicated UTI seems to be amikacin,cefoperazone/sulbactam,nitrofurantoin and fosfomycin trometamol.

Objective To study the clinical efficacy of anus-preserving rectectomy by using telescopic anastomosis of colon and rectal mucosa for the middle and lower rectal cancer. Methods A retrospective analysis was carried out in 402 cases with middle and lower rectal cancer undergoing telescopic anastomosis for anus-preserving procedure, including 241 males and 161 females, age ranging from 21 to 99 years, averaging at 55. 7 years. The distal margins of the tumors were within 6 - 9 cm to anal verge. According to TNM staging, there were 123 cases in Stage Ⅰ , 244 cases in Stage Ⅱ , 31 cases in Stage Ⅲ,and 4 cases in Stage Ⅳ. Results 345(345/402, 85. 8% ) cases were followed up, the median time of the follow-up was 6. 1 years. Postoperative complications included 17(4.2%) cases of stomal leakage, 11(2.7% ) cases of stomal stenosis. All patients recovered normal defecating function 12-24 weeks post operation. Local recurrence rate was 6. 3% (22/345). Hepatic and lung metastasis was 13. 6% (47/345) and 2. 6% (9/345)respectively. The five year survival rate was 68. 7% (112/163). Conclusions Anuspreserving rectectomy by using telescopic anastomosis is safe and effective procedure to treat middle and lower rectal cancer, with the preservation of anal function and without the increasing rate of local recurrence.