BACKGROUND:Trunk pressure biofeedback is considered a reliable indicator for assessing core muscle strength.It not only reflects the status of an individual's trunk strength but also has a close relationship with the function of respiratory muscles. OBJECTIVE:To explore the correlation between trunk pressure biofeedback and diaphragmatic function in young adults. METHODS:A total of 80 young adults from Shangrao Normal University,China were enrolled,including 34 males and 46 females,with an average age of(19.83±1.45)years.Diaphragmatic thickness and mobility were measured using a bedside musculoskeletal ultrasound system.Maximum inspiratory pressure was determined using a portable pulmonary function tester.Lumbar and abdominal pressures in prone and supine positions were assessed using a pressure biofeedback device.The degree of correlation between trunk pressure biofeedback and diaphragmatic function was determined using Pearson or Spearman correlation coefficients.A multivariate linear regression analysis was used to determine predictive models for diaphragmatic function. RESULTS AND CONCLUSION:Grouped by sex,age,height,body mass,trunk pressure biofeedback values,diaphragm thickness during quiet inspiration and expiration,diaphragmatic thickening ratio during quiet breathing,diaphragmatic thickness during deep inspiration and expiration,diaphragmatic thickening ratio during deep breathing,diaphragmatic mobility during deep inspiration,and maximum inspiratory pressure were higher in the male group than the female group(all P<0.05).Grouped by physical activity level,trunk pressure biofeedback values and maximum inspiratory pressure were lower in the sedentary group than in the exercise group(both P<0.05).Both anterior and posterior trunk pressure biofeedback were significantly correlated with diaphragmatic thickness during quiet inspiration and expiration,diaphragmatic thickening ratio during quiet breathing,diaphragmatic thickness during deep inspiration and expiration,diaphragmatic thickening ratio during deep breathing,diaphragmatic mobility during deep inspiration,and maximum inspiratory pressure(all P<0.01).Anterior trunk pressure biofeedback entered the predictive model for diaphragmatic thickness during quiet inspiration(F=27.228,P<0.001),during deep inspiration(F=38.615,P<0.001),and along with age for diaphragmatic mobility during deep inspiration(F=15.408,P<0.001).Anterior trunk pressure biofeedback,body mass,and age entered the predictive model for maximum inspiratory pressure(F=22.314,P<0.001).To conclude,there is a strong correlation between trunk pressure biofeedback and diaphragmatic thickness,diaphragmatic mobility,and maximum inspiratory pressure.The rapid and simple measurement of trunk pressure biofeedback can serve as a method for screening the diaphragmatic function in healthy young adults.

Pruritus is a common symptom in the patients with end-stage renal disease,up to 80％of the patients receiving hemodialysis suffer from pruritus,40％of these patients experience moderate to severe pru-ritus,which causes poor sleep,depression,work interference,decrease of overall quality of life and increase of death risk.However,at present,the clinical understanding of skin pruritus associated with end-stage kidney disease is not sufficient,and there is a lack of effective theories to reveal its pathogenesis.This article summa-rizes the latest research progress on the pathogenesis of this disease,hoping to provide the new ideas for clini-cal diagnosis and treatment.

Objective:To compare the consistency of lymphoma multigene detection panels based on next-generation sequencing (NGS) with FISH detection of B-cell lymphoma gene rearrangement.Methods:From January 2019 to May 2023, fusion genes detected by lymphoma-related 413 genes that targeted capture sequencing of 489 B-cell lymphoma tissues embedded in paraffin were collected from Henan Cancer Hospital, and the results were compared with simultaneous FISH detection of four break/fusion genes: BCL2, BCL6, MYC, and CCND1. Consistency was defined as both methods yielding positive or negative results for the same sample. The relationship between fusion mutation abundance in NGS and the positivity rate of cells in FISH was also analyzed.Results:Kappa consistency analysis revealed high consistency between NGS and FISH in detecting the four B-cell lymphoma-related gene rearrangement ( P<0.001 for all) ; however, the detection rates of positive individuals differed for the four genes. Compared with FISH, NGS demonstrated a higher detection rate for BCL2 rearrangement, a lower detection rate for BCL6 and MYC rearrangement, and a similar detection rate for CCND1 rearrangement. No correlation was found between fusion mutation abundance in NGS and the positivity rate of cells in FISH. Conclusions:NGS and FISH detection of B-cell lymphoma gene rearrangement demonstrate overall good consistency. NGS is superior to FISH in detecting BCL2 rearrangement, inferior in detecting MYC rearrangement, and comparable in detecting CCND1 rearrangement.

[Objective]To investigate the potential mechanism of Yuquan Capsule in treating diabetic nephropathy(DN)by network pharmacology and in vitro experiments.[Methods]The active ingredients and disease-associated genes of Yuquan Capsule were screened by Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP)and Traditional Chinese Medicine Integrated Database(TCMID),the target genes of DN were screened by Genome Annotation Database Platform(GeneCards),Disease Gene Network(DisGeNET)database and Therapeutic Target Database(TTD).The protein-protein interaction(PPI)network was drawn by STRING 11.5 database,and visualized by Cytoscape 3.7.2 software.The key compounds and core targets were screened by CytoHubba and MCODE plugins of Cytoscape 3.7.2 software.Gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis were performed by R software(ClusterProfiler package),and the molecular docking validation was performed by AutoDock and PyMOL software.[Results]There were 177 Yuquan Capsule against DN,477 active components and 135 targets of Yuquan Capsule against DN.The core targets included serine/threonine kinase 1(AKT1),interleukin-1 beta(IL1B),catalase(CAT),nitric oxide synthase 3(NOS3),leptin(LEP),insulin-like growth factor 1(IGF1)and C-C motif chemokine ligand 2(CCL2).GO enrichment analysis showed 2 557 related items,including 1 415 biological processes,657 cellular components and 48 molecular functions.KEGG pathway analysis showed that the targets of Yuquan Capsule against DN were enriched in 66 pathways,of which cyclic adenosine monophosphate(cAMP)signaling pathway and advanced glycation end products-receptor for advanced glycation end products(AGE-RAGE)signaling pathway in diabetic complications may be the key pathways of Yuquan Capsule in the treatment of DN.Molecular docking results showed that the core target and key compounds could bind well.Experimental verification showed that the protein level of CCL2 decreased in a drugdose-dependent manner,and the protein level of CAT and endothelial nitric oxide synthase(eNOs)increased in a drugdose-dependent manner.[Conclusion]Yuquan Capsule has the characteristics of multiple components and multiple targets in the treatment of DN.The mechanism may be related to the down-regulation of CCL2 and up-regulation of CAT and eNOs protein expression,inhibiting oxidative stress,and regulating the key pathway.

Coronavirus disease 2019 (COVID-19) can induce coagulation dysfunction in patients and is associated with an increased risk of thrombotic complications, including microvascular thrombosis, venous thromboembolism, and stroke. In patients undergoing maintenance hemodialysis, the risk of COVID-19-related coagulation dysfunction and thrombotic complications is further elevated. This article reviewed the pathogenesis of COVID-19-related hypercoagulability and thrombotic complications in patients undergoing maintenance hemodialysis, aiming to provide a reference for the diagnosis and treatment of this disease.

[摘 要] 目的：根据胃癌患者术前中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、淋巴细胞与单核细胞比值（LMR）的表达水平构建炎症反应评分（IRS）系统，分析IRS对胃癌患者术后预后的影响并构建列线图预测模型。方法: 选取2016年1月至2020年1月宜春市人民医院普外科收治的211例胃癌患者的临床资料，根据随访成功的198例患者术后3年生存状态分为死亡组（n=93）和生存组（n=105）。比较两组患者的一般临床资料，多因素COX回归风险模型分析影响胃癌患者预后的独立风险因素，R语言rms包构建列线图预测模型。结果: 两组胃癌患者肿瘤最大直径、病理分期、T分期、分化程度、神经侵犯、脉管侵犯、NLR、PLR、LMR比较差异均有统计学意义（均P<0.05）。依据NLP、PLR、LMR-IRS（NPL-IRS）构建标准，不同分值的胃癌患者OS率表现出一定的等级趋势差异（χ2=61.129，P<0.01）。病理分期Ⅲ期、分化程度低、脉管侵犯、NPL-IRS>1分是影响胃癌患者预后的独立危险因素（P<0.05）。决策曲线分析显示，风险阈值>0.16时，此预测模型可以提供显著额外的临床净收益。结论: 基于病理分期Ⅲ期、分化程度低、脉管侵犯、NPL-IRS>1分构建的列线图预测模型可以为胃癌患者预后评估提供重要的策略指导。

Objective:To explore the role and mechanism of tubastatin A (TubA) in alleviating brain injury after cardiac arrest and cardiopulmonary resuscitation (CA-CPR) by inhibiting endoplasmic reticulum stress-mediated cell apoptosis in swine.Methods:Twenty-three conventional male white swine, weighing 33-40 kg, aged 4 to 6 months, were divided into 3 groups by random number table method: sham group ( n=6), CA-CPR group ( n=9), and TubA group ( n=8). The CA-CPR swine model was established by 9 min of electrically induced CA through pacing catheter in the right ventricle and then 6 min of CPR in the CA-CPR group. The CA-CPR swine model was established by the same method, and then a dose of 4.5 mg/kg of TubA at 5 min after resuscitation was intravenously infused in the TubA group. The serum concentrations of neuron specific enolase (NSE) and S100β protein (S100β) were measured using ELISA before modeling and at 1, 2, 4 and 24 h after resuscitation. Neurological deficit score (NDS) was evaluated at 24 h after resuscitation. Thereafter, the animals were euthanized, and brain cortex tissues were harvested, and the expression levels of caspase-12 and caspase-3 were measured using immunohistochemistry. Cell apoptosis index was detected by TUNEL assay. The variables among the three groups were compared with one-way analysis of variance and the Bonferroni hoc test using SPSS software. Results:Twenty-four h after resuscitation, the serum concentrations of NSE and S100β were significantly increased, and NDS was markedly elevated in the CA-CPR and TubA groups compared with the sham group (all P<0.05). Compared with the CA-CPR group, serum concentration of NSE starting 2 h after resuscitation and serum concentration of S100β starting 1 h after resuscitation were significantly decreased in the TubA group [NSE (ng/mL): (23.1±2.0) vs. (20.2±2.0) at 2 h, (28.4±2.3) vs. (23.7±1.9) at 4 h, (32.1±2.7) vs. (26.6±2.0) at 24 h; S100β (pg/mL): (2239±193) vs. (1923±101) at 1 h, (2817±157) vs. (2360±141) at 2 h, (3384±250) vs. (2691±210) at 4 h, (3965±303) vs. (3119±260) at 24 h, all P<0.05], and NDS was markedly reduced (240±30 vs. 63±44, P<0.05). At 24 h after resuscitation, brain cortex tissue detection showed that the expression levels of caspase-12 and caspase-3 were significantly increased, and cell apoptosis index was markedly elevated in the CA-CPR and TubA groups compared with the sham group (all P<0.05). However, the expression levels of caspase-12 and caspase-3 were significantly decreased [caspase-12:(7.1±0.7) vs. (4.2±0.4); caspase-3: (13.3±1.6) vs. (7.7±0.8), all P<0.05], and cell apoptosis index was markedly reduced in the TubA group compared to the CA-CPR group [(31.1±8.6) vs. (17.3±2.2), P<0.05]. Conclusions:TubA alleviates brain injury and neurological dysfunction after CA-CPR in swine, which may be related to the inhibition of cell apoptosis mediated by endoplasmic reticulum stress.

Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.

Third space fluid(TSF) is a common complication of advanced malignancies, including malignant pleural effusion, malignant ascites, intracranial effusion, and pelvic effusion, etc. The pharmacokinetics(PK) of anti-tumor drugs in vivo are influenced by various factors, and TSF is one of the potential factors that contributes to PK variations, which may consequently affect the efficacy and safety of anti-tumor drugs. This paper aimed to comprehensively investigate PK studies related to anti-tumor drugs in patients with malignant tumors accompanied by TSF. The paper summarized the PK characteristics of common cytotoxic drugs, small molecule targeted drugs, and monoclonal antibodies in both blood and TSF.

Objective:To explore the effects of retroperitoneal laparoscopic ureterolithotomy (RLU) and urethral ureteroscopic lithotripsy (URL) on renal function, oxidative stress, and immunoglobulin levels in patients with upper ureteral calculi.Methods:The clinical data of 78 patients with upper ureteral calculi, who received treatment in Yiwu Central Hospital from June 2017 to April 2020, were collected for this study. The patients were divided into URL group ( n = 38, URL treatment) and RLU group ( n = 40, RLU treatment) according to different surgical methods. Renal function (creatinine, urea nitrogen, neutrophil gelatinase-associated lipocalin), oxidative stress (superoxide dismutase, malondialdehyde), immunoglobulin (Ig) (IgA, IgM, IgG), and complications were compared between the two groups. Results:At 1 day after surgery, creatinine, urea nitrogen, neutrophil gelatinase-associated lipocalin in the RLU group were (79.59 ± 6.02) μmol/L,(6.93±1.17) mmol/L,(4.78±0.61) μg/L, respectively, which were significantly lower than those in the URL group [(86.98 ± 8.27) μmol/L, (7.62 ± 1.24) mmol/L, (6.03 ± 0.79) μg/L, t = 4.53, 2.53, 7.85, P < 0.001, P = 0.014, P < 0.001). At 1 day after surgery, IgA, IgM, and IgG in the RLU group were (1.94 ± 0.25) g/L, (1.55 ± 0.24) g/L, (6.59 ± 1.25) g/L, respectively, which were significantly lower than those in the URL group [(2.38 ± 0.23) g/L, (1.82 ± 0.27) g/L, (7.89 ± 1.36) g/L, t = 8.08, 4.67, 4.40, P < 0.001, 0.001, 0.001]. At 1 day after surgery, malondialdehyde level was significantly lower in the RLU group than in the URL group [(7.49 ± 1.26) mmol/L vs. (8.93 ± 1.38) mmol/L, t = 4.817, P < 0.001]. At 1 day after surgery, superoxide dismutase level was significantly higher in the RLU group than in the URL group [(72.18 ± 7.55) mg/L vs. (63.49 ± 6.69) mg/L, t = 5.37, P < 0.001). There was no significant difference in the incidence of postoperative complications [15.79% (6/38) vs. 7.50% (3/40), χ2 = 1.31, P = 0.252]. Conclusion:RLU for the treatment of upper ureteral calculi has fewer effects on renal function, oxidative stress, and immunoglobulin level in patients with upper ureteral calculi compared with URL and does not increase the incidence of complications.