Objective: To systematically evaluate the association between random urinary electrolyte levels and hypertension among children and adolescents in Guizhou Province, so as to provide evidence for region specific dietary guidance and interventions. Methods: In 2023, a total of 2 480 children and adolescents aged 6 to 17 years were recruited from a nine-year coherent style school in Guizhou Province in a children health cohort, with follow ups conducted in 2024 and 2025. Random urine samples were collected to measure urinary sodium, potassium, calcium, and chloride, and the urinary sodium to potassium ratio (Na/K) was calculated. The diagnosis of hypertension was based on the criteria established by the Chinese Guidelines for Hypertension Prevention and Treatment (2024 revised edition) and relevant research. Linear mixed models and multinomial Logistic regression were used to assess the associations of urinary electrolytes with systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and the risk of hypertension. Results: At baseline, SBP, DBP, and MAP were 102.33 (94.33, 110.33), 61.33 (56.33, 67.00) and 75.22 (69.67, 81.33)mmHg among children and adolescents, respectively. After adjusting for potential confounders and two follow-ups, higher urinary Na/K ratio was positively associated with higher of SBP ( β=0.054, 95%CI =0.028- 0.081 ) and MAP ( β=0.038, 95%CI =0.010-0.066), as well as higher risks of hypertension ( OR=1.248, 95%CI =1.006-1.548) (all P <0.05). Higher of urinary chloride levels were positively associated with higher of SBP ( β=0.088, 95%CI = 0.009- 0.167), whereas higher of urinary potassium (SBP: β=-0.062, 95%CI =-0.096 to -0.028; MAP: β=-0.041, 95%CI = -0.078 to -0.005) and calcium levels (SBP: β=-0.036, 95%CI =-0.065 to -0.007) were negatively associated with blood pressure (all P < 0.05 ). Conclusion The urinary Na/K, as a comprehensive electrolyte marker, more stably reflects sodium load and excretory pressure in children and adolescents, and may serve as an early predictor of hypertension risk.

Objective: To establish a real-time quality control scheme based on the median (MD-IC) of internal control cycle threshold value in negative samples (NEG-IC-CT), so as to monitor anomalies such as progressive drift in nucleic acid testing system not covered by conventional internal quality control (IQC) in blood center nucleic acid laboratories, and to verify its feasibility. Methods: The internal control CT values of 54 426 negative samples were retrospectively collected. These samples were from four reagent batches of the two new and old equipment sets during the operation of the Wantai nucleic acid testing system in our blood center. The daily median of NEG-IC-CT values was used as the research indicator. Control limits were calculated using median absolute deviation (MAD) to construct the Median-MAD quality control chart. The monitoring performance of this scheme for the operation status of the testing system was simultaneously evaluated. Results: Statistical analysis showed significant differences in NEG-IC-CT value distribution between the new and old equipment sets, as well as between the two different reagent batches of the old equipment (P<0.000 1). The NEG-IC-CT value performance of the two different reagent batches of the new equipment was no significant difference in distribution (P>0.05). This scheme identified three typies of distinct anomalies. The out-of-control events observed with the old equipment in both the O1 and O2 reagent batches suggested potential performance decay due to equipment aging. The unreported change of reagent batch in time of Phase B with new equipment caused a stepwise drift on the quality control chart. In the later stage of Phase A with the new equipment, an alert was triggered, indicating potential quality risks associated with practices such as the mixed use of the remaining reagents and extremely long operator working hours. Conclusion: The realtime quality control scheme based on NEG-IC-CT value established in this study has been preliminarily validated for its monitoring effectiveness in nucleic acid testing in our blood center. This scheme performed well in detecting differences among testing systems and reagent batches, serving as an effective supplement to routine internal quality control. It can provide an intuitive and effective evaluation method for monitoring the performance of the nucleic acid testing process at blood center.

Osteoporosis is a common bone disease， whose incidence is still on the rise， posing great challenges to patients and society. This review mainly studies the pathogenesis of osteoporosis from the aspects of oxidative stress， inflammatory response， and glucolipotoxicity-induced injury and clarifies the efficacy and mechanism of some active ingredients of traditional Chinese medicine against osteoporosis through the integration of in vitro and in vivo experiments. The experimental results suggest that some active ingredients can improve bone resorption markers and maintain bone homeostasis by modulating inflammation， oxidative stress， etc. These active ingredients regulate osteoporosis through the receptor activator of nuclear transcription factor-κB （NF-κB） ligand （RANKL） pathway， osteoprotegerin （OPG） pathway， Wnt/β-catenin pathway， NF-κB pathway， mitogen-activated protein kinase （MAPK） pathway， adenosine monophosphate （AMP）-activated protein kinase （AMPK）/mammalian target of rapamycin （mTOR） pathway， and oxidative stress pathway. This review provides ideas for the progress of the prevention and treatment of osteoporosis with the active ingredients of traditional Chinese medicine， aiming to provide new potential lead compounds and reference for the development of innovative drugs and clinical therapy for the treatment of osteoporosis.

BACKGROUND: As an essential part of health services, rehabilitation is of great significance to improve the health and quality of life of the whole population. Accelerating aging calls for a significant expansion of rehabilitation services in China, but rehabilitation needs remain unclear. We conducted the study to explore the rehabilitation needs in China and project the trend of rehabilitation needs from 2020 to 2034. METHODS: The data of health conditions that might potentially benefit from rehabilitation were obtained from Global Burden of Disease (GBD) study. Estimated annual percentage changes (EAPCs) were calculated to quantify the trends of the age-standardized rates. Projections of rehabilitation needs were made until 2034 using Bayesian age-period-cohort analysis (BAPC). RESULTS: Approximately 460 million persons (33.3% of the total population) need rehabilitation in China, contributing to 63 million years lived with disabilities (YLDs) in 2019. The number of prevalent cases that need rehabilitation increased from around 268 (95% uncertainty interval [UI]: 257-282) million in 1990 to almost 460 (95% UI: 443-479) million in 2019, representing an increase of 71.3%. The highest contribution to the need for rehabilitation was musculoskeletal disorders with about 322 (95% UI: 302-343) million persons in seven aggregate disease and injury categories, and hearing loss with over 95 (95% UI: 84-107) million people among 25 health conditions. Based on the projection results, there will be almost 636 million people (45% of the total population) needing rehabilitation services in China by 2034, representing an increase of 38.3%. The rehabilitation needs of neoplasms, cardiovascular diseases, and neurological disorders are expected to increase significantly from 2019 to 2034, with increases of 102.3%, 88.8% and 73.2%, respectively. CONCLUSIONS The need for rehabilitation in China substantially increased over the last 30 years. It is predicted that over two in five people will require rehabilitation by 2034, thus suggesting the need to develop rehabilitation services that meet individuals' rehabilitation needs.
Humans ; China/epidemiology* ; Global Burden of Disease ; Female ; Male ; Musculoskeletal Diseases/epidemiology* ; Rehabilitation/trends* ; Quality of Life ; Middle Aged ; Aged ; Bayes Theorem

Objective To analyze the trend of global cellulitis disease burden from 1990 to 2019, and to provide a theoretical basis for the prevention and control of cellulitis disease. Methods The Global Burden of Disease 2021 (GBD2021) data were collected, and data on the incidence, mortality, and disability-adjusted life year (DALY) of cellulitis were analyzed for each country worldwide. The estimated annual percentage change (EAPC) and age-standardized rate (ASR) were used to estimate the trend change of cellulitis from 1990 to 2021. Results The global burden of cellulitis increased significantly in 2021, with 55.96 million cases, 28.9 million deaths and 876.1 million DALYs, respectively. Incidence and mortality rates were generally higher in males than in females. The incidence and DALYs were higher in high SDI regions, with the highest burden observed in South Asia. In contrast, East Asia exhibited the lowest burden and demonstrated a declining trend. There were significant differences between countries, with India having the highest prevalence, the United States having the highest incidence, and Bahrain having the fastest growing rate.In 2021, China had the lowest age-standardised incidence of cellulitis in the world and the fastest declining age-standardised incidence and age-standardised DALYs. Conclusion The global disease burden of cellulitis is increasing from 1990-2021, and cellulitis remains an an important global public health problem. Targeted preventive meausres should be taken in areas with different economical levels. Men, middle-aged and elderly people, and newborns are the key groups in need of attention and health education.

Probiotics are natural systems bridging synthetic biology, physical biotechnology, and immunology, initiating innate and adaptive anti-tumor immune activity. We previously constructed an all-in-one engineered food-grade probiotic Lactococcus lactis (FOLactis) which could boost the crosstalk among different immune cells such as dendritic cells (DCs), natural killer cells, and T cells. Herein, considering the limited clinical efficacy of naked personalized neoantigen peptide vaccines, we decorate FOLactis with tumor antigens by employing a Plug-and-Display system comprising membrane-inserted peptides. Intranodal injection of FOLactis coated with neoantigen peptides (Ag-FOLactis) induces robust DCs presentation and neoantigen-specific cellular immunity. Notably, Ag-FOLactis not only triggers a 45-fold rise in the quantity of locally reactive neoantigen-specific T cells but also induces epitope spreading in both subcutaneous and metastatic tumor-bearing models, leading to potent inhibition of tumor growth. These findings imply that Ag-FOLactis represents a powerful platform to rapidly and easily display antigens, facilitating the development of a bio-activated platform for personalized therapy.

OBJECTIVE: To explore the current status, evolution, hot topics, and future research trends in the field of burn-related sepsis research through a visual analysis of literature. METHODS: A bibliometric method was employed to retrieve articles related to burn-related sepsis from January 1, 1994, to May 16, 2024, in the China National Knowledge Infrastructure (CNKI) and the Web of Science database. The CiteSpace 6.3.R1 software was used to analyze the retrieved literature. The number of publications, authors, countries, and institutions in both Chinese and English literature was statistically analyzed. Co-occurrence analysis, clustering analysis, and co-citation analysis of keywords were performed. RESULTS: A total of 1 090 articles from the CNKI database and 1 143 articles from the Web of Science database were retrieved. Over the past 20 years, the volume of Chinese publications has remained stable, although there has been a slight decline in the past two years. In contrast, the number of English publications, after a period of growth, showed a sharp decline over the past three years. In Chinese literature, 1 457 authors published articles on burn-related sepsis as first authors, with 14 core authors publishing four or more articles. In English literature, 98 authors published articles on burn-related sepsis as first authors. Research on burn-related sepsis was conducted by 76 countries, with the United States having the most collaborations and publications. Globally, 1 349 institutions published articles on burn-related sepsis, with the top institutions being the First Affiliated Hospital of the PLA General Hospital (8 articles) for Chinese literature and the University of Texas Medical Branch (57 articles) for English literature. In the co-occurrence analysis, 208 Chinese keywords and 211 English keywords were included. Excluding keywords related to search terms, the top five most frequent keywords in Chinese literature were burn, sepsis, infection, severe burn, and procalcitonin; the top five most frequent keywords in English literature were sepsis, septic shock, mortality, injury, and burn injury. Chinese keyword analysis identified six clusters, with the largest being sepsis, followed by procalcitonin, infection, and severe burn. English keyword analysis identified seven clusters, with the largest being expression, followed by epidemiology, inhalation injury, and acute kidney injury. The persistent clusters in Chinese literature were procalcitonin, with recent emerging nodes being severe burn, inflammatory response, platelets, and predictive value. In English literature, the persistent clusters were inhalation injury and nitric oxide, with recent emerging nodes being continuous renal replacement therapy, hemorrhagic shock, and early enteral nutrition. The longest-lasting emergent keyword in Chinese literature was delayed resuscitation (2003-2010), with the highest emergent strength being severe burn. In English literature, the longest-lasting emergent keywords, each lasting five years, were nitric oxide (2007-2012), management (2019-2024), and impact (2019-2024), with the highest emergent strength being thermal injury. CONCLUSIONS Research on burn-related sepsis has shifted from focusing on early studies on pathogenesis and mortality to focus on prevention, treatment, and early diagnosis. Future research is expected to focus on early diagnosis and risk factors of burn-related sepsis.
Burns/complications* ; Sepsis/etiology* ; Humans ; Bibliometrics ; China

Objective:To identify serum metabolic markers for early prediction and diagnosis of gestational diabetes mellitus (GDM).Methods:A retrospective case-control study was conducted.The study subjects were from pregnant women enrolled in the Birth Cohort Study of the Women′s Hospital, Zhejiang University, from1 November 2018 to 30 March 2020.100 cases of GDM (GDM group, Age 36.03±3.91) and 150 non-GDM pregnant women matched for clinical information (control group, Age35.49±3.46) were retrospectively selected for the study. Fasting serum samples were collected at 15-20 weeks of gestation (prior to GDM diagnosis, T1 period) and 24-28 weeks of gestation (during GDM diagnosis, T2 period). Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used to quantify GDM-related serum metabolic small molecules, including 1, 5-anhydroglucitol, 3-hydroxybutyric acid, phenylalanine, and isoleucine. These molecules, along with basic clinical information (age, gestational week, BMI) and standard biochemical indicators (FPG), were used to develop predictive models for the early detection of GDM at T1 and the diagnosis of GDM at T2. Statistical analysis was performed using t-tests or Mann-Whitney U-tests.Result:The results of the targeted quantitative validation study indicate: At the T1 stage, the level of 1, 5-anhydroglucitol was found to be significantly lower ( P=0.001) in the GDM group compared to the control group. Conversely, the level of isoleucine was significantly higher ( P=0.027) in the GDM group. There were no significant differences in the levels of 3-hydroxybutyrate and phenylalanine between the two groups ( P>0.05). The combination of the 4 metabolites yielded the highest predictive value (AUC) for GDM at T1, with an AUC of 0.670 (95% CI: 0.602-0.739), P<0.001.At the T2 stage, the GDM group had significantly lower levels of 1, 5-anhydroglucitol ( P<0.05) and significantly higher levels of 3-hydroxybutyric acid and isoleucine ( P<0.05) than the control group, with no significant differences in phenylalanine levels ( P=0.626). The combination of the four metabolites had the highest diagnostic value (AUC) for GDM, 0.717 (95% CI 0.651-0.783), P<0.001.The analysis of seven different combinations of GDM prediction/diagnostic models created by combining four metabolites with basic clinical information and routine biochemical indicators showed: We found that the AUC value of the GDM diagnostic model built with FPG, BMI, pre-pregnancy BMI, age, gestational week, and the 4 metabolite indicators in T2 stage was the best, 0.794 (95% CI 0.736-0.851), P<0.001, with a sensitivity of 72%;The best AUC value for the GDM prediction model built with the same indicators at T1 was 0.711(95% CI 0.646-0.776), P<0.001, with a sensitivity of 77%. Conclusions:Four metabolic small molecules, 1, 5-anhydroxyglucitol, 3-hydroxybutyric acid, phenylalanine, and isoleucine, were integrated with clinical indicators (FPG) and clinical information (age, gestational week, BMI) to develop a predictive model for GDM at gestation (T1) and a diagnostic model for GDM at gestation (T2), demonstrating promising clinical prediction and diagnostic capabilities. 1, 5-Anhydroglucitol, 3-hydroxybutyric acid, phenylalanine, and isoleucine show potential as valuable markers for the prediction and diagnosis of GDM.

Objective:To observe the clinical characteristics and prognosis of patients with acute respiratory distress syndrome (ARDS) in sepsis combined with acute gastrointestinal injury (AGI) of different grades, and to further explore the risk factors associated with the poor prognosis of patients.Methods:The clinical data of patients with septic ARDS admitted to the intensive care unit (ICU) of Tianjin First Central Hospital from March to October 2023 were collected. According to the 2012 European Association of Critical Care Medicine AGI definition and grading criteria, the patients were categorized into AGI grade 0-Ⅳ groups. The clinical characteristics and 28-day clinical outcomes of the patients were observed; the risk factors related to the prognosis of patients with septic ARDS combined with AGI were analyzed by using univariate and multivariate Logistic regression; and the receiver operator characteristic curve (ROC curve) and calibration curves were plotted to evaluate the predictive value of each risk factor on the prognosis of patients with septic ARDS combined with AGI.Results:A total of 92 patients with septic ARDS were enrolled, including 7 patients in the AGI 0 group, 20 patients in the AGIⅠgroup, 38 patients in the AGIⅡ group, 23 patients in the AGIⅢ group, and 4 patients in the AGI Ⅳ group. The incidence of AGI was 92.39%. With the increase of AGI grade, the ARDS grade increased, and acute physiology and chronic health evaluationⅡ(APACHEⅡ), sequential organ failure assessment (SOFA), intra-abdominal pressure (IAP), white blood cell count (WBC), neutrophil count (NEU), lymphocyte count (LYM), lymphocyte percentage (LYM%), and 28-day mortality all showed a significant increasing trend, while the oxygenation index (PaO 2/FiO 2) showed a significant decreasing trend (all P < 0.05). Pearson correlation analysis showed that APACHEⅡscore, SOFA score, and ARDS classification were positively correlated with patients' AGI grade (Pearson correlation index was 0.386, 0.473, and 0.372, respectively, all P < 0.001), and PaO 2/FiO 2 was negatively correlated with patients' AGI grade (Pearson correlation index was -0.425, P < 0.001). Among the patients with septic ARDS combined with AGI, there were 68 survivors and 17 deaths at 28 days. The differences in APACHEⅡscore, SOFA score, ARDS grade, AGI grade, PaO 2/FiO 2, IAP, AGI 7-day worst value, length of ICU stay, and total length of hospital stay between the survival and death groups were statistically significant. Univariate Logistic regression analysis showed that SOFA score [odds ratio ( OR) = 1.350, 95% confidence interval (95% CI) was 1.071-1.702, P = 0.011], PaO 2/FiO 2 ( OR = 0.964, 95% CI was 0.933-0.996, P = 0.027) and AGI 7-day worst value ( OR = 2.103, 95% CI was 1.194-3.702, P = 0.010) were the risk factors for 28-day mortality in patients with septic ARDS combined with AGI. Multivariate Logistic regression analysis showed that SOFA score ( OR = 1.384, 95% CI was 1.153-1.661, P < 0.001), PaO 2/FiO 2 ( OR = 0.983, 95% CI was 0.968-0.999, P = 0.035) and AGI 7-day worst value ( OR = 1.992, 95% CI was 1.141-3.478, P = 0.015) were the independent risk factors for 28-day mortality in patients with septic ARDS combined with AGI. ROC curve analysis showed that SOFA score, PaO 2/FiO 2 and AGI 7-day worst value had predictive value for the 28-day prognosis of patients with septic ARDS combined with AGI. The area under the ROC curve (AUC) was 0.824 (95% CI was 0.697-0.950), 0.760 (95% CI was 0.642-0.877) and 0.721 (95% CI was 0.586-0.857), respectively, all P < 0.01; when the best cut-off values of the above metrics were 5.50 points, 163.45 mmHg (1 mmHg≈0.133 kPa), and 2.50 grade, the sensitivities were 94.1%, 94.1%, 31.9%, respectively, and the specificities were 80.9%, 67.6%, 88.2%, respectively. Conclusions:The incidence of AGI in patients with septic ARDS is about 90%, and the higher the AGI grade, the worse the prognosis of the patients. SOFA score, PaO 2/FiO 2 and AGI 7-day worst value have a certain predictive value for the prognosis of patients with septic ARDS combined with AGI, among which, the larger the SOFA score and AGI 7-day worst value, and the smaller the PaO 2/FiO 2, the higher the patients' mortality.

Objective To observe the efficacy of gray-scale ultrasound-based radiomics for differentiating peripheral pulmonary adenocarcinoma and squamous cell carcinoma.Methods Data of 88 patients with single peripheral lung adenocarcinoma and 58 patients with single peripheral lung squamous cell carcinoma proved pathologically with puncture biopsy and clearly visualized with lung ultrasound were retrospectively analyzed.The patients were divided into training set(n=103)and test set(n=43)at the ratio of 7:3.Based on gray-scale ultrasound of training set,radiomics features associated with differential diagnosis of peripheral lung adenocarcinoma and lung squamous cell carcinoma were extracted and screened.Using 4 different classifiers,including support vector machine(SVM),linear discriminant analysis(LDA),logistic regression(LR)and the least absolute shrinkage and selection operator combined with logistic regression(LASSO-LR),4 corresponding radiomics models were obtained,and the relative best models were selected according to their performances under 10-fold cross validation.The receiver operating characteristic curves were drawn,the areas under the curve(AUC)were calculated to evaluate the differentiating efficacy of each model,and DeLong test was used for the comparison.The differentiating accuracy of models were obtained under the best cutoff value with the maximum Youden index.Results The AUC of SVM,LDA,LR and LASSO-LR radiomics models for differentiating peripheral lung adenocarcinoma and lung squamous carcinoma in test set was 0.864,0.867,0.880 and 0.844,respectively,and no significant difference was found among 4 models(all P＞0.05).Under the best cutoff value of each model,the corresponding accuracy of SVM,LDA,LR and LASSO-LR radiomics models for differentiating peripheral lung adenocarcinoma and lung squamous cell carcinoma was 86.05％,83.72％,88.37％and 86.05％,respectively.Conclusion Radiomics models based on gray-scale ultrasound could be used to differentiate peripheral lung adenocarcinoma and lung squamous cell carcinoma.