Objective To explore the correlation between thyroid hormones and massive proteinuria in patients with type 2 diabetes mellitus (T2DM). Methods A total of 308 patients with T2DM admitted to 3201 Hospital between June 2020 and June 2025 were selected as the observation group, and another 250 healthy individuals who underwent physical examinations during the same period served as the control group. The thyroid hormones levels [free triiodothyronine (FT₃), thyroid stimulating hormone (TSH), and free thyroxine (FT₄)] were measured and compared between the two groups. Based on whether 24-hour urinary protein quantification was ≥ 3.5 g, the patients in the observation group were divided into a massive proteinuria group and a non-massive proteinuria group. Multivariate logistic regression analysis was used to analyze the factors influencing the occurrence of massive proteinuria in T2DM patients. Pearson method was applied to analyze the relationship of thyroid hormone indicators with severity indicators of massive proteinuria. Results Compared with the control group and the non-massive proteinuria group, FT₃ and FT₄ in the massive proteinuria group were lower, while TSH was higher (P<0.05). Multivariate logistic regression analysis suggested that glycosylated hemoglobin (OR=1.113, 95%CI: 1.045-1.185), TSH (OR=1.123, 95%CI: 1.006-1.253), eGFR (OR=0.894, 95%CI: 0.822-0.973), and FT₃ (OR=0.898, 95%CI: 0.828-0.973) were related factors for the occurrence of massive proteinuria in T2DM patients (P<0.05). Pearson correlation analysis revealed that FT3 and FT4 levels in T2DM patients were significantly negatively correlated with 24-hour urinary protein quantification (r=-0.514, -0.502), while the level of TSH was positively correlated with 24-hour urinary protein quantification (r=0.486) (P<0.001). Conclusion In T2DM patients, low FT3 and eGFR levels and high TSH and glycosylated hemoglobin levels are related factors for the occurrence of massive proteinuria, and thyroid hormone levels are significantly associated with the severity of massive proteinuria.

Objective:To investigate the effect of infusing different doses of graft cells on viral infections and survival after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods:Clinical data of 99 patients with hematological diseases who underwent allo-HSCT in Shanxi Bethune Hospital were retrospectively analysed.The proportion of mononuclear cells(MNC)was counted microscopically,the proportions and absolute counts of CD34+cells and lymphocyte subsets(including CD3+T,CD4+T,CD8+T,CD4+CD8+T,B,and NK cells)were detected by flow cytometry,and the infusion dose of each cell types was calculated.The patients were divided into high-dose group and low-dose group based on the median value of the infused cell dose.The effects of different doses of various graft cells on post-transplant viral infections(CMV,EBV,BKV)and survival were analyzed.Results:The low-dose MNC(＜7.97 × 108/kg)and high-dose CD4+CD8+T cell(≥3.02 × 106/kg)groups had a higher Epstein-Barr virus(EBV)infection rate(P=0.031;P=0.020).The high-dose CD34+cell group and low-dose CD3+T,CD8+T and natural killer(NK)cell groups showed a trend toward higher EBV infection rates,but the differences were not statitsically significant(P＞0.05).There was no significant difference in the rates of EBV infection between the high-dose and low-dose groups of CD4+T and B cells(P＞0.05).Multivariate analysis revealed that the doses of MNC and CD4+CD8+T cells in the graft were independent factors influencing EBV infection(P=0.023;P=0.016).The doses of cells in the graft showed no significant impact on CMV and BKV infection,or patient survival(P＞0.05).Conclusion:Infusing a lower dose of MNC and a higher dose of CD4+CD8+T cells increases the risk of EBV infection,but does not affect the survival outcome.

AIM:To evaluate the safety and toler-ability of single dose oral BTK inhibitor YZJ-3058 tablets under fasting conditions in healthy adults,as well as the pharmacokinetic and pharmacologi-cal characteristics of YZJ-3058 and its metabolites.METHODS:A total of 22 healthy subjects were en-rolled in this experiment and administered a single dose orally.They were divided into three groups:50 mg,100 mg,and 200 mg.Among them,2 sub-jects were enrolled in the 50 mg dose group,and 10 subjects were enrolled in the 100 mg and 200 mg dose groups,respectively.RESULTS:In healthy subjects,YZJ-3058 tablets were administered orally on an empty stomach at doses of 50,100,and 200 mg,with a median Tmax of 1.25 to 2.00 hours and an average Cmax of 62.85,89.44,and 99.20 ng/mL,re-spectively.The average AUC0-t was 183.87,297.72,and 453.98 h·ng-1·mL,respectively.The average AUC0-∞ was 189.30,321.33,and 551.44 h·ng-1·mL,and the median t1/2 was 1.16,5.06,and 7.97 hours,respectively.After a single oral administration of 50,100,and 200 mg YZJ-3058 tablets,the highest target occupancy rate was achieved at 4 hours.The average BTK occupancy rates at 24 hours after ad-ministration were 88.95％,96.73％,and 99.24％,re-spectively.The average BTK occupancy rates at 48 hours after administration were 75.65％,89.80％,and 96.68％,respectively.No serious adverse events or adverse events leading to withdrawal oc-curred,and all subjects had good tolerability.CON-CLUSION:YZJ-3058 tablets have good safety and tolerability for single oral administration on an empty stomach in healthy subjects within the dose range of 50-200 mg.Cmax and AUC increase with dose,with fast absorption and saturation.The ter-minal elimination rate gradually slows down with dose increase,and it has a significant and sus-tained occupying effect on BTK targets.

Objective To investigate the distribution and antimicrobial resistance profiles of common pathogens isolated from cerebrospinal fluid(CSF)in CHINET program from 2015 to 2021.Methods The bacterial strains isolated from CSF were identified in accordance with clinical microbiology practice standards.Antimicrobial susceptibility test was conducted using Kirby-Bauer method and automated systems per the unified CHINET protocol.Results A total of 14 014 bacterial strains were isolated from CSF samples from 2015 to 2021,including the strains isolated from inpatients(95.3％)and from outpatient and emergency care patients(4.7％).Overall,19.6％of the isolates were from children and 80.4％were from adults.Gram-positive and Gram-negative bacteria accounted for 68.0％and 32.0％,respectively.Coagulase negative Staphylococcus accounted for 73.0％of the total Gram-positive bacterial isolates.The prevalence of MRSA was 38.2％in children and 45.6％in adults.The prevalence of MRCNS was 67.6％in adults and 69.5％in children.A small number of vancomycin-resistant Enterococcus faecium(2.2％)and linezolid-resistant Enterococcus faecalis(3.1％)were isolated from adult patients.The resistance rates of Escherichia coli and Klebsiella pneumoniae to ceftriaxone were 52.2％and 76.4％in children,70.5％and 63.5％in adults.The prevalence of carbapenem-resistant E.coli and K.pneumoniae(CRKP)was 1.3％and 47.7％in children,6.4％and 47.9％in adults.The prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)and Pseudomonas aeruginosa(CRPA)was 74.0％and 37.1％in children,81.7％and 39.9％in adults.Conclusions The data derived from antimicrobial resistance surveillance are crucial for clinicians to make evidence-based decisions regarding antibiotic therapy.Attention should be paid to the Gram-negative bacteria,especially CRKP and CRAB in central nervous system(CNS)infections.Ongoing antimicrobial resistance surveillance is helpful for optimizing antibiotic use in CNS infections.

Objective To investigate the antimicrobial resistance of clinical isolates from elderly patients(≥65 years)in major medical institutions across China.Methods Bacterial strains were isolated from elderly patients in 52 hospitals participating in the CHINET Antimicrobial Resistance Surveillance Program during the period from 2015 to 2021.Antimicrobial susceptibility test was carried out by disk diffusion method and automated systems according to the same CHINET protocol.The data were interpreted in accordance with the breakpoints recommended by the Clinical and Laboratory Standards Institute(CLSI)in 2021.Results A total of 514 715 nonduplicate clinical isolates were collected from elderly patients in 52 hospitals from January 1,2015 to December 31,2021.The number of isolates accounted for 34.3％of the total number of clinical isolates from all patients.Overall,21.8％of the 514 715 strains were gram-positive bacteria,and 78.2％were gram-negative bacteria.Majority(90.9％)of the strains were isolated from inpatients.About 42.9％of the strains were isolated from respiratory specimens,and 22.9％were isolated from urine.More than half(60.7％)of the strains were isolated from male patients,and 39.3％isolated from females.About 51.1％of the strains were isolated from patients aged 65-＜75 years.The prevalence of methicillin-resistant strains(MRSA)was 38.8％in 32 190 strains of Staphylococcus aureus.No vancomycin-or linezolid-resistant strains were found.The resistance rate of E.faecalis to most antibiotics was significantly lower than that of Enterococcus faecium,but a few vancomycin-resistant strains(0.2％,1.5％)and linezolid-resistant strains(3.4％,0.3％)were found in E.faecalis and E.faecium.The prevalence of penicillin-susceptible S.pneumoniae(PSSP),penicillin-intermediate S.pneumoniae(PISP),and penicillin-resistant S.pneumoniae(PRSP)was 94.3％,4.0％,and 1.7％in nonmeningitis S.pneumoniae isolates.The resistance rates of Klebsiella spp.(Klebsiella pneumoniae 93.2％)to imipenem and meropenem were 20.9％and 22.3％,respectively.Other Enterobacterales species were highly sensitive to carbapenem antibiotics.Only 1.7％-7.8％of other Enterobacterales strains were resistant to carbapenems.The resistance rates of Acinetobacter spp.(Acinetobacter baumannii 90.6％)to imipenem and meropenem were 68.4％and 70.6％respectively,while 28.5％and 24.3％of P.aeruginosa strains were resistant to imipenem and meropenem,respectively.Conclusions The number of clinical isolates from elderly patients is increasing year by year,especially in the 65-＜75 age group.Respiratory tract isolates were more prevalent in male elderly patients,and urinary tract isolates were more prevalent in female elderly patients.Klebsiella isolates were increasingly resistant to multiple antimicrobial agents,especially carbapenems.Antimicrobial resistance surveillance is helpful for accurate empirical antimicrobial therapy in elderly patients.

Objective To investigate the distribution and antimicrobial resistance profiles of common pathogens isolated from cerebrospinal fluid(CSF)in CHINET program from 2015 to 2021.Methods The bacterial strains isolated from CSF were identified in accordance with clinical microbiology practice standards.Antimicrobial susceptibility test was conducted using Kirby-Bauer method and automated systems per the unified CHINET protocol.Results A total of 14 014 bacterial strains were isolated from CSF samples from 2015 to 2021,including the strains isolated from inpatients(95.3％)and from outpatient and emergency care patients(4.7％).Overall,19.6％of the isolates were from children and 80.4％were from adults.Gram-positive and Gram-negative bacteria accounted for 68.0％and 32.0％,respectively.Coagulase negative Staphylococcus accounted for 73.0％of the total Gram-positive bacterial isolates.The prevalence of MRSA was 38.2％in children and 45.6％in adults.The prevalence of MRCNS was 67.6％in adults and 69.5％in children.A small number of vancomycin-resistant Enterococcus faecium(2.2％)and linezolid-resistant Enterococcus faecalis(3.1％)were isolated from adult patients.The resistance rates of Escherichia coli and Klebsiella pneumoniae to ceftriaxone were 52.2％and 76.4％in children,70.5％and 63.5％in adults.The prevalence of carbapenem-resistant E.coli and K.pneumoniae(CRKP)was 1.3％and 47.7％in children,6.4％and 47.9％in adults.The prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)and Pseudomonas aeruginosa(CRPA)was 74.0％and 37.1％in children,81.7％and 39.9％in adults.Conclusions The data derived from antimicrobial resistance surveillance are crucial for clinicians to make evidence-based decisions regarding antibiotic therapy.Attention should be paid to the Gram-negative bacteria,especially CRKP and CRAB in central nervous system(CNS)infections.Ongoing antimicrobial resistance surveillance is helpful for optimizing antibiotic use in CNS infections.

Objective To investigate the antimicrobial resistance of clinical isolates from elderly patients(≥65 years)in major medical institutions across China.Methods Bacterial strains were isolated from elderly patients in 52 hospitals participating in the CHINET Antimicrobial Resistance Surveillance Program during the period from 2015 to 2021.Antimicrobial susceptibility test was carried out by disk diffusion method and automated systems according to the same CHINET protocol.The data were interpreted in accordance with the breakpoints recommended by the Clinical and Laboratory Standards Institute(CLSI)in 2021.Results A total of 514 715 nonduplicate clinical isolates were collected from elderly patients in 52 hospitals from January 1,2015 to December 31,2021.The number of isolates accounted for 34.3％of the total number of clinical isolates from all patients.Overall,21.8％of the 514 715 strains were gram-positive bacteria,and 78.2％were gram-negative bacteria.Majority(90.9％)of the strains were isolated from inpatients.About 42.9％of the strains were isolated from respiratory specimens,and 22.9％were isolated from urine.More than half(60.7％)of the strains were isolated from male patients,and 39.3％isolated from females.About 51.1％of the strains were isolated from patients aged 65-＜75 years.The prevalence of methicillin-resistant strains(MRSA)was 38.8％in 32 190 strains of Staphylococcus aureus.No vancomycin-or linezolid-resistant strains were found.The resistance rate of E.faecalis to most antibiotics was significantly lower than that of Enterococcus faecium,but a few vancomycin-resistant strains(0.2％,1.5％)and linezolid-resistant strains(3.4％,0.3％)were found in E.faecalis and E.faecium.The prevalence of penicillin-susceptible S.pneumoniae(PSSP),penicillin-intermediate S.pneumoniae(PISP),and penicillin-resistant S.pneumoniae(PRSP)was 94.3％,4.0％,and 1.7％in nonmeningitis S.pneumoniae isolates.The resistance rates of Klebsiella spp.(Klebsiella pneumoniae 93.2％)to imipenem and meropenem were 20.9％and 22.3％,respectively.Other Enterobacterales species were highly sensitive to carbapenem antibiotics.Only 1.7％-7.8％of other Enterobacterales strains were resistant to carbapenems.The resistance rates of Acinetobacter spp.(Acinetobacter baumannii 90.6％)to imipenem and meropenem were 68.4％and 70.6％respectively,while 28.5％and 24.3％of P.aeruginosa strains were resistant to imipenem and meropenem,respectively.Conclusions The number of clinical isolates from elderly patients is increasing year by year,especially in the 65-＜75 age group.Respiratory tract isolates were more prevalent in male elderly patients,and urinary tract isolates were more prevalent in female elderly patients.Klebsiella isolates were increasingly resistant to multiple antimicrobial agents,especially carbapenems.Antimicrobial resistance surveillance is helpful for accurate empirical antimicrobial therapy in elderly patients.

BACKGROUND:Emodin has a variety of pharmacological activities such as anti-inflammatory,anti-viral and anti-oxidative stress,and also has a certain protective effect on sepsis-induced myocardial injury,but its mechanism of action is still unclear.OBJECTIVE:To investigate whether emodin can improve myocardial injury in septic mice by promoting autophagy.METHODS:Thirty-two male Kunming mice were divided into sham operation group(n=4),sham operation+emodin group(n=4),model group(n=8),model+emodin group(n=8),and emodin+3-methyladenine group(n=8).The myocardial injury model of septic mice was constructed by cecal ligation and puncture.3-methyladenine(10 mg/kg)was injected intraperitoneally 1 hour before modeling.Emodin(20 mg/kg)was injected intraperitoneally 30 minutes before modeling,and the other groups were injected with the same amount of normal saline at the same time point.Blood and myocardial samples were collected from all mice 24 hours after surgery.ELISA was used to detect the levels of brain natriuretic peptide and cardiac troponin Ⅰ in serum.Western blot assay was used to detect the protein expression of LC3B,Beclin-1,and p62 in myocardial tissue.Hematoxylin-eosin staining was used to observe the pathological changes in myocardial tissue.Ultrasound was used to evaluate the cardiac function of mice.RESULTS AND CONCLUSION:(1)Compared with the sham operation group,there was no significant difference in the levels of serum brain natriuretic peptide,cardiac troponin Ⅰ,and the protein expression of myocardial autophagy proteins LC3Ⅱ/LC3Ⅰ and p62 in the sham operation+emodin group(P＞0.05).(2)Compared with the sham operation+emodin group,the levels of serum brain natriuretic peptide and cardiac troponin I were significantly increased in the model group(P＜0.05).Compared with the model group,the levels of serum brain natriuretic peptide and cardiac troponin I were decreased in the model+emodin group(P＜0.05).(3)Compared with the model group,the expression of LC3Ⅱ/LC3Ⅰ and Beclin-1 protein was increased and the expression of p62 protein was decreased in the myocardial tissue of the model+emodin group(P＜0.05).Compared with the model+emodin group,the expression of LC3Ⅱ/LC3Ⅰ and Beclin-1 protein decreased and the expression of p62 protein increased in the emodin+3-methyladenine group(P＜0.05).(4)The myocardial fibers in the sham operation group were normal,the myocardial fibers in the model group were disordered with a large number of inflammatory cell infiltration,the myocardial fibers in the model+emodin group were slightly disordered,and some vacuolar changes were observed.The myocardial fibers were disordered,and more inflammatory cell infiltration was observed in the emodin+3-methyladenine group.(5)Compared with the sham operation group,the left ventricular short axis shortening rate and left ventricular ejection fraction were decreased in the model group(P＜0.05).Compared with the model group,the left ventricular short axis shortening rate and left ventricular ejection fraction were increased in the model+emodin group(P＜0.05).Compared with the model+emodin group,the left ventricular ejection fraction of emodin+3-methyladenine group was decreased(P＜0.05),and the left ventricular short axis shortening rate was reduced but not statistically significant(P＞0.05).(6)The above results indicate that emodin pretreatment can improve myocardial injury and myocardial dysfunction in septic mice by promoting autophagy.

With the establishment of bio-psycho-social medical model,both social and psychological factors play an important role in the occurrence,development and treatment of diseases.Hypertension is a common chronic multiple disease in China,and patients are often complicated with depression and other e-motional disorders.The interaction between hypertension and depression significantly increases the risk of poor prognosis.Current studies have shown a bidirectional promoting relationship between hypertension and depression,and they have some com-mon pathogenesis.However,the specific mechanism of their co-morbidity has not been fully elucidated.Renin-angiotensin sys-tem(RAS)plays an important role in the regulation of hyperten-sion and depression and other emotions.It is composed of two antagonistic pathways.The balance is maintained by angioten-sin-converting enzyme 2(ACE2).Therefore,this article reviews the relationship and mechanism of RAS in hypertension,depres-sion and comorbid states,in order to provide new treatment ide-as for hypertension and depression.

Objective:To investigate the correlation between the types and quantities of immune cells in the graft and early immune reconstitution after allogeneic hematopoietic stem cell transplantation(allo-HSCT)and their influence on clinical prognosis.Methods:The clinical data of 83 patients with hematological diseases who received allo-HSCT in Shanxi Bethune Hospital from September 2020 to June 2023 were retrospectively analyzed.The number of mononuclear cells(MNC),CD34+cells and lymphocyte subsets(including CD3+T,CD3+CD4+T(Th),CD3+CD8+T(Ts),NK cells and B cells)infused into the recipients was counted,and the peripheral blood lymphocytes were detected before conditioning and on days 14,30,60 and 100 post-HSCT.Results:Multivariate analysis showed that the number of MNC in the graft affected the recovery of CD4+T lymphocytes after HSCT,and the number of CD4+T lymphocytes in the graft affected the recovery of NK cells and B cells after HSCT.The patient age,donor sex,stem cell source,degree of HLA matching,use of ATG before HSCT,the occurrence of acute graft-versus-host disease(aGVHD)after HSCT,and viral infection all affect the early cellular immune reconstitution post-HSCT.The number of infused cells had no significant impact on the median engraftment time for neutrophils and platelets after HSCT.Patients with lower numbers of CD3+T,CD4+T and B cells in the graft were more prone to viral infection after HSCT.However,the cells in the graft had no significant effect on disease recurrence or mortality.Conclusion:The recovery rate of lymphocyte count after allo-HSCT varies.The numbers of MNC and CD4+T cells in the graft may be related to the cellular immune reconstitution after HSCT,while the numbers of CD34+,CD3+T,CD8+T,NK and B cells have no significant effect on the cellular immune reconstruction.The numbers of CD3+T,CD4+T and B cells in the graft were negatively correlated with viral infection after HSCT,but the cellular components of the graft have no obvious influence on hematopoietic reconstitution,disease recurrence,death,recurrence-free survival(RFS)and overall survival(OS)after HSCT.