The incidence of early-onset gastric cancer (EOGC) is consistently increasing, and its etiology is notably complex. This increase may be attributed to distinctive factors that differ from those associated with late-onset gastric cancer (LOGC), including genetic predispositions, dietary factors, gastric microbiota dysbiosis, and screening of high-risk cases. These factors collectively contribute to the onset of cancer. EOGC significantly differs from LOGC in terms of clinicopathological and molecular characteristics. Moreover, multiple differences in prognosis and clinical management also exist. This study aimed to systematically review the latest research advancements in the epidemiological characteristics, etiological factors, clinicopathological and molecular features, prognosis, and treatment modalities of EOGC.

Methamphetamine abuse is a major public health problem in the world,and in recent years,methamphetamine is also the most abused synthetic drug in China.The neurotoxic or addiction mechanism of methamphetamine has not been fully clarified,and there is still a lack of specific withdrawal methods and drugs for methamphetamine abuse.Mitochondria are not on-ly the organelles to which methamphetamine directly produces toxic effects,but also participate in regulating the neurotoxic damage process of methamphetamine.Mitochondrial quality is the regulatory basis for maintaining mitochondrial homeostasis and is regulated by three main mechanisms,which are mitochon-drial biogenesis,mitochondrial dynamic,and mitophagy.This review summarizes the research progress of mitochondrial quality control in methamphetamine-induced neurotoxicity,which may provide theoretical support for further research on the mechanism of methamphetamine neurotoxicity and development the mito-chondria-targeting drugs.

Heme oxygenase-1(HO-1)is an inducible heme oxygenase and a catalytic enzyme for heme decomposition reactions,which can catalyze the heme decomposition into CO,biliverdin and Fe2+.HO-1 and its metabolites have anti-inflammatory,antioxidant and anti-apoptotic effects in human body,and play an important role in neurodegenerative diseases such as Alzheimer's disease,Parkinson's disease,amyotrophic lateral sclerosis,and Huntington's disease.This article will review the production,distribution,and gene structure of HO-1,the biological characteristics of its metabolites,and the role and mechanism of HO-1 in neurodegenerative diseases,in order to provide a theoretical basis for the clinical application of HO-1.

Objective To investigate the effects of AIDS and tuberculosis(TB)co-infection on CD8+T lymphocytes.Methods Serum CD8+T cells and CD4+T cells were analyzed and compared between human immunodeficiency virus(HIV)alone patients(n=200),TB alone patients(n=200),and HIV/TB co-infection patients(n=200).Results CD8+T cells were significantly higher in HIV alone group compared to HIV/TB co-infection group and TB alone group(x2=128.779,P＜0.001).The level of CD8+T lymphocytes in HIV/TB co-infection group and HIV alone group was higher than normal level(ZHIV/TB=8.343,PHIV/TB＜0.001,ZHIV=7.988,PHIV＜0.001).The CD8+T cells in TB alone group decreased significantly compared with normal levels(ZTB=8.682,PTB＜0.001).The levels of CD4+T cells in the three groups of patients were all lower than normal(ZHIV=11.088,PHIV＜0.001,ZTB=5.562,PTB＜0.001,ZHIV/TB=12.077,PHIV/TB＜0.001).The stratified analysis of CD8+T cell levels by CD4+T cell counts,showed that when CD4+T cell count was≤100 cells/μL,the level of CD8+T cells in HIV alone group was higher than that in TB alone group.HIV alone group had higher CD8+T cells than HIV/TB co-infection group,and the level of CD8+T cells in HIV/TB co-infection group was significantly lower than normal(Z0-100=1.604,P0-100=0.109).When CD4+T cells ≥101 cells/μL,HIV/TB co-infection group had higher CD8+T cells than TB alone group.HIV alone group had higher CD8+T cells than TB alone group.When CD4+T cells＞500 cells/μL,CD8+T cell levels were within the normal range in all three groups of patients.Taking the HIV alone group as a reference,with the decrease of CD4+T cell count,the CD8+T cell count decreased more significantly in TB alone group and HIV/TB co-infection group than in HIV alone group(slope was 0.344 and 0.216,respectively,P＜0.001).Conclusions With the decline of CD4+T cells,both HIV/TB co-infection and TB alone are associated with decrease in CD8+T cells,and the decrease in the TB alone group is more prominent.

This study was aimed at analyzing the Salmonella infection rate,serotype distribution,and drug resistance rate among children with foodborne diseases in Wuhan,to provide evidence for the prevention and control of foodborne diseases in children.We collected pediatric cases of foodborne diseases and fecal specimens in Wuhan from 2017 to 2022,and conducted statistical analysis in SPSS 22.0.A total of 1 180 cases of foodborne diseases in children were monitored,and 281 strains of Salmonella were detected.Salmonella was distributed across 27 serotypes,primarily Salmonella enteritidis(138 strains,ac-counting for 49.11％)and Salmonella typhimurium(37 strains,accounting for 13.17％).The Salmonella-positive cases in-cluded more boys than girls(1.58∶1 ratio),and the age group with the highest detection rate was 7-18 years(34.48％).The proportion of positive patients gradually decreased,and the detection rate gradually increased,with increasing age.Milk and dairy products,fruits and fruit products,and grain and grain products were the main suspected food exposures with high Sal-monella detection rates.The Salmonella detection rate was highest in the third quarter(44.64％),and significant differences were observed in the positivity rates of Salmonella samples across seasons(x2=178.483,P＜0.05).The main clinical mani-festations of children with Salmonella infection were fever(87.19％)and diarrhea(96.44％),primarily watery stool(51.96％).Salmonella showed different degrees of resistance to 14 antibiotics(1.08％-75.99％),primarily ampicillin(75.99％),tetracycline(68.10％),and cefazolin(50.18％).A significant seasonal pattern was observed in the detection of Sal-monella in foodborne diseases among children in Wuhan,and in various suspected food exposures.The serotype composition was polymorphic,and the Salmonella resistance rate was relatively high.Therefore,active monitoring of foodborne diseases and Salmonella resistance surveillance must continue to be strengthened.

AIM To investigate the renoprotective effects and mechanism of Caragana sinica roots,Astragali Radix and their combination use on the rat model of diabetic kidney disease(DKD).METHODS Sixty SD rats were randomly divided into the normal group,the model group,the Empagliflozin group(10 mg/kg),the C.sinica roots group(3.1 g/kg),the Astragali Radix group(3.1 g/kg),and the C.sinica roots plus Astragali Radix group(6.2 g/kg).In contrast to the intact rats of the normal group,rats of the other groups underwent left nephrectomy and intraperitoneal injection of streptozotocin(STZ)followed by 8-week intragastric gavage of the corresponding agent,during which their levels of FBG and 24 h urinary microprotein(24 h U-mAlb)were detected regularly.The rats killed at the end of the trial had their levels of Scr,BUN and Cystatin C detected;their renal pathological changes observed by HE,PAS and Masson stainings;their expressions of macrophage marker proteins CD68 and iNOS detected by immunohistochemistry;their expressions of renal JNK/SAPK pathway proteins such as JNK,p-JNK,TNF-α,IL-1β and ICAM-1 detected by Western blot;and their serum levels of TNF-α,IL-1β and ICAM-1 detected by ELISA as well.RESULTS Compared with the normal group,the model group displayed increased levels of FBG,24 h U-mAlb,BUN,Scr and Cystatin C(P＜0.01);more renal pathological damage,and increased levels of TNF-α,IL-1β and ICAM-1 in the renal tissue and serum(P＜0.01);and increased renal protein expressions of JNK and p-JNK(P＜0.01).Compared with the model group,all of the groups intervened with an agent shared decreased levels of FBG,24 h U-mAlb,BUN,Scr and Cystatin C(P＜0.05,P＜0.01);alleviated renal pathological damage,and decreased levels of TNF-α,IL-1β and ICAM-1 in renal tissue and serum(P＜0.01).There existed no group difference between the Astragali Radix group and the C.sinica roots group in terms of all indices levels(P＞0.05).The C.sinica roots plus Astragali Radix group demonstrated its superiority over either C.sinica roots group or Astragali Radix group in terms of all the indices levels(P＜0.05,P＜0.01).CONCLUSION C.sinica roots,Astragali Radix or their combination use can alleviate the renal pathological damage and improve the renal function of DKD rats through inhibiting the M1 macrophages,reducing the secretion of inflammatory factors,whose mechanism may lie in the inhibition of JNK/SAPK signal pathway activation.A better effect can be anticipated by the combination use of C.sinica roots and Astragali Radix.

AIM To investigate the impact of the combination use of Caragana sinica Radix and Astragali Radix on a rat model of diabetic kidney disease(DKD).METHODS The SD rats were randomly divided into the normal group,the model group,the Engelgin group,the Caragana sinica Radix group,the Astragali Radix group and the Caragana sinica Radix-Astragali Radix compatibility group,with 10 rats in each group.Following the successful establishment of a DKD model by unilateral amputate renal combined with intraperitoneal injection of streptozotocin(STZ),the corresponding gastric gavage of drugs were administered for 8 weeks.The rats had their 24 h urinary microalbumin(24 h U-mALB)detected at 0,4 and 8 weeks;their levels of Scr,BUN,CysC,MDA and SOD activity detected by ELISA;their renal ROS expression detected by fluorescence probe method;their renal pathological changes observed by HE,PAS,Masson and PASM-Masson staining;their renal expressions of NOX4,Drp1,MFN2 and P62 detected by immunohistochemistry;and their renal expressions of PINK1,MFN2,Parkin,LC3-Ⅱ/Ⅰ,P62 and p-Drp1 proteins detected by Western blot.RESULTS Compared with the model group,each treatment group displayed lower contents of 24 h U-mALB,BUN,Scr and CysC in the serum of rats(P＜0.01);reduced pathological structure damage of the renal tissue;decreased MDA level in serum and kidney(P＜0.01);increased SOD activity(P＜0.01);increased renal protein expressions of PINK1,MFN2,Parkin and LC3-Ⅱ/Ⅰ(P＜0.05,P＜0.01);and decreased protein expressions of p-Drp1 and P62(P＜0.01).And the Astragali Radix group and the Caragana sinica Radix-Astragali Radix compatibility group took the lead(P＜0.05,P＜0.01).CONCLUSION Upon the rat model of DKD,the compatibility of Caragana sinica Radix and Astragali Radix may alleviate their renal pathological damage and improve their renal function by activating the mitochondrial autophagy to improve mitochondrial dynamics and inhibit their oxidative stress via PINK1/MFN2/Parkin pathway.

Objective:This study aims to explore the connotation and importance of clinical research infrastructure, elucidate the key points and operational models of clinical research wards, and summarize the experiences and practices of clinical research wards at Peking Union Medical College Hospital.Methods:The study employed on-site investigations and literature reviews to analyze the construction models and key features of clinical research wards in various medical institutions.Results:Additionally, it introduced advanced experiences from foreign centers and examined the challenges encountered during the process.Conclusions:As a phased achievement, it presents the experience and practices of Peking Union Medical College Hospital in constructing and operating clinical research wards based on National Facility for Translational Medicine (PUMCH). The construction of clinical research facilities and clinical research wards should focus on facility positioning, talent pool, financial investment, management operation, and information systems. This study provides references for the future construction, operation, and development of clinical research facilities.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To discuss the regulatory effect of physiological tensile stress on the differentiation of chondrocytes,and to clarify the associated signaling pathway mechanism.Methods:The ATDC5 chondrocytes were cultured in vitro and subjected to physiological tensile stress by four-point bending cell mechanical loading device.Initially,the cells were divided into control group and tensile stress group(2 000 μstrain/2 h group),and further divided into different stress magnitudes(1 000,2 000,and 3 000 μstrain)for 2 h,and 2 000 μstrain for different duration time(1,2,and 4 h)groups;the cells without tensile stress were used as control group.Real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the expression levels of type Ⅱ collagen(Col-Ⅱ),type Ⅹ collagen(Col-Ⅹ),aggregated proteoglycom(Aggrecan),sex-determining region Y-box protein 9(SOX9),vascular endothelial growth factor(VEGF),proliferating cell nuclear antigen(PCNA),Nel-like molecule tyep 1(Nell-1),Runt-related transcription factor 2(Runx2),Indian hedgehog(Ihh),patched homolog 1(Ptch-1),GLI family zinc finger protein 1(Gli-1),and hedgehog interacting protein 1(Hhip-1)mRNA in the cells in various groups;Western blotting method was used to detect the expression levels of Nell-1,Runx2,and Ihh proteins in the cells in various groups.The ATDC5 cells were divided into control group,cyclopamine group,tensile stress group,and cyclopamine + tensile stress group.RT-qPCR method was used to detect the expression levels of Nell-1,Ihh,Ptch-1,Gli-1,and Hhip-1 mRNA in the cells in various groups;Western blotting method was used to detect the expression levels of Nell-1 and Ihh proteins in the cells in various groups.Results:Compared with control group,the expression levels of Col-Ⅱ,Col-Ⅹ,Aggrecan,SOX9,VEGF,and PCNA mRNA in the cells in 2 000 μstrain/2 h group were significantly increased(P<0.01);after treated with 2 000 μstrain tensile stress for different duration time(1,2,and 4 h)or different tensile stresses(1 000,2 000,and 3 000 μstrain)for 2 h,compared with control group,the expression levels of Runx2 mRNA in the cells in other groups were increased with the prolongation of time or the increasing of tensile stress(P<0.01),and the expression levels of Nell-1,Ihh,Ptch-1,Gli-1,and Hhip-1 mRNA were gradually increased(P<0.01),the expression levels reached the peaking at 2 000 μstrain/2 h,and then decreased but remained significantly higher than that in control group(P<0.01).The Western blotting results showed that the expression levels of Nell-1,Runx2,and Ihh proteins in the cells were consistent with the change trend of mRNA expression levels.After pre-treated with cyclopamine,compared with control group,the expression levels of Ihh,Ptch-1,Gli-1,and Hhip-1 mRNA in the cells in cyclopamine group were significantly decreased(P<0.01),and the expression levels of Ihh,Ptch-1,Gli-1,and Hhip-1 mRNA in the cells in tensile stress and cyclopamine+tensile stress groups were significantly increased(P<0.01);compared with cyclopamine group,the expression levels of Nell-1,Ihh,Ptch-1,Gli-1,and Hhip-1 mRNA in the cells in cyclopamine+tensile stress group were significantly increased(P<0.01);compared with tensile stress group,the expression levels of Ihh,Ptch-1,Gli-1,and Hhip-1 mRNA in the cells in cyclopamine + tensile stress group were significantly decreased(P<0.01).Compared with control group,the expression level of Ihh protein in the cells in cyclopamine group was significantly decreased(P<0.01),but there was no significant difference in expression level of Nell-1 protein in the cells between control group and cyclopamine group(P>0.05),while the expression levels of Nell-1 and Ihh proteins in the cells in tensile stress group and cyclopamine + tensile stress group were significantly increased(P<0.01);compared with cyclopamine group,the expression levels of Nell-1 and Ihh proteins in the cells in tensile stress group and cyclopamine + tensile stress group were significantly increased(P<0.01);compared with tensile stress group,in the expression levels of Nell-1 and Ihh proteins in the cells in cyclopamine + tensile stress group had no significant differences(P>0.05).Conclusion:After stimulated with physiological tensile stress,Nell-1 can activate the Ihh signaling pathway upstream,and regulate the differentiation of the ATDC5 chondrocytes.