Diabetic kidney disease （DKD） is one of the most common microvascular complications of diabetes. Traditional Chinese medicine （TCM） plays a unique role in improving clinical symptoms， reducing proteinuria， and delaying the initiation of dialysis. Over time， scholars have held diverse views on the etiology， pathogenesis， and treatment strategies of DKD. This paper systematically reviews the etiology and pathogenesis， syndrome differentiation and treatment， and medication rules of DKD， aiming to provide a reference for clinical practice. Regarding etiology， DKD is closely related to insufficient innate endowment， improper diet， emotional disorders， overexertion， and prolonged diabetes. Its pathogenesis evolves dynamically. Specifically， early stage is characterized by Yin deficiency with dryness-heat and subtle discharge. Middle stage involves both Qi and Yin deficiency with dampness and blood stasis. Late stage presents Yin and Yang deficiency with intrinsic turbidity toxins. Blood stasis and sugar toxicity are the core pathological factors， persisting throughout the disease course and accelerating renal collateral damage and fibrosis. In terms of diagnosis and treatment， contemporary scholars advocate stage-specific treatment， emphasize the integration of prevention and therapy， recommend whole-course management， and support comprehensive TCM and Western medicine approaches. Analysis of medication rules shows that treatment consistently addresses the core principle of deficiency at the root and excess at the surface， strengthens the body while dispelling pathogenic factors， emphasizes promoting blood circulation and removing blood stasis， consolidates the kidney and astringes essence， clears Fu-organs and eliminates turbidity and toxins， invigorates the spleen， replenishes Qi， protects the stomach， and advocates treatment based on pathogenic wind. Further refinement of the academic thoughts of classical TCM masters and research into innovative pathogenesis theories and clinically effective prescriptions are needed to enhance TCM's ability to prevent and treat major clinical diseases， including DKD.

OBJECTIVE: To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) on postoperative pain in patients undergoing modified radical mastectomy for breast cancer. METHODS: A total of 140 female patients scheduled for unilateral modified radical mastectomy for breast cancer undergoing general anesthesia were randomized into a TEAS group (70 cases) and a sham TEAS group (70 cases, 2 cases dropped out). Patients in both groups received TEAS or sham TEAS at bilateral Neiguan (PC6), Zusanli (ST36), and Danzhong (CV17), respectively, from 30 min before anesthesia induction until the end of surgery, and on 1st, 2nd, and 3rd days after surgery for 30 min a time, once a day. On 1st, 2nd, and 3rd days after surgery, the pain visual analogue scale (VAS) score was observed; on 3, 6, 12 months after surgery, the incidence rate of chronic pain was observed; before surgery, and on 1st, 3rd, and 7th days after surgery, the serum levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-10 were detected; the number of analgesia pump press, rescue analgesia, and the occurrence of adverse reaction after surgery were recorded in the two groups. RESULTS: In the TEAS group, the VAS scores on 1st and 2nd days after surgery, and the incidence rates of chronic pain on 3 and 6 months after surgery were lower than those in the sham TEAS group (P<0.05). On 1st, 3rd, and 7th days after surgery, the serum levels of TNF-α, IL-6, and IL-10 were increased compared with those before surgery in both groups (P<0.05, P<0.01); the above indexes in the TEAS group were lower than those in the sham TEAS group (P<0.05). The number of analgesia pump press and the incidence rate of rescue analgesia after surgery in the TEAS group were lower than those in the sham TEAS group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions after surgery between the two groups (P>0.05). CONCLUSION TEAS can effectively improve both the postoperative acute pain and chronic pain in patients undergoing modified radical mastectomy for breast cancer, the mechanism may relate to inhibiting the inflammatory reaction.
Humans ; Female ; Acupuncture Points ; Pain, Postoperative/blood* ; Middle Aged ; Breast Neoplasms/surgery* ; Adult ; Transcutaneous Electric Nerve Stimulation ; Mastectomy, Modified Radical/adverse effects* ; Interleukin-6/blood* ; Tumor Necrosis Factor-alpha/blood* ; Interleukin-10/blood* ; Aged

OBJECTIVES: To investigate the changes in blood levels of calcium and bone metabolism biochemical markers in patients with primary osteoporosis receiving treatment with denosumab. METHODS: Seventy-three patients with primary osteoporosis treated in our Department between December, 2021 and December 2023 were enrolled. All the patients were treated with calcium supplements, vitamin D and calcitriol in addition to regular denosumab treatment every 6 months. Blood calcium, parathyroid hormone (PTH), osteocalcin (OC), type I procollagen amino-terminal propeptide (PINP), and type I collagen carboxy-terminal telopeptide β special sequence (β‑CTX) data before and at 3, 6, 9, and 12 months after the first treatment were collected from each patient. RESULTS: Three months after the first denosumab treatment, the bone turnover markers (BTMs) OC, PINP, and β-CTX were significantly decreased compared to their baseline levels by 39.5% (P<0.001), 56.2% (P<0.001), and 81.8% (P<0.001), respectively. At 6, 9, and 12 months of treatment, OC, PINP, and β-CTX remained significantly lower than their baseline levels (P<0.001). Blood calcium level was decreased (P<0.05) and PTH level increased (P<0.05) significantly in these patients at months of denosumab treatment, but their levels were comparable to the baseline levels at 6, 9, and 12 months of the treatment (P>0.05). CONCLUSIONS Denosumab can suppress BTMs and has a good therapeutic effect in patients with primary osteoporosis, but reduction of blood calcium and elevation of PTH levels can occur during the first 3 months in spite of calcium supplementation. Blood calcium and PTH levels can recover the baseline levels as the treatment extended, suggesting the importance of monitoring blood calcium and PTH levels during denosumab treatment.
Humans ; Denosumab/therapeutic use* ; Calcium/blood* ; Parathyroid Hormone/blood* ; Biomarkers/blood* ; Osteoporosis/blood* ; Osteocalcin/blood* ; Procollagen/blood* ; Female ; Collagen Type I/blood* ; Peptide Fragments/blood* ; Bone Density Conservation Agents/therapeutic use* ; Bone and Bones/metabolism* ; Male ; Middle Aged ; Vitamin D ; Peptides/blood* ; Aged

Objective:To validate and evaluate the performance of opened reagent warehouse of VITROS 5600 full automatic dry biochemical immunoassay analyzer,which carried domestic serum cystatin C(Cys C)kit of Lidman.Methods:The precision,correctness,linear range,the maximum dilution and biological reference interval of Cystatin C were validated according to evaluation criteria of the National Committee for Clinical Laboratory Standardization(NCCLS)for instrument,which also referred to,and others.Results:①Precision measurement results:the Sintra-assay of cystatin C were respectively 0.046 and 0.147,and the Sindoor were respectively 0.046 and 0.130,which were less than those of the Sintra-assay of the manufacturer's statement(0.083,0.178),and the requirement of industry standard for Sindoor(0.100,0.213)of imprecision.②Correctness:The absolute value|b|of bias of detecting standard substances of five concentration levels were respectively 0.032,0.014,0.062,0.013,and 0.200,all of which were less than the prescribed bias in the industry standards(0.04,0.08,0.16,0.32,0.64).③Linear range:The linear regression equation was y=1.011 2x+0.111,R2=0.997 4,showing a linear relationship.④The cystatin C:the measurement range was 0.51-7.66 mg/L,and the maximum acceptable dilution was 2-fold,and the clinically reportable range was 0.51～15.32 mg/L;⑤Biological reference interval validation:All the detection values of cystatin C of the health population(the age of 40 cases≤50 years old,and that of 20 cases>50 years old)were within the claimed reference intervals of manufactory.Conclusion:The precision,correctness,linear range and biological reference interval of the opened reagent warehouse of VITROS 5600 full automatic dry biochemical immunoassay analyzer,which carried Liedemann serum cystatin C kit,can meet the experimental requirements in clinical application,and can be used in detecting clinical routine specimen.

Objective To investigate the effects of dapagliflozin on the risk of malignant ventricular arrhythmia(MVA)during hospitalization in patients with acute myocardial infarction(AMI).Methods A retrospective study was conducted to select patients with AMI who underwent percutaneous coronary intervention(PCI)in the department of cardiology of the Third Affiliated Hospital of Nanjing Medical University between January 2018 and November 2023.Clinical datas collected during hospitalization included demographics(gender,age),baseline vital signs(systolic blood pressure,diastolic blood pressure,heart rate),comorbidities(hypertension,diabetes mellitus),body mass index(BMI),smoking,alcohol consumption,ST segment elevation myocardial infarction(STEMI),Killip class≥3,laboratory parameters[white blood cell count(WBC),neutrophil percentage(NEU%),serum creatinine(SCr)],procedural data(number of coronary stents implanted,culprit vessels being the left main coronary artery,left anterior descending artery,right coronary artery,left circumflex artery and intraoperative hypotension),medications[angiotensin converting enzyme inhibitor/angiotensinⅡreceptor blocker(ACEI/ARB),β-blockers,aspirin,ticagrelor,clopidogrel,platelet glycoproteinⅡb/Ⅲa receptor antagonists,Statin],and electrocardiogram characteristics[the number of cases frequent ventricular premature contractions(premature beats)and the number of cases of sinus rhythm].The study endpoint was the occurrence of MVA during hospitalization among enrolled patients.Patients were categorized into the MVA group and the non-MVA group based on the occurrence of MVA during their hospital stay.Differences in clinical characteristics between the two groups were compared.Univariate and multivariate Logistic regression analyses were employed to evaluate the impact of dapagliflozin use on the risk of MVA in patients with AMI.Results A total of 2 893 eligible AMI patients were enrolled and 145 patients(5.01%)experienced MVA during hospitalization.Compared with the MVA group,the proportion of patients taking dapagliflozin was higher in the non-MVA group[13.2%(363/2 748)vs.6.2%(9/145),P=0.014],the proportion of males was higher[74.3%(2 042/2 748)vs.66.9%(97/145),P=0.048],the age was younger(years:64.82±13.91 vs.69.78±14.07,P<0.001),the heart rate at admission was slower(beats/min:80.09±15.72 vs.84.31±20.92,P=0.002),the proportion of patients with Killip grade≥3 was lower[11.5%(317/2 748)vs.38.6%(56/145),P<0.001],the proportion of smoking patients was higher[48.0%(1 319/2 748)vs.33.8%(49/145),P<0.05],SCr level was lower(μmol/L:84.73±58.52 vs.102.87±59.47,P<0.001),and the proportion of patients taking ACEI/ARB and β-blockers was higher[64.9%(1 783/2 748)vs.49.0%(71/145),65.1%(1 788/2 748)vs.53.8%(78/145),both P<0.05],the rate of frequent premature ventricular beats was lower[1.0%(28/2 748)vs.11.7%(17/145),P<0.05],and the proportion of patients with intraoperative hypotension was lower[3.2%(86/2 748)vs.10.6%(15/145),P<0.05].After adjusting numerous confounding factors,multifactorial Logistic regression analysis showed that dapagliflozin may significantly reduced the risk of MVA in patients with AMI after PCI[odds ratio(OR)=0.417,95%confidence interval(95%CI)was 0.200-0.880,P=0.022].Subgroup analysis suggested that there were 1 042 AMI patients with diabetes mellitus,of whom 348 took dapagliflozin,and 8 patients(2.30%)had MVA.The risk of MVA was reduced in patients taking dapagliflozin(Log-Rank:χ2=11.983,P=0.001).Conclusion The use of dapagliflozin significantly reduced the risk of MVA during hospitalization in patients with AMI.

Glucose transporters (GLUTs) are pivotal membrane proteins that facilitate the passive transport of glucose into cells. However, their aberrant overexpression is closely linked to the Warburg effect and chemotherapy resistance of tumors. GLUTs are complex multi-pass transmembrane proteins that require detergents for extraction from the cell membrane during preparation. The persistent presence of detergents in the sample can disrupt lipid-protein interactions, potentially leading to conformational distortion and functional losses of GLUTs, severely hindering the research into their structures and transport mechanisms. To eliminate detergent interference and preserve its authentic conformation, this study employs nanodisc technology and utilizes the self-assembly of the membrane scaffold protein MSP1E3D1 and phospholipids to produce a biomimetic membrane environment, thereby overcoming the limitations of conventional methods. The C-terminal His10-tagged GLUT1 was heterologously expressed in the insect cell Sf9/Bac-to-Bac system, and the GLUT1-nanodisc complex was obtained after detergent solubilization, affinity chromatography purification via anti-His antibody resin, and self-assembly. The successfully reconstituted nanodisc complex was further purified by Ni-NTA affinity chromatography. Nanodisc reconstitution produced monodisperse GLUT1 particles that retained native secondary structure, as confirmed by far-UV circular dichroism (CD) spectroscopy and dynamic light scattering (DLS). Unlike conventional detergent micelles, which lack a true lipid bilayer, distort transmembrane-helix topology, and occlude ligand-binding sites, the nanodisc platform embeds GLUT1 in a phospholipid bilayer that preserves its authentic conformation while eliminating detergent interference. The resulting GLUT1-nanodisc complex is therefore a superior scaffold for high-resolution cryo-EM structural analysis, permitting detailed interrogation of the transporter's conformational cycle, its interactions with partner proteins, and downstream structure-guided, high-throughput drug screening.
Nanostructures/chemistry* ; Glucose Transporter Type 1/biosynthesis* ; Humans ; Animals ; Phospholipids/chemistry* ; Detergents/chemistry*

Objective To investigate the expression and prognostic value of heat shock protein B7(HSPB7)in gastric cancer.Methods Immunohistochemistry SP was used to detect HSPB7 and p53 protein expression in 73 cases of gastric cancer and adjacent normal tissues,and their relationships with clinicopatho-logical parameters were analyzed.Spearman's rank correlation analysis was performed to analyze their correla-tion.Kaplan-Meier survival curves and Log-rank tests were used for survival analysis,and a Cox proportional hazards model was applied to analyze prognostic factors.qPCR was used to determine HSPB7 mRNA expres-sion in 22 cases of gastric cancer and normal gastric tissues,and differences between cancer and normal tissues were analyzed.Data from The Cancer Genome Atlas(TCGA)database were used to further analyze HSPB7 mRNA expression differences between gastric cancer and normal tissues and their relationship with clinico-pathological parameters.Results HSPB7 was mainly localized in the cytoplasm,and its expression in gastric cancer tissues was significantly lower than that in adjacent normal tissues(P<0.05),and its expression in gastric cancer tissues was related to TNM stage,tumor invasion depth,differentiation degree and lymph node metastasis(P<0.05).The expression of p53 in gastric cancer was significantly higher than that in adjacent normal tissues(P<0.05),and the expression in gastric cancer tissues was correlated with TNM stage,tumor invasion depth and differentiation degree(P<0.05).Spearman rank correlation analysis showed that the ex-pressions of HSPB7 and p53 were negatively correlated in gastric cancer(r=-0.351,P=0.002).The 5-year survival rate of patients in the positive group was significantly higher than that in the negative group(χ2=10.611,P<0.001).Compared with gastric cancer tissues,the mRNA expression level of HSPB7 in adjacent normal tissues was significantly higher(t=-6.180,P<0.001).The results of bioinformatics analysis showed that the mRNA expression of HSPB7 in normal gastric samples was significantly higher than that in gastric cancer samples(P<0.001),and it was related to age,pathological stage and T stage(P<0.05).Conclusion HSPB7 protein is expressed at low levels in gastric cancer tissues,and it is closely related to the clinicopathological pa-rameters and prognosis of gastric cancer patients,which may be used as a predictive index of gastric cancer malignancy.In gastric cancer tissues,they may have antagonistic effects in tumor progression,and their related signaling pathways need to be further explored.

Yttrium-90(90Y)selective internal radiation therapy(SIRT)is an emerging modality for the treatment of hepatocellular carcinoma(HCC),leveraging the nuclide 90Y to deliver targeted radiation therapy.90Y has a long half-life and can be used to selectively ablate tumor cells by high-energy beta rays.It has high biological effectiveness and robust local control capabilities.In recent years,with the continuous advancement of basic and clinical research,the application of 90Y-SIRT in the conversion treatment of unresectable HCC(uHCC)has made significant progress.However,challenges remain in the clinical application of 90Y-SIRT,including how to improve the efficacy of conversion therapy and how to optimize therapy regimens.This review aims to summarize the research progress of90Y-SIRT in the conversion therapy of uHCC.

Objective:To construct and verify a nomogram prediction model basing on the influencing factors of the ac-tivity of daily living(ADL)disorders in ischemic stroke(IS),providing evidences for the early clinical imple-mentation of efficient rehabilitation therapies.Method:We retrospectively collected clinical data of 401 IS patients hospitalized in the department of Rehabili-tation of Guangdong Provincial Hospital of Chinese Medicine from January 2019 to December 2022,focusing on factors that may influence their ADL.These patients were randomly divided into the training(280 cases)and the validation(121 cases)sets according to 7∶3.We used univariate and multivariate logistic regression to analyze the influencing factors for the occurrence of ADL disorders in IS patients,and established the risk pre-diction model for the occurrence of ADL disorders by a visualized nomogram.The performance of this predic-tion model was assessed by the area under the curve(AUC),specificity,sensitivity,and calibration curve.Result:The results of multivariate logistic regression analysis in the training sets showed that age,diabetes mellitus,NIHSS score,FMA score,Hb,PLT,and HDL were independent influencing factors for the occur-rence of ADL disorders in IS patients.The nomogram model was constructed with the above 7 factors.The AUC,specificity,and sensitivity of this model were 0.875,82.8%,and 75.4%in the validation set,respec-tively,indicating that the model has a good discriminative ability.The calibration curve showed that the mod-el agrees well with the actual predicted probability.Conclusion:The nomogram risk prediction model constructed in this study can effectively predict the probabili-ty of ADL disorder in IS patients,aiding medical staff in implementing early rehabilitation intervention as early as possible and reduce the occurrence of ADL disorder.