ObjectiveTo investigate the risk factors for post-acute pancreatitis diabetes mellitus （PPDM-A） in patients with acute pancreatitis （AP）， to construct a nomogram prediction model， and to provide a reference for the development of individualized treatment regimens. MethodsA total of 351 patients with AP who were admitted to Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University from June 2021 to January 2025 were prospectively enrolled， and they were randomly divided into modeling group with 246 patients and validation group with 105 patients at a ratio of 7∶3. According to the presence or absence of PPDM-A in the patients with AP， the modeling group was further divided into PPDM-A group with 86 patients and non-PPDM-A group with 160 patients. Clinical data were collected from all patients. The least absolute shrinkage and selection operator （LASSO） regression analysis was used to determine independent variables， and a Logistic regression analysis was used to investigate the influencing factors for PPDM-A. R software was used to construct a nomogram model. The receiver operating characteristic curve was used to assess the discriminatory ability of the model， and the Hosmer-Lemeshow test was used to test the model fitting degree， and the calibration curve was used to evaluate the model consistency； and decision curve analysis （DCA） was used to assess its clinical application value. The independent-samples t test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between two groups. ResultsAmong the 246 patients， 86 developed PPDM-A， resulting in an incidence rate of 34.96%. There were significant differences between the PPDM-A group and the non-PPDM-A group in the proportion of patients with an age of ≥60 years （65.12% vs 40.62%， P<0.05）， male sex （75.58% vs 55.63%， P<0.05）， a body mass index （BMI） of ≥24 kg/m² （63.95% vs 37.50%， P<0.05）， alcoholic AP （56.98% vs 36.87%， P<0.05）， moderate-to-severe AP （54.65% vs 35.00%， P<0.05）， or a computed tomography severity index （CTSI） score of ≥4 points （48.84% vs 28.75%， P<0.05）， as well as significant differences in the levels of blood calcium （1.46±0.35 mmol/L vs 1.89±0.37 mmol/L， P<0.05） and random blood glucose （Glu） （17.68±4.12 mmol/L vs 11.68±4.27 mmol/L， P<0.05）. The LASSO regression analysis obtained 8 independent variables. The Logistic regression analysis showed that age， sex， BMI， alcoholic AP， moderate-to-severe AP， CTSI score， and Glu were risk factors for PPDM-A （all P<0.05）， while blood calcium was a protective factor （P<0.05）. The model had an area under the ROC curve （AUC） of 0.932 （95% confidence interval ［CI］： 0.903 — 0.962） in the modeling group， and the Hosmer-Lemeshow goodness-of-fit test yielded χ²=7.346 （P=0.728）， the accuracy of model fitting was good； the calibration curve showed that the predicted probability was consistent with the actual probability， indicating that the consistency was good. The model had an AUC of 0.835 （95%CI： 0.753 — 0.917） in the validation group， and the Hosmer-Lemeshow goodness-of-fit test yielded χ²=7.014 （P=0.711）， the accuracy of model fitting was good； the calibration curve showed that the predicted probability was consistent with the actual probability， indicating that the consistency was good. The DCA results of the modeling group showed that the model exhibited a high clinical value in evaluating PPDM-A when the threshold probability was 0.13 — 0.94. ConclusionAge， sex， BMI， alcoholic AP， moderate-to-severe AP， blood calcium， CTSI score， and Glu are influencing factors for PPDM-A. The nomogram model constructed based on the above influencing factors shows good performance in predicting the risk of PPDM-A and can thus provide a reference for developing prevention strategies for PPDM-A in clinical practice.

ObjectiveTo clarify the anti-inflammatory and lung-protective effects of Yantiao prescription on lipopolysaccharide （LPS）-induced acute lung injury （ALI）， and to explore the impact of Yantiao prescription on the metabolic pathways of arachidonic acid （AA） in vivo. MethodsThirty male C57BL/6J mice were randomly divided into the following groups based on body weight： normal group， model group， dexamethasone group （2 mg·kg^-1）， low-dose Yantiao prescription group （18 g·kg^-1）， and high-dose Yantiao prescription group （36 g·kg^-1）， with 6 mice in each group. The ALI mouse model was established by intraperitoneal injection of LPS. The treatment groups received oral gavage once a day for 7 consecutive days， and serum and lung tissue were collected at the end of the experiment. The content of pro-inflammatory cytokines tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， and interleukin-6 （IL-6） in serum was detected by enzyme-linked immunosorbent assay （ELISA）. Hematoxylin-eosin （HE） staining was used to assess lung tissue pathology. The wet/dry weight ratio （W/D） and myeloperoxidase （MPO） activity in lung tissue were measured. The content of AA metabolites in serum and lung tissue was measured by liquid chromatography triple quadrupole-mass spectrometry （LC-MS/MS）. ResultsCompared with the conditions in the normal group， the content of serum pro-inflammatory cytokines TNF-α， IL-1β， and IL-6 in the model group was significantly increased （P<0.01）. The alveolar structure in mice was severely damaged， with markedly thickened alveolar walls and extensive inflammatory cell infiltration. The W/D ratio and MPO activity in lung tissue were significantly increased （P<0.01）. The content of AA metabolites， including prostaglandin D₂ （PGD₂）， prostaglandin E₂ （PGE₂）， 11（S）-hydroxy-eicosatetraenoic acid ［11（S）-HETE］， and 5-hydroxy-eicosatetraenoic acid （5-HETE） in serum and lung tissue was significantly increased （P<0.05）， while the content of 11，12-epoxyeicosatrienoic acid （11，12-EET） and 14，15-epoxyeicosatrienoic acid （14，15-EET） in serum was significantly decreased （P<0.01）. Compared with the results in the model group， the content of serum pro-inflammatory cytokines TNF-α， IL-1β， and IL-6 in the dexamethasone group， low-dose Yantiao prescription group， and high-dose Yantiao prescription group was significantly reduced （P<0.05）. Mild thickening of alveolar walls， scattered inflammatory cell infiltration， and relatively intact tissue structure with improved alveolar architecture were observed. The W/D ratio and MPO activity in lung tissue were significantly reduced （P<0.01）. The content of AA metabolites PGD₂， PGE₂， 11（S）-HETE， and 5-HETE in serum from the dexamethasone group was significantly decreased （P<0.05）， while the content of 14，15-EET in serum significantly increased （P<0.01）， and the content of 5-HETE in lung tissue significantly decreased （P<0.01）. In the low-dose and high-dose Yantiao prescription groups， the content of AA metabolites PGD₂， PGE₂， 11（S）-HETE， and 5-HETE in serum and lung tissue was significantly decreased （P<0.05）， while the content of 11，12-EET in both serum and lung tissue was significantly increased （P<0.05）. ConclusionYantiao prescription has significant protective effects against LPS-induced ALI， which are related to its regulation of AA metabolic pathways in vivo.

Objective: To assess the impact of long-term antiretroviral therapy (ART) on human immunodeficiency virus (HIV) blood screening outcomes in post-exposure prophylaxis (PEP) failure cases through a longitudinal analysis of blood screening results over a 7-year period in a patient with HIV PEP failure. Methods: This study conducted 13 follow-up assessments for a high-risk individual who initiated ART shortly after exposure. The effectiveness of various blood screening methods, including immunological assays and nucleic acid testing (NAT), was analyzed. Blood samples were also tested with HIV RNA quantification testing, Western blot (WB) confirmation testing, chemiluminescence immunoassay (CLIA), and HIV rapid tests utilizing gold and selenium labels. A comprehensive analysis was performed to evaluate the changes in diagnostic capabilities of different testing methods for HIV biomarkers over an extended period following PEP failure. Results: The patient had two high-risk exposures: one day before ART initiation (BA1) and seven days preceding treatment (BA7). On the first day after the ART treatment (AA1), the HIV RNA concentration (viral load) was 9.07×10 copies/mL; by day five (AA5), the viral load decreased to 1.04×10 copies/mL. At day eleven (AA11), NAT and ELISA tests were both positive, with the WB result remaining indeterminate (gp160+). At day 48 (AA48), the S/CO value of the fourth generation ELISA reagent was 1.07, while results from a 6-sample pool and quantitative NAT were negative. However, a single sample NAT returned a positive result and WB tests indicated positivity for p17, p24, and gp160. At AA74, the quantitative NAT rebounded to 2.83×10 copies/mL, with positive NAT results for single and 6-sample pool NAT tests. The S/CO values of the imported and domestic ELISA reagents were 3.39 and 23.44, respectively. At AA201, 6-sample pool and quantitative NAT were negative again, while single sample NAT remained positive. From AA319 to AA2221, all NAT results have remained consistently below the minimum detection limit. At AA2221, S/CO values of the imported and domestic ELISA reagents were 3.47 and 23.44, respectively. Conclusion: The findings indicate that patients experiencing PEP failure after high-risk HIV exposure are at a higher risk of being missed by mixed-sample NAT pools and individual serological tests. Nonetheless, anti-HIV antibody levels are sustained at elevated values for an extended duration, underscoring antibody testing as an effective measure for blood screening.

Objective : To investigate the relationship between the risk occurrence of rectal cancer and the single nucleotide polymorphisms(SNP) of zinc finger protein 6(ZBED6), and to provide the experimental basis for early diagnosis and treatment of rectal cancer. Methods: Polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) technology was used to genotype the ZBED6 gene in 109 randomly selected rectal cancer patients and 110 unrelated healthy controls. To evaluate the relationship between alleles, genotypes and the risk of rectal cancer, unconditional Logistic regression analysis was used toORand 95%CI. Results: The SNP rs7552670 of ZBED6 had significant correlation with the risk of rectal cancer. Compared with the population carrying the TT genotype, those carrying the TC genotype had a 2.653 fold increased risk of rectal cancer(TTvsTC:OR=2.635, 95%CI=1.501-4.690). Other SNPs had no significant correlation with the risk of rectal cancer. Conclusion There is an interaction between the polymorphisms of ZBED6(rs7552670) and rectal cancer. The population carried ZBED6 rs7552670 TC genotype had an growing risk of rectal cancer.

The influence of material properties on fingerprint development effects were systematically studied.Firstly,carbon dots/NaYF4 and Cu nanoclusters/starch nanocomposites respectively possessing different fluorescent intensities and dual fluorescent colors,as well as NaYF4 micro-/nano-materials exhibiting different morphologies,sizes,and surface properties were chemically synthesized and further used for latent fingerprint development.Then,the developing effects were comprehensively evaluated by visual analysis combining with spectral characterization and Python-based calculation.Finally,the influences of material properties on latent fingerprint development were quantitatively evaluated from three dimensions including contrast,sensitivity,and selectivity.The fluorescence properties of developing materials and substrates could significantly affect the developing contrast,namely,the stronger the developing signal,the higher the contrast;the weaker the background noise,the higher the contrast.The sizes and morphologies of the developing materials could respectively influence the quantity and quality of developed minutiae,and significantly affect the developing sensitivity,namely,the smaller the particle size of developing materials,the more the quantity of developed minutiae and the higher the sensitivity;the smaller the surface area of developing materials,the higher the quality of developed minutiae and the higher the sensitivity.The surface properties together with the sizes and morphologies of developing materials could influence their adsorption performances,and significantly affect the developing selectivity,namely,the stronger the specific adsorption of developing materials with fingerprint substance,and the weaker the non-specific adsorption of developing materials with substrate,the higher the selectivity.Moreover,the fingerprint development using the materials with suitable surface area and appropriate mass would have a high selectivity.

Under the background of forensic medicine becoming a first-level discipline,the opportuni-ties and challenges of discipline development coexist.Starting from the actual situation and characteris-tics of local medical colleges and universities,this paper discusses the problems and solutions for the development of forensic medicine discipline from the perspective of building a regional high-level medical university.Combined with the experiences of carrying out forensic medicine education in our college,this paper supplies our thoughts and practices on improving the discipline system,enhancing the ability to serve society,perfecting the talent cultivation model and promoting forensic culture,to provide reference and inspiration for the development of forensic medicine in other universities,jointly promote the advancement of forensic medicine in China to a new stage,and contribute the wisdom and strength of forensic medical experts to the construction of a law-based China,a safe China and a healthy China.

Non-cystic fibrosis bronchiectasis(referred to as bronchiectasis)is a common chronic airway disease.Neutrophils have traditionally been considered to play a dominant role in the airway inflammation of bronchiectasis.However,it has been discovered that approximately 20％to 30％of bronchiectasis patients exhibited elevated eosinophil counts(Sputum eosinophil ratio＞3％or blood eosinophil count＞300/μl)in their sputum and blood samples,referred to as eosinophilic bronchiectasis(EB).Based on this novel discovery of the inflammatory phenotype,some scholars have advocated treating bronchiectasis as an"inflammatory disease"rather than an"infectious disease"in a novel therapeutic approach.This article reviews the discovery and the latest research advancements of EB,exploring its pathophysiological basis,clinical characteristics,and treatment,with the aim to facilitate the understanding and management of EB.

[Purpose]To analyze the incidence and mortality of liver cancer in cancer registration areas of Zhejiang Province in 2021 and the epidemiological trends of liver cancer from 2000 to 2021.[Methods]Using liver cancer data from 2000 to 2021 reported by Zhejiang Provincial Can-cer Registries,stratified by sex,age,and urban-rural areas,indicators including crude incidence rate,crude mortality rate,age-standardized incidence rate by Chinese standard population(ASIRC),age-standardized mortality rate by Chinese standard population(ASMRC),age-standardi-zed incidence rate by world standard population(ASIRW),age-standardized mortality rate by world standard population(ASMRW)were calculated.Joinpoint Regression Program(Version 5.3.0)was used to fit the log-linear relationship between rates and years,and calculate the annual percentage change(APC)and average annual percentage change(AAPC)with 95％confidence interval(CI).[Results]In 2021,the crude incidence rate of liver cancer in Zhejiang cancer registration areas was 26.93/105(ASIRC:13.35/105),and the crude mortality rate was 20.87/105(ASMRC:9.52/105).The number of new cases and deaths of liver cancer accounted for 5.07％and 11.33％of all malig-nant tumor cases and deaths,respectively.The incidence and mortality rates of liver cancer in male were significantly higher than those in female(crude incidence rate:40.17/105 vs 13.85/105;ASIRC:20.60/105 vs 6.34/105;crude mortality rate:30.78/105 vs 11.07/105;ASMRC:14.67/105 vs 4.57/105),and those in rural areas were higher than those in urban areas(crude incidence rate:30.39/105 vs 24.79/105;ASIRC:15.35/105 vs 12.10/105;crude mortality rate:24.32/105 vs 18.72/105;ASMRC:11.30/105 vs 8.40/105).In 2021,the incidence rate of liver cancer was low before the age of 30 years old,and increased significantly with age after 30 years old,reaching the peak in male aged 85 years old and above(170.04/105)and in female aged 80～84 years old(84.74/105).The mortality rate showed a similar trend to the incidence rate,which was low before the age of 30 years old and increased significantly with age after 30 years old,peaking in male aged 85 years old and above(211.64/105)and in female aged 80～84 years old(98.31/105).From 2000 to 2021,the crude incidence rate of liver cancer in Zhejiang Province showed an overall upward trend(AAPC=1.01％,95％CI:0.44％～1.58％),while the ASIRC remained relatively stable(AAPC=-0.81％,95％CI:-1.48％～0.02％)with a significant remained relatively stable(AAPC=-0.81％,95％CI:-1.48％～0.02％),after 2010,the ASIRC remained relatively stable(AAPC=-0.81％,95％CI:-1.48％～0.02％)with a significant decreased significantly.Both the crude mortality rate(AAPC=-0.84％,95％CI:-1.23％～-0.36％)and ASMRC(AAPC=-2.78％,95％CI:-3.28％～-2.20％)showed sig-nificant downward trends,and the decline of ASMRC was more obvious.[Conclusion]From 2000 to 2021,the incidence of liver cancer in cancer registration areas of Zhejiang Province showed a fluctuating downward trend,and the mortality showed a steady downward trend,but the disease burden remains heavy.Rural areas,the elderly,and males are high-risk populations,which should be the key targets of liver cancer prevention and control.

Cervical spinal cord injury without fracture-dislocation (CSCIWFD) is referred to as a special type of cervical spinal cord injury characterized by traumatic spinal cord dysfunction and no significant bony structural abnormalities on imagines. Duo to the high risk of missed diagnosis during the initial consultation, CSCIWFD may lead to progressive neurological deterioration or even complete paralysis, severely impacting patients′ prognosis. Currently, there are no established consensuses over the diagnosis and treatment of CSCIWFD, such as the lack of evidence-based standards for indications of non-surgical treatment and risk of secondary neurological injury, as well as debates over the optimal timing for surgical intervention and indications for different surgical approaches. To address these issues, the Spine Trauma Group of the Orthopedic Branch of the Chinese Medical Doctor Association organized experts in the relevant fields to formulate Diagnosis and treatment guideline for acute cervical spinal cord injury without fracture- dislocation in adults ( version 2025) . Based on evidence-based medicine and the principles of scientific rigor and clinical applicability, the guidelines proposed 11 recommendations covering terminology, diagnosis, evaluation treatment, and rehabilitation, etc., aiming to standardize the management of CSCIWFD.

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.