Renal Fanconi syndrome (FS) is a rare renal manifestation of primary Sjögren's syndrome (pSS). This study aims to analyze the clinical and prognostic characteristics of patients with pSS-associated renal FS (pSS-FS) and provide insights for clinical management.

ObjectiveTo investigate the mechanism of salt processing of Psoraleae Fructus （PF） through modern analytical techniques and biotechnology， focusing on its effects related to hepatotoxicity and anti-osteoporosis activity. MethodsThe zebrafish model was utilized to evaluate the impact of PF and salt-processed Psoraleae Fructus （SPF） on the hepatotoxicity （using 134.17 ， 178.89， 268.34 mg·L^-1 as low， medium， and high dose groups of PF， 135.04， 180.06， 270.08 mg·L^-1 as low， medium， and high dose groups of SPF， respectively） and anti-osteoporotic activity （using 33.54 ， 67.08 and 134.17 mg·L^-1 as low， medium， and high dose groups of PF， 33.76， 67.52， 135.04 mg·L^-1 as low， medium， and high dose groups of SPF， respectively）， which was using alizarin red skull staining of zebrafish as an indicator of different batches of PF. The specific dosage of a batch of PF was taken as an example. Then ultra-performance liquid chromatography-quadrupole-time of flight-mass spectrometry（UPLC-Q-TOF-MS） analysis was employed to identify the chemical composition of PF before and after salt processing， and PCA， OPLS-DA， and independent sample t-test were used to elucidating the compositional changes associated with the effects of salt processing on hepatotoxicity and anti-osteoporosis activity. ResultsUnder specific conditions， PF induced notable hepatotoxicity in zebrafish while simultaneously demonstrating protective effect against prednisolone-induced osteoporosis. In comparison to PF， SPF showed alleviated hepatotoxicity while retaining significant anti-osteoporosis activity. UPLC-Q-TOF-MS analysis revealed that after salt processing， the overall chemical composition of PF showed a downward trend， with 69 components showing a decrease in content， represented by psoralen， and 13 components showing an increase， represented by 4′-O-methyl psoralen B. Further multivariate statistical analysis revealed 11 key differential components before and after salt processing of PF， including psoralen and bakuchiol. ConclusionSalt processing effectively diminishes hepatotoxicity without impairing therapeutic efficacy against osteoporosis of PF， which may be related to the compositional changes before and after salt processing of PF and provides key evidence to reveal the scientific significance of salt processing of PF.

ObjectiveTo investigate the associations of multiple glycolipid metabolic indicators and their cumulative abnormality burden with incident colorectal cancer risk in a general population-based prospective cohort, and to examine the mediating role of glycolipid metabolic abnormalities in the relationships between smoking, alcohol consumption, physical activity, and colorectal cancer incidence. MethodsA total of 17 897 eligible participants recruited from the Taizhou Cohort between 2011 and 2014 were included. Cox proportional hazards regression models were used to assess the associations of conventional and derived glycolipid indicators, as well as a glycolipid abnormality index constructed from total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting plasma glucose, and insulin, with incident colorectal cancer risk. Restricted cubic spline models were applied to evaluate dose-response relationships for major indicators. Receiver operating characteristic curves were generated to compare predictive performance across indicators. Mediation analyses were conducted to assess the mediating effects of the glycolipid abnormality index on the associations of smoking, alcohol consumption, and physical activity with colorectal cancer incidence. ResultsDuring a median follow-up of 11.2 years, 102 incident colorectal cancer cases were identified, with an incidence density of 51.2 per 100 000 person-years. After adjustment for potential confounders, Cox proportional hazards regression analyses showed that decreased high-density lipoprotein cholesterol was associated with a 1.74-fold higher risk of colorectal cancer (HR=1.74, 95%CI: 1.03‒2.95), elevated low-density lipoprotein cholesterol was associated with a 1.78-fold higher risk (HR=1.78, 95%CI: 1.05‒3.02), and abnormal fasting plasma glucose was associated with a 1.86-fold higher risk (HR=1.86, 95%CI: 1.15‒3.02). Triglycerides and fasting plasma glucose showed an approximately linear increasing association with colorectal cancer risk in multivariable restricted cubic spline models. The glycolipid abnormality index showed a clear gradient association with colorectal cancer risk; participants with three or more abnormal indicators had a 3.08-fold higher risk than those without abnormalities (HR=3.08, 95%CI: 1.60‒5.92). The area under the curve was 0.795, higher than that of individual glycolipid indicators and other combined indices, and gender-stratified analyses showed generally consistent patterns. Glycolipid metabolic abnormalities partially mediated the associations of smoking, alcohol consumption, and physical activity with colorectal cancer incidence, with mediation proportions of 8.33%, 9.45%, and 9.04%, respectively. ConclusionGlycolipid metabolic abnormalities are associated with an increased risk of incident colorectal cancer. The glycolipid abnormality index shows an increasing relationship with colorectal cancer risk and demonstrates better discrimination, and it partially mediates the associations of smoking, alcohol consumption, and physical activity with colorectal cancer incidence in the overall population.

Objective To explore the effects of breast-conserving surgery (BCS), simple mastectomy (SM), and modified radical mastectomy (MRM) on early postoperative upper limb motor function, physical and psychological status in breast cancer patients. Methods A total of 212 female breast cancer patients undergoing surgery at the Department of Breast Surgery of Zhangzhou Affiliated Hospital of Fujian Medical University from October 2024 to December 2025 were enrolled. Patients were divided into the BCS group (n＝34), SM group (n＝79), and MRM group (n＝99). General demographic and clinical data were collected. At 3–7 days postoperatively, the Constant-Murley score (CMS), active range of motion (AROM) of the shoulder joint, and the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score were used to assess upper limb function; the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Functional Assessment of Cancer Therapy-Breast (FACT-B), and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate patients’ psychological status, quality of life, and sleep quality. Results The total CMS score, pain score, and range of motion score in the BCS group were higher than those in the SM and MRM groups (P＜0.05). The BCS group showed greater forward flexion range of motion than that in the SM and MRM groups (P＜0.05); and the SM group showed smaller internal rotation range of motion than that in the MRM and BCS groups (P＜0.05). The PHQ-9 depression score in the BCS group was significantly higher than that in the MRM group (P＜0.05). There were no statistically significant differences among the three groups in QuickDASH, GAD-7, FACT-B, or PSQI scores. Conclusions Early postoperative upper limb function and depression status varied among breast cancer patients undergoing different surgical procedures. Patients undergoing BCS had better preservation of upper limb function but higher depression scores.

Since the first successful transcatheter aortic valve replacement (TAVR) was performed globally in 2002, the TAVR technology has become increasingly mature. With more than a decade of development in China, its application experience, device research and development, procedural improvements, evidence-based medicine, and guideline updates have continuously progressed, leading to a significant increase in the number of procedures conducted. Compared to traditional surgical operations, TAVR has different postoperative monitoring points and principles for the prevention and management of complications, necessitating the formulation of corresponding monitoring and treatment protocols that align with the technical characteristics of the procedure. This guideline is based on clinical practice and incorporates both domestic and international literature as well as the experiences of Fuwai Hospital. It distills and organizes routine postoperative monitoring practices, process optimization, and complication management for TAVR, establishing a set of practical guidelines for postoperative monitoring in China. These guidelines have strong practical value for optimizing postoperative management strategies and preventing and managing complications, which is beneficial for early functional recovery of patients, shortening hospital stays, and reducing complication rates. They provide guidance and reference for domestic peers and support the standardized development and quality improvement of postoperative management for TAVR in China.

Objective To investigate the epidemiological characteristics of knee osteoarthritis(KOA)among military personnel in plateau regions and to explore its risk factors.Methods From July 2023 to July 2024,a multi-stage stratified cluster random sampling method was employed to survey the prevalence of KOA and related risk factors among military personnel in the northwest plateau regions of China,covering different altitudes(1500-4500 m)and geographical areas(Gansu,Qinghai,Tibet,and Xinjiang).All study subjects were divided into KOA and non-KOA groups based on the presence or absence of KOA.Variables including age,gender,body mass index(BMI),education level,smoking status,military rank,military branch,service duration,regional altitude,annual average temperature,training duration,perceived training intensity,and history of knee injury were selected for univariate analyses between groups.Variables with P<0.05 in the univariate analyses were included in the binary multifactor logistic regression to identify risk factors for KOA.Results A total of 3000 questionnaires were distributed,and 2854 valid questionnaires were collected,with a response rate of 95.13%.The sample included 2584 males and 270 females,with 510 cases of KOA,resulting in a prevalence rate of 17.9%.Univariate analysis showed that there were statistically significant differences between KOA and non-KOA groups in terms of age,BMI,smoking status,military rank,military branch,service duration,regional altitude,annual average temperature,training duration,perceived training intensity,and history of knee injury(P<0.05).However,no significant differences were found in gender and education level(P>0.05).Binary multivariate logistic regression analysis revealed that older age(OR=1.382,P=0.017),higher BMI(P<0.01),smoking(OR=1.929,P<0.01),higher military rank(OR=1.485,P=0.007),being a member of the Armed Police(P<0.01),longer service duration(P<0.01),higher regional altitude(OR=1.459,P<0.01),lower annual average temperature(OR=1.188,P=0.001),longer training duration(P<0.01),higher perceived training intensity(OR=2.450,P<0.01),and history of knee injury(OR=2.768,P=0.002)were independent risk factors for KOA.Conclusions Older age,overweight/obesity,smoking,higher military rank,being a member of the Armed Police,longer service duration,higher altitude,cold climate,longer training duration,higher training intensity,and history of knee injury are independent risk factors for KOA among military personnel in the northwest plateau regions of China.

Objective To investigate the mechanism of hippocampal neuronal plasticity of newborn neurons in the hippocampus by which exercise improves the fear and anxiety symptoms of post-traumatic stress disorder(PTSD).Methods Totally 40 C57BL/6J male mice were randomly divided into by control group(Ctrl)and PTSD group,the PTSD group was divided into a no-exercise group(PTSD),a low-intensity exercise group(L)and a high-intensity exercise group(H).The PTSD model mice were constructed by combining conditioned plantar-foot shock(CF)and single-session sustained stress(SPS).After the exercise intervention,the fear and anxiety levels of the mice were assessed using the conditioned fear test and the elevated cross maze test;Subsequently,the densities of the newborn mature neurons in dentate gyrus(DG)of hippocampus were detected by immunofluorescent double-labelling staining,and the newborn neuron morphology was marked by injecting retrovirus pRetro-U6-EF1-EGFP-3xFLAG-WPRE in DG of hippocampus to observe its morphology.The morphology of the newborn neurons was labelled to observe their dendritic length and the number of branch points;Meanwhile,the concentration level of adiponctin(APN)in the hippocampal area was determined by ELISA.Results The result showed that both high and low-intensity exercise interventions significantly reduced the freezing time of PTSD mice in the conditioned fear test,and in the elevated cross maze experiment,the residence time and the number of entries in the open arm of the mice in the H group increased significantly compared with those in the PTSD group,while the residence time and the number of entries in the closed arm were significantly reduced.In addition,both high and low-intensity exercise interventions significantly increased the surface density and dendritic length of newborn mature neurons in the hippocampal DG region of PTSD mice,and high-intensity exercise significantly increased the number of dendritic branching points,and the density of newborn mature neurons in the H group was more significantly increased compared with that in the L group.At the same time,the hippocampal APN concentration increased significantly in both L and H groups compared with the PTSD group,and it was more significant in the H group.Conclusion Exercises have an ameliorative effect on anxiety and fear symptoms in PTSD mice,and at the same time,it can increase hippocampal neuroplasticity and adiponctin secretion in PTSD mice,suggesting that the improvement of fear and anxiety symptoms in PTSD by exercise may be related to the increase of hippocampal neuroplasticity and APN secretion,and the improvement effect is better with high-intensity exercise.

Objective To evaluate the clinical safety and efficacy of NOVA stent implantation in the treatment of symptomatic middle cerebral artery(MCA)atherosclerotic stenosis.Methods The clinical data,including surgical results,perioperative complications,imaging manifestations and follow-up findings,of 21 patients with severe MCA atherosclerotic stenosis,who received NOVA stent implantation at the Affiliated Tongji Hospital of Tongji University of China from November 2021 to February 2023,were retrospectively analyzed.Results Successful NOVA stent implantation was accomplished in all the 21 patients.The residual stenosis was less than 30％,with no bleeding complications.After stent implantation,the median stenosis ratio of responsible vessels decreased from preoperative 85.04％to postoperative 5.95％,the difference was statistically significant(P＜0.01).During the follow-up period of 10-14 months,one patient(4.76％)developed in-stent restenosis,one patient developed transient ischemic attack(TIA),and one patient developed posterior circulation cerebral infarction.No cerebral hemorrhage or death occurred.After treatment,the clinical symptoms were stable in 16 patients(76.19％),improved in 4 patients(19.04％),and worsened in one patient(4.76％).Conclusion For the treatment of patients with symptomatic MCA atherosclerotic stenosis,NOVA stent implantation is clinically safe and effective.However,multicenter randomized controlled studies with larger sample size and longer follow-up period need to be conducted before its curative efficacy can be further validated.

Objective To discuss the application of CT myocardial perfusion imaging(CT-MPI)combined with plaque quantification technique in assessing reperfusion injury in patients with myocardial ischemia.Methods The clinical data of 100 patients with myocardial ischemia,who were admitted to the People's Hospital of Xinjiang Uygur Autonomous Region of China from June 2019 to June 2024,were retrospectively analyzed.CT-MPI and plaque quantification technique examination were performed in all patients before percutaneous coronary intervention(PCI).According to the presence or absence of reperfusion injury after PCI,the patients were divided into non-injury group(n=38)and injury group(n=62).The CT-MPI parameters,including time-to-peak(TTP),myocardial blood flow(MBF)and myocardial blood volume(MBV),and the plaque quantification technique parameters,including eccentricity index(EI),remodeling index(RI),calcified plaque volume(CPV),minimum lumen area(MLA),narrowness degree(ND),non-calcified plaque volume(NCPV),total plaque volume(TPV)and plaque length(PL),were compared between the two groups.Receiver operating characteristic(ROC)curve was used to analyze the value of CT-MPI and plaque quantification technique in assessing reperfusion injury in patients with myocardial ischemia,and logistic regression analysis was used to determine the factors influencing reperfusion injury.Results TTP in the injury group was longer than that in the non-injury group,while MBF and MBV in the injury group were lower than those in the non-injury group(all P＜0.05).No statistically significant differences in El,RI,CPV and MLA existed between the two groups(all P＞0.05).ND,NCPV,TPV and PL in the injury group were higher than those in the non-injury group(P＜0.001).ROC curve analysis showed that the area under ROC curve(AUC)of combination use of TTP MBF,MBV,ND,NCPV,TPV and PL for evaluating reperfusion injury in patients with myocardial ischemia was 0.914,which was higher than the values obtained by the separate evaluation of the above seven indicators,and the results were 0.781,0.784,0.760,0.791,0.775,0.792 and 0.798 respectively(all P＜0.05).Logistic regression analysis revealed that TTP,MBF,MBV,ND,NCPV,TPV and PL were the risk factors for reperfusion injury in patients with myocardial ischemia(all P＜0.05).Conclusion CT-MPI combined with plaque quantification technique can effectively evaluate the reperfusion injury in patients with myocardial ischemia,providing important reference for the diagnosis and treatment of reperfusion injury,therefore,it has high clinical application value.

This study analyzed the practical experience of the World Health Organization,the European Union,the United States,and Japan,to reveal the characteristics of health emergency drills in terms of institutional construction,technological integration,and international collaboration.The health emergency drills present three major development trends:paradigm shift driven by social demand,efficiency improvement empowered by intelligent technology,and deepening international cooperation under the global governance framework.In response to the construction needs of China's public health emergency system,policy recommendations were proposed to establish a hierarchical classification system,a full-cycle training strategy for major infectious diseases,a dual wheel drive mechanism by both techniques and qualified personnel,and a path for global governance participation.