One of the basic questions in the aging field is whether there is a fundamental difference between the aging of lower invertebrates and mammals. A major difference between the lower invertebrates and mammals is the abundancy of noncoding RNAs, most of which are not conserved. We have previously identified a noncoding RNA Terc-53 that is derived from the RNA component of telomerase Terc. To study its physiological functions, we generated two transgenic mouse models overexpressing the RNA in wild-type and early-aging Terc-/- backgrounds. Terc-53 mice showed age-related cognition decline and shortened life span, even though no developmental defects or physiological abnormality at an early age was observed, indicating its involvement in normal aging of mammals. Subsequent mechanistic study identified hyaluronan-mediated motility receptor (Hmmr) as the main effector of Terc-53. Terc-53 mediates the degradation of Hmmr, leading to an increase of inflammation in the affected tissues, accelerating organismal aging. adeno-associated virus delivered supplementation of Hmmr in the hippocampus reversed the cognition decline in Terc-53 transgenic mice. Neither Terc-53 nor Hmmr has homologs in C. elegans. Neither do arthropods express hyaluronan. These findings demonstrate the complexity of aging in mammals and open new paths for exploring noncoding RNA and Hmmr as means of treating age-related physical debilities and improving healthspan.
Animals ; Mice ; RNA, Untranslated/metabolism* ; Aging/genetics* ; Mice, Transgenic ; Telomerase/metabolism* ; RNA/genetics* ; Hippocampus/metabolism* ; Humans ; Mice, Inbred C57BL

Objective To analyze the clinical research literature of in vitro fertilization and embryo transfer(IVF-ET)failure,and summarize the traditional Chinese medicine(TCM)syndromes and syndrome elements,so as to provide theoretical basis for TCM syndrome differentiation and treatment of IVF-ET failure.Methods Using"in vitro fertilization and embryo transfer""IVF-ET"and"embryo transfer failure"as search terms,the literature related to TCM that had appeared in CNKI and Wanfang Data Knowledge Service Platform were searched since these database was constructed.After excluding irrelevant literature,statistical analysis was performed on the frequency and frequency of symptoms and signs.Results Kidney Yang deficiency,kidney deficiency,blood stasis,kidney Yin deficiency and liver qi stagnation were the common syndroms of failure.The disease location with high frequency of syndrome elements was kidney,and the disease was blood stasis.Conclusion Kidney-Yang deficiency syndrome is the most common type of failure,and TCM disease location syndrome is the most common in kidney.The disease deficiency is mostly Yang deficiency,and the excess is mostly blood stasis.

Mesenchymal stem cells(MSCs)are adult stem cells that exist in bone marrow,fat,cord blood,bone,muscle and other tissues.MSCs not only have the unique self-renewal ability and multidirectional differentiation potential of stem cells,but also have the function of immune regulation.Arginine is a conditionally essential amino acid,and its metabolic regulation is essential for maintaining cell function and overall health.In MSCs,arginine metabolism may have a certain effect on cell proliferation,differentiation,inflammatory response,and tumor development.This article summarizes the effects of arginine metabolism on the differentiation,inflammation,immunity,and tumor development in different types of MSCs,discusses new strategies for the treatment of metabolic syndrome,and provides new ideas for the treatment of inflammatory diseases and tumors by MSCs from the perspective of arginine metabolism.

Objective:To explore the clinicopathological characteristics and prognosis of fumarate hydratase-deficient uterine leiomyoma (FH-dUL).Methods:Clinical data and follow-up information for 117 patients with FH-dUL diagnosed through surgical pathology and immunohistochemistry in the First Affiliated Hospital of Nanjing Medical University from January 2020 to December 2024, were collected. A control group of 130 patients with common uterine leiomyomas was also included. The differences between the two groups in clinical, imaging, and pathological characteristics were compared. Additionally, recurrence rates, fertility outcomes for FH-dUL patients, and the incidence of renal cancer in FH germline mutation carriers were monitored.Results:(1) Comparison of clinicopathological characteristics: the median age of 117 FH-dUL patients was 35 years, and the median age at first diagnosis of uterine leiomyomas was 29 years, both significantly younger than the control group (41 and 36 years; both P<0.01). The FH-dUL group showed significantly higher incidences of uterine myomectomy, multiple leiomyomas, diffusion restriction on pelvic magnetic resonance imaging diffusion weighted imaging, and typical pathological features (candelabra-like vessels, bizarre nuclei, cytoplasmic eosinophilic globules, perinuclear halo, cellular atypia) and higher ultrasound blood flow score (all P<0.05). Of the 30 FH-dUL patients who underwent genetic testing, 9 had germline mutations, 3 had somatic mutations, and 6 had mutations of unclear origin. Among the 9 FH gene germline mutation patients, 2 had already developed renal cell carcinoma. (2) Recurrence analysis: among the 56 patients who underwent uterine myomectomy, 22 (39.3%, 22/56) experienced recurrence during follow-up, compared to 12 (21.8%, 12/55) of the 55 patients in the control group, the difference between the two groups was statistically significant ( P=0.046). Multivariate binary logistic regression analysis showed that cellular leiomyomas ( OR=9.489, 95% CI: 1.740-51.755; P=0.009) and multiple uterine leiomyomas ( OR=10.709, 95% CI: 1.354-84.683; P=0.025) were significant risk factors for recurrence in FH-dUL. (3) Fertility analysis: among the 66 FH-dUL patients who underwent fertility-preserving surgery, 16 had the intention to have fertility desire, only 2 (2/16) completed their fertility plans during follow-up. Conclusions:Clinicopathological features and imaging features help to differentiate FH-dUL from common type uterine fibroids, but lack specificity, and the diagnosis of FH-dUL is based on immunohistochemistry. The recurrence rate after resection of FH-dUL is high, and cellular and multiple leiomyomas are important predictors of recurrence. It is crucial to perform genetic testing, genetic counseling, drug treatment to prevent recurrence, fertility guidance, and long-term comprehensive management after surgery for FH-dUL management.

Mesenchymal stem cells(MSCs)are adult stem cells that exist in bone marrow,fat,cord blood,bone,muscle and other tissues.MSCs not only have the unique self-renewal ability and multidirectional differentiation potential of stem cells,but also have the function of immune regulation.Arginine is a conditionally essential amino acid,and its metabolic regulation is essential for maintaining cell function and overall health.In MSCs,arginine metabolism may have a certain effect on cell proliferation,differentiation,inflammatory response,and tumor development.This article summarizes the effects of arginine metabolism on the differentiation,inflammation,immunity,and tumor development in different types of MSCs,discusses new strategies for the treatment of metabolic syndrome,and provides new ideas for the treatment of inflammatory diseases and tumors by MSCs from the perspective of arginine metabolism.

Objective:To explore the clinicopathological characteristics and prognosis of fumarate hydratase-deficient uterine leiomyoma (FH-dUL).Methods:Clinical data and follow-up information for 117 patients with FH-dUL diagnosed through surgical pathology and immunohistochemistry in the First Affiliated Hospital of Nanjing Medical University from January 2020 to December 2024, were collected. A control group of 130 patients with common uterine leiomyomas was also included. The differences between the two groups in clinical, imaging, and pathological characteristics were compared. Additionally, recurrence rates, fertility outcomes for FH-dUL patients, and the incidence of renal cancer in FH germline mutation carriers were monitored.Results:(1) Comparison of clinicopathological characteristics: the median age of 117 FH-dUL patients was 35 years, and the median age at first diagnosis of uterine leiomyomas was 29 years, both significantly younger than the control group (41 and 36 years; both P<0.01). The FH-dUL group showed significantly higher incidences of uterine myomectomy, multiple leiomyomas, diffusion restriction on pelvic magnetic resonance imaging diffusion weighted imaging, and typical pathological features (candelabra-like vessels, bizarre nuclei, cytoplasmic eosinophilic globules, perinuclear halo, cellular atypia) and higher ultrasound blood flow score (all P<0.05). Of the 30 FH-dUL patients who underwent genetic testing, 9 had germline mutations, 3 had somatic mutations, and 6 had mutations of unclear origin. Among the 9 FH gene germline mutation patients, 2 had already developed renal cell carcinoma. (2) Recurrence analysis: among the 56 patients who underwent uterine myomectomy, 22 (39.3%, 22/56) experienced recurrence during follow-up, compared to 12 (21.8%, 12/55) of the 55 patients in the control group, the difference between the two groups was statistically significant ( P=0.046). Multivariate binary logistic regression analysis showed that cellular leiomyomas ( OR=9.489, 95% CI: 1.740-51.755; P=0.009) and multiple uterine leiomyomas ( OR=10.709, 95% CI: 1.354-84.683; P=0.025) were significant risk factors for recurrence in FH-dUL. (3) Fertility analysis: among the 66 FH-dUL patients who underwent fertility-preserving surgery, 16 had the intention to have fertility desire, only 2 (2/16) completed their fertility plans during follow-up. Conclusions:Clinicopathological features and imaging features help to differentiate FH-dUL from common type uterine fibroids, but lack specificity, and the diagnosis of FH-dUL is based on immunohistochemistry. The recurrence rate after resection of FH-dUL is high, and cellular and multiple leiomyomas are important predictors of recurrence. It is crucial to perform genetic testing, genetic counseling, drug treatment to prevent recurrence, fertility guidance, and long-term comprehensive management after surgery for FH-dUL management.

Objective To analyze the clinical research literature of in vitro fertilization and embryo transfer(IVF-ET)failure,and summarize the traditional Chinese medicine(TCM)syndromes and syndrome elements,so as to provide theoretical basis for TCM syndrome differentiation and treatment of IVF-ET failure.Methods Using"in vitro fertilization and embryo transfer""IVF-ET"and"embryo transfer failure"as search terms,the literature related to TCM that had appeared in CNKI and Wanfang Data Knowledge Service Platform were searched since these database was constructed.After excluding irrelevant literature,statistical analysis was performed on the frequency and frequency of symptoms and signs.Results Kidney Yang deficiency,kidney deficiency,blood stasis,kidney Yin deficiency and liver qi stagnation were the common syndroms of failure.The disease location with high frequency of syndrome elements was kidney,and the disease was blood stasis.Conclusion Kidney-Yang deficiency syndrome is the most common type of failure,and TCM disease location syndrome is the most common in kidney.The disease deficiency is mostly Yang deficiency,and the excess is mostly blood stasis.

Background::Liver cancer remains the sixth most commonly diagnosed cancer and the third leading cause of cancer-related deaths worldwide, causing a heavy burden globally. An updated assessment of the global epidemiology of the liver cancer burden that addresses geographical disparities is necessary to better understand and promote healthcare delivery.Methods::Data were extracted from the GLOBOCAN 2022 database, including the number, crude, and age-standardized rates of incidence and mortality at the global, country, continent, and human development index (HDI) regional levels. Age-standardized rates (incidence and mortality) per 100,000 person-years were adjusted based on the Segi-Doll World standard population. The mortality-to-incidence ratios (MIR) for each region and country were calculated. The HDI and gross national income (GNI) for 2022 were obtained, and a Pearson correlation analysis was conducted with the incidence, mortality, and MIR.Results::In 2022, approximately 866,136 new liver cancer cases and 758,725 related deaths were recorded worldwide, with a global MIR of 0.86. Males had a disproportionately higher burden than females across all levels, and the highest burden was observed in the elderly population. Geographically, the regions with the highest incidence rates included Micronesia, Eastern Asia, and Northern Africa, and the regions with the highest mortality rates included Northern Africa, Southeastern Asia, Eastern Asia, and Micronesia. Notably, Mongolia had a strikingly high burden compared to other countries. The highest MIR was observed in North America and the lowest in Africa. Negative associations of HDI and GNI with liver cancer mortality and MIR were identified, irrespective of sex.Conclusions::The current liver cancer burden underscores the presence of remarkable geographic heterogeneity, which is particularly evident across countries with varying HDI levels, highlighting the urgent need to prioritize health accessibility and availability to achieve health inequities.

Objective To explore the application value of"Internet+Case-based Discussion"in the standardized train-ing of traditional Chinese medicine resident physicians.Methods"Internet+Case-based Discussion"was conducted for 150 resident physicians from three grades who received training in a case hospital.K-means cluster analysis was used to group the e-valuation of resident physicians,and the teaching evaluation of different types of resident physicians was compared.Semantic net-work analysis was used to identify training suggestions and demands of resident physicians.Results There was no statistically significant difference in teaching evaluations among the three grades of resident physicians(P>0.05),and the overall accept-ance was high among resident physicians of different grades.Cluster analysis distinguished the high-scoring group from the medi-um-scoring group,and the difference was statistically significant(P<0.001).Resident physicians in the medium-scoring group believed that teaching teachers lacked close integration of teaching with case discussion and clinical auxiliary result interpretation(P<0.001).Conclusion In the standardized training of traditional Chinese medicine resident physicians,"Internet+Case-based Discussion"can effectively ensure teaching quality and promote the sharing and utilization of teaching resources.

Objective:To observe the effects and safety of dienogest on the volume and symptoms of ovarian endometrioma (OMA).Methods:The clinical data of 75 patients with OMA who underwent treatment with dienogest (2 mg/day) at the First Affiliated Hospital of Nanjing Medical University from July 1st 2020 to March 31st 2024 were retrospectively analysed, mainly comparing the changes in the volume of OMA and the visual analogue scale (VAS) scores of endometriosis-related pain before and after the treatment, as well as observing the changes in the blood biological indicators, liver and kidney function, coagulation function and changes in breast.Results:The median cyst volumes of the OMA patients at 3, 6 and 12 months of dienogest treatment were 13.21 cm 3 (volume reduction rate: 36.00%), 8.33 cm 3 (volume reduction rate: 56.00%) and 4.10 cm 3 (volume reduction rate: 77.62%), respectively, which were all significantly decreased from the pre-treatment period (all P<0.05). The VAS scores of pain of the OMA patients at 3, 6 and 12 months of dienogest treatment all were 0 mm. Blood cancer antigen 125 (CA 125) and cancer antigen 19-9 (CA 19-9) levels decreased progressively during treatment (all P<0.05). There were no statistical differences in the coagulation indexes, liver and kidney function indexes of the patients during dienogest treatment compared with those before treatment (all P>0.05). During the follow-up period, there were a few patients with changes in the growth sites or lesion category of the breast nodules, but there were no occurrence of breast cancer or precancerous lesions. Conclusion:Dienogest is effective in reducing OMA volume and alleviating endometriosis-related pain with few adverse effects.