Objective:To explore the diagnosis and treatment strategy of emphysematous pyelonephritis (EPN).Methods:The clinical data of 11 cases patients with EPN admitted to 3 hospitals from March 2016 to June 2022 were retrospectively analyzed, among them, 4 cases from Qianhai Shekou Free Trade Zone Hospital, 5 cases from the Second Hospital Affiliated to Kunming Medical University, 2 cases from the Second Affiliated Hospital of Hubei University of Scinece and Technology. Among the 11 patients, 2 were males and 9 were females, aged 50-82 years; the lesions were located on the left side in 6 cases, right side in 4 cases and bilateral in 1 case; all patients had type 2 diabetes and poor glycemic control. The clinical manifestations at admission including back pain in 8 cases, fever in 11 cases, nausea and vomiting in 5 cases, disturbance of consciousness in 3 cases, septic shock in 3 cases, accompanied with ureteral or kidney stones in 5 cases. The pathogenic bacteria were Escherichia coli in 8 cases, Klebsiella pneumoniae in 2 cases and Proteus mirabilis in 1 case. All patients received minimally invasive surgery, anti-infection, subcutaneous injection of insulin, fluid rehydration and nutritional support after admission. 2 cases had a combination of an initial ureteral stenting and second stage percutaneous drainage, 3 patients underwent ureteral stent implantation, 6 patients underwent percutaneous drainage. According to the CT classification of EPN, there were 1 case of type Ⅰ, 3 cases of type Ⅱ, 2 cases of type ⅢA, 4 cases of type ⅢB, and 1 case of type Ⅳ. Results:All 11 cases were cured, 4 cases were admitted to intensive care unit for 2-7 days, 1 case underwent nephrectomy during hospitalization, and 1 case underwent nephrectomy due to renal atrophy during follow-up. After 12 to 18 months of follow-up with urinary CT or B-ultrasound, there were no recurrence cases.Conclusions:EPN is a rare and serious renal parenchymal necrotic infection. Early urinary CT examination is necessary for the diagnosis, and positive minimally invasive surgery combined with comprehensive medical treatment is the preferred treatment strategy. If those above treatment does not work, nephrectomy should be performed.

Objective:To determine the prevalence of self-reported food allergies among children in the grasslands of North China and to analyze its associated risk factors.Methods:In this study, a cross-sectional epidemiological survey method was used to select children under 14 years old by multi-stage, stratified and random cluster sampling in the grassland ecological area of Zhangbei County, Hebei Province, China from May to July 2018. Face-to-face questionnaires were administered to gather food allergy-related information from the participants. Multivariate logistic regression analysis was used to analyze the risk factors associated with self-reported food allergy.Results:A total of 2 086 children completed the survey. The prevalence of self-reported food allergies was 22.0%(459/2 086). The prevalence of multiple food allergies (≥3 types) was 3.1%(64/2 086) versus 16.3% (341/2 086) for a single food allergy among all children. Mango allergy (6.1%, 127/2 086) was the most common, followed by peach allergy (4.1%, 85/2 086). Children who reported food allergies had a significantly higher prevalence of all 4 atopic disorders (eczema, asthma, allergic rhinitis, and allergic conjunctivitis than those without food allergies(35.73% vs. 20.65%, 5.88% vs. 2.77%, 17.86% vs. 7.38%, 16.78% vs. 10.45%, χ2 =44.663 1, 10.434 3, 45.038 3, 13.728 4, all P<0.001).Significantly associated risk factors of food allergy were found to be pollen allergy ( OR: 2.29; 95% CI: 1.80-2.92) and drug allergy ( OR: 1.53; 95% CI: 1.12-2.09). Conclusions:The prevalence of self-reported food allergies among children in the Zhangbei County area of the North China Grassland was relatively high. Pollen allergy and drug allergy are major risk factors.

The inherent complexity of Alzheimer's disease (AD) and failed clinical trials have spiked the interest in multifunctional ligands that target at least two key disease-associated macromolecules in AD pathology. Here we present a focused series of pleiotropic N-carbamoylazole prodrugs with dual mechanism of action. Pseudo-irreversible inhibition of the first therapeutic target, human butyrylcholinesterase (hBChE), enhances cholinergic transmission, and thereby provides symptomatic treatment, same as the standard therapeutics in use for AD. Simultaneously, this step also functions as a metabolic activation that liberates a nanomolar selective α ₂-adrenergic antagonist atipamezole, which blocks pathological amyloid β (Aβ)-induced and noradrenaline-dependent activation of GSK3β that ultimately leads to hyperphosphorylation of tau, thus achieving a disease-modifying effect. Lead compound 8 demonstrated long-term pseudo-irreversible hBChE inhibition, metabolic activation in human plasma, blood-brain barrier permeability, and p.o. bioavailability in mice. Multi-day in vivo treatment with 8 in an Aβ-induced AD murine model revealed a significant alleviation of cognitive deficit that was comparable to rivastigmine, the current drug of choice for AD therapy. Furthermore, decreased GSK3β activation and lowered tau phosphorylation were observed in APP/PS1 mice. This surpasses the symptomatic-only treatment with cholinesterase inhibitors, as it directly blocks an essential pathological cascade in AD. Therefore, these multifunctional α ₂-adrenergic antagonists-butyrylcholinesterase inhibitors, exemplified by lead compound 8, present an innovative, small molecule-based, disease-modifying approach to treatment of AD.

Objective:To investigate the metabolic pathways and potential molecular targets associated with dapagliflozin in the treatment of type 2 diabetes mellitus.Methods:Plasma samples from patients with type 2 diabetes mellitus were collected before and after 12 months of dapagliflozin treatment and analyzed using UPLC-VION IMS Q-Tof-based metabolomics and timsTOF Pro2 diaPASEF-based proteomics. Multivariate statistical analyses were performed to identify significant differences pre- and post-treatment. Correlation analysis was then conducted to assess relationships between differentially expressed metabolites and proteins closely associated with type 2 diabetes mellitus. Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment analyses were used to construct metabolic pathway maps and predict therapeutic targets.Results:After 12 months of dapagliflozin treatment, 162 differential metabolites were identified, with 59 upregulated and 103 downregulated. A total of 440 differentially expressed proteins were detected, of which 272 were upregulated and 168 were downregulated. The main classes of differential metabolites included sphingolipids, glycerophospholipids, and glycosphingolipids. Key differentially expressed proteins included importin subunit alpha-11, synemin, Janus kinase 1, and far upstream element-binding protein 2. Correlation analysis revealed 98 shared enriched pathways between differential metabolites and proteins, involving neurotrophin signaling, chemokine signaling, and B cell receptor signaling pathways. Metabolic pathway analysis suggested that dapagliflozin might regulate insulin secretion by modulating glucose-dependent insulinotropic polypeptide, calmodulin-dependent protein kinase, and diacylglycerol levels.Conclusion:Dapagliflozin may exert therapeutic effects in type 2 diabetes mellitus through multiple mechanisms, including the modulation of metabolic and proteomic profiles, participation in key cellular signaling pathways, and regulation of insulin secretion.

Objective To compare the clinical efficacy and safety of 1 470 nm laser en bloc resection of bladder tumor(1 470 nm-EBRBT)and transurethral resection of bladder tumor(TUR-BT).Methods Clinical data of 85 non-muscle-invasive bladder cancer(NMIBC)patients from June 2018 to June 2021 were analyzed retrospectively.The patients were divided into 1 470 nm-EBRBT group(n=40)and TUR-BT group(n=45)according to different surgical methods,the postoperative chemotherapy regimen of bladder perfusion was the same in both groups.The surgical safety,clinical efficacy,pathological results and recurrence free survival rate of two groups were recorded.Results There were no statistically significant differences in operation time,incidence of bladder perforation,and incidence of postoperative delayed hemorrhage between the two groups(P＞0.05).Compared with the TUR-BT group,the 1 470 nm-EBRBT group had less blood loss,shorter bladder irrigation time,catheter indwelling time and postoperative hospital time,and no obturator nerve reflex,the differences were statistically significant(P＜0.05).The proportion of detrusor in the first resected pathological specimens in 1 470 nm-EBRBT group was higher than that in TUR-BT group(P＜0.05).There were no statistically significant differences in tumor recurrence rate of one year,tumor cumulative recurrence rate of two years and recurrence free survival time between the two groups(P＞0.05).Conclusion Compared with traditional TUR-BT,1 470 nm-EBRBT is a safe and effective method,which has the advantages of complete pathological specimens,fewer complications,faster recovery and so on.Therefore,it is worthy of clinical application.

Objective:To explore the mediating effect of disease uncertainty on cancer-related fatigue and quality of life in postoperative thyroid cancer patients, and to provide assistance for health management of thyroid cancer patients.Methods:From January 2023 to June 2024, thyroid cancer patients who underwent surgical treatment in Xiang′an Hospital of Xiamen University were selected by convenience sampling method. Conduct a survey using The general information questionnaire, Cancer Quality of Life for Thyroid Cancer 34, Cancer Fatigue Scale, and Mishel Uncertainty in Illness Scale were used to conduct cross-sectional investigation. SPSS 22.0 was used to statistically analyze the relationship between the three factors, and AMOS 24.0 software was used to establish a structural equation model to analyze the mediating effect of disease uncertainty on cancer-related fatigue and quality of life in postoperative thyroid cancer patients.Results:Finally, 495 valid questionnaires were ultimately collected. Among 495 postoperative patients with thyroid cancer, there were 135 males and 360 females, with an age of (39.58 ± 12.97) years old. The uncertainty score of postoperative thyroid cancer patients was (60.98 ± 11.61) points, cancer-related fatigue score was (42.85 ± 7.35) points, and quality of life score was (57.51 ± 9.81) points. Pearson correlation analysis showed that cancer-related fatigue was positively correlated with disease uncertainty ( r=0.392, P<0.01) and negatively correlated with quality of life ( r=-0.465, P<0.01). Disease uncertainty was negatively correlated with quality of life ( r=-0.378, P<0.01). Disease uncertainty partially mediated the relationship between cancer-related fatigue and quality of life in postoperative thyroid cancer patients, with a mediation effect value of -0.14, accounting for 32.56% of the total effect. Conclusions:The disease uncertainty score and the quality of life score of postoperative thyroid cancer patients were at a moderate level, the cancer-related fatigue score was at an upper moderate level. Disease uncertainty is an important mediating variable between cancer-related fatigue and quality of life in postoperative thyroid cancer patients. Improving disease uncertainty in postoperative thyroid cancer patients can reduce cancer-related fatigue and improve their quality of life.

Objective:To determine the prevalence of self-reported food allergies among children in the grasslands of North China and to analyze its associated risk factors.Methods:In this study, a cross-sectional epidemiological survey method was used to select children under 14 years old by multi-stage, stratified and random cluster sampling in the grassland ecological area of Zhangbei County, Hebei Province, China from May to July 2018. Face-to-face questionnaires were administered to gather food allergy-related information from the participants. Multivariate logistic regression analysis was used to analyze the risk factors associated with self-reported food allergy.Results:A total of 2 086 children completed the survey. The prevalence of self-reported food allergies was 22.0%(459/2 086). The prevalence of multiple food allergies (≥3 types) was 3.1%(64/2 086) versus 16.3% (341/2 086) for a single food allergy among all children. Mango allergy (6.1%, 127/2 086) was the most common, followed by peach allergy (4.1%, 85/2 086). Children who reported food allergies had a significantly higher prevalence of all 4 atopic disorders (eczema, asthma, allergic rhinitis, and allergic conjunctivitis than those without food allergies(35.73% vs. 20.65%, 5.88% vs. 2.77%, 17.86% vs. 7.38%, 16.78% vs. 10.45%, χ2 =44.663 1, 10.434 3, 45.038 3, 13.728 4, all P<0.001).Significantly associated risk factors of food allergy were found to be pollen allergy ( OR: 2.29; 95% CI: 1.80-2.92) and drug allergy ( OR: 1.53; 95% CI: 1.12-2.09). Conclusions:The prevalence of self-reported food allergies among children in the Zhangbei County area of the North China Grassland was relatively high. Pollen allergy and drug allergy are major risk factors.

Objective:To explore the mediating effect of disease uncertainty on cancer-related fatigue and quality of life in postoperative thyroid cancer patients, and to provide assistance for health management of thyroid cancer patients.Methods:From January 2023 to June 2024, thyroid cancer patients who underwent surgical treatment in Xiang′an Hospital of Xiamen University were selected by convenience sampling method. Conduct a survey using The general information questionnaire, Cancer Quality of Life for Thyroid Cancer 34, Cancer Fatigue Scale, and Mishel Uncertainty in Illness Scale were used to conduct cross-sectional investigation. SPSS 22.0 was used to statistically analyze the relationship between the three factors, and AMOS 24.0 software was used to establish a structural equation model to analyze the mediating effect of disease uncertainty on cancer-related fatigue and quality of life in postoperative thyroid cancer patients.Results:Finally, 495 valid questionnaires were ultimately collected. Among 495 postoperative patients with thyroid cancer, there were 135 males and 360 females, with an age of (39.58 ± 12.97) years old. The uncertainty score of postoperative thyroid cancer patients was (60.98 ± 11.61) points, cancer-related fatigue score was (42.85 ± 7.35) points, and quality of life score was (57.51 ± 9.81) points. Pearson correlation analysis showed that cancer-related fatigue was positively correlated with disease uncertainty ( r=0.392, P<0.01) and negatively correlated with quality of life ( r=-0.465, P<0.01). Disease uncertainty was negatively correlated with quality of life ( r=-0.378, P<0.01). Disease uncertainty partially mediated the relationship between cancer-related fatigue and quality of life in postoperative thyroid cancer patients, with a mediation effect value of -0.14, accounting for 32.56% of the total effect. Conclusions:The disease uncertainty score and the quality of life score of postoperative thyroid cancer patients were at a moderate level, the cancer-related fatigue score was at an upper moderate level. Disease uncertainty is an important mediating variable between cancer-related fatigue and quality of life in postoperative thyroid cancer patients. Improving disease uncertainty in postoperative thyroid cancer patients can reduce cancer-related fatigue and improve their quality of life.

Objective To compare the clinical efficacy and safety of 1 470 nm laser en bloc resection of bladder tumor(1 470 nm-EBRBT)and transurethral resection of bladder tumor(TUR-BT).Methods Clinical data of 85 non-muscle-invasive bladder cancer(NMIBC)patients from June 2018 to June 2021 were analyzed retrospectively.The patients were divided into 1 470 nm-EBRBT group(n=40)and TUR-BT group(n=45)according to different surgical methods,the postoperative chemotherapy regimen of bladder perfusion was the same in both groups.The surgical safety,clinical efficacy,pathological results and recurrence free survival rate of two groups were recorded.Results There were no statistically significant differences in operation time,incidence of bladder perforation,and incidence of postoperative delayed hemorrhage between the two groups(P＞0.05).Compared with the TUR-BT group,the 1 470 nm-EBRBT group had less blood loss,shorter bladder irrigation time,catheter indwelling time and postoperative hospital time,and no obturator nerve reflex,the differences were statistically significant(P＜0.05).The proportion of detrusor in the first resected pathological specimens in 1 470 nm-EBRBT group was higher than that in TUR-BT group(P＜0.05).There were no statistically significant differences in tumor recurrence rate of one year,tumor cumulative recurrence rate of two years and recurrence free survival time between the two groups(P＞0.05).Conclusion Compared with traditional TUR-BT,1 470 nm-EBRBT is a safe and effective method,which has the advantages of complete pathological specimens,fewer complications,faster recovery and so on.Therefore,it is worthy of clinical application.

Objective:To investigate the metabolic pathways and potential molecular targets associated with dapagliflozin in the treatment of type 2 diabetes mellitus.Methods:Plasma samples from patients with type 2 diabetes mellitus were collected before and after 12 months of dapagliflozin treatment and analyzed using UPLC-VION IMS Q-Tof-based metabolomics and timsTOF Pro2 diaPASEF-based proteomics. Multivariate statistical analyses were performed to identify significant differences pre- and post-treatment. Correlation analysis was then conducted to assess relationships between differentially expressed metabolites and proteins closely associated with type 2 diabetes mellitus. Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment analyses were used to construct metabolic pathway maps and predict therapeutic targets.Results:After 12 months of dapagliflozin treatment, 162 differential metabolites were identified, with 59 upregulated and 103 downregulated. A total of 440 differentially expressed proteins were detected, of which 272 were upregulated and 168 were downregulated. The main classes of differential metabolites included sphingolipids, glycerophospholipids, and glycosphingolipids. Key differentially expressed proteins included importin subunit alpha-11, synemin, Janus kinase 1, and far upstream element-binding protein 2. Correlation analysis revealed 98 shared enriched pathways between differential metabolites and proteins, involving neurotrophin signaling, chemokine signaling, and B cell receptor signaling pathways. Metabolic pathway analysis suggested that dapagliflozin might regulate insulin secretion by modulating glucose-dependent insulinotropic polypeptide, calmodulin-dependent protein kinase, and diacylglycerol levels.Conclusion:Dapagliflozin may exert therapeutic effects in type 2 diabetes mellitus through multiple mechanisms, including the modulation of metabolic and proteomic profiles, participation in key cellular signaling pathways, and regulation of insulin secretion.