BACKGROUND: The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. METHODS: This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. RESULTS: Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n  = 278] vs . 43.7% [ n  = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. CONCLUSION This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Artery Disease/drug therapy* ; Retrospective Studies ; Renal Dialysis/methods* ; Middle Aged ; Aged ; China ; Proportional Hazards Models ; Treatment Outcome

OBJECTIVE: Cigarette smoking exacerbates the progression of pulmonary tuberculosis (TB). The role of tertiary lymphoid structures (TLS) in chronic lung diseases has gained attention; however, it remains unclear whether smoking-exacerbated lung damage in TB is associated with TLS. This study aimed to analyze the characteristics of pulmonary TLS in smokers with TB and to explore the possible role of TLS in smoking-related lung injury in TB. METHODS: Lung tissues from 36 male patients (18 smokers and 18 non-smokers) who underwent surgical resection for pulmonary TB were included in this study. Pathological and immunohistological analyses were conducted to evaluate the quantity of TLS, and chest computed tomography (CT) was used to assess the severity of lung lesions. The correlation between the TLS quantity and TB lesion severity scores was analyzed. The immune cells and chemokines involved in TLS formation were also evaluated and compared between smokers and non-smokers. RESULTS: Smoker patients with TB had significantly higher TLS than non-smokers ( P < 0.001). The TLS quantity in both the lung parenchyma and peribronchial regions correlated with TB lesion severity on chest CT (parenchyma: r = 0.5767; peribronchial: r = 0.7373; both P < 0.001). Immunohistochemical analysis showed increased B cells, T cells, and C-X-C motif chemokine ligand 13 (CXCL13) expression in smoker patients with TB ( P < 0.001). CONCLUSION Smoker TB patients exhibited increased pulmonary TLS, which was associated with exacerbated lung lesions on chest CT, suggesting that cigarette smoking may exacerbate lung damage by promoting TLS formation.
Humans ; Male ; Tuberculosis, Pulmonary/immunology* ; Middle Aged ; Tertiary Lymphoid Structures/pathology* ; Adult ; Lung/pathology* ; Smoking/adverse effects* ; Smokers ; Aged ; Tomography, X-Ray Computed

Objective : To develop and to validate a combined model integrating18F-FDG PET/CT radiomics with clinical features to distinguish between lymphoma and lymphoid inflammatory hyperplasia. Methods : A retrospective study was conducted on a cohort of 232 patients diagnosed with lymphoma or lymphoid inflammatory hyperplasia. Comparative analyses of clinical and traditional imaging indicators were performed to identify inter-group differences. The clinical features were delineated and extracted using medical software including 3D-Slicer and Lifex. Selection of the features was performed to construct a PET/CT-based radiomics Logistic model, with a combined model integrating PET/CT with clinical features then used to evaluate the discriminative efficacy of these models. Results: Analysis of inter-group differences indicated that age, CTmean, and metabolic tumor volume(MTV)were effective for differentiating between lymphoma and lymphoid inflammatory hyperplasia(P<0.05). The PET/CT-based radiomics Logistic model differentiated between lymphoma and lymphoid inflammatory hyperplasia, with an area under curve(AUC) of 0.924(95%CI: 0.884-0.960) and 0.863(95%CI: 0.774-0.939) in the training and testing cohorts, respectively. The integrated Logistic model that combined PET/CT-based radiomics with clinical features to distinguish between lymphoma and lymphoid inflammatory hyperplasia achieved an AUC of 0.933(95%CI: 0.889-0.969) in the training cohort and 0.884(95%CI: 0.792-0.964) in the testing cohort. Decision curve analysis(DCA) demonstrated that the integrated model provided the greatest clinical net benefit. Conclusion The hybrid model integrating18F-FDG PET/CT radiomics with clinical features shows robust diagnostic efficacy to distinguish between lymphoma and lymphoid inflammatory hyperplasia.

In recent years,micro photoionization detectors(μPID),with their rapid response speed and excellent sensitivity,have attracted widespread attention in both scientific research and industry.This study developed a portable gas chromatograph based on μPID technology(GC-μPID),and examined its key performance characteristics such as reproducibility,sensitivity,and online analytical capability.The results showed that the method's relative standard deviation(RSD)was controlled within 2.7%,demonstrating good reproducibility;for the standard curves of 27 kinds of volatile organic compounds(VOCs),the linearity was excellent(R2≥0.99),with detection limits of≤10 μg/m3 and benzene series compounds reaching detection limits as low as 0.5 μg/m3.In field applications at an industrial park,this method successfully identified and quantified 17 kinds of VOCs,accurately capturing their diurnal concentration variations.The results above validated that the method developed here had the capability of onsite real-time monitoring and provided an effective tool for in situ monitoring atmospheric pollutants.

Objective To evaluate the potential of the BIBP-H fluorescent probe in the detection of the oxidative stress levels after cerebral ischemia-reperfusion(CIRI).Methods In vitro,the potential of BIBP-H probe was in detection of oxidative stress was first assessed with fluorescence imaging in rat neuroblastoma(B104)cells after L-glutamic acid stimulation.And then,the effects of edaravone and dexborneol(EDA)and glutathione(GSH)pretreatment on the fluorescence intensity were evaluated.Later,a totally of 28 male C57BL/6 mice were randomly assigned into four groups:transient middle cerebral artery occlusion(tMCAO)group,EDA+tMCAO group,GSH+tMCAO group,and sham group.After 1.5 h ischemia and 12 h reperfusion,the mice were treated with BIBP-H via tail vein injection.In vivo,ex vivo,and tissue fluorescence imaging were utilized to evaluate the probe's cerebral ischemia-reperfusion injury(CIRI).Results ① BIBP-H probe did not exhibit fluorescence signals in cultured B104 cells,but showed red fluorescence in B104 cells treated with L-glutamic acid.The signals significantly decreased when pretreated with EDA or GSH.② Both the sham-operated mice intravenously injected with the BIBP-H probe and the tMCAO mice without injection of the probe showed negative results in in vivo fluorescence imaging.③ tMCAO mice treated with BIBP-H exhibited red fluorescence signals in the ischemic hemisphere in vivo,with significantly reduced fluorescence intensity after EDA or GSH infusion during reperfusion ④ The fluorescence area examined with BIBP-H was consistent the cerebral infarction area detected with triphenyltertrazolium.Conclusions The BIBP-H probe effectively monitored oxidative stress levels both in vivo and in vitro,demonstrating its potential in CIRI detection.

BACKGROUND:The relationship between rheumatoid arthritis and coronary atherosclerosis has received extensive attention.Inflammation is related to rheumatoid arthritis and coronary atherosclerosis,indicating that there may be a common pathophysiological pathway between the two diseases.However,observational studies have not yet clarified the causal relationship.OBJECTIVE:To explore whether there is a causal relationship between rheumatoid arthritis and coronary atherosclerosis,as well as the potential causal relationship with 1 400 serum metabolites and 91 inflammatory factors through a Mendelian randomization analysis.METHODS:Coronary atherosclerosis data are from Finngen database,rheumatoid arthritis data are from IEU OpenGWAS database,serum metabolites data are from Canadian Longitudinal Study on Aging,Augsburg Cooperative Health Research and British Twin Project Research,and data of 91 inflammatory proteins are from research published in Nature Immunology in 2023.Mendelian randomization analysis was performed using data from genome-wide association studies,and causal effects were evaluated using inverse variance weighting,MR-Egger regression,weighted median,weighted model,and simple model methods,with inverse variance weighting being the primary analysis method.To enhance robustness,Cochran's Q-test MR-Egger intercept was used for sensitivity analysis.RESULTS AND CONCLUSION:(1)Inverse variance weighting results showed that rheumatoid arthritis was positively correlated with the increased relative risk of coronary atherosclerosis(odds ratio=1.002,95％confidence interval=1.001-1.003,P=0.003).There was no reverse causal relationship between coronary atherosclerosis and rheumatoid arthritis.In addition,96 serum metabolites and 9 inflammatory factors were found to have causal relationships with coronary atherosclerosis.There was a causal relationship between 51 serum metabolites and 7 inflammatory factors and rheumatoid arthritis.(2)This study provided epidemiological evidence between rheumatoid arthritis and coronary atherosclerosis,and emphasized the potential role of serum metabolites and inflammatory factors in the pathogenesis of these diseases.These findings may contribute to the development of new treatment strategies.Due to the limited inclusion of data from Asian populations,most contemporary studies used international databases and European population analyses.By collecting and analyzing the health data of European populations,it is conducive to a better understanding of the effects and potential role of Chinese medicine in Europe,and to further promote the practice of modern integration of Western and Chinese medicine.Meanwhile,through the comparative study with the European databases,it is possible to reveal the genetic differences and susceptibility to diseases among different populations,providing more dimensions and perspectives for global health research.

According to statistics from the Extracorporeal Life Support Organization(ELSO),as of October 2023,a total of 198 623 patients worldwide had received extracorporeal membrane oxygenation(EC-MO)support.In recent years,the number of ECMO treatment cases in China has increased rapidly,reaching 10 656 cases in 2022.It was previously believed that fat emulsions could easily lead to ECMO system failures due to their hydrophobic nature,thereby limiting their use during ECMO.However,many clinically used drugs are lipid-soluble,and restricting their use not only increases treatment difficulty for these patients but may e-ven affect their prognosis.With advancements in material technology and membrane lung manufacturing processes,intravenous lipid emulsion(ILE)now exerts significant effects on ECMO systems.This article re-views recent domestic and international research progress regarding the effects of ILE on ECMO systems,ai-ming to provide more evidence-based medical support for ILE application in ECMO patients.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To explore the effectiveness of digital management platform led by outpatient specialist nurses among patients with type 2 diabetes in outpatient settings.Methods:From March 2024 to March 2025, adult patients with type 2 diabetes who visited the Endocrinology Clinic at Peking Union Medical College Hospital were selected using convenience sampling. Patients were randomly assigned to the control group and intervention group using the random number table method. Patients in control group received routine education on type 2 diabetes during their clinic visits after enrollment. Intervention group was managed by nurses through a digital management platform, establishing long-term connections with patients. Based on the platform, nurses regularly provided patients with knowledge updates, promptly responded to patient inquiries, reviewed daily dietary records, monitored blood glucose data, conducted weekly telephone follow-ups, and scheduled regular clinic visits to precisely intervene in patients' lifestyles. The glycated hemoglobin (HbA1c) and self-management behavior scores were compared between two groups of patients before and after three months of intervention.Results:A total of 46 patients were enrolled and completed the 3-month follow-up, including 25 in control group and 21 in intervention group. There were no statistically significant differences in HbA1c or self-management behavior scores between the two groups of patients before intervention ( P>0.05). At three months of intervention, the HbA1c reduction in intervention group was greater than that in control group, with a statistically significant difference ( P<0.05). There was no statistically significant difference in Summary of Diabetes Self-Care Activities Scale scores between the two groups ( P>0.05). The difference in changes in diabetic foot self-screening scores between intervention group and control group was statistically significant ( P<0.05) . Conclusions:Specialist nurse-led precision health care management utilizing digital platforms can improve HbA1c and enhance self-management behaviors for diabetic foot in patients with type 2 diabetes, which is expected to be promoted and applied in the outpatient management of diabetes patients.

Objective To investigate the correlation between the expression of lectin galactoside binding soluble-3 binding protein(LGALS3BP),GTP enzyme activating protein SH3 functional region binding protein 1(G3BP1)and Wnt/β-catenin pathway genes in endometrial cancer(EC)tissues and its clinical prognostic significance.Methods 138 patients with EC treated in Cangzhou Central Hospital from February 2016 to February 2019 were selected.qRT-PCR was used to detect the expression of LGALS3BP mRNA,G3BP1 mRNA and Wnt/β-catenin pathway genes Wnt5a mRNA,β-catenin mRNA and matrix metalloproteinase-9(MMP-9)mRNA in cancer and adjacent tissues.The expression of LGALS3BP protein and G3BP1 protein in cancer and adjacent tissues was detected by immunohistochemistry.Pearson correlation analysis was used to analyze the correlation between LGALS3BP mRNA,G3BP1 mRNA and Wnt/β-catenin pathway genes.Kaplan-Meier curve was used to analyze the effect of LGALS3BP mRNA and G3BP1 mRNA on the survival and prognosis of EC patients.COX regression model was used to analyze the factors affecting the prognosis of EC patients.Results The expression of LGALS3BP mRNA(3.01±0.34),G3BP1 mRNA(2.87±0.33),Wnt5a mRNA(2.29±0.26),β-catenin mRNA(3.25±0.41)and MMP-9 mRNA(2.68±0.36)in EC cancer tissues were higher than those in adjacent tissues(1.10±0.23,1.06±0.24,0.84±0.17,0.88±0.26,0.69±0.17),and the differences were statistically significant(t=52.109～58.719,all P<0.001).The expression of LGALS3BP mRNA and G3BP1 mRNA in EC was positively correlated with the expression of Wnt5a mRNA,β-catenin mRNA and MMP-9 mRNA(r=0.675～0.781,all P<0.001).The expression of LGALS3BP protein(3.54±0.47 vs 0.51±0.16)and G3BP1 protein(2.84±0.44 vs 0.42±0.13)in EC cancer tissues were higher than that in adjacent tissues,and the differences were statistically significant(t=71.692,61.962,all P<0.001).The expression of LGALS3BP mRNA and G3BP1 mRNA in cancer tissues of EC patients with FIGO stage Ⅲ and lymph node metastasis were higher than that of FIGO stage Ⅰ～Ⅱ and no lymph node metastasis,and the differences were statistically significant(t=40.279～557.671,all P<0.001).The 5-year survival rate of LGALS3BP mRNA high expression group was 58.82%(40/68),which was lower than that of low expression group 94.29%(66/70),and the difference was statistically significant(Log-rank χ2=24.970,P<0.001).The 5-year survival rate of G3BP1 mRNA high expression group was 62.12%(41/66),which was lower than that of low expression group 90.28%(65/72),and the difference was statistically significant(Log-rank χ2=15.960,P<0.001).FIGO stage Ⅲ,lymph node metastasis,high expression of LGALS3BP mRNA and high expression of G3BP1 mRNA were risk factors for poor prognosis of EC patients(Wald χ2=7.847～12.054,all P<0.001).Conclusion The expression of LGALS3BP and G3BP1 mRNA is elevated in EC,both of which are associated with Wnt/β-catenin pathway genes,promoting the malignant progression of EC tumors,and are new tumor markers for evaluating the prognosis of EC patients.