AIM: To investigate the influence of pterygium thickness and area on corneal refractive status.METHODS: Prospective longitudinal study. A total of 60 cases(60 eyes)of pterygium patients admitted to our hospital from January 2024 to September 2024 were randomly selected. All patients underwent pterygium excision combined with pedicle conjunctival flap transplantation for treatment. Optical coherence tomography(OCT)was used to measure the preoperative thickness of patient's pterygium, and a digital slit lamp microscope was used to measure the area of pterygium. The corneal refractive status(degree of corneal astigmatism and average curvature)and changes in uncorrected visual acuity of patients before surgery, 1 d, 1, and 3 mo after surgery were compared. The relationship between preoperative thickness and area of pterygium in patients and corneal refractive status indicators at different postoperative time points were analyzed, and Logistic regression was used to analyze the impact of pterygium thickness and area on postoperative visual improvement in patients.RESULTS: All patients completed follow-up after surgery for 3 mo. At 3 mo after surgery, visual acuity improved in 21 eyes(35%). The results of bivariate Pearson correlation analysis showed that the thickness and area of pterygium positively correlated with the degree of corneal astigmatism and uncorrected visual acuity before surgery and 1 d, 1, and 3 mo after surgery(all P<0.05), and negatively correlated with the average corneal curvature before surgery and 1 d, 1, and 3 mo after surgery(all P<0.05). Logistic regression analysis showed that the thickness and area of pterygium before surgery, high degree of corneal astigmatism, and low uncorrected visual acuity(large LogMAR value)were all risk factors for poor postoperative visual improvement in patients(OR>1, P<0.05). The large average corneal curvature before surgery was a protective factor for poor postoperative visual improvement in patients(OR<1, P<0.05).CONCLUSION: The increase in thickness and area of pterygium can, to some extent, improve corneal astigmatism, reduce the average curvature of the cornea, and affect postoperative visual recovery.

arcopenia is a systemic skeletal muscle disorder characterized by a decrease in skeletal muscle mass and progressive decline in function， with multiple signaling pathways involved in its occurrence and development. Among them， the AMP-activated protein kinase （AMPK） signaling pathway， as a key pathway regulating cellular energy homeostasis， plays an important role in the regulation of skeletal muscle metabolism and functional maintenance by improving abnormalities in glucose and lipid metabolism， balancing skeletal muscle protein synthesis and degradation， improving mitochondrial function， promoting autophagy， and inhibiting inflammatory responses and oxidative stress. This article reviews the research progress on how various traditional Chinese medicine （TCM） monomers， including polyphenols， flavonoids， and terpenoids； various traditional Chinese medicine extracts， such as those from Lycium barbarum ， Asini Corii Colla， and Panax quinquefolium ， and TCM compounds， such as Guiqi zhuangjin decoction， Jianpi qiangji granules， and Qigu capsules， intervene in sarcopenia by regulating the AMPK signaling pathway to promote muscle protein synthesis， inhibit protein degradation， improve mitochondrial function， and alleviate inflammation and oxidative stress. Additionally， their molecular mechanisms are explored. The aim is to deeply elucidate the basis of TCM in the prevention and treatment of sarcopenia and to provide theoretical support for the development of related innovative drugs.

Objective To explore the prognostic factors for patients with descending duodenum gastrointestinal stromal tumors (GIST), analyze the impact of different surgical approaches on prognosis, and develop a predictive model for surgical approach selection. Methods This single-center retrospective cohort study included patients with primary descending duodenum GIST treated in Zhongshan Hospital, Fudan University from January 2010 to January 2015, with follow-up until August 2025. The primary outcomes were incidence of postoperative complications, disease-free survival (DFS) rate, and overall survival (OS) rate. Cox regression and logistic regression were used to identify factors influencing prognosis and surgical approach selection, respectively. A nomogram model for selecting the surgical approach was constructed. Results A total of 78 patients with descending duodenum GIST were included, with age of (56.14±11.76) years. The 1-, 5-, and 10-year OS rates were 100%, 98.7%, and 85.7%, respectively, and the corresponding DFS rates were 100%, 90.9%, and 82.3%. Intraoperative blood loss, postoperative gastroparesis, mucosal ulceration, maximum tumor diameter, and Ki-67-positive cell ratio were independent risk factors for DFS, while maximum tumor diameter and mitotic figure were independent risk factors for OS (P＜0.05). The 10-year DFS rate was higher in the local resection group than in the pancreaticoduodenectomy group (89.45% vs 74.24%; HR＝0.300, P＝0.013), but there was no statistical difference in OS between the two groups. The incidence of postoperative complications in the pancreaticoduodenectomy group was higher than that in the local resection group (P＜0.001). Maximum tumor diameter and distance from tumor to the duodenal papilla were independent factors influencing surgical approach selection. The nomogram model based on these two indices demonstrated good discrimination and accuracy upon internal validation. Conclusions The long-term prognosis of patients with descending duodenal GIST is favorable, and surgical treatment achieves satisfactory outcomes. The nomogram model developed in this study can effectively guide individualized surgical approach selection and provide a reference for clinical decision-making.

ObjectiveTo investigate the current professional competency among full-time and part-time personnel of the nosocomial infection control administration in Shanghai, so as to provide a scientific basis for future training programmes. MethodsIn December 2024, a questionnaire survey was conducted by the Shanghai Nosocomial Infection Quality Control Center among full-time and part-time personnel of the nosocomial infection control administration across medical institutions at various levels and types in Shanghai using convenience sampling method. The questionnaire consisted of two parts: demographic information and professional competency assessment. The professional competency scale comprised four dimensions: fundamental cognition, basic skills, professional expertise, and personal qualities, totaling 35 items. ResultsA total of 1 179 questionnaires were distributed, with 1 144 valid responses collected, yielding an effective response rate of 97.03%. Statistically significant differences were observed among full-time and part-time personnel of the nosocomial infection control administration in terms of age (t=5.32, P=0.021), professional background (χ²=9.90, P=0.019), educational qualifications (χ²=19.10, P<0.001), professional titles (χ²=12.60, P=0.002), and the levels of medical institutions (χ²=111.08, P<0.001). The scores of full-time personnel of the nosocomial infection control administration in fundamental cognition [92 (82, 99) points] and basic skills [88 (78, 96) points] were significantly higher than those of part-time personnel(Z=-2.21, P=0.027;Z=-2.74, P=0.006). Statistically significant differences were found in fundamental cognition scores between full-time and part-time personnel of the nosocomial infection control administration regarding occupational safety protection, definition of healthcare-associated infection outbreaks, types of drug-resistant bacteria and their prevention and control strategies, and transmission routes of different infectious diseases (all P<0.05). Statistically significant differences were also observed in basic skills scores including proficient use of monitoring platforms, formulation and revision of standard operating procedures (SOPs), independent completion of targeted surveillance, guidance on basic infection control skills, guidance for key departments, and follow-up of personnel with occupational exposure (all P<0.05). However, no statistically significant differences were found in scores of professional knowledge and personal qualities (P>0.05). ConclusionThere are certain differences in professional competency between full-time and part-time personnel of the nosocomial infection control administration in Shanghai in terms of fundamental cognition and basic skills. Part-time personnel can effectively improve their professional competency through systematic training on basic infection control knowledge and practical skills, thereby comprehensively enhancing the overall quality of the nosocomial infection administration team.

BACKGROUND:At present,the incidence of scoliosis is increasing year by year,especially in adolescent idiopathic scoliosis.Therefore,it is more and more important to strengthen the research on the treatment of adolescent scoliosis. OBJECTIVE:To summarize the current status,hotspots,emerging trends,and frontiers of global research on the treatment of adolescent idiopathic scoliosis to provide reference and guidance for future related research. METHODS:The literature related to the treatment of adolescent idiopathic scoliosis was retrieved on the Web of Science Core Collection(WOSCC)database from 2013 to 2023.CiteSpace 6.2.R1 software was used for visual analysis of countries,institutions,authors,and keywords. RESULTS AND CONCLUSION:(1)A total of 561 English articles were included in this study.Among countries,institutions,and authors,the United States has contributed the most.Nanjing University and Qiu,Yong(Affiliated Drum Tower Hospital,Nanjing University School of Medicine)are the most published institution and author.The academic journal with the largest number of articles is the European Spine Journal.(2)In the analysis of cited literature,the top 10 most cited articles mainly describe the effects of surgical treatment and conservative treatment on improving adolescent idiopathic scoliosis,especially improving the curvature of patients.(3)Through the summary of highly cited articles and the keyword clustering,keyword prominence in-depth mining,the research hotspots are currently the relationship between Cobb angle and treatment choice,the therapeutic effect of exercise therapy and the therapeutic effect of posterior vertebral fusion.(4)The prognosis of patients with different curvatures has not been studied in depth,and the etiology of adolescent idiopathic scoliosis has not been clarified,so the relationship between curvature and prognosis and the etiology of adolescent idiopathic scoliosis may be a new research trend in the future.

As the most common type of protein glycosylation, N-glycosylation begins with the synthesis of the dolichol-linked oligosaccharide (DLO) precursor in the endoplasmic reticulum. The mannosyltransferase Alg1 catalyzes the addition of the first mannose molecule to DLO, serving as a key enzyme in this biochemical pathway. The defect of human ALG1 gene can lead to the congenital disorders of glycosylation (CDG), i.e., ALG1-CDG. Therefore, it is of great significance to establish the expression and activity assay system of Homo sapiens Alg1 (HsAlg1) in vitro. In this study, full-length plasmid pET28a-His6-HsAlg1 and transmembrane domain-lacking plasmid pET28a-His6-HsAlg1_23-464 were constructed and expressed in Escherichia coli, and the activity of recombinant HsAlg1 and HsAlg1_23-464 was measured by liquid chromatography tandem mass spectrometry (LC-MS) with dolichyl-pyrophosphate GlcNAc2 (DPGn2) as the substrate. The results showed that HsAlg1 had transglycosylation activity, while the activity decreased after protein purification, which was partially restored upon re-addition of membrane components. However, HsAlg1_23-464 was unable to catalyze glycosylation. The results indicate that the N-terminal transmembrane domain (TMD) of HsAlg1 plays an important role in the catalytic reaction. This study lays a foundation for further expression and activity analysis of ALG1-CDG-related mutants.
Humans ; Escherichia coli/metabolism* ; Mannosyltransferases/biosynthesis* ; Glycosylation ; Recombinant Proteins/metabolism* ; Protein Domains

Objective To analyze the clinicopathological characteristics and survival prognosis of young female patients with gastric adenocarcinoma. Methods A retrospective analysis was conducted on female patients who underwent radical gastrectomy at Zhongshan Hospital, Fudan University between January 2014 and December 2020, with postoperative pathological confirmation of gastric adenocarcinoma. Those aged ≤45 years were defined as the young group (n＝287), and were matched in a 1∶2 ratio by pTNM stage with female patients aged ≥60 years (elderly group, n＝574). Clinicopathological characteristics were compared between the two groups. Survival curves were plotted using the Kaplan-Meier method, and overall survival (OS) rates were assessed by log-rank test. Prognostic factors in the young group were analyzed using Cox regression models. Results Compared to elderly patients, young female gastric cancer patients exhibited a higher prevalence of tumors in the middle third of the stomach and a lower proportion in the upper third of the stomach. Molecular profiling revealed a higher frequency of HER2-low expression and elevated Ki-67 index. Pathologically, these patients were more frequently diagnosed with poorly differentiated or undifferentiated adenocarcinoma and signet ring cell carcinoma, while Lauren classification showed a predominance of the diffuse type with a lower proportion of the intestinal type (P＜0.05). Stratified analysis showed no significant difference in OS rates between the two groups for stage Ⅱ and Ⅲ patients; however, among stage Ⅰ patients, the young group had significantly better OS rates than the elderly group (P＝0.037). Multivariate Cox analysis and log-rank test confirmed that pN₃ stage (HR＝3.576, 95%CI 1.652–7.740), stage Ⅲ (HR＝3.581, 95%CI 1.059–12.106), and diffuse type (HR＝2.711, 95%CI 1.316–5.585) were risk factors for poor prognosis in young female gastric cancer patients. Conclusions Young female patients with gastric adenocarcinoma typically present with clinicopathological features such as the diffuse type, poor differentiation, and high proliferation. Moreover, pN₃ stage, stage Ⅲ cancer, and the diffuse type histology are correlated with a poor prognosis in this demographic.

Objective To investigate changes in gut microbiota during diabetic nephropathy(DN)pro-gression using 16S rDNA sequencing technology.Methods A total of 90 male SD rats were randomly divided into a normal control group(n=10,no modeling,regular feeding)and a model group(diabetes model).The diabetes model was established by a single intraperitoneal injection of streptozotocin(STZ)at 60 mg/kg,with regular feeding.According to the feeding time after modeling,the rats were divided into 2-week,4-week,8-week,and 12-week model groups(fed for 2,4,8,and 12 weeks after model establishment),with 20 rats in each group.Blood urea nitrogen(BUN)was measured using the urease method,serum creatinine(Scr)was deter-mined by the picric acid method,and ELISA was used to detect urinary kidney injury molecule-1(KIM-1)and neutrophil gelatinase-associated lipocalin(NGAL)levels.HE,PAS,and Masson staining were used to observe renal tissue pathological changes.Gut microbiota was collected from the rats,and 16S rDNA gene sequencing was used to analyze the gut microbiota to understand changes in the gut microbiota.Results Compared with the normal control group,the levels of KIM-1 and NGAL in urine of rats in all model groups were significantly increased(P<0.05).Pathological staining results showed that,compared with the normal control group,rats in all model groups exhibited diffuse thickening of the glomerular basement membrane and pathological chan-ges such as local necrosis and vacuolar degeneration in renal tubular epithelial cells.16S rDNA sequencing re-sults indicated that the abundance and structure of intestinal microbiota in rats of all model groups changed.Compared with the normal control group,in the 8-week and 12-week model groups,the relative abundance of Bacteroides and Akkermansia decreased,while the relative abundance of Roseburia,Alloprevotella,Prevotel-laceae-Ga6A1,and Ruminococcaceae UCG-005 increased.Compared with the normal control group,in the 12-week model group,the abundance of Akkermansia decreased and that of Prevotellaceae-NK3B31 increased.Conclusion The abundance and structure of gut microbial community in DN rats under conventional feeding at different time points change significantly,further confirming the"gut-kidney axis"theory.

Objective To investigate the efficacy of sevelamer(SL)and calcium acetate(CA)in treating hyperphosphatemia in patients with end-stage renal disease(ESRD)undergoing maintenance hemodialysis(MHD)and their effects on calcium-phosphorus metabolism and levels of peripheral blood fetuin-A and fibroblast growth factor-23(FGF-23).Methods A total of 92 ESRD patients attending the First Hospital of Zibo between January 2022 and December 2023 were enrolled.They were randomly assigned to either the CA group(46 cases)or the SL group(46 cases)using a random number table method.Patients in both groups received MHD and conventional treatment.Additionally,patients in the CA group were given CA,while those in the SL group were given SL,with the treatment continuing for 3 months.The outcome indicators were assessed and compared between the two groups.The primary outcome indicator was clinical efficacy.The secondary outcome indicators included calcium-phosphorus metabolism indicators(blood calcium,blood phosphorus,calcium-phosphorus product,and intact parathyroid hormone[iPTH]),coronary artery calcification score(CACs),serum biochemical indicators(including fetuin-A,FGF-23,and C-reactive protein[CRP]),and adverse reactions and cardiovascular events during the course of treatment.Results There were no statistically significant differences in baseline data between the two groups(P>0.05).There was a significant difference in clinical efficacy between the SL group and the CA group(P<0.05).The differences in blood calcium,blood phosphorus,calcium-phosphorus product,iPTH,and CACs before and after treatment were statistically significant between the two groups(P<0.05).The differences in fetuin-A,FGF-23,and CRP before and after treatment were also statistically significant between the two groups(P<0.05).During treatment,there was no significant difference in the incidences of adverse reactions and cardiovascular events between the two groups(P>0.05).Conclusion SL demonstrates superior efficacy compared to CA in treating hyperphosphatemia in MHD patients.SL effectively regulates calcium-phosphorus metabolism,reduces CACs,regulates peripheral blood fetuin-A and FGF-23 levels,and leads to fewer adverse reactions.SL may be a preferred option for clinical management.

OBJECTIVES: To investigate the effect of amentoflavone (AF) for alleviating lipopolysaccharide (LPS)-induced acute lung injury (ALI) in mice and inhibiting NLRP3/ASC/Caspase-1 axis-mediated pyroptosis. METHODS: Female BALB/c mice were randomly divided into control group, LPS group, and AF treatment groups at low, moderate and high doses (n=12). ALI models were established by tracheal LPS instillation, and in AF treatment groups, AF was administered by gavage 30 min before LPS instillation. Six hours after LPS instillation, the mice were euthanized for examining lung tissue histopathological changes, protein levels in BALF, and MPO levels in the lung tissue. In the in vitro experiment, RAW264.7 cells were pretreated with AF, AC (a pyroptosis inhibitor), or their combination for 2 h before stimulation with LPS and ATP. The changes in cell proliferation and viability were detected using CCK-8 assay, and IL-1β, IL-6, IL-18, and TNF-α levels were determined with ELISA. Immunohistochemistry, immunofluorescence assay, and immunoblotting were used to detect the protein levels of NLRP3, ASC, cleaved caspase-1, and GSDMD N in rat lung tissues and the treated cells. RESULTS: In mice with LPS exposure, AF treatment significantly improved lung pathologies and edema, reduced protein levels in BALF and pulmonary MPO level, inhibited the high expression of NLRP3/ASC/Aspase-1 axis, reduced the expression of GSDMD N, and lowered the release of IL-1β, IL-6, IL-18, and TNF‑α. In RAW264.7 cells with LPS and ATP stimulation, AF pretreatment effectively reduced cell death, inhibited activation of the NLRP3/ASC/Aspase-1 axis, and reduced GSDMD N expression and the inflammatory factors. The pyroptosis inhibitor showed a similar effect to AF, and their combination produced more pronounced effects in RAW264.7 cells. CONCLUSIONS Amentoflavone can alleviate ALI in mice possibly by inhibiting NLRP3/ASC/Caspase-1 axis-mediated cell pyroptosis.
Animals ; Pyroptosis/drug effects* ; Acute Lung Injury/pathology* ; Mice ; Mice, Inbred BALB C ; Female ; Lipopolysaccharides ; Biflavonoids/pharmacology* ; RAW 264.7 Cells ; NLR Family, Pyrin Domain-Containing 3 Protein ; Caspase 1/metabolism* ; Lung