Objective:To evaluate the application of blood glucose management evidence in hemodialysis patients with diabetic nephropathy within clinical practice, establish review indicators, and analyze both obstacles and enablers.Methods:Based on the feasibility, appropriateness, meaningfulness, and effectiveness (FAME) principle, the best evidence for blood glucose management in hemodialysis patients with diabetic nephropathy was evaluated. Ultimately, 21 pieces of evidence were included, and review indicators were established. A baseline review was conducted at the Hemodialysis Center of the Department of Nephrology, Zhongshan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, from August to September 2024. Based on the review findings, obstacles and enablers in the evidence-based practice process were analyzed, and change strategies were developed.Results:A total of 39 review indicators were established. Among these, one indicator achieved a 100.00% implementation rate, four indicators achieved an implementation rate between 80.00% and <100.00%, six indicators achieved an implementation rate between 60.00% and<80.00%, 19 indicators achieved an implementation rate between>0 and<60.00%, and nine indicators achieved a 0 implementation rate. After analyzing each review indicator, the primary obstacles included evidence not being transformed into clear and accessible formats, low awareness among healthcare providers and patients, lack of incentive mechanisms, significant gaps from existing nursing processes, insufficient manpower, need for external support, and requirement for additional training. Additionally, factors that promoted evidence translation included reliable sources of evidence, recognition and support for change from administrators and teams, a culture and experience of change within the team, the potential for change to yield significant benefits, and the availability of resources within the hospital to support the change.Conclusions:There is a significant gap between blood glucose management evidence and clinical practice among hemodialysis patients with diabetic nephropathy. Appropriate change strategies should be developed through clinical review and analysis of obstacles and enablers to promote the translation and application of evidence in clinical practice.

Cell ablation has recently emerged as a valuable technique for investigating cell lineage and function during the development of organisms.The nervous system contains diverse cellular populations,whose roles under physiological and pathological conditions are still not fully understood.Various cell ablation methods have been reported to specifically ablate different types of cell populations in the nervous system and have also been used to study cellular functions under physiological conditions as well as the pathogenesis of neurologi-cal system diseases.In this article,we have summarized common cell ablation techniques and focus on their applications in neurobio-logical and neurological system disease research.

Objective:To evaluate the application of blood glucose management evidence in hemodialysis patients with diabetic nephropathy within clinical practice, establish review indicators, and analyze both obstacles and enablers.Methods:Based on the feasibility, appropriateness, meaningfulness, and effectiveness (FAME) principle, the best evidence for blood glucose management in hemodialysis patients with diabetic nephropathy was evaluated. Ultimately, 21 pieces of evidence were included, and review indicators were established. A baseline review was conducted at the Hemodialysis Center of the Department of Nephrology, Zhongshan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, from August to September 2024. Based on the review findings, obstacles and enablers in the evidence-based practice process were analyzed, and change strategies were developed.Results:A total of 39 review indicators were established. Among these, one indicator achieved a 100.00% implementation rate, four indicators achieved an implementation rate between 80.00% and <100.00%, six indicators achieved an implementation rate between 60.00% and<80.00%, 19 indicators achieved an implementation rate between>0 and<60.00%, and nine indicators achieved a 0 implementation rate. After analyzing each review indicator, the primary obstacles included evidence not being transformed into clear and accessible formats, low awareness among healthcare providers and patients, lack of incentive mechanisms, significant gaps from existing nursing processes, insufficient manpower, need for external support, and requirement for additional training. Additionally, factors that promoted evidence translation included reliable sources of evidence, recognition and support for change from administrators and teams, a culture and experience of change within the team, the potential for change to yield significant benefits, and the availability of resources within the hospital to support the change.Conclusions:There is a significant gap between blood glucose management evidence and clinical practice among hemodialysis patients with diabetic nephropathy. Appropriate change strategies should be developed through clinical review and analysis of obstacles and enablers to promote the translation and application of evidence in clinical practice.

Objective To investigate the association between intestinal microbiota dysbiosis and colonic polyps,Helicobacter pylori(Hp)infection,and intestinal metaplasia.Methods A total of 200 patients diagnosed with colonic polyps,Hp infection,or both conditions.These patients were classified into three groups:the colonic polyp group(n=90),the Hp infection with intestinal metaplasia group(n=49),and the colonic polyp combined with Hp infection and intestinal metaplasia group(n=61).Additionally,62 individuals who underwent routine health examinations at our hospital during the same period were enrolled as a control group.The study compared gut microbiota imbalances across these groups to investigate the association between intestinal dysbiosis and colonic pol-yps,Hp infection,and the co-occurrence of colonic polyps with Hp-related intestinal metaplasia.Logistic regression analysis was performed to identify risk factors associated with the development of intestinal metaplasia due to Hp infection in patients with colonic polyps.Results Compared to the control group,intestinal flora imbalance was significantly more prevalent in the colorectal polyp group,the Hp infection with intestinal metaplasia group,and the colorectal polyp combined with Hp infection and intestinal metaplasia group(P<0.05).Moreover,intestinal flora imbalance in the colorectal polyp with Hp infection and intestinal metaplasia group was significantly higher than that in both the colorectal polyp group and the Hp infection with intestinal metaplasia group(P<0.05).Regarding exhaled gas levels,H2 and CH4 concentrations were significantly elevated in the groups with colorectal polyps accom-panied by Hp infection and intestinal metaplasia,those with colorectal polyps alone,and those with Hp infection and intestinal metaplasia,compared to the control group(P<0.05).Similarly,exhaled H2S levels were significantly higher in the group with colorectal polyps complicated by Hp infection and intestinal metaplasia than in the control group(P<0.05).Furthermore,exhaled H2 and CH4 levels showed positive correlations with the presence of colorectal polyps,Hp infection with intestinal metaplasia,and colorectal polyps combined with Hp infection and intestinal metaplasia(P<0.05).Exhaled H2S levels were positively correlated with colorectal polyps complicated by Hp infec-tion and intestinal metaplasia(P<0.05).Logistic regression analysis indicated that a history of smoking,atrophic gastritis,peptic ulcer,and intestinal flora imbalance are independent risk factors for Hp infection-associated intesti-nal metaplasia in patients with colorectal polyps(P<0.05).Conclusion Intestinal flora imbalance is associated with colorectal polyps and Hp-induced intestinal metaplasia,suggesting that microbial dysbiosis may represent a potential risk factor for the development of these conditions.

Cell ablation has recently emerged as a valuable technique for investigating cell lineage and function during the development of organisms.The nervous system contains diverse cellular populations,whose roles under physiological and pathological conditions are still not fully understood.Various cell ablation methods have been reported to specifically ablate different types of cell populations in the nervous system and have also been used to study cellular functions under physiological conditions as well as the pathogenesis of neurologi-cal system diseases.In this article,we have summarized common cell ablation techniques and focus on their applications in neurobio-logical and neurological system disease research.

Objective To investigate the association between intestinal microbiota dysbiosis and colonic polyps,Helicobacter pylori(Hp)infection,and intestinal metaplasia.Methods A total of 200 patients diagnosed with colonic polyps,Hp infection,or both conditions.These patients were classified into three groups:the colonic polyp group(n=90),the Hp infection with intestinal metaplasia group(n=49),and the colonic polyp combined with Hp infection and intestinal metaplasia group(n=61).Additionally,62 individuals who underwent routine health examinations at our hospital during the same period were enrolled as a control group.The study compared gut microbiota imbalances across these groups to investigate the association between intestinal dysbiosis and colonic pol-yps,Hp infection,and the co-occurrence of colonic polyps with Hp-related intestinal metaplasia.Logistic regression analysis was performed to identify risk factors associated with the development of intestinal metaplasia due to Hp infection in patients with colonic polyps.Results Compared to the control group,intestinal flora imbalance was significantly more prevalent in the colorectal polyp group,the Hp infection with intestinal metaplasia group,and the colorectal polyp combined with Hp infection and intestinal metaplasia group(P<0.05).Moreover,intestinal flora imbalance in the colorectal polyp with Hp infection and intestinal metaplasia group was significantly higher than that in both the colorectal polyp group and the Hp infection with intestinal metaplasia group(P<0.05).Regarding exhaled gas levels,H2 and CH4 concentrations were significantly elevated in the groups with colorectal polyps accom-panied by Hp infection and intestinal metaplasia,those with colorectal polyps alone,and those with Hp infection and intestinal metaplasia,compared to the control group(P<0.05).Similarly,exhaled H2S levels were significantly higher in the group with colorectal polyps complicated by Hp infection and intestinal metaplasia than in the control group(P<0.05).Furthermore,exhaled H2 and CH4 levels showed positive correlations with the presence of colorectal polyps,Hp infection with intestinal metaplasia,and colorectal polyps combined with Hp infection and intestinal metaplasia(P<0.05).Exhaled H2S levels were positively correlated with colorectal polyps complicated by Hp infec-tion and intestinal metaplasia(P<0.05).Logistic regression analysis indicated that a history of smoking,atrophic gastritis,peptic ulcer,and intestinal flora imbalance are independent risk factors for Hp infection-associated intesti-nal metaplasia in patients with colorectal polyps(P<0.05).Conclusion Intestinal flora imbalance is associated with colorectal polyps and Hp-induced intestinal metaplasia,suggesting that microbial dysbiosis may represent a potential risk factor for the development of these conditions.

Objective Utilizing transcriptomic sequencing,this study aimed to monitor the expression alterations of GIMAP8 and SEC14L5 throughout the progression of pulmonary fibrosis,thereby providing insights into the underlying mechanisms of its pathogenesis and evolution.Methods C57BL/6 male mice were assigned in a randomized manner to either the Silica or PBS group.The Silica group underwent non-exposed endotracheal intubation on days 0 and 14 with 50 μL 100 mg/mL silica suspension,while the control group received 50 μL phosphate-buffered saline solution.On day 28,lung function was detected and the mice were sacrificed,and lung morphology,fibrosis,and mRNA levels were observed.Results When contrasted with individuals in good health,a differential expression analysis of mRNA in patients with pneumoconiosis identified a total of 584 mRNAs with significant expression differences.Among these,the expression of 242 mRNA was observed to be markedly elevated,while that of 342 mRNA was found to be considerably diminished.The enrichment analysis indicated that the primarily affected mRNAs with altered expression were associated with pathways such as p53,nuclear factor-κB,tumor necrosis factor,AMP-activated protein kinase,and other signaling pathways.In the Silica mice,the alveolar structures were compromised,characterized by the presence of collagen fiber accumulation and the formation of fibrous masses.In contrast,the PBS mice maintained a normal pulmonary architecture.GIMAP8 expression was up-regulated whereas SEC14L5 expression was down-regulated in lung tissues in the Silica mice,and mice in the Silica group had poorer lung function.Conclusions The onset and progression of pulmonary fibrosis may be significantly influenced by GIMAP8 and SEC14L5 expression in patients with pneumoconiosis and in silicosis animal models.This association could serve as a foundational molecular insight,paving the way for the development of preventative and therapeutic strategies against these conditions.

Objective: To investigate the efficacy and safety of rapamycin in children with tuberous sclerosis complex (TSC) associated renal disease. Methods: A prospective self-control study was conducted. The clinical data of 92 children diagnosed with tuberous sclerosis complex associated kidney disease at the People′s Liberation Army General Hospital from January 2011 to January 2019 were collected. The long-term rapamycin treatment for all patients initiated at 1 mg/(m²·d), which was gradually adjusted to reach a blood concentration of 5-10 μg/L. The changes of the maximum diameter of renal lesions in children after rapamycin treatment were observed and analyzed with Wilcoxon test. Results: Ninety-two children, including 52 males and 40 females, who met the criteria were analyzed. Sixty patients had only renal angiomyolipoma(RAML), while 24 patients had only multiple renal cysts(MRC), and 8 patients had both lesions. The age of TSC diagnosis was 16.0 (7.0, 42.0) months, and the age of initial treatment with rapamycin was 63.5 (21.0, 103.0) months. The follow-up lasted for 12.0 (4.0, 23.0) months. Sequencing of TSC1 and TSC2 genes was performed in 54 children with TSC, including 3 patients (6%) with mutations in TSC1 gene and 51 patients (94%) with mutations in TSC2 gene. The maximum RAML diameter before treatment was 7.0 (4.0, 9.0) mm. The best effect reached at 3 months of treatment, with the diameter of 4.0 (0,7.0) mm. The maximum diameters at 6 months, 1 year and 1-2 years were 5.0 (0,9.8) mm, 5.0 (1.5, 8.5) mm, 5.5 (3.0, 9.0) mm, respectively, and were significantly different from the baseline (Z=-2.404,-2.350,-2.750,P=0.016,0.019,0.006, respectively). The maximum diameter after 2-3 years, and ≥3 years were 5.0 (3.9,7.0) mm and 6.0 (1.0, 11.0) mm, without significant difference from the baseline (Z=-0.856,-0.102,P=0.393,0.919, respectively).The maximum diameters of MRC after 3 months, 6 months, 1 year,1-2 years, 2-3 years, and ≥3 years were 11.0 (5.0, 14.0) mm,3.0 (0.0,11.0) mm,5.0 (0,21.0) mm,0 (0,14.0) mm,0 (0,10.0) mm, and 0 (0,18.3) mm, respectively, but were not significantly different rom the baseline (7.0 (5.0, 15.7) mm)(Z=-0.944,-1.214,-1.035,-1.896,-1.603,-1.214,P=0.345,0.225,0.301,0.058,0.109,0.225, respectively).Twenty-nine patients (32%) had oral ulcers during the entire treatment period, and no serious adverse reactions were observed. Conclusions Rapamycin could decrease the diameter of TSC-related RAML, but could not inhibit the growth of cysts. It is well tolerated in the treatment of renal diseases associated with tuberous sclerosis complex.

To investigate the efficacy and safety of rapamycin in children with tuberous sclerosis complex (TSC) associated renal disease. Methods A prospective self?control study was conducted. The clinical data of 92 children diagnosed with tuberous sclerosis complex associated kidney disease at the People's Liberation Army General Hospital from January 2011 to January 2019 were collected. The long?term rapamycin treatment for all patients initiated at 1 mg/(m2·d), which was gradually adjusted to reach a blood concentration of 5-10 μg/L. The changes of the maximum diameter of renal lesions in children after rapamycin treatment were observed and analyzed with Wilcoxon test. Results Ninety?two children, including 52 males and 40 females, who met the criteria were analyzed. Sixty patients had only renal angiomyolipoma(RAML), while 24 patients had only multiple renal cysts(MRC), and 8 patients had both lesions. The age of TSC diagnosis was 16.0 (7.0, 42.0) months, and the age of initial treatment with rapamycin was 63.5 (21.0, 103.0) months. The follow?up lasted for 12.0 (4.0, 23.0) months. Sequencing of TSC1 and TSC2 genes was performed in 54 children with TSC, including 3 patients (6%) with mutations in TSC1 gene and 51 patients (94%) with mutations in TSC2 gene. The maximum RAML diameter before treatment was 7.0 (4.0, 9.0) mm. The best effect reached at 3 months of treatment, with the diameter of 4.0 (0, 7.0) mm. The maximum diameters at 6 months, 1 year and 1-2 years were 5.0 (0,9.8) mm, 5.0 (1.5, 8.5) mm, 5.5 (3.0, 9.0) mm, respectively, and were significantly different from the baseline (Z=-2.404,-2.350,-2.750, P=0.016,0.019,0.006, respectively). The maximum diameter after 2-3 years, and≥3 years were 5.0 (3.9,7.0) mm and 6.0 (1.0, 11.0) mm, without significant difference from the baseline (Z=-0.856,-0.102, P=0.393, 0.919, respectively).The maximum diameters of MRC after 3 months, 6 months, 1 year,1-2 years, 2-3 years, and≥3 years were 11.0 (5.0, 14.0) mm,3.0 (0.0,11.0) mm,5.0 (0,21.0) mm,0 (0,14.0) mm,0 (0,10.0) mm, and 0 (0, 18.3) mm, respectively, but were not significantly different rom the baseline (7.0 (5.0, 15.7) mm) (Z=-0.944,-1.214,-1.035,-1.896,-1.603,-1.214, P=0.345, 0.225, 0.301, 0.058, 0.109, 0.225, respectively). Twenty?nine patients (32%) had oral ulcers during the entire treatment period, and no serious adverse reactions were observed. Conclusions Rapamycin could decrease the diameter of TSC?related RAML, but could not inhibit the growth of cysts. It is well tolerated in the treatment of renal diseases associated with tuberous sclerosis complex.

Objective To investigate effects of arthroscopic reconstruction of medial patellofemoral ligament (MPFL) using partial peroneus longus tendon autograft in treating recurrent patellar dislocation.Methods Forty-six patients (53 knees) with recurrent dislocation of patella received autologous partial peroneus longus tendon grafting for MPFL reconstruction after arthroscopic lateral retinaculum release from May 2009 to April 2010.Anatomic relation between femoral trochlea and patella,and motion path of patella were observed arthroscopically in adjustment of flexion and extension strength of grafted tendon in different angles.Successively,the tendon ends were fixed within bone tunnel of medial femoral condyle by using absorbable interface screws with synchronous superomedial displacement of tibial tuberosity.Stability of patellofemoral joint,dislocation recurrence,subjective symptoms of affected knees and general function recovery condition of affected limbs were studied.Results All patients were followed up for average 18 months (range,12-24 months),which showed the improvement of knee joint stability,without recurrence of patellar dislocation.Apprehensive test was negative.Axial X-ray films and CT of patella showed normal anatomical relation of patellofemoral joint.The Kujala patellar stability questionnaire scored (54.6 ±5.4) points before operation and (92.3 ±8.9) points after operation (t =55.41,P ＜ 0.01).All patients showed some improvement of motor ability after operation.CT examination showed that the congruence angle of patella and femoral trochlea was improved from preoperative (27.8 ± 8.1) ° to postoperative (2.3 ± 9.4) ° (t =20.87,P ＜ 0.01).Otherwise,ankle joint in the tendon donor site acted well,with normal function.Conclusion Arthroscopic lateral patellar retinaculum release and MPFL reconstruction using partialperoneus longus tendon autograft are effective in treatment of recurrent patellar dislocation in combination with superomedial displacement of tibial tuberosity,and avoid potential complications in tendon removal from around knee joint.