Objective To explore the number of peripheral blood regulatory T cells (Treg) in patients with chronic kidney disease (CKD) and its correlation with vascular calcification. Methods This was a single-center, cross-sectional, and observational study. Non-dialysis patients with CKD treated at Zhongshan Hospital, Fudan University from March 2021 to March 2022 were enrolled. Abdominal aortic calcification (AAC) was assessed using lateral abdominal X-ray. Number of Treg and cytokine levels were measured by flow cytometry. Logistic regression analysis was performed to evaluate the related factors for AAC in CKD patients. Results A total of 83 patients were included, aged 17–86 years, with 57 males (68.7%). The distribution of CKD stages was as follows: stage G1 in 7 patients (8.4%), stage G2 in 17 patients (20.5%), stage G3 in 21 patients (25.3%), stage G4 in 19 patients (22.9%), and stage G5 in 19 patients (22.9%). No AAC was observed in patients with stages G1 and G2, while the prevalence of AAC in patients with stages G3, G4, and G5 was 23.8%, 21.1%, and 26.3%, respectively. Compared with stage G1 patients, those with stages G3–5 showed decreased number of peripheral blood Treg and elevated levels of interleukin (IL)-6 and IL-17F (P＜0.05). The area under the receiver operating characteristic curve for number of peripheral blood Treg in predicting AAC in CKD patients was 0.766 (95%CI 0.652–0.879, P＝0.002). Logistic regression analysis showed that decreased number of Treg was related factor for AAC in CKD patients (OR＝0.957, 95%CI 0.922–0.992, P＝0.018). Conclusion As CKD progresses, number of peripheral blood Treg significantly decreases, which is correlated with AAC in CKD patients.

Diabetic kidney disease （DKD） is a microvascular complication of diabetes， with a complex pathogenesis， in which mitochondrial dysfunction is considered to be the core of DKD development. Taking mitochondria as a target to regulate mitochondrial energy metabolism， mitochondrial oxidative stress， mitophagy， and mitochondrial dynamic function represents a promising strategy for the DKD prevention and treatment， with good prospects in clinical application. Traditional Chinese medicine （TCM） has great potential to mediate mitochondrial dysfunction in the DKD prevention and treatment. This article deeply explores the intrinsic relationship between various forms of mitochondrial dysfunction and DKD， and summarizes the current research status of various Chinese herbal compounds and Chinese herbal formulas in targeting mitochondrial dysfunction for the DKD prevention and treatment. This article aims to provide new targets and strategies for the DKD prevention and treatment， and the research and development of TCM.

Objective: To analyze the disease burden of chronic obstructive pulmonary disease (COPD) and changes in its risk factors among residents in Zhejiang Province from 1990 to 2021, so as to identify key priorities for COPD prevention and control. Methods: Data on COPD mortality and disability-adjusted life years (DALY) for residents in Zhejiang Province from 1990 to 2021 were collected from the Global Burden of Disease (GBD) 2021 database. Standardized mortality and standardized DALY rate were calculated using the GBD 2021 world population standard structure. Premature mortality was computed via the life table method. The average annual percent change (AAPC) was applied to analyze trends in COPD mortality, DALY rate, and premature mortality. Changes in deaths of COPD risk factors were evaluated using population attributable fraction (PAF). Results: From 1990 to 2021, the standardized COPD mortality in Zhejiang Province decreased from 272.40/100 000 to 70.56/100 000 (AAPC=-4.395%), and the standardized DALY rate declined from 4 167.37/100 000 to 1 071.89/100 000 (AAPC=-4.396%). Similar downward trends were observed in both males (AAPC=-3.933%, -4.173%) and females (AAPC=-4.785%, -4.480%), all P<0.05. Crude mortality and DALY rates increased with age, and the crude mortality and DALY rates of various age groups in Zhejiang Province showed decreasing trends from 1990 to 2021 (all P<0.05). The premature mortality declined from 4.37% to 0.60% from 1990 to 2021 (AAPC=- 6.206%), with consistent trends across males and females (AAPC=- 6.144%, - 6.379%, all P<0.05). From 1990 to 2021, particulate matter pollution showed the largest reduction in PAF (- 56.76%), while ambient ozone pollution had the largest increase (103.07%) in Zhejiang Province. By 2021, smoking became the leading risk factor for deaths of COPD (PAF=43.32%). Conclusions The standardized mortality, standardized DALY rate, and premature mortality for COPD show consistent declining trends in Zhejiang Province from 1990 to 2021. However, risk factors such as smoking and ambient ozone pollution require intensified focus to further reduce disease burden of COPD.

OBJECTIVES: In recent years, the incidence and detection rate of pancreatic cystic lesions (PCLs) have increased significantly. Endoscopic ultrasound (EUS) plays an indispensable role in the diagnosis and differential diagnosis of PCLs. However, evidence comparing the diagnostic performance of EUS-guided fine-needle aspiration (EUS-FNA) and fine-needle biopsy (FNB) remains limited. This study aims to compare the diagnostic yield, adequacy of tissue acquisition, and safety between EUS-FNA and EUS-FNB in evaluating PCLs to inform clinical practice. METHODS: A retrospective review was conducted on patients with PCLs who underwent either EUS-FNA or EUS-FNB between January 2014 and August 2021. The diagnostic yield, tissue acquisition adequacy, and incidence of adverse events were compared between the 2 groups. RESULTS: A total of 90 patients with PCLs were included (52 in the FNA group and 38 in the FNB group). The diagnostic yield was similar between the FNA and FNB groups (94.2% vs 94.7%, P>0.05). The adequacy of tissue acquisition was 71.2% in the FNA group and 81.6% in the FNB group (P>0.05). No statistically significant difference was observed in the incidence of adverse events between the 2 groups (P>0.05). CONCLUSIONS Both EUS-FNA and EUS-FNB demonstrate equally high diagnostic yields and tissue adequacy in PCLs, with excellent safety profiles. Both methods are safe and effective diagnostic tools for evaluating PCLs.
Humans ; Endoscopic Ultrasound-Guided Fine Needle Aspiration/adverse effects* ; Retrospective Studies ; Female ; Male ; Pancreatic Cyst/diagnostic imaging* ; Middle Aged ; Biopsy, Fine-Needle/adverse effects* ; Aged ; Pancreatic Neoplasms/diagnosis* ; Adult ; Endosonography/methods* ; Pancreas/pathology* ; Diagnosis, Differential

Osteoarthritis (OA), the most prevalent joint disease of late life, is closely linked to cellular senescence. Previously, we found that the senescence of fibroblast-like synoviocytes (FLS) played an essential role in the degradation of cartilage. In this work, single-cell sequencing data further demonstrated that cartilage acidic protein 1 (CRTAC1) is a critical secreted factor of senescent FLS, which suppresses mitophagy and induces mitochondrial dysfunction by regulating SIRT3 expression. In vivo, deletion of SIRT3 in chondrocytes accelerated cartilage degradation and aggravated the progression of OA. Oppositely, intra-articular injection of adeno-associated virus expressing SIRT3 effectively alleviated OA progression in mice. Mechanistically, we demonstrated that elevated CRTAC1 could bind with NRF2 in chondrocytes, which subsequently suppresses the transcription of SIRT3 in vitro. In addition, SIRT3 reduction could promote the acetylation of FOXO3a and result in mitochondrial dysfunction, which finally contributes to the degradation of chondrocytes. To conclude, this work revealed the critical role and underlying mechanism of senescent FLSs-derived CRTAC1 in OA progression, which provided a potential strategy for the OA therapy.

Objective:To explore the association between single nucleotide polymorphism (SNP) rs2073618 and rs3102735 of the TNFRSF11B gene and the susceptibility to gastric cancer. Methods:A case-control study was conducted. A total of 577 patients with primary gastric cancer treated at Zhenjiang First People′s Hospital from May 2013 to June 2017 were selected as the case group, and 678 healthy individuals who underwent physical examinations at the same hospital during the same period were enrolled as the control group. Blood samples were collected from both groups, and genomic DNA was extracted. The target gene fragments were amplified using PCR, and genotyping was performed using the Snapshot technique. Statistical analysis was conducted using SPSS v2.0 software. This study was approved by the Medical Ethics Committee of the Zhenjiang First People′s Hospital (Ethics No. 20150083). Results:① The smoking rate was significantly higher in the case group than in the control group ( P=0.006). ② The T > C polymorphism at the rs3102735 locus of the TNFRSF11B gene was significantly associated with an increased risk of gastric cancer (CC vs. TT: OR=2.164, 95% CI=1.063~4.406, P=0.030). In contrast, the rs2073618 polymorphism did not show a significant association with gastric cancer susceptibility ( P>0.05). ③ Stratified analysis by age, gender, smoking status, and drinking status revealed no significant association between the rs2073618 polymorphism and gastric cancer susceptibility ( P>0.05). However, the rs3102735 polymorphism showed a significant association with gastric cancer risk in individuals over 62 years of age (CC vs. TT: OR=5.44, 95% CI=1.54~19.21, P=0.003). Conclusion:The rs3102735 polymorphism of the TNFRSF11B gene may be associated with susceptibility to gastric cancer, particularly in older populations. This polymorphism could serve as a potential indicator for identifying high-risk groups for gastric cancer.

The menopausal age is one of the important menopausal factors, and women of different menopausal ages have different risks of diabetes. This study reviewed the evidence from prospective studies on the association between the age at natural menopause and diabetes risk, both domestically and internationally, and presented its research design and main findings. Advanced menopause, especially premature and early menopause, will increase the risk of diabetes in postmenopausal women. The research on the influence of delayed menopause on the incidence of diabetes is still insufficient. Many factors may modify the association between menopausal age and the risk of diabetes.

This article summarizes the experience of providing remote nursing care for a pediatric patient with severe burns using augmented reality(AR)technology.Key nursing points include:to establish a remote management team to enhance multidisciplinary collaboration;to conduct remote nursing ward rounds to provide real-time guidance for clinical nursing practice;to remotely guide PICC(Peripherally Inserted Central Catheter)insertions and conduct precise fluid management;to remotely assess ward environments and provide guidance on disinfection and isolation measures;to alleviate pediatric pain through comprehensive management measures.After meticulous care and treatment,the patient's condition stabilized after 23 days,and the patient was transferred to a specialized hospital for continued treatment requiring skin grafting.

OBJECTIVE: To explore the association between single nucleotide polymorphism (SNP) rs2073618 and rs3102735 of the TNFRSF11B gene and the susceptibility to gastric cancer. METHODS: A case-control study was conducted. A total of 577 patients with primary gastric cancer treated at Zhenjiang First People's Hospital from May 2013 to June 2017 were selected as the case group, and 678 healthy individuals who underwent physical examinations at the same hospital during the same period were enrolled as the control group. Blood samples were collected from both groups, and genomic DNA was extracted. The target gene fragments were amplified using PCR, and genotyping was performed using the Snapshot technique. Statistical analysis was conducted using SPSS v2.0 software. This study was approved by the Medical Ethics Committee of the Zhenjiang First People's Hospital (Ethics No. 20150083). RESULTS: The smoking rate was significantly higher in the case group than in the control group (P = 0.006). The T>C polymorphism at the rs3102735 locus of the TNFRSF11B gene was significantly associated with an increased risk of gastric cancer (CC vs. TT: OR = 2.164, 95%CI = 1.063~4.406, P = 0.030). In contrast, the rs2073618 polymorphism did not show a significant association with gastric cancer susceptibility (P > 0.05). Stratified analysis by age, gender, smoking status, and drinking status revealed no significant association between the rs2073618 polymorphism and gastric cancer susceptibility (P > 0.05). However, the rs3102735 polymorphism showed a significant association with gastric cancer risk in individuals over 62 years of age (CC vs. TT: OR = 5.44, 95%CI = 1.54~19.21, P = 0.003). CONCLUSION The rs3102735 polymorphism of the TNFRSF11B gene may be associated with susceptibility to gastric cancer, particularly in older populations. This polymorphism could serve as a potential indicator for identifying high-risk groups for gastric cancer.
Humans ; Stomach Neoplasms/genetics* ; Polymorphism, Single Nucleotide ; Male ; Female ; Genetic Predisposition to Disease ; Middle Aged ; Case-Control Studies ; Osteoprotegerin/genetics* ; Aged ; Adult ; Genotype