ObjectiveTo explore psychological experiences and care needs of elderly patients with chronic obstructive pulmonary disease (COPD) following dysphagia. MethodsFrom April to June, 2024, 13 elderly patients with COPD and dysphagia received treatment in Yixing No. 2 People's Hospital (Yixing Occupational Disease Institute) and Northern Jiangsu People's Hospital were interviewed. Nvivo 11.0 and content analysis were employed to analyze and summarize themes. ResultsTwo main themes were identified. The psychological experiences included fear of eating due to swallowing and choking, swallowing anxiety in social situations, concerns about malnutrition, and emotional loss related to family. The care needs included improvement in swallowing function, adjustment of food texture, assistance with disease adaptation and effective access to health education information. ConclusionHealthcare professionals should thoroughly understand the psychological and needs of elderly patients with COPD-related dysphagia, and comprehensive nursing strategies should be developed and implemented to improve swallowing function and overall quality of life.

BACKGROUND: Chronic kidney disease (CKD) is associated with common pathophysiological processes, such as inflammation and fibrosis, in both the heart and the kidney. However, the underlying molecular mechanisms that drive these processes are not yet fully understood. Therefore, this study focused on the molecular mechanism of heart and kidney injury in CKD. METHODS: We generated an microRNA (miR)-26a knockout (KO) mouse model to investigate the role of miR-26a in angiotensin (Ang)-II-induced cardiac and renal injury. We performed Ang-II modeling in wild type (WT) mice and miR-26a KO mice, with six mice in each group. In addition, Ang-II-treated AC16 cells and HK2 cells were used as in vitro models of cardiac and renal injury in the context of CKD. Histological staining, immunohistochemistry, quantitative real-time polymerase chain reaction (PCR), and Western blotting were applied to study the regulation of miR-26a on Ang-II-induced cardiac and renal injury. Immunofluorescence reporter assays were used to detect downstream genes of miR-26a, and immunoprecipitation was employed to identify the interacting protein of LIM and senescent cell antigen-like domain 1 (LIMS1). We also used an adeno-associated virus (AAV) to supplement LIMS1 and explored the specific regulatory mechanism of miR-26a on Ang-II-induced cardiac and renal injury. Dunnett's multiple comparison and t -test were used to analyze the data. RESULTS: Compared with the control mice, miR-26a expression was significantly downregulated in both the kidney and the heart after Ang-II infusion. Our study identified LIMS1 as a novel target gene of miR-26a in both heart and kidney tissues. Downregulation of miR-26a activated the LIMS1/integrin-linked kinase (ILK) signaling pathway in the heart and kidney, which represents a common molecular mechanism underlying inflammation and fibrosis in heart and kidney tissues during CKD. Furthermore, knockout of miR-26a worsened inflammation and fibrosis in the heart and kidney by inhibiting the LIMS1/ILK signaling pathway; on the contrary, supplementation with exogenous miR-26a reversed all these changes. CONCLUSIONS Our findings suggest that miR-26a could be a promising therapeutic target for the treatment of cardiorenal injury in CKD. This is attributed to its ability to regulate the LIMS1/ILK signaling pathway, which represents a common molecular mechanism in both heart and kidney tissues.
Animals ; MicroRNAs/metabolism* ; Angiotensin II/toxicity* ; Mice ; Renal Insufficiency, Chronic/chemically induced* ; Mice, Knockout ; Disease Models, Animal ; Male ; Signal Transduction/genetics* ; LIM Domain Proteins/genetics* ; Mice, Inbred C57BL ; Cell Line ; Humans

Inherited thrombocytopenia (IT) is a group of rare hereditary platelet disorders characterized by reduced platelet counts and, sometimes accompanied by platelet dysfunction. This review comprehensively summarizes various cell models used in IT research, which are derived from different sources, including patient-derived primary cells (such as megakaryocytes, platelets, and hematopoietic stem and progenitor cells), stem cell lines (encompassing both adult and pluripotent stem cells), and immortalized megakaryocyte cell lines derived from tumor cells. These cell models provide an indispensable research platform for in-depth exploration of the pathogenesis of IT, screening of potential therapeutic drugs, and evaluation of drug efficacy. Additionally, this review delves into the research progress of utilizing gene editing technologies to simulate IT-causing mutations and their pathogenic mechanisms, and summarizes the application prospects and challenges of in vitro cell models in the field of IT research.

OBJECTIVE To analyze the prevalence of potentially inappropriate medication （PIM） in elderly patients with femoral neck fractures at admission and compare the concordance of 3 evaluation criteria. METHODS A retrospective study was conducted to review the data of elderly patients with femoral neck fractures admitted to the Department of Orthopedics in Northern Jiangsu People’s Hospital from July 2022 to June 2023. The PIMs were identified according to the Criteria of Potentially Inappropriate Medications for Older Adults in China：2017 edition （hereinafter referred to as Chinese criteria）， American Geriatrics Society 2023 Updated AGS Beers Criteria® for Potentially Inappropriate Medication in Older Adults （hereinafter referred to as 2023 Beers criteria）， third version criteria for screening tool of older people’s prescriptions for potentially inappropriate medication （hereinafter referred to as STOPP criteria version 3）. The concordance of the 3 evaluation criteria was compared by using Kappa statistics. RESULTS A total of 246 patients were included in this study； 49 patients （19.92%） with 77 PIMs were detected by the Chinese criteria， 64 patients （26.02%） with 118 PIMs were detected by the 2023 Beers criteria， and 41 patients （16.67%） with 67 PIMs were detected by the STOPP criteria version 3； 22 patients met all three criteria simultaneously. The concordance among the three criteria showed moderate agreement （0.417≤Kappa≤0.486） when compared in pairs. CONCLUSIONS There are certain differences in the PIM evaluated by the three criteria， but the prevalence of PIMs is below 30% according to the different H202134） criteria. Benzodiazepines， antipsychotics， antidepressants， and other drugs may increase the risk of patients falling again.

Objective To investigate the efficacy of red and blue lights combined with Yufa Shengfa solution and 5% minoxidil solution in treating Ludwig type Ⅰ female androgenetic alopecia. Methods A total of 160 patients with Ludwig type Ⅰ female androgenetic alopecia were randomly divided into group A (Yufa Shengfa solution combined with 5% minoxidil solution), group B (red and blue lights therapy combined with Yufa Shengfa solution), group C (red and blue lights therapy combined with 5% minoxidil solution) and group D (red and blue lights therapy combined with Yufa Shengfa solution and 5% minoxidil solution), with 40 cases in each group. All the patients orally took compound glycyrrhizin tablets and Centrum multivitamins, and the therapeutic period was 3 months. Differences in hair diameter, hair density, and the number of hair follicles with multiple hairs were compared before and after treatment. Results The hair density, hair diameter, and the number of hair follicles with multiple hairs improved significantly in 4 groups compared with those before treatment, and group D showed the best improvement in these parameters, with significant between-group differences (P < 0.001). There were no serious adverse events or side effects during treatment in all the patients. Conclusion Red and blue lights therapy combined with Yufa Shengfa solution and 5% minoxidil solution is an effective non-surgical treatment for Ludwig type Ⅰ female androgenetic alopecia.

[摘 要] 目的：探究CD133（又称PROM1）在胰腺癌组织中的表达及其与患者临床病理特征和预后的关系。方法：采用GEPIA网站分析TCGA数据库中胰腺癌患者CD133的表达情况，基于TCGA数据库分析人胰腺癌组织中PROM1 mRNA表达与肿瘤干细胞家族基因的相关性。利用免疫组织化学（IHC）染色技术研究CD133在胰腺癌组织中的表达及其临床意义，采用Wilcoxon秩和检验分析胰腺癌组织及其癌旁组织中CD133表达水平的差异，以χ2检验分析胰腺癌组织中CD133的表达与临床病理特征之间的关系，利用Kaplan-Meier法及Log-rank检验分析CD133不同表达水平的生存差异，以拟合Cox模型评价不同指标的预后价值。采用风险比（HR）及95%置信区间（95%CI）评估CD133表达水平与胰腺癌患者死亡风险的关联强度。结果：TCGA数据库分析显示，与癌旁组织相比，CD133在胰腺癌组织中的表达显著上调（P < 0.05）。胰腺癌组织中PROM1mRNA表达水平与肿瘤干细胞家族EPCAM、POU5F1、CD24、CD44和CXCR4相关；在不同分化程度、TNM分期和淋巴结转移情况的胰腺癌组织中，CD133的表达水平差异均有统计学意义（均P < 0.05）；单因素Cox模型分析显示，OS率在胰腺癌患者年龄[HR = 0.544，95% CI（0.299，0.990），P < 0.05]、浸润深度[HR = 0.496，95% CI（0.292，0.842），P < 0.05]、TNM分期[HR = 2.148，95% CI（1.352，3.412），P < 0.05]、CD133表达[HR = 1.935，95% CI（1.090，3.433），P < 0.05]等方面的差异均有统计学意义。多因素Cox模型分析显示，患者TNM分期[HR = 0.116，95%CI（ 0.025，0.551），P < 0.05]、淋巴结转移[HR = 0.392，95%CI（0.160，0.960），P < 0.05]和CD133表达[HR = 2.080，95%CI（1.053，4.106），P < 0.05]可作为预后评估的独立危险因素。结论：胰腺癌组织中CD133呈高表达，且CD133表达与胰腺癌患者的预后显著相关，是胰腺癌免疫治疗的潜在新靶点。

Objective To analyze the epidemiological characteristics of syphilis in Yangzhou City from 2013 to 2023, to understand the syphilis epidemic trends, and provide a scientific basis for formulating prevention and control strategies. Methods Syphilis case reports in Yangzhou City from 2013 to 2023 were collected through the infectious disease surveillance module of the Chinese Center for Disease Control and Prevention Information System. The annual average reported incidence rate and annual average growth rate were calculated. Descriptive epidemiological methods were employed to analyze the overview of syphilis and its temporal, geographical and demographic distribution characteristics. Linear trend chi-square tests were conducted to analyze the syphilis epidemic trends. Results A total of 19, 457 syphilis cases were reported in Yangzhou City from 2013 to 2023, with an annual average reported incidence rate of 39.17/100, 000. The overall incidence of syphilis showed an upward trend, with the reported incidence rate increasing from 37.26/100, 000 in 2013 to 43.27/100, 000 in 2023 (χ²= 50.528, P < 0.001), representing an annual average growth rate of 1.51%. The majority of reported cases were latent syphilis, accounting for 64.99% (12, 646/19, 457). The number of reported cases of primary, secondary and congenital syphilis revealed an overall decreased trend, while the number of reported cases of tertiary and latent syphilis increased trend. There was no significant seasonality or periodicity in the reported incidence rate of syphilis in Yangzhou City from 2013 to 2023. The top three districts with the highest annual average reported incidence rates were the Development District, Guangling District and Hanjiang District, with incidence rates of 50.93/100, 000, 50.89/100, 000 and 43.18/100, 000, respectively. There were 10, 290 male syphilis cases (52.89%) and 9, 167 female syphilis cases (47.11%). The top three occupations were farmers (8, 682 cases), homemakers and unemployed individuals (5, 379 cases) and retired personnel (2, 559 cases), accounting for 85.42% (16, 620/19, 457) of the reported cases. Conclusion The incidence of syphilis in Yangzhou City generally shows an upward trend, and the disease epidemic spectrum changes annually, with latent syphilis currently being the primary form. The prevention and control situation is severe. Therefore, syphilis prevention and control efforts should be further strengthened to block its transmission and prevalence.

Objective To evaluate the prognostic value of C-reactive protein (CRP), performance status (PS), lactate dehydrogenase (LDH), albumin (ALB) and derived neutrophil-to-lymphocyte ratio (dNLR) composite index (C-PLAN) as a prognostic indicator in advanced esophageal cancer patients treated with immune checkpoint inhibitor (ICI). Methods Hematologic indexes of 147 patients with advanced esophageal cancer treated by ICI in the Affiliated Hospital of Yangzhou University were collected before the first immunotherapy. CRP, PS, LDH, ALB and dNLR were scored and added to obtain C-PLAN index. Chi-square test was used to analyze the correlation between C-PLAN index and clinicopathological features; Kaplan-Meier survival curve was used to analyze the effects of C-PLAN index on overall survival (OS) and progression-free survival (PFS). Univariate and multifactor Cox proportional regression models were used to analyze whether C-PLAN index could be used as an independent factor affecting prognosis. Results A total of 147 patients with advanced esophageal cancer were divided into low-risk group (scored < 2, n=46) and high-risk group (scored ≥2, n=101) according to C-PLAN index. C-PLAN index was not correlated with age, sex, PS score, smoking, clinical stage, body mass index, pathological type, treatment strategy and operation (P>0.05). PFS and OS in the low-risk group were significantly better than those in the high-risk group (P < 0.001). In univariate Cox regression analysis, C-PLAN index was the influencing factor of PFS (P < 0.001) and OS (P=0.002). In multivariate Cox analysis, C-PLAN index was an independent prognostic factor of PFS (P=0.001) and OS (P=0.006). Conclusion C-PLAN index can be used as a reliable clinical index to predict the prognosis of patients with advanced esophageal cancer treated by ICI.

Objective To observe the clinical manifestations of 3 cases with myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease and anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis antibody overlapping syndrome (MNOS), aiming to expand the understanding of the clinical spectrum of such syndromes. Methods Retrospective analysis was performed on the data of 3 patients with MNOS who were positive for both MOG antibodies and NMDAR antibodies. Clinical features, neuroimaging characteristics, and outcomes were collected, and cell-based assay (CBA) technique was used for diagnosis. Results One case presented both positive MOG antibodies and NMDAR antibodies, but the clinical manifestations were typical symptoms of anti-NMDAR encephalitis. In one case, the clinical and cranial magnetic resonance imaging (MRI) features of demyelinating disease recurred after anti-NMDAR encephalitis, with atypical symptoms of MNOS such as numbness and weakness in limbs, blurred vision, and diplopia. The last case presented both positive MOG antibodies and NMDAR antibodies, but the clinical manifestations were typical symptoms of anti-NMDAR encephalitis. In MNOS, MOG antibody-associated disease and anti-NMDAR encephalitis may appear simultaneously or sequentially, with epilepsy being the most common symptom. Cranial MRI findings showed that the patients presented and mainly involved supratentorial lesions, which may also involve the brainstem, but no spinal cord lesions were found. All patients showed slightly abnormal cerebrospinal fluid. Patients showed a good response to first-line immunotherapy during the acute phase of the disease, with a favorable prognosis. But most patients were prone to relapse. Conclusion In MNOS patients, anti-NMDAR encephalitis may present with clinical and(or)MRI features of demyelinating disease simultaneously or sequentially. The clinical manifestations of patients are complex and diverse. Patients with atypical symptoms require to improving the understanding of MNOS and timely treatment.

Objective To explore the influencing factors of dwarfism in children and construct a nomogram model. Methods From June 2020 to December 2022, 1, 500 children were selected as the research objects, and 1, 422 cases were effectively investigated. According to incidence of dwarfism, the children were divided into normal group (n=1, 351) and dwarfism group (n=71). Univariate and multivariate Logistic regression analyses were used to explore the influencing factors of dwarfism in children; the R software was used to construct a nomogram model for prediction of the occurrence of dwarfism in children, and the receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the discrimination and consistency of the nomogram model. Results Among the 1 422 children, 71 cases had dwarfism, with an incidence rate of 4.99%. Multivariate Logistic regression analysis showed that birth weight, family history of dwarfism, milk intake and physical exercise were the influencing factors for the occurrence of dwarfism in children (P < 0.05). The area under the curve of the ROC curve predicted by the nomogram model for the occurrence of dwarfism in children was 0.897 (95%CI, 0.856 to 0.938), with good discrimination; the calibration curve slope of the nomogram model for predicting the occurrence of dwarfism in children approached 1, and the Hosmer-Lemeshow goodness of fit test showed that the was 5.020 and P was 0.740, indicating good consistency. Conclusion The nomogram model for predicting the occurrence of dwarfism in children based on four influencing factors of birth weight, family history of dwarfism, milk intake and physical exercise has good discrimination and consistency, which can provide reference for the development of personalized intervention measures in clinical practice.