One of the basic questions in the aging field is whether there is a fundamental difference between the aging of lower invertebrates and mammals. A major difference between the lower invertebrates and mammals is the abundancy of noncoding RNAs, most of which are not conserved. We have previously identified a noncoding RNA Terc-53 that is derived from the RNA component of telomerase Terc. To study its physiological functions, we generated two transgenic mouse models overexpressing the RNA in wild-type and early-aging Terc-/- backgrounds. Terc-53 mice showed age-related cognition decline and shortened life span, even though no developmental defects or physiological abnormality at an early age was observed, indicating its involvement in normal aging of mammals. Subsequent mechanistic study identified hyaluronan-mediated motility receptor (Hmmr) as the main effector of Terc-53. Terc-53 mediates the degradation of Hmmr, leading to an increase of inflammation in the affected tissues, accelerating organismal aging. adeno-associated virus delivered supplementation of Hmmr in the hippocampus reversed the cognition decline in Terc-53 transgenic mice. Neither Terc-53 nor Hmmr has homologs in C. elegans. Neither do arthropods express hyaluronan. These findings demonstrate the complexity of aging in mammals and open new paths for exploring noncoding RNA and Hmmr as means of treating age-related physical debilities and improving healthspan.
Animals ; Mice ; RNA, Untranslated/metabolism* ; Aging/genetics* ; Mice, Transgenic ; Telomerase/metabolism* ; RNA/genetics* ; Hippocampus/metabolism* ; Humans ; Mice, Inbred C57BL

【Objective】 To observe the clinical efficacy of ultrasound-guided autologous platelet- rich plasma (PRP) injection for the treatment of common peroneal nerve compression syndrome, and to provide reference for the treatment of peripheral nerve compression diseases. 【Methods】 A patient with common peroneal nerve compression syndrome was treated with ultrasound-guided injection of autologous PRP for nerve water separation. The efficacy of PRP injection treatment on common peroneal nerve compression syndrome was evaluated by observing the patient′s symptoms, electrophysiological and imaging manifestations. 【Results】 After systematic injection therapy, the patient′s symptoms, signs and electromyography showed significant improvement, and there were no significant adverse reactions after 3 months of follow-up. 【Conclusion】 Ultrasound guided PRP injection therapy improves neurological dysfunction in common peroneal nerve compression syndrome.

Objective:To investigate the lipidomics differences of CD4+T immune cells in diabetic kidney disease(DKD)mice,and screen out the differential metabolites with biological significance.Methods:CD4(L3T4)MicroBeads immunomagnetic beads were used to isolate CD4+T immune cells from spleen of BKS.Cg-Dock7m+/+Leprdb/J mice with spontaneous DKD;the purity of CD4+T cells were identified by flow cytometry.The non-targeted lipidomics of CD4+T cells were detected by LC-MS/MS,and the differ-ential metabolites were analyzed.Results:A total of 463 metabolites were detected by LC-MS.PCA and OPLS-DA analysis showed that the metabolic components were significantly separated;twenty-four differential metabolites were screened out.KEGG and enrich-ment analysis showed that the differential metabolites involved in the disorder of glycerol phospholipid metabolism.Conclusion:Phos-pholipid metabolism of CD4+T cells is closely related to the occurrence of DKD.Phospholipid metabolism targeting DKD CD4+T cells in DKD may be a new direction of DKD treatment.

Background Arsenic, cobalt, barium, and other individual metal exposure have been confirmed to be associated with the incidence of kidney stones. However, there are few studies on the association between mixed metal exposure and kidney stones, especially in occupational groups. Objective To investigate the association between mixed metal exposure and kidney stones in an occupational population from a metal smelting plant. Methods A questionnaire survey was conducted to collect sociodemographic characteristics, medical history, and lifestyle information of 1158 mixed metal-exposed workers in a metal smelting plant in Guangdong Province from July 2021 to January 2022. Midstream morning urine samples were collected from the workers, the concentrations of 18 metals including lithium, vanadium, chromium, manganese, cobalt, nickel, copper, zinc, arsenic, selenium, strontium, molybdenum, cadmium, cesium, barium, tungsten, titanium, and lead were measured by inductively coupled plasma mass spectrometry, and the urinary mercury levels were measured by cold atomic absorption spectroscopy. Based on predetermined inclusion criteria, a total of 919 mixed metal-exposed workers were included in the study, including 117 workers in the kidney stone group and 802 workers in the non-kidney stone group. With a detection rate of urinary metals greater than 80% as entry criterion, 16 eligible metals were finally included for further analysis. Parametric or non-parametric methods were used to compare the differences between continuous or categorical variables of the non-kidney stone group and the kidney stone group. Logistic regression models were constructed to explore the association between individual metal exposures and kidney stones. Weighted quantile sum (WQS) regression models were used to evaluate the association between mixed metal exposure and kidney stones, as well as the weights of each metal on kidney stones. Then Bayesian kernel machine regression (BKMR) models were used to explore the overall effect of mixed metal exposure on renal calculi and the potential interactions between metals. Results We found that there were significant differences in sex, age, length of service, and body mass Index (BMI) between the non-kidney stone group and the kidney stone group (P<0.05). The urinary concentrations of molybdenum and barium in the kidney stone group were higher than those in the non-kidney stone group, and the differences were statistically significant (P<0.05). The logistic regression models demonstrated that urinary cobalt, arsenic, molybdenum, and barium were positively correlated with the risk of kidney stones (P_trend<0.05). The WQS regression models showed that the mixed exposure to vanadium, cobalt, arsenic, molybdenum, and barium was positively associated with the risk of kidney stones (P<0.05). Among them, molybdenum, arsenic, and barium accounted for 0.391, 0.337, and 0.154, respectively. The BKMR results revealed a positive association between metal mixture exposure and the risk of kidney stones (P<0.05). When other metals were fixed at the 25th, 50th, or 75th percentile, arsenic, molybdenum, cobalt, and barium exhibited significant positive effects on the risk of kidney stones (P<0.05), while vanadium showed a significant negative effect (P<0.05). The interaction analysis demonstrated interactions between barium and cobalt, as well as between vanadium and cobalt (P<0.05). Conclusion In the occupational population of this smelter, occupational mixed metal exposure could increase the risk of kidney stones, and the main metals are molybdenum, arsenic, barium, and cobalt.

Background::The pharmacokinetic and clinical behaviors of many proton pump inhibitors (PPIs) in peptic ulcer treatment are altered by CYP2C19 genetic polymorphisms. This non-inferiority study evaluated the efficacy and safety of the novel PPI anaprazole compared with rabeprazole. We also explored the influence of Helicobacter pylori ( H. pylori) infection status and CYP2C19 polymorphism on anaprazole. Methods::In this multicenter, randomized, double-blind, double-dummy, positive-drug parallel-controlled, phase III study, Chinese patients with duodenal ulcers were randomized 1:1 to receive rabeprazole 10 mg + anaprazole placebo or rabeprazole placebo + anaprazole 20 mg once daily for 4 weeks. The primary efficacy endpoint was the 4-week ulcer healing rate assessed by blinded independent review. Secondary endpoints were the proportion of patients with improved overall and individual duodenal ulcer symptoms at 4 weeks. Furthermore, exploratory subgroup analysis of the primary endpoint by H. pylori status and CYP2C19 polymorphism was conducted. Adverse events were monitored for safety. Non-inferiority analysis was conducted for the primary endpoint. Results::The study enrolled 448 patients (anaprazole, n = 225; rabeprazole, n = 223). The 4-week healing rates were 90.9% and 93.7% for anaprazole and rabeprazole, respectively (difference, -2.8% [95% confidence interval, -7.7%, 2.2%]), demonstrating non-inferiority of anaprazole to rabeprazole. Overall duodenal ulcer symptoms improved in 90.9% and 92.5% of patients, respectively. Improvement rates of individual symptoms were similar between the groups. Healing rates did not significantly differ by H. pylori status or CYP2C19 genotype for either treatment group. The incidence of treatment-emergent adverse events was similar for anaprazole (72/220, 32.7%) and rabeprazole (84/219, 38.4%). Conclusions::The efficacy of anaprazole is non-inferior to that of rabeprazole in Chinese patients with duodenal ulcers.Registration::ClinicalTrials.gov, NCT04215653.

Objective:To standardize the naming of organ at risk (OAR) and target area during cervical cancer radiotherapy based on AAPM TG-263.Methods:After self-programming of Matlab software to implement the reading and resolution of radiotherapy structure files, the naming of each substructure was automatically output, recorded and restored. After naming all substructures, the structure names were classified by keywords. According to TG-263, a standard naming conversion table of OAR and target area was developed, and the classified structure names were standardized through procedures. Finally, the standardized named radiotherapy structure files were output and imported into the treatment planning system (TPS).Results:The radiation structure of 144 patients with cervical cancer was successfully transformed and displayed correctly in TPS. Before the transformation, the naming of OAR and target area lacked of uniform norms and standards, and the naming of the same structure significantly differed. After the transformation, 43 naming methods of OAR and 74 naming methods of the target area were unified into 20 and 8 naming methods, which were more convenient for staff understanding and communication.Conclusion:The standardization of cervical cancer radiotherapy structure naming can reduce the inconsistency of naming and provide reference for the standardized naming of pelvic tumors.

Objective To investigate the influence of multidisciplinary team (MDT) model on decisionmaking of adjuvant chemotherapy for breast cancer and analyze relevant influencing factors.Methods The patients with invasive breast cancer who underwent surgery and MDT discussion for adjuvant treatment in Shaoxing People's Hospital,from May 2016 to May 2018,were retrospectively analyzed.The patient's clinicopathological characteristics and postoperative adjuvant treatment and MDT records were obtained.Here the chemotherapy decision alternation was defined as disagreement in chemotherapy or not,or inconsistence in regiments between the attending doctor and multidisciplinary team.Results A total of 385 patients were enrolled in the multidisciplinary discussion and 327 patients (327/385,84.9％) were suggested to receive chemotherapy.Differences between attending doctor's recommendation and MDT panel's decision were found in 23 (23/385,6％) patients,of whom 15 patients (15/23,65.2％) were escalated adjuvant treatment and 8 patients (8/23,34.8％) were de-escalated adjuvant treatment.The relevant pathological indicators affecting the change of chemotherapy decision-making included the Ki67 expression index in the intermediate state of 15％ to 30％,the low expression of ER/PR and the small tumor of T1a.Conclusion MDT can influence the decision of adjuvant chemotherapy for breast cancer surgery,and can be promoted in grassroots hospitals at all levels.

Objective To investigate the predictive value of thromboelastography (TEG) parameters for hematoma enlargement after intracerebral hemorrhage.Methods Patients with primary intracerebral hemorrhage within 6 h after onset admitted to the Second People's Hospital of Changshu between March 2016 and March 2018 were enrolled prospectively.Hematoma enlargement was defined as the volume of hematoma detected by CT within 48 h after onset increased by ＞ 12.5 cm3 or ＞ 33％ compared with that at admission.The baseline data in the hematoma enlargement group and the non-hematoma enlargement group were compared.Multiple logistic regression analysis was used to determine the independent correlation between TEG parameters and hematoma enlargement.The receiver operating characteristic (ROC) curve was used to analyze the predictive value of TEG parameters for hematoma enlargement.Results A total of 141 patients with intracerebral hemorrhage were enrolled,of which 38 (27.0％) had hematoma enlargement.Compared with the non-hematoma enlargement group,the baseline National Institutes of Health Stroke Scale score (P =0.001),thrombin time (P =0.022),fasting blood glucose (P =0.007),hematoma ruptured into the ventricle (P =0.001),baseline hematoma volume (P =0.001),and coagulation reaction time measured by TEG (P=0.002) were significantly increased in the hematoma enlargement group,while the baseline Glasgow Coma Scale score (P =0.001) and α angle measured by TEG (P =0.021) were significantly decreased.Multivariate logistic regression analysis showed that after adjusting confounding factors,the prolonged coagulation reaction time (odds ratio [OR] 3.436,95％ confidence interval [CI] 1.083-9.905;P =0.036) and decreased α angle (OR 0.777,95％ CI0.656-0.921;P =0.004) were the independent predictors of hematoma enlargement after intracerebral hemorrhage.The area under the curve of coagulation reaction time predicting hematoma enlargement was 0.680 (95％ CI 0.588-0.772;P =0.004),and the sensitivity and specificity were 84.2％ and 52.4％ when 4.0 min was the cut-off value.The area under the curve of α angle predicting hematoma enlargement was 0.636 (95％ CI 0.534-0.738;P =0.007).The sensitivity and specificity were 73.7％ and 57.3％ when the cut-off value was 65.1 °.Conclusion The prolonged coagulation reaction time and the decrease of α angle detected by TEG had certain predictive value for hematoma enlargement after cerebral hemorrhage.

Objective To evaluate the muscle mass in maintenance hemodialysis (MHD) patients and analyze the influential factors.Methods Ninety-seven patients on MHD and 34 healthy people were recruited.Muscle mass was measured by bioelectrical impedance analysis and compared.Patients'age,sex,height,body weight,walking activity,modified quantitative subjective global assessment (MQSGA) score and laboratory tests were recorded.The relationship of appendicular skeletal muscle mass/height2 (ASM/H2) and other factors were analyzed using multivariate linear regression.Results Compared with normal cohort,the MHD patients showed lower body fat rate and lower ASM/H2 (both P ＜ 0.05).In 97 MHD patients,21.4％ of male patients suffered from sarcopenia,and 24.4％ of female patients suffered from sarcopenia.Patients were divided into two groups according to the level of ASM/H2 (male ＜ 7.0 kg/m2,female ＜ 5.8 kg/m2).The grip strength,serum creatinine,1,25(OH)2D and mid-arm muscle circumference in low ASM/H2 group were lower than those in normal ASM/H2 group,and the differences were significant (all P ＜ 0.05).In multivariable regression model,male (β=0.534,P=0.003),1,25(OH)2D (β=0.582,P=0.024),creatinine (β=0.421,P=0.037),grip strength (β=0.681,P=0.001),and lg[NT-proBNP] (β=-1.760,P=0.042) were independently associated with ASM/H2 in MHD patients.Conclusion The prevalence of sarcopenia is much higher in MHD patients than in healthy people.The levels of grip strength,NT-proBNP,creatinine and 1,25(OH)2D are the important influential factors for muscle mass in MHD patients.

Objective To assess the safety and diagnostic accuracy of manual carbon dioxide (C02) digital angiography in performing endovascular therapy (EVT) for arteriosclerosis obliterans (ASO) of lower extremity in patients who have renal insufficiency or iodine allergy. Methods The clinical data of 19 patients with lower extremity ASO complicated by renal insufficiency or iodine allergy, who were admitted to authors' hospital to receive EVT of lower extremity with intraoperative C02 angiography during the period from January 2013 to March 2015, were retrospectively analyzed. Using manual bolus injection of C02, or with additional use of minimum dose of iodinated contrast media, CO2 angiography was performed so as to guide EVT procedure. The safety and diagnostic accuracy of manual C02 angiography were evaluated. Results A total of 21 endovascular treatments were performed in 19 patients with lower extremity ASO, and a total of 28 arterial segment lesions were treated. The technical success rate was 100％. Ankle-brachial index (ABI) was improved from preoperative 0. 56±0. 08 to postoperative 0. 74±0. 07, the difference was statistically significant (t= -20. 605, P＜0. 00l). The mean serum creatinine (sCr) levels tested at 48 h and one week after the treatment were (159. 91±33. 21) μmol/L and (143. 44±43. 59) μmol/L respectively, which were not significantly different from preoperative (139. 5±37. 6) μmol/L (t=-1. 098, P=0. 285), and none of these results met the standard of contrast nephropathy. Among the 21 times of EVT procedure, additional use of iodinated contrast media was employed in 13 procedures, the average used amount of iodine contrast agent was (12±5. 5) mL. After the treatment, sCr level was elevated, the estimated glomerular filtration rates (eGFR) were lower than 50 mL· min-1 · 1. 73 m-2, which restored to preoperative level in one week. CO2 angiography showed that the image quality of all arteries above the knee joint met the requirements of treatment, except for one patient whose images could not accurately display the length and extent of the stenosis due to restenosis of the superficial femoral artery. The image quality of the arteries below the knee level was usual. Conclusion In performing EVT procedure to treat lower extremity ASO the use of C02 angiography is safe. The image quality of all arteries above the knee joint is satisfactory, it can significantly reduce, or even avoid, the use of iodine contrast agents. Therefore, this technique is especially suitable for patients who have renal insufficiency or iodine allergy. (J Intervent Radiol, 2018, 27:211-214)