ObjectiveTo investigate the prevalence of muscle changes （including sarcopenia and myosteatosis） and related influencing factors in patients with porto-sinusoidal vascular disorder （PSVD）， and to provide a theoretical basis for the early identification， prevention， and intervention of muscle changes in PSVD patients. MethodsA total of 132 PSVD patients who were diagnosed in Nanjing Second Hospital from July 2017 to July 2024 were enrolled as case group， and the hospital staff who underwent physical examination in 2025 were enrolled as healthy control group. Propensity score matching was performed based on age and sex at a ratio of 1∶1. According to muscle status assessed by abdominal CT， the subjects were divided into non-muscle change group， mild muscle change group （myosteatosis alone）， and severe muscle change group （sarcopenia alone or sarcopenia comorbid with myosteatosis）， with the type and severity of muscle change as the exposure factors. General information， laboratory tests， L3-level CT images， and liver biopsy data were collected for the patients in the case group， and general information and CT images were collected for the individuals in the healthy control group. Sarcopenia was diagnosed by measuring skeletal muscle index at the L3 level （<44.77 cm²/m² for men and <32.50 cm²/m² for women）， and myosteatosis was defined by mean muscle attenuation combined with BMI （BMI <24.9 kg/m² with attenuation <41 HU or BMI ≥25 kg/m² with attenuation <33 HU）. Demographic， laboratory， and clinical parameters were compared between the case group and the healthy control group. The independent-samples t test was used for comparison of normally distributed continuous data between groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. The univariate and multivariate Logistic regression analyses were used to identify the factors associated with sarcopenia in PSVD. ResultsAmong the 132 patients with PSVD， there were 83 patients with portal hypertension （PH） and 49 patients without PH， and there were significant differences between these two groups in age， albumin， albumin/globulin ratio， leukocyte count， neutrophil count， red blood cell count， platelet count， direct bilirubin， indirect bilirubin， hemoglobin， blood calcium， cholinesterase， total bile acid， triglyceride， total cholesterol， prothrombin time， international normalized ratio， activated partial thromboplastin time， decompensation， gastroesophageal or ectopic varices， bleeding and ascites （all P<0.05）. The analyses after matching showed that compared with the healthy control group， the case group had significantly higher prevalence rates of abnormal muscle structure （43.18% vs 18.94%， P<0.001）， mild muscle changes （22.73% vs 7.58%， P<0.001）， and severe muscle changes （20.45% vs 11.36%， P<0.001）. Further comparison showed that there was no significant difference in the proportion of patients with muscle changes between the PSVD patients with PH and those without PH （42.17% vs 44.90%， P=0.760）. The binary Logistic regression analysis with the presence or absence of muscle changes as the dependent variable showed that age （odds ratio ［OR］=1.05， 95% confidence interval ［CI］： 1.02 — 1.09， P<0.05）， subcutaneous fat index （OR=1.03， 95%CI： 1.01 — 1.06， P<0.05）， hemoglobin （OR=0.97， 95%CI： 0.95 — 0.99， P<0.05）， and thrombin time （OR=1.26， 95%CI： 1.06 — 1.49， P<0.05） were independent influencing factors for muscle changes in PSVD patients. The multivariate ordinal Logistic regression analysis with the severity of muscle changes as the dependent variable showed that age （OR=1.04， 95%CI： 1.01 — 1.07， P<0.05） and thrombin time （OR=1.17， 95%CI： 1.01 — 1.36， P<0.05） were independent risk factors for the grading of muscle changes. ConclusionMuscle changes are common in PSVD patients， and these changes may be caused by PSVD itself rather than PH. Age， fat distribution， thrombin time， and hemoglobin are important influencing factors for muscle changes.

Objective:To analyze pancreatic cancer incidence and mortality data in China and worldwide and to provide data for pancreatic cancer prevention and control efforts.Methods:Data of pancreatic cancer incidence and mortality rates, along with historical and predictive data, were obtained from the GLOBOCAN 2022 database. Epidemiological characteristics of pancreatic cancer was analyzed by region, sex, age and Human Development Index (HDI). Spearman's correlation coefficient test was used to assess the relationship between HDI and age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR).Results:In 2022, the global number of new cases and deaths of pancreatic cancer will be 511 thousand and 467 thousand, respectively, with an ASIR and ASMR of 4.7/10 5 and 4.2/10 5, respectively. North America and Europe had the highest pancreatic cancer incidence and mortality rates of 8.5/10 5 and 7.3/10 5, respectively. Global ASIR and ASMR in men were both 1.4 times higher than those in women. HDI levels were positively correlated with ASIR ( r=0.79, P＜0.001) and ASMR ( r=0.78, P＜0.001) of pancreatic cancer in all regions. The number of pancreatic cancer cases and deaths in China were 119 thousand and 106 thousand, respectively, while the ASIR and ASMR of pancreatic cancer were 4.4/10 5 and 3.9/10 5, respectively. Both ASIR and ASMR in men were both 1.5 times higher than those in women in China. The number of pancreatic cancer incidence and death cases in China in 2050 is predicted to be 216 thousand and 204 thousand cases, with an increase of 81.5% and 92.5% compared with 2022, respectively. Conclusions:The disease burden of pancreatic cancer varies significantly among different regions, genders and ages. Pancreatic cancer incidence and mortality are positively correlated with HDI. The incidence and mortality rates of pancreatic cancer in China are close to the global average, but the number of new cases and deaths is high. Prevention and control should be strengthened to improve the survival of pancreatic cancer patients.

Objective:To analyze pancreatic cancer incidence and mortality data in China and worldwide and to provide data for pancreatic cancer prevention and control efforts.Methods:Data of pancreatic cancer incidence and mortality rates, along with historical and predictive data, were obtained from the GLOBOCAN 2022 database. Epidemiological characteristics of pancreatic cancer was analyzed by region, sex, age and Human Development Index (HDI). Spearman's correlation coefficient test was used to assess the relationship between HDI and age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR).Results:In 2022, the global number of new cases and deaths of pancreatic cancer will be 511 thousand and 467 thousand, respectively, with an ASIR and ASMR of 4.7/10 5 and 4.2/10 5, respectively. North America and Europe had the highest pancreatic cancer incidence and mortality rates of 8.5/10 5 and 7.3/10 5, respectively. Global ASIR and ASMR in men were both 1.4 times higher than those in women. HDI levels were positively correlated with ASIR ( r=0.79, P＜0.001) and ASMR ( r=0.78, P＜0.001) of pancreatic cancer in all regions. The number of pancreatic cancer cases and deaths in China were 119 thousand and 106 thousand, respectively, while the ASIR and ASMR of pancreatic cancer were 4.4/10 5 and 3.9/10 5, respectively. Both ASIR and ASMR in men were both 1.5 times higher than those in women in China. The number of pancreatic cancer incidence and death cases in China in 2050 is predicted to be 216 thousand and 204 thousand cases, with an increase of 81.5% and 92.5% compared with 2022, respectively. Conclusions:The disease burden of pancreatic cancer varies significantly among different regions, genders and ages. Pancreatic cancer incidence and mortality are positively correlated with HDI. The incidence and mortality rates of pancreatic cancer in China are close to the global average, but the number of new cases and deaths is high. Prevention and control should be strengthened to improve the survival of pancreatic cancer patients.

AIM:To investigate the expression of lipolysis-stimulated lipoprotein receptor(LSR)in dextran sodium sulfate(DSS)-induced colitis mice,and the effects of Lsr-specific knockout and overexpression in intestinal epithe-lium on intestinal inflammation in colitis mice.METHODS:C57BL/6J mice were administered 3%(w/v)DSS in drink-ing water for 6 days to induce colitis.Following the experiment,RNA-seq was employed to screen differentially expressed genes between the control group and experimental group.Changes in LSR expression were assessed using RT-qPCR,Western blot,and immunofluorescence staining.Intestinal epithelial Lsr-specific knockout mice were generated using the Cre-loxP system and subjected to DSS-induced colitis.Colitis severity was evaluated through changes in body weight,dis-ease activity index(DAI)score,colon length,and hematoxylin-eosin(HE)staining.Additionally,serum levels of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),IL-6,and IL-18 were measured via ELISA.Immunofluorescence staining was utilized to detect neutrophil and macrophage infiltration in colon tissues,while periodic acid-Schiff(PAS)staining was used to observe goblet cell numbers.Furthermore,adeno-associated virus(AAV-Lsr)was intraperitoneally injected to achieve LSR overexpression.Successful LSR overexpression was confirmed,and a DSS-induced colitis model was established using similar methods to observe intestinal inflammation.RESULTS:Results showed decreased LSR ex-pression in DSS-induced colitis mice.Intestinal epithelial Lsr-specific knockout mice exhibited increased susceptibility to DSS-induced colitis,evidenced by significantly reduced body weight(P<0.05),increased DAI(P<0.01),shortened co-lon length(P<0.05),and exacerbated pathological injury.Levels of pro-inflammatory cytokines TNF-α(P<0.05),IL-1β(P<0.01),IL-6(P<0.05),and IL-18(P<0.01)were significantly elevated,along with increased inflammatory cell infiltration and reduced goblet cell numbers in the colon.Conversely,LSR overexpression via AAV significantly alleviated intestinal inflammation in DSS-induced colitis mice.CONCLUSION:In conclusion,LSR expression decreased in DSS-induced colitis mice,and its loss exacerbated intestinal inflammation in this model.AAV-mediated LSR overexpression provided therapeutic relief from intestinal inflammation in DSS-induced colitis mice.

Objective:To investigate the role of immunoglobulin-like domain-containing receptor 2 (Ildr2) in renal fibrosis induced by ischemia-reperfusion.Methods:Ildr2 knockout mice (KO group) were constructed using CRISPR/Cas9 technology, and wild-type mice were as the control group (WT group). The unilateral renal ischemia-reperfusion (UIR) model (UIR group) was constructed by clamping the left renal pedicle, and was divided into KO-UIR group and WT-UIR group after modeling. Sham operation mice (sham group) were not treated with ischemia. Serum creatinine was measured by creatinine oxidase method. Blood urea nitrogen was detected by the diacetyloxime colorimetric method. The urinary albumin level was measured by enzyme-linked immunosorbent assay, and urinary albumin/creatinine ratio was calculated. HE, PAS and MASSON staining were used to detect the infiltration of inflammatory cells and the degree of fibrosis in renal tissues. The mRNA expression levels of Ildr2, kidney injury-associated molecules neutrophil gelatinase-associated lipocalin ( NGAL) and kidney injury molecule-1 ( KIM-1), fibrosis markers typeⅠcollagen α 1 ( Col1α1), fibronectin 1 ( Fn1), α-smooth muscle actin ( α-SMA) and connective tissue growth factor ( CTGF), as well as inflammation-related molecules macrophage marker F4/80 and monocyte chemoattractant protein-1 ( MCP-1) were detected by real time quantitative PCR (qRT-PCR). The protein levels of Ildr2, α-SMA and Col1α1 were detected by immunofluorescence and Western blotting. Results:(1) qRT-PCR and Western blotting showed that the expression levels of Ildr2 mRNA and protein in UIR group were significantly lower than those in sham group (both P<0.05). (2) There were no significant differences in body weight, serum creatinine, blood urea nitrogen, total cholesterol, low density lipoprotein, high density lipoprotein and triglyceride between KO group and WT group (all P>0.05). qRT-PCR results showed that there were no significant differences in the mRNA expression levels of NGAL, KIM-1, α-SMA, Col1α1, CTGF, Fn1, MCP-1 and F4/80 between KO group and WT group (all P>0.05). Histological staining showed no abnormal inflammatory cell infiltration and interstitial fibrosis between KO group and WT group. (3) Compared with the WT-UIR group, serum creatinine and blood urea nitrogen in the KO-UIR group were significantly higher (both P<0.05). qRT-PCR results showed that the mRNA expression levels of NGAL, F4/80, MCP-1, Col1α1, α-SMA, and CTGF in the KO-UIR group were significantly higher than those in the WT-UIR group (all P<0.05). Immunofluorescence and Western blotting results also showed that the protein expression levels of Col1α1 and α-SMA in the KO-UIR group were significantly higher than those in the WT-UIR group (all P<0.05). Histological staining showed that, compare with WT-UIR group, KO-UIR group had more severe inflammatory infiltration and more collagen fiber deposition. Conclusion:Ildr2 knockout does not cause phenotypic changes in mice under normal physiological conditions. Ildr2 plays a regulatory role in UIR injury, and Ildr2 deletion aggravates the degree of renal fibrosis induced by UIR.

Objective To assess the efficacy and safety of 100 mg or 200 mg yimitasvir phosphate combined with sofosbuvir in patients with non-cirrhotic chronic hepatitis C virus ( HCV) genotype 1 infection who were treatment-na?ve or had a virologic failure to prior interferon-based treatment.Methods A multicenter, randomized, open-label, phase 2 clinical trial was conducted.The patients were randomly assigned to yimitasvir phosphate 100 mg+sofosbuvir 400 mg group (Group 100 mg) and yimitasvir phosphate 200 mg+sofosbuvir 400 mg group ( Group 200 mg) in a 1∶1 ratio with the stratified factors of " treatment-naive" or"treatment-experienced" for 12 weeks and followed up for 24 weeks after the end of treatment.During the clinical trial, HCV RNA was tested in all patients.Resistance of virus in patients who didn′t achieved sustained virological response (SVR) was monitored.Safety and tolerability were assessed by monitoring adverse events , physical examination , laboratory examination, electrocardiogram, and vital signs during the study.The primary end point was SVR12 after the end of therapy.Descriptive statistics were used for categorical variables and eight descriptive statistics were used for continuous variables.Descriptive statistics were used and summarized according to HCV genotypes and treatment groups.Safety data were presented using descriptive statistics and summarized according to treatment groups.Results A total of 174 subjects were screened from July 31, 2017 to September 26, 2018.One hundred and twenty-nine patients were successfully enrolled and received treatment , and 127 completed the study.There were 64 patients and 65 patients assigned to Group 100 mg and Group 200 mg, respectively.Among the 129 patients who underwent randomization and were treated , 18.6% were treatment-experienced and: 100%were HCV genotype 1b infection.The total SVR rate was 98.4%(127／129), with 98.4%(63／64, 95%confidence interval [CI]: 91.60%-99.96%) in the Group 100 mg, and 98.50%(64／65, 95%CI: 91.72%-99.96%) in the Group 200 mg.There was no significant difference between the two groups (χ2 ＝0.000 2, P＝0.989 2).The SVR rates in treatment-naive group and treatment-experienced group were 98.10%(95%CI: 93.29%-99.77%) and 100.00%(24／24, 95%CI: 85.75%-100.00%), respectively.Virological failure during treatment ( including breakthrough , rebound and poor efficacy) and relapse after treatment did not occur during the trial.By Sanger sequencing , 11.6%(15／129) patients had baseline NS5A Y93H／Y or Y93H resistance-associated substitutions ( RAS), 1.6%( 2／129) patients had baseline NS5A L31M RAS.No mutation was observed in NS5B S282 at baseline.There was no S282 mutation in HCV NS5B.A total of 100 (77.5%) subjects had adverse events.No adverse events ≥Grade 3 or severe adverse events related to the study treatment.No patient prematurely discontinued study treatment owing to an adverse event.No life-threatening adverse event was reported.Conclusion Twelve weeks of yimitasvir phosphate 100 mg or 200 mg combined with sofosbuvir 400 mg daily is a highly effective and safe regimen for patients without cirrhosis with HCV genotype 1b infection who had not been treated previously or had a virologic failure to prior interferon-based treatment.

Objective To investigate changes in serum levels of antinuclear antibody(ANA), anti?double?stranded DNA(dsDNA)antibody and anti?extractable nuclear antigen(ENA)antibody before and after anti?tumor necrosis factor?α(TNF?α)therapy in psoriatic patients. Methods Clinical data obtained from 32 patients with psoriasis were analyzed retrospectively. Of the 32 patients, 13 received intravenous injection of 5 mg/Kg infliximab at week 0, 2, 6 for 3 sessions, then once every 8 weeks(infliximab group), while other 19 received subcutaneous injection of 25 mg etanercept twice every week(etanercept group). The treatments in the 2 groups both lasted more than 3 months. Serum levels of ANA, anti?dsDNA antibody and anti?ENA antibody and changes of clinical symptoms were detected and observed respectively before each treatment in the infliximab group, as well as every 3- 6 months in the etanercept group. The 75%reduction in psoriasis area and severity index(PASI75)and disease activity score of 28 joints(DAS28) were used to evaluate clinical efficacy. Serum levels of ANA, anti?dsDNA antibody and anti?ENA antibody were measured by indirect immunofluorescence(IIF)assay, Western blot analysis combined with enzyme?linked immunosorbent assay(ELISA), and Western blot analysis, respectively. Results After 3?month treatment, the 32 patients achieved clinical remission to different extents. Of 32 patients receiving anti?TNF?αtherapy, 7(21.9%)developed new autoantibodies. Concretely speaking, 4 patients in the infliximab group developed autoantibodies in 8.3 ± 5.1 months, including 3 cases positive for ANA and 3 for anti?ENA antibody. Three patients in the etanercept group developed autoantibodies in 9.0 ± 3.0 months, including 3 cases positive for ANA and 1 for anti?ENA antibody. Conclusion Partial patients with psoriasis may develop autoantibodies after anti?TNF?αtherapy.

Objective: To evaluate the intestinal trophic effects and adverse reactions of nasojejunal and jejunostomy tube im-plants on patients with total gastrectomy. Methods:A total of 86 patients with advanced gastric cancer were randomly and equally di-vided into two groups. Groups A and B received enteral nutrition therapies through nasojejunal and jejunostomy feeding tube implants, respectively. The therapeutic efficacy of the two methods of enteral nutrition therapy and the corresponding adverse reactions observed in the two groups were compared. Results:Group B patients demonstrated shorter anal evacuation and defecation times than group A patients, the difference is statistically significant (P<0.05). Moreover, the bodyweight, total protein, and albumin levels of the patients significantly decreased in both groups after enteral nutrition therapy was administered (P<0.05). Postoperative nutritive indexes were higher in group B than in group A;however, no significant difference was obtained between the two groups (P>0.05). Nonetheless, the patients in group B tolerated the treatment well compared with those in group A (P<0.05). The complication rates of groups A and B were 18.6%and 23.3%, respectively, but this difference was not significant (P>0.05). Conclusion:Patients subjected to total gastrecto-my showed higher tolerance to jejunal tube implants for enteral nutrition than to nasojejunal tube implants, indicating that jejunal tube implants can be used to improve the nutritional status of patients.

OBJECTIVE: To explore the distribution of allergen tested by skin prick test (SPT) in about 5,843 allergic rhinitis patients in south Shanghai. METHOD: SPT test was conducted in 5,843 allergic rhinitis patients who came to our clinic from January 2007 to August 2012. The result was analyzed by age, sex and year. RESULT: The top three allergens by percentage are dermatophagoides pteronyssinus, dermatophagoides culinae and fungus among 15 common allergens. Incidence rate between male and female in each year had statistical significance, both of which showed no increasing trend with year. Incidence rates among different age groups aging from 6 to 17 years' old had no statistically significant difference, but statistically significant difference among different age groups existed in other age groups. Incidence rate showed increasing trend with year in age group of 40-65, which was not observed in other groups. The incidence rate showed decreasing trend with age in male and female, while the incidence rate in male was always higher than female. CONCLUSION In south Shanghai, primary allergens causing allergic rhinitis are dermatophagoides pteronyssinus, dermatophagoides culinae and fungus. Statistically significant difference about allergic rhinitis existed in age and sex. SPT has important significance in diagnosis of allergens.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Allergens ; immunology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic ; diagnosis ; epidemiology ; immunology ; Skin Tests ; Young Adult

OBJECTIVE: To investigate the effect of nasal instillation of vitamin D3 on patients with allergic rhinitis symptoms including nasal itching, sneezing, clear nasal discharge, and nasal congestion. METHOD: Thirty subjects with allergic rhinitis proved by skin prick test (SPT) and 30 subjects with deviated septum alone were recrui ted and administrated with 300 000 IU of vitamin D3 by nasal instillation weekly. Seven days after the intervention, the four major symptoms including nasal itching, sneezing, clear nasal discharge, and nasal congestion were evaluated by score. RESULT: After intranasal instillation of vitamin D3, the symptoms in allergic rhinitis group in cluding nasal itching, sneezing, nasal discharge and nasal congestion, and serum 25-hydroxyvitamin D level has statistical differences (P < 0.05). CONCLUSION Vitamin D3 could be well absorbed through nasal mucosa. It demonstrated to have significantly effect on serum 25-hydroxyvitamin D to improve the symptoms for patients with allergic rhinitis. Vitamin D3 may be a kind of adjuvant therapy for prevention and treatment of allergic rhinitis.
Administration, Intranasal ; Adult ; Cholecalciferol ; administration & dosage ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic ; drug therapy ; Young Adult