BACKGROUND: Renal osteodystrophy (ROD) is a skeletal pathology associated with chronic kidney disease-mineral and bone disorder (CKD-MBD) that is characterized by aberrant bone mineralization and remodeling. ROD increases the risk of fracture and mortality in CKD patients. The underlying mechanisms of ROD remain elusive, partially due to the absence of an appropriate animal model. To address this gap, we established a stable mouse model of ROD using an optimized adenine-enriched diet and conducted exploratory analyses through ribonucleic acid sequencing (RNA-seq). METHODS: Eight-week-old male C57BL/6J mice were randomly allocated into three groups: control group ( n = 5), adenine and high-phosphate (HP) diet group ( n = 20), and the optimized adenine-containing diet group ( n = 20) for 12 weeks. We assessed the skeletal characteristics of model mice through blood biochemistry, microcomputed tomography (micro-CT), and bone histomorphometry. RNA-seq was utilized to profile gene expression changes of ROD. We elucidated the functions of differentially expressed genes (DEGs) using gene ontology (GO) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, and gene set enrichment analysis (GSEA). DEGs were validated via quantitative real-time polymerase chain reaction (qRT-PCR). RESULTS: By the fifth week, adenine followed by an HP diet induced rapid weight loss and high mortality rates in the mouse group, precluding further model development. Mice with optimized adenine diet-induced ROD displayed significant abnormalities in serum creatinine and blood urea nitrogen levels, accompanied by pronounced hyperparathyroidism and hyperphosphatemia. The femur bone mineral density (BMD) of the model mice was lower than that of control mice, with substantial bone loss and cortical porosity. ROD mice exhibited substantial bone turnover with an increase in osteoblast and osteoclast markers. Transcriptomic profiling revealed 1907 genes with upregulated expression and 723 genes with downregulated expression in the femurs of ROD mice relative to those of control mice. Pathway analyses indicated significant enrichment of upregulated genes in the sphingolipid metabolism pathway. The significant upregulation of alkaline ceramidase 1 ( Acer1 ), alkaline ceramidase 2 ( Acer2 ), prosaposin-like 1 ( Psapl1 ), adenosine A1 receptor ( Adora1 ), and sphingosine-1-phosphate receptor 5 ( S1pr5 ) were successfully validated in mouse femurs by qRT-PCR. CONCLUSIONS Optimized adenine diet mouse model may be a valuable proxy for studying ROD. RNA-seq analysis revealed that the sphingolipid metabolism pathway is likely a key player in ROD pathogenesis, thereby providing new avenues for therapeutic intervention.
Animals ; Mice ; Chronic Kidney Disease-Mineral and Bone Disorder/genetics* ; Male ; Disease Models, Animal ; Mice, Inbred C57BL ; Sphingolipids/metabolism* ; Transcriptome/genetics* ; Signal Transduction/genetics* ; X-Ray Microtomography ; Adenine

Objective:To adapt the Mindful Breastfeeding Scale (MINDF-BFS) into Chinese and assess its reliability and validity among breastfeeding mothers in China.Methods:Following the Beaton cross-cultural adaptation guideline, the original scale was translated, back-translated, discussed by experts, pre-tested, culturally adapted, and revised to develop the Chinese version of the MINDF-BFS. A convenience sampling method was used to select 305 postpartum women from Guangzhou Women and Children's Medical Center, Guangzhou Medical University, who visited between March and June 2024, as the study participants. The reliability and validity of the Chinese version of MINDF-BFS were evaluated.Results:The Chinese version of MINDF-BFS consisted of nine items, with the item-level content validity index ranged from 0.900 to 1.000, and the average scale-level content validity index was 0.990. Exploratory factor analysis extracted one common factor, with a variance contribution of 73.290%. Confirmatory factor analysis showed a good model fit. The Cronbach's α coefficient for the scale was 0.923, the split-half reliability coefficient was 0.915, and the test-retest reliability coefficient was 0.926.Conclusions:The Chinese version of MINDF-BFS has good psychometric properties and is suitable for assessing the mindful breastfeeding levels of Chinese postpartum women.

Objective:To report the 5-year survival outcomes and recurrence patterns of robotic total gastrectomy (RTG) for locally advanced proximal gastric cancer in order to provide more valuable long-term follow-up results for clinical practice.Methods:This was a prospective, single-arm, open-label clinical trial (FUGES-014; Clinical-Trials.gov, NCT03524287). Patients with locally advanced proximal gastric cancer who underwent RTG at Fujian Medical University Union Hospital from March 5, 2018, to February 10, 2020, were included in the analysis. To evaluate the long-term efficacy of RTG in the most objective manner possible, we performed a propensity score-matched (1∶2) comparative analysis with historical control patients who had undergone laparoscopic total gastrectomy (LTG) from the FUGES-002 study (ClinicalTrials.gov, NCT02333721) in which the 5-year disease-free survival (DFS), 5-year overall survival (OS), and recurrence patterns were compared between the two groups.Results:Prior to matching, there were 48 cases in the RTG group and 263 cases in the LTG group; patients in the LTG group had more advanced cT and pT stages ( P=0.044 and 0.006, respectively) compared to the RTG group. After matching, there were 48 cases in the RTG group and 96 cases in the LTG group; however, no statistically significant differences were observed in the baseline clinical characteristics between the two groups (all P>0.05). Both groups had a median follow-up of 72 months. The 5-year DFS rates were 75.0% (95%CI: 63.7%- 88.3%) in the RTG group and 61.4% (95%CI: 52.5%-72.0%) in the LTG group ( P=0.116). Similarly, the 5-year OS rates were 79.2% (95%CI: 68.5%-91.5%) and 64.6% (95%CI: 55.7%-74.9%) in the RTG and LTG groups, respectively ( P=0.100). Within 5 years after surgery, tumor recurrence occurred in 10 patients (20.8%) in the RTG group and 33 patients (34.4%) in the LTG group ( P=0.124), and peritoneal recurrence was the predominant pattern in both groups (8.3%[4/48] vs. 10.4%[10/96]; risk difference: -0.02, P=0.554). Gastric cancer-related death was the predominant cause of death in both groups (16.7% [8/48] vs. 31.2% [30/96]; risk difference: -0.15, P=0.064). Among patients stratified by different pathological stages, no statistically significant differences were found in DFS, OS, or recurrence rates between the RTG and LTG groups (all P>0.05). Conclusions:We find the long-term oncological outcomes of RTG for locally advanced proximal gastric cancer to be noninferior to those of LTG. RTG should therefore be considered as a valid option for standardized minimally invasive surgery for locally advanced proximal gastric cancer.

Objective:To report the 5-year survival outcomes and recurrence patterns of robotic total gastrectomy (RTG) for locally advanced proximal gastric cancer in order to provide more valuable long-term follow-up results for clinical practice.Methods:This was a prospective, single-arm, open-label clinical trial (FUGES-014; Clinical-Trials.gov, NCT03524287). Patients with locally advanced proximal gastric cancer who underwent RTG at Fujian Medical University Union Hospital from March 5, 2018, to February 10, 2020, were included in the analysis. To evaluate the long-term efficacy of RTG in the most objective manner possible, we performed a propensity score-matched (1∶2) comparative analysis with historical control patients who had undergone laparoscopic total gastrectomy (LTG) from the FUGES-002 study (ClinicalTrials.gov, NCT02333721) in which the 5-year disease-free survival (DFS), 5-year overall survival (OS), and recurrence patterns were compared between the two groups.Results:Prior to matching, there were 48 cases in the RTG group and 263 cases in the LTG group; patients in the LTG group had more advanced cT and pT stages ( P=0.044 and 0.006, respectively) compared to the RTG group. After matching, there were 48 cases in the RTG group and 96 cases in the LTG group; however, no statistically significant differences were observed in the baseline clinical characteristics between the two groups (all P>0.05). Both groups had a median follow-up of 72 months. The 5-year DFS rates were 75.0% (95%CI: 63.7%- 88.3%) in the RTG group and 61.4% (95%CI: 52.5%-72.0%) in the LTG group ( P=0.116). Similarly, the 5-year OS rates were 79.2% (95%CI: 68.5%-91.5%) and 64.6% (95%CI: 55.7%-74.9%) in the RTG and LTG groups, respectively ( P=0.100). Within 5 years after surgery, tumor recurrence occurred in 10 patients (20.8%) in the RTG group and 33 patients (34.4%) in the LTG group ( P=0.124), and peritoneal recurrence was the predominant pattern in both groups (8.3%[4/48] vs. 10.4%[10/96]; risk difference: -0.02, P=0.554). Gastric cancer-related death was the predominant cause of death in both groups (16.7% [8/48] vs. 31.2% [30/96]; risk difference: -0.15, P=0.064). Among patients stratified by different pathological stages, no statistically significant differences were found in DFS, OS, or recurrence rates between the RTG and LTG groups (all P>0.05). Conclusions:We find the long-term oncological outcomes of RTG for locally advanced proximal gastric cancer to be noninferior to those of LTG. RTG should therefore be considered as a valid option for standardized minimally invasive surgery for locally advanced proximal gastric cancer.

Objective:To adapt the Mindful Breastfeeding Scale (MINDF-BFS) into Chinese and assess its reliability and validity among breastfeeding mothers in China.Methods:Following the Beaton cross-cultural adaptation guideline, the original scale was translated, back-translated, discussed by experts, pre-tested, culturally adapted, and revised to develop the Chinese version of the MINDF-BFS. A convenience sampling method was used to select 305 postpartum women from Guangzhou Women and Children's Medical Center, Guangzhou Medical University, who visited between March and June 2024, as the study participants. The reliability and validity of the Chinese version of MINDF-BFS were evaluated.Results:The Chinese version of MINDF-BFS consisted of nine items, with the item-level content validity index ranged from 0.900 to 1.000, and the average scale-level content validity index was 0.990. Exploratory factor analysis extracted one common factor, with a variance contribution of 73.290%. Confirmatory factor analysis showed a good model fit. The Cronbach's α coefficient for the scale was 0.923, the split-half reliability coefficient was 0.915, and the test-retest reliability coefficient was 0.926.Conclusions:The Chinese version of MINDF-BFS has good psychometric properties and is suitable for assessing the mindful breastfeeding levels of Chinese postpartum women.

Objective To establish the rapid discriminate analysis and quantitative analysis methods for carbonized Typhae Pollen(CTP)using near infrared spectroscopy coupled with chemometrics.Methods A total of 186 batches of CTP samples were prepared and categorized into three group including light degree CTP,moderate CTP,and heavy degree CTP.The NIR spectra of these samples were characterized.Then partial least squares-discriminant analysis(PLS-DA),k-nearest neighbors(KNN),support vector machine(SVM)algorithms were separately applied to build the discriminant models.The performance of discriminant models was evaluated in terms of the accuracy(ACC)and the error rate(ER).The partial least squares algorithm was used to establish the quantitative model for the prediction of 3,4-dihydroxybenzoic acid,3-hydroxybenzoic acid,4-hydroxybenzoic acid,azelaic acid,quercetin,quercetin-3-(2G-rhamnosylrutinoside),kaempferol,kaempferol-3-(2G-rhamnosylrutinoside),isorhamnetin,typhaneoside,isorhamnetin-3-O-neohesperidin,and naringenin of CTP samples.The correlation coefficients(rcal,rpre),the root mean square error of calibration(RMSEC),the root mean square error of prediction(RMSEP),and the ratio of performance deviation(RPD)were calculated to assess the PLS model.Results Compared with PLS-DA and KNN models,the SVM model yielded the best classification.The ACC of SVM model was 90.08％for calibration set and 93.44％for prediction set,while the ER was 9.08％for calibration set and 5.31 for prediction set.The values of rcal and r for PLS models were greater than 0.9,and the RPD of that was greater than 2.3.Conclusion In this study,the NIR spectroscopy coupled with chemometrics was firstly applied to develop the rapid discriminant analysis and quantitative analysis methods for CTP.The NIR-based method is rapid,non-destructive,and accurate,and it provides the scientific basis and method support for the rapid judgment of the processing degree of CTP and analysis of the changes of chemical components to ensure the quality of CTP.

Objective:To analyze the effect of different vascular access on the outcome in peripheral blood stem cells collection by a network Meta-analysis, and to provide a reference for clinical medical staff to select the best vascular access.Methods:A systematic search was carried out in Chinese Knowledge Infrastructure database (CNKI), Wanfang Database, VIP Database, Chinese Biomedical Literature Database, Cochrane Library, Web of Science, PubMed, Embase, from inception until April 15, 2023. Two researchers independently screened literature and extracted data. Bayesian network meta-analysis was performed using R4.2.2 and Addis-1.16.6 softwares.Results:A total 7 pieces of research were included, 5 vascular access methods were peripheral artery, peripheral vein, artery-vein, femoral vein-central venous catheter (FV-CVC), and internal jugular vein-CVC (IJV-CVC). The results showed that compared with the peripheral veins, there was no significant difference on CD34 cells between other vascular accesses in the primary outcome measure when collected peripheral blood stem cell collection. On the single blood volume treatment time, peripheral vein and IJV-CVC were statistically significant ( MD = 14.80, 95% CI 2.70-22.38, P<0.05) . The SUCRA ranking probability chart showed that on CD34 cells, FV- CVC>IJV-CVC>artery-vein>peripheral artery>peripheral vein access; for a single blood volume treatment time and monocyte number, peripheral artery was superior and the next was peripheral vein. Conclusions:Current evidence suggested that Peripheral artery may be the best vascular access in peripheral blood stem cells collection, which opens a new way to establish the vascular access for peripheral blood stem cells collection, but it needs to be confirmed by large clinic trials.

Objective To establish the rapid discriminate analysis and quantitative analysis methods for carbonized Typhae Pollen(CTP)using near infrared spectroscopy coupled with chemometrics.Methods A total of 186 batches of CTP samples were prepared and categorized into three group including light degree CTP,moderate CTP,and heavy degree CTP.The NIR spectra of these samples were characterized.Then partial least squares-discriminant analysis(PLS-DA),k-nearest neighbors(KNN),support vector machine(SVM)algorithms were separately applied to build the discriminant models.The performance of discriminant models was evaluated in terms of the accuracy(ACC)and the error rate(ER).The partial least squares algorithm was used to establish the quantitative model for the prediction of 3,4-dihydroxybenzoic acid,3-hydroxybenzoic acid,4-hydroxybenzoic acid,azelaic acid,quercetin,quercetin-3-(2G-rhamnosylrutinoside),kaempferol,kaempferol-3-(2G-rhamnosylrutinoside),isorhamnetin,typhaneoside,isorhamnetin-3-O-neohesperidin,and naringenin of CTP samples.The correlation coefficients(rcal,rpre),the root mean square error of calibration(RMSEC),the root mean square error of prediction(RMSEP),and the ratio of performance deviation(RPD)were calculated to assess the PLS model.Results Compared with PLS-DA and KNN models,the SVM model yielded the best classification.The ACC of SVM model was 90.08％for calibration set and 93.44％for prediction set,while the ER was 9.08％for calibration set and 5.31 for prediction set.The values of rcal and r for PLS models were greater than 0.9,and the RPD of that was greater than 2.3.Conclusion In this study,the NIR spectroscopy coupled with chemometrics was firstly applied to develop the rapid discriminant analysis and quantitative analysis methods for CTP.The NIR-based method is rapid,non-destructive,and accurate,and it provides the scientific basis and method support for the rapid judgment of the processing degree of CTP and analysis of the changes of chemical components to ensure the quality of CTP.