BACKGROUND: Diabetic foot is a complex condition with high incidence, recurrence, mortality, and disability rates. Current treatments for diabetic foot ulcers are often insufficient. This study was conducted to identify potential therapeutic targets for diabetic foot. METHODS: Datasets related to diabetic foot and diabetic skin were retrieved from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) were identified using R software. Enrichment analysis was conducted to screen for critical gene functions and pathways. A protein interaction network was constructed to identify node genes corresponding to key proteins. The DEGs and node genes were overlapped to pinpoint target genes. Plasma and chronic ulcer samples from diabetic and non-diabetic individuals were collected. Western blotting, immunohistochemistry, and enzyme-linked immunosorbent assays were performed to verify the S100 calcium binding protein A9 (S100A9), inflammatory cytokine, and related pathway protein levels. Hematoxylin and eosin staining was used to measure epidermal layer thickness. RESULTS: In total, 283 common DEGs and 42 node genes in diabetic foot ulcers were identified. Forty-three genes were differentially expressed in the skin of diabetic and non-diabetic individuals. The overlapping of the most significant DEGs and node genes led to the identification of S100A9 as a target gene. The S100A9 level was significantly higher in diabetic than in non-diabetic plasma (178.40 ± 44.65 ng/mL vs. 40.84 ± 18.86 ng/mL) and in chronic ulcers, and the wound healing time correlated positively with the plasma S100A9 level. The levels of inflammatory cytokines (tumor necrosis factor-α, interleukin [IL]-1, and IL-6) and related pathway proteins (phospho-extracellular signal regulated kinase [ERK], phospho-p38, phospho-p65, and p-protein kinase B [Akt]) were also elevated. The epidermal layer was notably thinner in chronic diabetic ulcers than in non-diabetic skin (24.17 ± 25.60 μm vs. 412.00 ± 181.60 μm). CONCLUSIONS S100A9 was significantly upregulated in diabetic foot and was associated with prolonged wound healing. S100A9 may impair diabetic wound healing by disrupting local inflammatory responses and skin re-epithelialization.
Calgranulin B/therapeutic use* ; Diabetic Foot/metabolism* ; Humans ; Datasets as Topic ; Computational Biology ; Mice, Inbred C57BL ; Animals ; Mice ; Protein Interaction Maps ; Immunohistochemistry

OBJECTIVES: Nasopharyngeal carcinoma is often diagnosed at a late stage due to its concealed location and exhibits marked regional clustering, posing a significant public health challenge in China. This study aims to analyze the disease burden of nasopharyngeal carcinoma in China using the latest 2021 Global Burden of Diseases (GBD) database, providing epidemiological evidence for precise prevention and control of nasopharyngeal carcinoma. METHODS: Age-standardized incidence rate (ASIR), mortality rate, and disability-adjusted life year (DALY) rate were used as indicators of disease burden. Stratified analyses were conducted by age, sex, socio-demographic index (SDI), and relevant risk factors. The autoregressive integrated moving average (ARIMA) model and Bayesian age-period-cohort (BAPC) model were employed to project ASIR trends through 2050. RESULTS: In 2021, China's age-standardized incidence, mortality, and DALY rates of nasopharyngeal carcinoma were 3.4/100 000, 1.5/100 000, and 48.7/100 000, respectively, all higher than the global average. Across all age groups, Chinese males exhibited higher ASIR, mortality, and DALY rates than females. From 1990 to 2021, the disease burden of nasopharyngeal carcinoma in China decreased gradually with rising SDI. The proportion of nasopharyngeal carcinoma burden attributed to alcohol consumption, smoking, and occupational formaldehyde exposure in China exceeded global levels, especially among males. Projections from both models indicate a rising trend in ASIR for males, females, and the general population in China and globally from 2022 to 2050. CONCLUSIONS Over the past 30 years, the disease burden of nasopharyngeal carcinoma in China has decreased with the increasing SDI values but remains higher than the global average. Furthermore, ASIR is projected to increase over the next 30 years. It is imperative for China to enhance healthcare resource allocation for nasopharyngeal carcinoma prevention, diagnosis, and treatment, particularly among high-risk male populations.
Humans ; China/epidemiology* ; Male ; Nasopharyngeal Carcinoma/mortality* ; Female ; Middle Aged ; Nasopharyngeal Neoplasms/mortality* ; Adult ; Incidence ; Global Burden of Disease ; Disability-Adjusted Life Years ; Aged ; Risk Factors ; Adolescent ; Databases, Factual ; Young Adult ; Cost of Illness ; Child ; Bayes Theorem

Ischemic stroke（IS） is a common cerebrovascular disease in clinics，with a high disability rate. In recent years，the incidence of IS has gradually increased，especially in young people，which seriously affects the physical and mental health and quality of life of patients. Western medicine has made some progress in the treatment of IS but still faces some limitations. Therefore， choosing a measure that can assist in the treatment of IS is particularly important. A large number of studies have confirmed that traditional Chinese medicine can treat IS based on the effective ingredients and extracts of traditional Chinese medicine monomers and formulas，utilizing advantages such as multiple targets，multiple bioactive ingredients，multiple systems，and fewer adverse reactions to ensure the safety and effectiveness of the treatment pathway. At present，the mechanism of action of traditional Chinese medicine in treating IS can be achieved by intervening in various signaling pathways，mainly including secretory glycoprotein/β-catenin（Wnt/β-catenin） signaling pathway，phosphatidylinositol 3-kinase/protein kinase B（PI3K/Akt） signaling pathway，nuclear factor kappa-B（NF-κB） signaling pathway，Toll-like receptor 4/NOD-like receptor protein 3（TLR4/NLRP3） signaling pathway，mitogen-activated protein kinase（MAPK） signaling pathway，and neurogenic site-gap homologous protein（Notch） signaling pathway. This article summarized the relationship between IS and related signaling pathways in recent years，as well as the regulation of IS-related pathways and corresponding mechanisms by traditional Chinese medicine，so as to provide a reference for future clinical and experimental research on IS.

Gastric cancer is one of the major types of cancer threatening human health worldwide. Its pathogenesis has not been fully elucidated, and patients are often diagnosed at an advanced stage. The oral cavity is the second largest microbial pool after the intestine in the human body, and thus the relationship between oral bacteria and human health is attracting increasing interest. Oral bacteria are closely related to gastric cancer and potentially serve as noninvasive diagnostic screening biomarkers for the disease. Imbalance in and displacement of these bacteria can promote the occurrence and development of gastric cancer. Hence, this article reviews the association between oral bacteria and gastric cancer, aiming to provide a basis for further elucidating the pathogenesis of gastric cancer and screening it early through noninvasive methods and serve as a reference for subsequent related research.

Objective:To systematically evaluate the qualitative study on the sexual health needs of patients with ostomy based on theoretical domains framework (TDF), providing reference for clinical care and practice.Methods:A comprehensive search was conducted for qualitative studies on the sexual experience of ostomy patients in the China National Knowledge Infrastructure, Wanfang Data, VIP database, China Biology Medicine, PubMed, Embase, Web of Science, Cochrane Library, Elton B. Stephens Company (EBSCO), Elsevier Scopus (SCOPUS), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, with a timeframe of from the creation of the databases to April 15, 2024. The Joanna Briggs Institute Evidence Based Healthcare Center Critical Appraisal Tool was used to evaluate the quality of eligible literature, and the theoretical domain framework was used to integrate the extracted results.Results:A total of 11 articles were included and 51 results were extracted. Based on the theoretical framework, map the sexual health needs of ostomy patients to six core areas: knowledge, skills, optimism, outcome beliefs, environment and resources, and emotions.Conclusions:Medical staff should pay attention to the sexual health needs of patients with intestinal stomas. Based on the six core areas of knowledge, skills, optimism, outcome beliefs, environment and resources, and emotions, they should deeply explore the factors that affect their sexual health, provide professional guidance and comprehensive care, and improve their sexual health level and quality of life.

Objective:To investigate the short-term efficacy and safety of Donafenib as postoperative adjuvant therapy for patients with high risk of recurrence after radical resection of hepatocellular carcinoma (HCC).Methods:The propensity score matching (PSM) and retrospective cohort study was conducted. The clinicopathological data of 157 HCC patients with high risk of recurrence after radical resection who were admitted to 6 medical centers, including The First Affiliated Hospital of Nanjing Medical University et al, from June 2021 to February 2023 were collected. There were 128 males and 29 females, aged (59±10)years. Of 157 patients, 101 cases undergoing Donafenib as postoperative adjuvant therapy were divided into the the Donafenib group, and 56 cases under-going no systemic postoperative adjuvant therapy were divided into the control group. Observation indicators: (1) PSM and comparison of general data of patients between the two groups after matching; (2) postoperative treatment; (3) follow-up and survival of patients; (4) analysis of risk factors affecting recurrence-free survival of patients. PSM was done based on the principle of optimal perfect matching, with the clamp value of 0.5, and the Donafenib group and the control group were matched at a ratio of 1.25∶1. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers and/or percentages, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data between groups was conducted using the Kruskal-Wallis H test. The Kaplan-Meier method was used to calculate survival rates and draw survival curves, and the Log-Rank test was used for survival analysis. The COX proportional hazard model was used for univariate and multivariate analyses. Results:(1) PSM and comparison of general data of patients between the two groups after matching. Of 157 patients, 126 cases were successfully matched, including 70 cases in the Donafenib group and 56 cases in the control group, respectively. The elimination of tumor number confounding bias ensured comparability between the two groups after PSM. (2) Postoperative treatment. After PSM, of 70 patients in the Donafenib group, there were 23 cases receiving Donafenib monotherapy, 26 cases combined with transcatheter arterial chemoembolization (TACE), 14 cases combined with immunotherapy, and 7 cases combined with TACE+immunotherapy. Of 56 patients in the control group, there were 37 cases receiving postoperative follow-up alone and 19 cases combined with TACE. (3) Follow-up and survival of patients. All 157 patients were followed up, and the follow-up time of the 101 patients in Donafenib group and the 56 patients in control group were 10.1(range, 6.3-14.6)months and 22.2(range, 15.1-25.5)months, respectively. During the follow-up period, 70 patients in the Donafenib group experienced treatment-related adverse reactions, inclu-ding 8 cases of grade 3 adverse reactions, 23 cases of grade 2 and 39 cases of grade 1 adverse reactions, respectively. After PSM, the postoperative 12-, 18-month recurrence-free survival rates were 83.7%, 83.7% in the 70 patients of Donafenib group and 67.8%, 58.9% in the 56 patients of control group, respectively, showing a significant difference in the postoperative recurrence-free survival time between the two groups ( hazard ratio=0.395, 95% confidence interval as 0.176-0.888, P<0.05). (4) Analysis of risk factors affecting recurrence free survival of patients. Results of multivariate ana-lysis showed that microvascular invasion, vascular thrombus, clinical stage as ⅢA were independent risk factors affecting recurrence-free survival in patients with high risk of recurrence after radical resection of HCC ( hazard ratio=2.181, 2.612, 2.612, 95% confidence interval as 1.028-4.629, 1.128-6.047, 1.128-6.047, P<0.05), Donafenib as postoperative adjuvant therapy was an independent protective factor affecting recurrence-free survival in patients with high risk of recurrence after radical resection of HCC ( hazard ratio=0.457, 95% confidence interval as 0.227-0.920, P<0.05). Results of further analysis showed that after PSM, there were significant differences in the postoperative recurrence-free survival time in patients with different clinical factors, including male, age ≥60 years, tumor diameter >5 cm, positive microvascular invasion, positive hepatitis B virus infection, alpha fetoprotein <200 μg/L, between the Donafenib group and the control group ( hazard ratio=0.283, 0.202, 0.174, 0.345, 0.273, 0.180, 95% confidence interval as 0.114-0.707, 0.044-0.937, 0.038-0.794, 0.128-0.929, 0.091-0.819, 0.052-0.620, P<0.05). Conclusion:Donafenib as postoperative adjuvant therapy can effectively reduce the short-term recurrence rate in patients with high risk of recurrence after radical resection of HCC, with good safety and tolerance.

Objective·To compare the effects and complications of carbon dioxide laser laryngectomy and open partial laryngectomy in the treatment of laryngeal carcinoma.Methods·Clinical data of 101 patients with stage Ⅰ-Ⅲ laryngeal squamous cell carcinoma admitted to Renji Hospital,Shanghai Jiao Tong University School of Medicine from January 2013 to January 2018 were selected and divided into open surgery group and minimally invasive group according to different surgical methods.The open surgery group received open partial laryngectomy(57 cases),and the minimally invasive group received carbon dioxide laser laryngectomy(44 cases).Follow-up visits were made by telephone and outpatient visits,and the operation time,postoperative laryngeal mucosa edema time,length of stay,5-year survival rate,complication rate and recurrence rate of the two groups were compared in the different clinical stages(stage Ⅰ,stage Ⅱ,and stage Ⅲ)and tumor locations(glottic type and non-glottic type).Results·The operation time,postoperative laryngeal mucosa edema time and length of stay of the minimally invasive group were shorter than those of the open surgery group(P＜0.05).Comparison of the 5-year survival rates of patients with the same clinical stage and glottic type between the two groups showed no statistically significant difference(both P＞0.05);while comparison of the 5-year survival rates of patients with non-glottic type between the two groups(62.5％in the open surgery group vs 0 in the minimally invasive group)showed a statistically significant difference(P＜0.05).In the minimally invasive group,there were 3 cases of complications,including 1 case of fever and 2 cases of lung infection;in the open surgery group,there were 14 cases of complications,including 5 cases of fever,7 cases of lung infection and 2 cases of pharyngeal fistula.The complication rate of patients in the minimally invasive group(6.82％,3/44)was lower than that in the open surgery group(24.60％,14/57),and the difference was statistically significant(P＜0.05);the complication rate of patients with stage Ⅱ and glottic type in the minimally invasive group was significantly lower than that in the open surgery group(P＜0.05).Comparing the recurrence rate of patients in the two groups(10.53％in the open surgery group vs 2.27％in the minimally invasive group),the difference was not statistically significant(P＞0.05).Conclusion·Compared with open partial laryngectomy,carbon dioxide laser laryngectomy has faster postoperative recovery and lower complication rate in the treatment of early and middle laryngeal malignant tumors,so it is worth promoting.

Objective:To evaluate the pharmacodynamics of ropivacaine for ultrasound-guided pericapsular nerve group (PENG) block in hip surgery.Methods:American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ patients of either sex with hip trauma (femoral neck or trochanteric fracture), aged 18-64 yr, with body mass index of 18-30 kg/m 2, scheduled for elective hip surgery under general anesthesia, with VAS score>4 points at 15 degrees of hip flexion, were selected. PENG block was performed at 30 min before anesthesia, and 0.375% ropivacaine was injected with an initial dose of 15 ml and the successive volume gradient of 1.2 ml after successful localization. VAS score was assessed at 30 min after injection. When the VAS score was 3, the block was considered effective, a lower volume gradient was given in the next patient, otherwise a higher volume gradient was given in the next patient, which was repeated until 7 up-and-down cross waveforms were obtained. Probit analysis was used to calculate the median effective volume (EV 50) and 95% effective volume (EV 95) and 95% confidence interval ( CI) of 0.375% ropivacaine for PENG block. Results:The EV 50 (95% CI) of 0.375% ropivacaine for PENG block was 11.36 ml (9.41-12.64 ml), and the EV 95 (95% CI) of 0.375% ropivacaine for PENG block was 14.19 ml (95% CI 12.80-25.07 ml). Conclusions:The EV 50 of 0.375% ropivacaine is 11.36 ml when used for ultrasound-guided PENG block in hip surgery.

Background Prolonged awkward postures during occupational activities can lead to excessive musculoskeletal load on the wrist of workers and symptoms such as wrist pain or discomfort. Objective To survey the prevalence of wrist pain among workers in 10 key industries and analyze its correlation with wrist working postures. Methods By using stratified cluster sampling method, workers from 10 key industries, such as footwear manufacturing industry, shipbuilding manufacturing industry, and automobile manufacturing industry, were selected from seven regions in North China, East China, Central China, South China, Southwest China, Northwest China, and Northeast China. The demographic information, wrist working postures, pain in wrist of the workers were collected through a cross-sectional survey. Pearson χ² test was used to compare prevalence by selected factors, trend χ² test for between group comparison, and unconditional logistic regression models for the association of wrist working postures with wrist pain. Results There were 64052 workers enrolled in this survey, and 56286 provided valid questionnaires (the effective rate was 87.8%). According to the survey, the prevalence of wrist pain was 23.3% (13112/56286), and the industries with higher prevalences were footwear manufacturing (27.1%, 1927/7106), automobile manufacturing (24.9%, 5378/21560), and shipbuilding and related equipment manufacturing (24.4%, 850/3488) industries. Finger pinching (OR=2.09, 95%CI: 1.95-2.24), frequent wrist bending (OR=2.03, 95%CI: 1.92-2.15), fixed wrist bending (OR=1.77, 95%CI: 1.69-1.85), wrist on hard edge (OR=1.34, 95%CI: 1.28-1.40), and arms over shoulders (OR=1.11, 95%CI: 1.05-1.17) increased the risk of reporting wrist pain. Conclusion Awkward postures are related to wrist pain among workers in selected 10 key industries. The related factors are wrist on hard edge, frequent wrist bending, finger pinching, fixed wrist bending, and arms over shoulders.