Kidney transplantation is an effective treatment for end-stage renal disease.However,post transplantation diabetes mellitus(PTDM)is a common complication after kidney transplantation,affecting 10%to 40%of recipients and increasing the risk of cardiovascular disease,infections,sepsis and other conditions.The pathogenesis of PTDM is complex,including pancreatic β-cell dysfunction and insulin resistance.Tacrolimus,a commonly used immunosuppressive drug,is an independent risk factor for PTDM.Its mechanisms include damaging pancreatic β-cells,mediating impaired mitochondrial autophagy,etc.In addition,tacrolimus also raises blood glucose levels through various pathways,such as affecting gut microbiota metabolism and activating bile acid signaling pathways.In recent years,some new anti-diabetic drugs have shown certain application prospects in kidney transplant recipients,but the evidence-based medical evidence for their combined use still needs further exploration.In the future,it is necessary to conduct in-depth research on the multiple sites of action of tacrolimus to reduce the occurrence of PTDM and improve the prognosis of kidney transplant recipients.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Objective To summarize the change law of tongue images in postoperative patients with anorectal disease by observing the postoperative tongue image changes in 400 patients with anorectal disease;To investigate the relationship between the severity of postoperative symptoms in anorectal disease and tongue symptoms.Methods Totally 400 patients meeting the inclusion criteria were selected from the first Department of Anorectal Medicine of Inner Mongolia Hospital of Traditional Chinese Medicine during January 2023 to December 2023.Tongue texture and tongue coating,postoperative wound pain degree,duration of pain,defecation situation and degree of wound edema of patients were observed and recorded before surgery,on the 1st,3rd,5th,7th and 10th days after surgery,respectively.Results The data recorded for 6 time spots of before surgery and 1,3,4,5,10 d after surgery showed significant differences in the tongue coating results of patients,indicating that the postoperative tongue image of patients with anorectal disease presented dynamic changes,with the general law being light red tongue or red tongue before surgery,thin white tongue or little fur,gradually changing into red tongue,blue tongue,thin white dry tongue or thin yellow tongue 1-3 days after operation,red tongue or purple tongue 3-7 days,white greasy tongue or yellow thick greasy tongue,and tongue coating subside after 10 days.Tongue quality gradually recovered,and tongue image changes were closely related to clinical symptoms.Conclusion The tongue image of anorectal patients after operation has obvious characteristic expression,and its change is regular,and it is related to the symptoms,degree and outcome of the disease.

Aim To explore the effect of liraglutide on myocardial injury in diabetic rats by activating Nrf2/HO-1 signaling pathway.Methods Forty rats were divided into thenormal group,model group,metformin group and liraglutide group.After modeling,the nor-mal group and model group did not intervene,the met-formin group was administrated with 250 g·kg-1 met-formin,and the liraglutide group was injected with 0.324 g·kg-1 liraglutide,once a day for a total of one month.Blood sugar and insulin levels were detec-ted by ELISA,and the pathological changes were ob-served by HE staining.The expression of Nrf2,HO-1,NLRP3,IL-1 β and caspase-1 were detected by West-ern blot and fluorescent quantitative PCR,respective-ly.Results Compared with the model group,the fasting glucose,NLRP3,caspase-1,IL-1β of the treatment group were reduced,while insulin,Nrf2,HO-1 levels increased(P＜0.05),of which the effects of liraglutide group was more obvious.Conclu-sions Liraglutide has a protective effect on diabetic myocardium,and its mechanism may be related to the regulation of Nrf2/HO-1 signaling pathway and the im-provement of pyroptosis.

Objective To preliminarily investigate the safety and efficacy of percutaneous microwave ab-lation(MWA)in patients with advanced breast cancer involving the skin or nipple-areola complex(NAC).Methods This study included breast cancer patients with skin or NAC involvement treated at the Fifth Medical Center of the Chinese PLA General Hospital from January 2011 to August 2024.Patients underwent percutaneous MWA with water isolation technique to protect surrounding tissues.Clinical data were retrospectively collected,and the technical success rate,complications,prognosis,patient satisfaction with breast aesthetics,and quality of life improvement were analyzed.Results A total of 19 patients(24 lesions)meeting the inclusion and ex-clusion criteria were analyzed.The cases included 4 with T4N0M0,2 with T4N1M0,3 with T4N2M0,1 with T4N3M0,1 with T4N2M1,and 8 with T4N3M1.The average diameter of the 24 lesions was(4.9±3.4)cm,with an average of(1.6±0.6)ablation sessions per lesion.The median ablation time was 36.9(26.1,61.7)minutes,and the median ablation energy was 84.2(45.6,149.2)kJ.The technical success rate was 100%.Postoperatively,7 patients(7/19,36.8%)experienced skin burns around the lesion or nipple shedding,all of which healed naturally.The median overall survival was 35.0(17.0,45.5)months,and the median recur-rence-free survival was 17.0(11.0,38.5)months.Patient satisfaction with post-treatment breast aesthetics was 89.5%,and all patients reported significant improvement in their quality of life.Conclusions Percutane-ous microwave ablation for breast cancer involving the skin or NAC was preliminary demonstrates to be safe and effective,suggesting its potential as a viable treatment option for patients with inoperable breast cancer.

Aim To explore the effect of liraglutide on myocardial injury in diabetic rats by activating Nrf2/HO-1 signaling pathway.Methods Forty rats were divided into thenormal group,model group,metformin group and liraglutide group.After modeling,the nor-mal group and model group did not intervene,the met-formin group was administrated with 250 g·kg-1 met-formin,and the liraglutide group was injected with 0.324 g·kg-1 liraglutide,once a day for a total of one month.Blood sugar and insulin levels were detec-ted by ELISA,and the pathological changes were ob-served by HE staining.The expression of Nrf2,HO-1,NLRP3,IL-1 β and caspase-1 were detected by West-ern blot and fluorescent quantitative PCR,respective-ly.Results Compared with the model group,the fasting glucose,NLRP3,caspase-1,IL-1β of the treatment group were reduced,while insulin,Nrf2,HO-1 levels increased(P＜0.05),of which the effects of liraglutide group was more obvious.Conclu-sions Liraglutide has a protective effect on diabetic myocardium,and its mechanism may be related to the regulation of Nrf2/HO-1 signaling pathway and the im-provement of pyroptosis.

Objective To preliminarily investigate the safety and efficacy of percutaneous microwave ab-lation(MWA)in patients with advanced breast cancer involving the skin or nipple-areola complex(NAC).Methods This study included breast cancer patients with skin or NAC involvement treated at the Fifth Medical Center of the Chinese PLA General Hospital from January 2011 to August 2024.Patients underwent percutaneous MWA with water isolation technique to protect surrounding tissues.Clinical data were retrospectively collected,and the technical success rate,complications,prognosis,patient satisfaction with breast aesthetics,and quality of life improvement were analyzed.Results A total of 19 patients(24 lesions)meeting the inclusion and ex-clusion criteria were analyzed.The cases included 4 with T4N0M0,2 with T4N1M0,3 with T4N2M0,1 with T4N3M0,1 with T4N2M1,and 8 with T4N3M1.The average diameter of the 24 lesions was(4.9±3.4)cm,with an average of(1.6±0.6)ablation sessions per lesion.The median ablation time was 36.9(26.1,61.7)minutes,and the median ablation energy was 84.2(45.6,149.2)kJ.The technical success rate was 100%.Postoperatively,7 patients(7/19,36.8%)experienced skin burns around the lesion or nipple shedding,all of which healed naturally.The median overall survival was 35.0(17.0,45.5)months,and the median recur-rence-free survival was 17.0(11.0,38.5)months.Patient satisfaction with post-treatment breast aesthetics was 89.5%,and all patients reported significant improvement in their quality of life.Conclusions Percutane-ous microwave ablation for breast cancer involving the skin or NAC was preliminary demonstrates to be safe and effective,suggesting its potential as a viable treatment option for patients with inoperable breast cancer.

Nanoparticle delivery systems have good application prospects in the field of precision therapy, but the preparation process of nanomaterial has problems such as short in vivo circulation time, easy recognition, and clearance by the immune system in the body. In recent years, biomimetic nanoparticle delivery systems mediated by natural cell membranes have become a research hotspot to address these issues. The natural membrane biomimetic nanoparticle delivery system cleverly integrates the advantages of natural biofilm "autologous" and "artificial" functional carriers by using endogenous cell membranes to modify the surface of nanocarriers, endowing them with characteristics such as tumor targeting, low immunogenicity, and long blood circulation. Currently, biomimetic nanoparticle delivery systems have been used in the treatment of malignant tumors, cardiovascular diseases, bacterial infections, and other diseases. This paper analyzes the development status and current research hotspots of natural cell membrane camouflaged biomimetic nanoparticle delivery systems mainly reviews the latest research progress of red blood cell membrane camouflaged biomimetic nanoparticle delivery systems in the field of disease treatment in recent years. It focuses on exploring the advantages, future development prospects, and limitations of biomimetic nanoparticle delivery systems based on red blood cell membrane camouflage in improving drug delivery, to provide a reference for the in-depth research and development of this system.

BackgroundDepression has become a public health concern that affects the physical and mental health of college students. acute stress response is a risk factor of depression. Exploring the relationship and mechanism between acute stress response and depression is of great significance for preventing and intervening depression in college students. ObjectiveTo examine the relationship between acute stress response and depression among college students， and to analyze the mediating role of rumination and the moderated effect of perceived social support， so as to provide references for the prevention and intervention of depression in college student . MethodsFrom March to April 2020， a cluster sampling method was employed to select 1 355 college students from three universities in Hubei， Jiangxi and Guangxi Zhuang Autonomous Region. Participants were assessed with Acute Stress Disorder Scale （ASDS）， Ruminative Responses Scale （RRS）， Brief form of Perceived Social Support Questionnaire （F-SozU） and Patients' Health Questionnaire Depression Scale-9 item （PHQ-9）. Pearson correlation analysis was adopted to examine the correlation between the scores of each scale. The mediating role of rumination between acute stress response and depression and the moderated role of perceived social support were examined respectively by using Model 4 and Model 14 in Macro Program Process 3.3. ResultsA total of 1 303 valid questionnaires were collected， yielding a valid response rate of 96.16%. The results of Pearson correlation analysis showed that ASDS score was positively correlated with RRS score and PHQ-9 score （r=0.649， 0.528， P<0.01） among college students. The mediation analysis results demonstrated that rumination played a partial mediating role between acute stress response and depression， with the mediating effect value of 0.273 （95% CI：0.222~0.328）， accounting for 68.59% of the total effect. Perceived social support played a moderated role in the latter path of the mediation model （rumination → depression） （β=-0.004， 95% CI： -0.017~-0.004， P<0.01）. ConclusionRumination played a partial mediating role between acute stress response and depression in college students， and perceptive social support played a moderated role between rumination and depression. ［Funded by Scientific Research Fund Project of Education Department of Yunnan Province （number， 2025J0437）］