Objective To analyze the disease burden and trends of bladder cancer in China and globally from 1992 to 2021.  Methods Using the GBD 2021 database, the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) rates of bladder cancer in China and globally from 1992–2021 were analyzed. Average annual percentage change (AAPC) was calculated using Joinpoint regression. Subgroup analyses by sex and age were conducted, and a Bayesian age-period-cohort (BAPC) model was used to predict trends in age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) for the next 15 years.  Results In 2021, China reported 106 000 new cases (ASIR: 5.14/100 000), 571 000 prevalent cases (age-standardized prevalence rate, ASPR: 26.61/100 000), 43 000 deaths (ASMR: 2.34/100 000), and a DALY rate of 45.31/100 000. From 1992–2021, China showed upward trends in ASIR and ASPR but declines in ASMR and DALYs, while global ASIR, ASMR, and DALYs decreased overall with slow ASPR growth. The peak cases in China and globally were both concentrated in the 65-79 age group, with a significantly higher burden on males than females. In China, smoking-related ASMR and ASDR exceeded global averages and rose, whereas high glucose-related indexes were lower and declined. Projections for 2021–2036 indicated that the global incidence and mortality rates would be rising, but ASIR/ASPR would be declining, while in China, the incidence rate would continue to rise, and the mortality rate will stabilize, with a significant increase in ASIR and a gradual decrease in ASPR.  Conclusion From 1992 to 2021, the incidence of bladder cancer in China has shown a continuous upward trend and is projected to persist in the future, with significant gender and age differences. Particular attention should be given to elderly males aged 85-89. The disease burden of bladder cancer attributable to smoking continues to rise, highlighting the urgent need to strengthen tobacco control policies.

ObjectiveTo clarify whether METTL14 mediates the core role of acupuncture at Neiguan (PC6) in promoting myelination and improving behavior in young autistic rats through gene intervention technology. MethodsThe ASD model was established by intraperitoneal injection of valproic acid (VPA) in pregnant rats. Male offspring were intracerebroventricularly injected with adenovirus-packaged METTL14 shRNA (sh-METTL14) or its control (sh-NC) on postnatal day 1, with a model group set as well. Subsequently, the juvenile rats were divided into model group, acupuncture group, acupuncture+sh-NC group, and acupuncture+sh-METTL14 group. The acupuncture group received acupuncture at Neiguan (PC6) from postnatal day 7, once daily for 21 consecutive days. Neurobehavioral changes were evaluated by behavioral tests; METTL14 knockdown efficiency and the expression of METTL14, METTL3, and PTEN were detected by quantitative real-time PCR (qRT-PCR) and Western blot (WB); PTEN m⁶A levels were measured by RNA immunoprecipitation-qPCR (RIP-qPCR); myelin ultrastructure, expression of myelin basic protein (MBP) and neurofascin 155 (NF155), and dendritic spine density were observed using transmission electron microscopy (TEM), enzyme-linked immunosorbent assay (ELISA), immunofluorescence, qRT-PCR, and primary neuron culture. ResultsBehaviorally, knockdown of METTL14 significantly counteracted the beneficial effects of acupuncture in improving self-grooming, open field exploration, three-chamber social interaction, and Morris water maze learning and memory (P<0.05, P<0.01). Compared with the acupuncture+sh-NC group, the acupuncture+sh-METTL14 group showed significantly decreased mRNA and protein expression of hippocampal METTL14 (P<0.01), and the upregulating effects of acupuncture on METTL3 and PTEN expression were reversed (P<0.01). Meanwhile, knockdown of METTL14 significantly inhibited the acupuncture-induced increase in PTEN m⁶A levels (P<0.01). Morphologically, knockdown of METTL14 attenuated the improvement of myelin structure by acupuncture, reversed the downregulation of MBP and upregulation of NF155 induced by acupuncture, and blocked the increase in dendritic spine density (P<0.05, P<0.01). ConclusionMETTL14 is a key molecule mediating the therapeutic effect of acupuncture at Neiguan. Acupuncture at Neiguan upregulates METTL14, thereby enhancing m⁶A methylation modification of PTEN mRNA to stabilize its expression, ultimately promoting myelin development and improving behavioral symptoms in ASD juvenile rats. This preliminarily reveals the modern biological connotation of “opening Xuanfu and dredging myelin”.

ObjectiveTo clarify whether METTL14 mediates the core role of acupuncture at Neiguan (PC6) in promoting myelination and improving behavior in young autistic rats through gene intervention technology. MethodsThe ASD model was established by intraperitoneal injection of valproic acid (VPA) in pregnant rats. Male offspring were intracerebroventricularly injected with adenovirus-packaged METTL14 shRNA (sh-METTL14) or its control (sh-NC) on postnatal day 1, with a model group set as well. Subsequently, the juvenile rats were divided into model group, acupuncture group, acupuncture+sh-NC group, and acupuncture+sh-METTL14 group. The acupuncture group received acupuncture at Neiguan (PC6) from postnatal day 7, once daily for 21 consecutive days. Neurobehavioral changes were evaluated by behavioral tests; METTL14 knockdown efficiency and the expression of METTL14, METTL3, and PTEN were detected by quantitative real-time PCR (qRT-PCR) and Western blot (WB); PTEN m⁶A levels were measured by RNA immunoprecipitation-qPCR (RIP-qPCR); myelin ultrastructure, expression of myelin basic protein (MBP) and neurofascin 155 (NF155), and dendritic spine density were observed using transmission electron microscopy (TEM), enzyme-linked immunosorbent assay (ELISA), immunofluorescence, qRT-PCR, and primary neuron culture. ResultsBehaviorally, knockdown of METTL14 significantly counteracted the beneficial effects of acupuncture in improving self-grooming, open field exploration, three-chamber social interaction, and Morris water maze learning and memory (P<0.05, P<0.01). Compared with the acupuncture+sh-NC group, the acupuncture+sh-METTL14 group showed significantly decreased mRNA and protein expression of hippocampal METTL14 (P<0.01), and the upregulating effects of acupuncture on METTL3 and PTEN expression were reversed (P<0.01). Meanwhile, knockdown of METTL14 significantly inhibited the acupuncture-induced increase in PTEN m⁶A levels (P<0.01). Morphologically, knockdown of METTL14 attenuated the improvement of myelin structure by acupuncture, reversed the downregulation of MBP and upregulation of NF155 induced by acupuncture, and blocked the increase in dendritic spine density (P<0.05, P<0.01). ConclusionMETTL14 is a key molecule mediating the therapeutic effect of acupuncture at Neiguan. Acupuncture at Neiguan upregulates METTL14, thereby enhancing m⁶A methylation modification of PTEN mRNA to stabilize its expression, ultimately promoting myelin development and improving behavioral symptoms in ASD juvenile rats. This preliminarily reveals the modern biological connotation of “opening Xuanfu and dredging myelin”.

Objective:To develop an evidence-based nursing practice program based on the Stetler model to extend the lifespan of arteriovenous fistulas (AVF) in maintenance hemodialysis (MHD) patients and evaluate its effectiveness.Methods:An evidence-based nursing practice program was constructed based on the best evidence for extending AVF lifespan in MHD patients. Expert group discussions were held to determine review indicators. A baseline survey was conducted among 100 MHD patients and 42 nurses using covenience sompling at the Blood Purification Center of Wuxi People's Hospital from January to December 2023, to identify barriers and facilitators. In the following year, from January to December 2024, the evidence-based practice was implemented at the same hospital, and the AVF surgical intervention rate and AVF self-management levels of MHD patients were compared before and after the practice.Results:No statistically significant difference was found in the AVF surgery rates before and after the evidence-based practice ( P>0.05) . However, after implementing the evidence-based practice, MHD patients' scores on the AVF self-management scale significantly improved, and the difference was statistically significant ( P<0.01) . Conclusions:The evidence-based practice based on the Stetler model is beneficial for standardizing the clinical management of AVF, reducing the need for surgical interventions, and improving MHD patients' ability to self-manage their AVF.

Objective:To explore the clinical effects of sterilization of vas deferens by irrigation in clinic.Methods:Eighty-six male patients with voluntary sterilization were divided into control group(usual vasectomy,n=50)and observation group(sterilization of vas deferens by irrigation,n=36).The age,testicular volume,preoperative average concentration of spern,serum testosterone level,recovery duration evaluated by Artificial Obstruction Azoospermia(AOA)and degree of satisfaction were compared between the two groups of patients.Results:There were significant differences in recovery duration,degree of satisfaction between the two groups(P＜0.05).And there was no significant difference in age([32.0±5.5]years vs[31.0±6.3]years),testicular volume([16.0±4.8]mL vs[17.0±4.4]mL),preopera-tive average concentration of sperm([39.6±20.2]× 106/mL vs[40.2±22.6]× 106/mL)and levels of blood testosterone([4.3±0.8]ng/mL vs[4.4±0.8]ng/mL).There was significant difference in patency rate between the two sides of testicular ducts(91.7％vs 83.3％,P＜0.05).Conclusion:The method of sterilization of vas deferens by irrigation is worth popularizing in clinic.

BACKGROUND:Pathological cardiac hypertrophy is a risk factor for various heart diseases,but its pathogenesis remains unclear.Circular RNAs are strongly associated with cardiac hypertrophy.However,the role of circular RNA CHACR in cardiac hypertrophy and its regulatory mechanisms have not been clarified.OBJECTIVE:To investigate the role of circular RNA CHACR in pressure overload-induced cardiac hypertrophy and the underlying mechanisms.METHODS:(1)Transverse aortic constriction was used to induce cardiac hypertrophy in vivo after in situ injection of cyclic RNA CHACR overexpressing lentivirus into the heart for 1 week.Heart mass/tibia length ratio and lung mass/tibia length ratio were calculated;cardiomyocyte surface area was measured;hypertrophic marker gene expression levels were detected;myocardial fibrosis degree was detected,and cardiac function was assessed.(2)H9c2 cardiomyocytes were treated with circular RNA CHACR overexpressing lentivirus for 72 hours,and then treated with 1 μmol/L angiotensin Ⅱ for 24 hours to induce hypertrophy of cardiomyocytes.The hypertrophy was assessed by measuring the surface area of cardiomyocytes,the expression level of hypertrophic marker genes,and the protein/DNA ratio.Oxidative stress damage was assessed by detecting reactive oxygen species levels and mitochondrial membrane potential.RESULTS AND CONCLUSION:(1)The expression level of circular RNA CHACR was significantly decreased in both in vivo and in vitro myocardial hypertrophy models(P＜0.01).(2)The overexpression of circular RNA CHACR significantly inhibited the cardiac hypertrophy induced by transverse aortic constriction,including reducing the enlarged heart volume,significantly decreasing the increased heart mass/tibia length ratio(P＜0.05),lung mass/tibia length ratio(P＜0.05),and cardiomyocyte surface area(P＜0.05),and decreasing the upregulated expression levels of hypertrophic markers atrial natriuretic peptide(P＜0.05)and brain natriuretic peptide(P＜0.05).(3)Cardiac fibrosis induced by transverse aortic constriction in mice was significantly inhibited by enforcing expression of circular RNA CHACR,as evidenced by reduced fibrotic area(P＜0.01)and decreased expression levels of the fibrosis marker gene Acta1(P＜0.05).(4)Overexpression of circular RNA CHACR significantly improved cardiac function in mice,including significantly increased ejection fraction(P＜0.05)and fractional shortening(P＜0.01).(5)Enforced expression of circular RNA CHACR significantly inhibited angiotensin Ⅱ-induced cardiomyocyte hypertrophy,including a significant reduction in cardiomyocyte surface area(P＜0.05),downregulation of atrial natriuretic peptide(P＜0.05),and brain natriuretic peptide(P＜0.05)expression levels,and a significant decrease in protein/DNA ratio(P＜0.05).(6)Overexpression of circular RNA CHACR significantly inhibited the elevation of reactive oxygen species levels(P＜0.001)and the decrease in mitochondrial membrane potential(P＜0.05)induced by angiotensin Ⅱ.These results confirm that the expression level of circular RNA CHACR is significantly decreased in cardiac hypertrophy at both in vivo and in vitro myocardial hypertrophy models,and overexpression of circular RNA CHACR significantly inhibits cardiac hypertrophy,alleviates cardiac fibrosis,improves cardiac function,and significantly attenuates angiotensin Ⅱ-induced oxidative stress damage.

Objective To design an 8-channel gene analyzer to take the place of the widely used gene analyzer with problems in inconvenient consumable replacement and short storage time of electrophoresis polymer.Methods The 8-channel gene analyzer had its mechanical components composed of an automatic sample loading table,a polymer injection module,a high-voltage temperature control module,an optical module and an integrated U box,its electrical control system made up of a host computer(an embedded computer)and three slave computers(a sampling control board,a polymer injection control board and a high-voltage temperature control board).The automatic sample loading table involved in four motors and transmission systems for x,y,z directions and optical alignment,the transmission systems adopted mainly belt drive mode and the optical alignment motor had its threads with an anti-backlash structure;the polymer injuection module was manipulated by the polymer injection control board,and the polymer block was made of highly transparent acrylic material;the high-voltage temperature control module realized the regulation of electrophoresis voltage and the detection of electrophoresis current by the low-ripple precision high-voltage power supply,and controlled the temperature of the heating furnace by the proportional-integral-differential(PID)algorithm;the optical module consisted of an excitation module and a light-receiving module,which had the base of the reflector made of low expansion coefficient alloy material;the integrated U box had the electrophoresis polymer,capillary array,polymer block and anode buffer in a plastic housing;the host computer had the data acquisition software programmed with C# and C++,and the slave computers were controlled by STM32 SCM.Results The 8-channel gene analyzer had no significant differences with the widely used ABI3500 gene analyzer in resolution,precision accuracy and clinical results.Conclusion The 8-channel gene analyzer gains advantages in consumable replacement and storage time of electrophoresis polymer,and can meet the requirements for gene sequencing.[Chinese Medical Equipment Journal,2025,46(2):24-30]

Objective:To develop an evidence-based nursing practice program based on the Stetler model to extend the lifespan of arteriovenous fistulas (AVF) in maintenance hemodialysis (MHD) patients and evaluate its effectiveness.Methods:An evidence-based nursing practice program was constructed based on the best evidence for extending AVF lifespan in MHD patients. Expert group discussions were held to determine review indicators. A baseline survey was conducted among 100 MHD patients and 42 nurses using covenience sompling at the Blood Purification Center of Wuxi People's Hospital from January to December 2023, to identify barriers and facilitators. In the following year, from January to December 2024, the evidence-based practice was implemented at the same hospital, and the AVF surgical intervention rate and AVF self-management levels of MHD patients were compared before and after the practice.Results:No statistically significant difference was found in the AVF surgery rates before and after the evidence-based practice ( P>0.05) . However, after implementing the evidence-based practice, MHD patients' scores on the AVF self-management scale significantly improved, and the difference was statistically significant ( P<0.01) . Conclusions:The evidence-based practice based on the Stetler model is beneficial for standardizing the clinical management of AVF, reducing the need for surgical interventions, and improving MHD patients' ability to self-manage their AVF.

Objective To addresses the challenges arising from the rapid expansion of pharmaceutical clinical trials and the growing demands for quality management,this paper investigates the application of low-code technology in project management.Its goals are to enhance the operational efficiency and execution capabilities of clinical trial institutions,ensure trial quality and safety,and accelerate the translation of pharmaceutical scientific achievements.Methods A brainstorming session was conducted to analyze the technical and functional requirements for managing pharmaceutical clinical trial projects.Utilizing the ＂template design＂ and ＂decision analysis＂ functionalities of low-code technology,the study adopted a modular and visually driven data management approach to develop a system compliant with Good Clinical Practice(GCP)standards.This system integrates key functionalities,including project progress management,funding management,drug inventory management,and quality control.Its effectiveness was evaluated through real-world operation and performance validation.Results The system had demonstrated stable operation with substantial improvements in practical application.Compared with conventional management approaches,it significantly enhanced project management efficiency:the time required for project schedule management was reduced by 80%,the efficiency of financial processing increased by 95%,drug inventory management efficiency improved by 75%,and the time spent on quality control was shortened by 60%.Conclusion The pharmaceutical clinical trial project management system developed using low-code technology offers substantial advantages and promising application potential.It represents a critical practice in applying digital and intelligent tools to advance pharmaceutical productivity in the medical and healthcare sectors.

Objective To carry out emergency medical system modification design for EC135 P3H helicopter without compromising the original airframe structure so as to enhance aeromedical rescue capabilities.Methods Firstly,the original cabin seats were removed and medical floor was installed in the cabin;secondly,the medical chair,medical stretcher trolley and its fixing components,storage boxes and oxygen cylinders were mounted onto the floor;finally,a medical equipment fixing frame was formed based on the original helicopter sill structure so as to accommodate medical devices such as defibrillators,ventilators and injection pumps.The modification design scheme had its effectiveness verified with overall aircraft load balance analysis,mechanical analysis,dynamic impact tests of seats and actual modification and flight tests.Results EC135 P3H helicopter proved to meet all the airworthiness certification requirements after emergency medical system modification.Conclusion The proposed modification scheme enables EC135 P3H helicopter to rapidly transition between standard and medical configurations,enhancing its emergency medical rescue capabilities and providing references for medical modifications of helicopters with similar configurations.