Polycystin-2 (also known as PC2, TRPP2, PKD2) is a major contributor to the underlying etiology of autosomal dominant polycystic kidney disease (ADPKD), which is the most prevalent monogenic kidney disease in the world. As a transient receptor potential (TRP) channel protein, PC2 exhibits cation-permeable, Ca²⁺-dependent channel properties, and plays a crucial role in maintaining normal Ca²⁺ signaling in systemic physiology, particularly in ADPKD chronic kidney disease. Structurally, PC2 protein consists of six transmembrane structural domains (S1-S6), a polycystin-specific “tetragonal opening for polycystins” (TOP) domain located between the S1 and S2 transmembrane structures, and cytoplasmic N- and C-termini. Although the cytoplasmic N-terminus and C-terminus of PC2 may not be significant in the gating of PC2 channels, there is still much protein structural information that needs to be thoroughly investigated, including the regulation of channel function and the assembly of homotetrameric ion channels. This is further supported by the presence of human disease-associated mutation sites on the PC2 structure. Moreover, PC2 synthesized in the endoplasmic reticulum is enriched in specific subcellular localization via membrane transport and can assemble itself into homotetrameric ion channels, as well as form heterotrimeric receptor-ion channel complexes with other proteins. These complexes are involved in a wide range of physiological functions, including the regulation of mechanosensation, cell polarity, cell proliferation, and apoptosis. In particular, PC2 assembles with chaperone proteins to form polycystic protein complexes that affect Ca²⁺ transport in cell membranes, cilia, endoplasmic reticulum, and mitochondria, and are involved in activating cell fate-related signaling pathways, particularly cell differentiation, proliferation, survival, and apoptosis, and more recently, autophagy. This leads to a shift of cystic cells from a normal uptake, quiescent state to a pathologically secreted, proliferative state. In conclusion, the complex structural and functional roles of PC2 highlight its critical importance in the pathogenesis of ADPKD, making it a promising target for therapeutic intervention.

Lung cancer is one of the malignant tumors with the highest mortality and the fastest growing incidence,which seriously threatens human life and health.With the popularization of low-dose spiral CT and the enhancement of public awareness of physical examination,more and more ground-glass nodules have been detected.Accumulating studies have shown that for patients with nodules diameter≤2 cm and ground-glass opacity≥50% ,under the condition of ensuring the cutting edge,thoracoscopic sublobectomy or subsegmentectomy can more effectively preserve the lung function of patients,and has gradually become the recommended surgical method.In recent years,with the continuous improvement of thoracoscopic surgery technology,thoracoscopic subsegmentectomy and combined subsegmentectomy have been gradually carried out.Compared with lobectomy and segmentectomy,subsegmental resection can retain more normal lung tissue and reduce the loss of lung function under the condition of ensuring the safe cutting edge.However,thoracoscopic subsegmental resection requires a higher level of surgical technique and anatomical knowledge for the operator,and is rarely reported in relevant literature.Therefore,this article reviews the progress of anatomical subsegmentectomy and combined subsegmentectomy in the treatment of early non-small cell lung cancer.

Objective:To investigate two cases of rare pathogenic genes,initiation codon mutations in HBA2 gene,combined with Southeast Asian deletion and their family members to understand the relationship of HBA2:c.2T＞C and HBA2:c.2delT mutations with clinical phenotype.Methods:The peripheral blood of family members was obtained for blood cell analysis and capillary electrophoresis hemoglobin analysis.Gap-PCR and reverse dot blotting(RDB)were used to detect common types of mutations in α-thalassaemia gene.Sanger sequencing was used to analyze HBA1 and HBA2 gene sequence.Results:Two proband genotypes were identified as--SEA/αα with HBA2:c.2T＞C and--SEA/αα with HBA2:c.2delT.HBA2:c.2T＞C/WT and HBA2:c.2delT/WT was detected in family members.They all presented with microcytic hypochromic anemia.Conclusion:When HBA2:c.2T＞C and HBA2:c.2delT are heterozygous that can lead to static α-thalassemia phenotype,and when combined with mild α-thalassemia,they can lead to the clinical manifestations of hemoglobin H disease.This study provides a basis for genetic counseling.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To investigate the effect of Hounsfield Units (HU) at the upper instrumented vertebra (UIV) on postoperative proximal junctional kyphosis (PJK) after pelvic fixation with second sacral alar-iliac (S 2AI) screws in patients with degenerative spinal deformity. Methods:A total of 66 patients with degenerative spinal deformity who underwent pelvic fixation with S 2AI screws from August 2015 to April 2021 were retrospectively reviewed. The cohort included 4 males and 62 females, aged 61.9±7.3 years (range, 43-78 years), with a follow-up period of 18.4±14.3 months (range, 6-60 months). The prevalence of PJK was 26%. Patients were divided into two groups based on the occurrence of PJK during postoperative follow-up: the PJK group (17 cases) and the non-PJK group (49 cases). HU measurements were taken at the UIV, the vertebral body cephalad to the UIV (UIV+1), and the L 3 and L 4 vertebral bodies. The following sagittal radiographic parameters were measured: thoracic kyphosis (TK), lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), PI minus LL (PI-LL), and sagittal vertical axis (SVA) at preoperative, postoperative, and final follow-up. General information and HU values of the two groups were compared, and Pearson correlation analysis was performed on HU values, bone mineral density (BMD), and T scores. Logistic regression analysis was used to explore the risk factors for PJK. Results:The HU values of L 3 and L 4 were significantly positively correlated with the BMD and T scores respectively ( r=0.530, P<0.001; r=0.537, P<0.001). Age, gender, follow-up time, fixation levels, bone mineral density (BMD) and T-score were not significantly different between PJK and non-PJK group. The average HU values of UIV and UIV+1 in PJK group was 104.3±32.9, whlie the average HU values of UIV and UIV+1 in non-PJK group was 133.7±29.5. The difference of HU between the two groups was statistically significant ( t=3.441, P=0.001). Logistic regression analysis showed that average HU values of UIV and UIV+1 [ OR=0.960, 95% CI(0.933, 0.987), P=0.004] and changes of lumbar lordosis [ OR=1.049, 95% CI(1.007, 1.092), P=0.023] were independent risk factors for PJK, with an optimal cutoff obtained by ROC that 106 for average HU values of UIV and UIV+1 and 22.5° for changes of LL. Conclusion:The average HU values of UIV and UIV+1 < 106 and changes of lumbar lordosis > 22.5° are independent risk factors for PJK after pelvic fixation with second sacralalar-iliac in patients with degenerative spinal deformity.

Objective     To investigate the current status of constipation during postoperative hospitalization and the factors associated with moderate to severe constipation at discharge in lung cancer patients. Methods     Lung cancer patients who underwent surgery in 6 tertiary hospitals in Sichuan Province from November 2017 to January 2020 were enrolled. The MD Anderson Symptom Scale-Lung Cancer Module was used to collect postoperative constipation scores. Unconditional logistic stepwise regression was used to analyze the related influencing factors for moderate to severe constipation on the day of discharge. Results     Finally 337 patients were collected. There were 171 males and 166 females, with an average age of 55.0±10.3 years. Constipation scores of lung cancer patients increased from postoperative day 1 to day 3, and showed a decreasing trend from day 3 to day 7. Moderate to severe constipation was present in 68 (20.2%) patients at discharge. The postoperative hospital stay (OR=0.743, P<0.001) and the dose of morphine used during postoperative hospitalization (OR=1.002, P=0.015) were influencing factors for moderate to severe constipation at discharge in lung cancer patients. Conclusion    Lung cancer patients have the most severe constipation on postoperative day 3. Moderate to severe constipation at discharge is associated with the postoperative hospital stay and the dose of morphine used during postoperative hospitalization.

Currently,the research or publications related to the clinical comprehensive evaluation of Chinese patent medicine are increasing,which attracts the broad attention of all circles. According to the completed clinical evaluation report on Chinese patent medicine,there are still practical problems and technical difficulties such as unclear responsibility of the evaluation organization,unclear evaluation subject,miscellaneous evaluation objects,and incomplete and nonstandard evaluation process. In terms of evaluation standards and specifications,there are different types of specifications or guidelines with different emphases issued by different academic groups or relevant institutions. The professional guideline is required to guide the standardized and efficient clinical comprehensive evaluation of Chinese patent medicine and further improve the authority and quality of evaluation. In combination with the characteristics of Chinese patent medicine and the latest research achievement at home and abroad,the detailed specifications were formulated from six aspects including design,theme selection,content and index,outcome,application and appraisal,and quality control. The guideline was developed based on the guideline development requirements of China Assoication of Chinese medicine. After several rounds of expert consensus and public consultation,the current version of the guideline has been developed.
Medicine, Chinese Traditional ; Nonprescription Drugs ; Consensus ; China ; Reference Standards ; Drugs, Chinese Herbal

Objective To analyze and study the actual therapeutic effect of the combined treatment of budesonide-formoterol and ipratropium bromide with non-invasive positive pressure ventilation(NIPPV)in elderly patients with chronic obstructive pulmonary disease(COPD)and type Ⅱ respiratory failure.Methods Patients diagnosed clinically with COPD and type Ⅱ respiratory failure were selected for the study.The control group received NIPPV-style oxygen therapy for 3-4 hours each time,tid,for a total of 28 days,while the treatment group received budesonide-formoterol inhalation powder 1 inhalation and ipratropium bromide solution 2 mL aerosol inhalation on the basis of control group,twice a day for three consecutive days,for a total of four treatment cycles,with a cycle interval of 4 days and a total treatment duration of 28 days.Changes in arterial carbon dioxide partial pressure(PaCO2),the ratio of forced expiratory volume in one second to forced vital capacity(FEV1/FVC),6-minute walk test distance,BODE index,and other indicators were observed before and after treatment in the two groups.Results A total of 115 patients were included in the study,including 58 in the control group and 57 in the treatment group.After treatment,the FEV1/FVC in the treatment group and the control group were(65.12±5.11)％and(60.12±1.43)％,respectively;PaCO2 were(36.99±3.28)and(40.05±1.46)mmHg,respectively;6-minute walk test distances were(459.15±17.25)and(400.15±25.16)m,respectively;BODE index were 3.00±0.42 and 3.81±0.28,respectively.The overall survival rates in the two groups after 1 year were(88.14±12.16)％and(71.14±11.14)％,respectively,and the rates of improvement in lung function were 73.68％(42 cases/57 cases)and 58.62％(34 cases/58 cases),respectively.The differences in these indicators between the two groups were statistically significant(all P＜0.05).The incidence of drug adverse reactions in the treatment group and the control group were 21.05％(12 cases/57 cases)and 18.97％(11 cases/58 cases),respectively,without significant difference(P＞0.05).Conclusion The combined treatment of budesonide-formoterol and ipratropium bromide with NIPPV can significantly improve the exercise tolerance of patients with COPD and type Ⅱ respiratory failure.It can also significantly reduce BODE index and delay the occurrence of all-cause mortality events within 1 year.

This study aimed to evaluate the cost-effectiveness of Chaiyin Granules compared with Oseltamivir Phosphate Capsules in the treatment of influenza(exogenous wind-heat syndrome). Based on a randomized, double-blind, positive drug parallel control clinical trial, this study evaluated the pharmacoeconomics of Chaiyin Granules with cost-effectiveness analysis method. A total of 116 patients with influenza from eight hospitals(grade Ⅱ level A above) in 6 cities were selected in this study, including 78 cases in the experimental group with Chaiyin Granules and Oseltamivir Phosphate Capsules placebo, and 38 cases in the control group with Oseltamivir Phosphate Capsules and Chaiyin Granules placebo. The total cost of this study included direct medical cost, direct non-medical cost, and indirect cost. The remission time of clinical symptoms, cure time/cure rate, antipyretic onset time/complete antipyretic time, viral nucleic acid negative rate, and traditional Chinese medicine(TCM) syndrome curative effect were selected as the effect indicators for cost-effectiveness analysis. Four-quadrant diagram was used to estimate the incremental cost-effectiveness ratio. The results showed that Chaiyin Granules were not inferior to Oseltamivir Phosphate Capsules in the remission time of clinical symptoms of influenza(3.1 d vs 2.9 d, P=0.360, non-inferiority margin was 0.5 d). Compared with Oseltamivir Phosphate Capsules, Chaiyin Granules would delay the remission time of clinic symptoms of influenza for 1 d, but could save 213.9 yuan. 1 d delay in cure time could save 149.3 yuan; 1% reduction in the cure rate could save 8.2 yuan; 1 d delay in antipyretic onset time could save 295.4 yuan; 1 d delay in complete antipyretic time could save 114.3 yuan; 1% reduction in the 5-day cure rate of TCM syndrome could save 19.2 yuan. Different from other indicators, there was no statistically significant difference between two groups in the effect of negative conversion rate of viral nucleic acid, but the cost was lower and the effect was superior, and the pharmacoeconomics was not different from that of Oseltamivir Phosphate Capsules in the field of influenza treatment.
Humans ; Antipyretics/therapeutic use* ; Antiviral Agents/therapeutic use* ; Cost-Effectiveness Analysis ; Influenza, Human/drug therapy* ; Nucleic Acids/therapeutic use* ; Oseltamivir/therapeutic use* ; Phosphates/therapeutic use* ; Treatment Outcome ; Double-Blind Method

Objective: To analyze the clinical epidemiological characteristics including composition of pathogens , clinical characteristics, and disease prognosis acute bacterial meningitis (ABM) in Chinese children. Methods: A retrospective analysis was performed on the clinical and laboratory data of 1 610 children <15 years of age with ABM in 33 tertiary hospitals in China from January 2019 to December 2020. Patients were divided into different groups according to age,<28 days group, 28 days to <3 months group, 3 months to <1 year group, 1-<5 years of age group, 5-<15 years of age group; etiology confirmed group and clinically diagnosed group according to etiology diagnosis. Non-numeric variables were analyzed with the Chi-square test or Fisher's exact test, while non-normal distrituction numeric variables were compared with nonparametric test. Results: Among 1 610 children with ABM, 955 were male and 650 were female (5 cases were not provided with gender information), and the age of onset was 1.5 (0.5, 5.5) months. There were 588 cases age from <28 days, 462 cases age from 28 days to <3 months, 302 cases age from 3 months to <1 year of age group, 156 cases in the 1-<5 years of age and 101 cases in the 5-<15 years of age. The detection rates were 38.8% (95/245) and 31.5% (70/222) of Escherichia coli and 27.8% (68/245) and 35.1% (78/222) of Streptococcus agalactiae in infants younger than 28 days of age and 28 days to 3 months of age; the detection rates of Streptococcus pneumonia, Escherichia coli, and Streptococcus agalactiae were 34.3% (61/178), 14.0% (25/178) and 13.5% (24/178) in the 3 months of age to <1 year of age group; the dominant pathogens were Streptococcus pneumoniae and the detection rate were 67.9% (74/109) and 44.4% (16/36) in the 1-<5 years of age and 5-<15 years of age . There were 9.7% (19/195) strains of Escherichia coli producing ultra-broad-spectrum β-lactamases. The positive rates of cerebrospinal fluid (CSF) culture and blood culture were 32.2% (515/1 598) and 25.0% (400/1 598), while 38.2% (126/330)and 25.3% (21/83) in CSF metagenomics next generation sequencing and Streptococcus pneumoniae antigen detection. There were 4.3% (32/790) cases of which CSF white blood cell counts were normal in etiology confirmed group. Among 1 610 children with ABM, main intracranial imaging complications were subdural effusion and (or) empyema in 349 cases (21.7%), hydrocephalus in 233 cases (14.5%), brain abscess in 178 cases (11.1%), and other cerebrovascular diseases, including encephalomalacia, cerebral infarction, and encephalatrophy, in 174 cases (10.8%). Among the 166 cases (10.3%) with unfavorable outcome, 32 cases (2.0%) died among whom 24 cases died before 1 year of age, and 37 cases (2.3%) had recurrence among whom 25 cases had recurrence within 3 weeks. The incidences of subdural effusion and (or) empyema, brain abscess and ependymitis in the etiology confirmed group were significantly higher than those in the clinically diagnosed group (26.2% (207/790) vs. 17.3% (142/820), 13.0% (103/790) vs. 9.1% (75/820), 4.6% (36/790) vs. 2.7% (22/820), χ²=18.71, 6.20, 4.07, all P<0.05), but there was no significant difference in the unfavorable outcomes, mortility, and recurrence between these 2 groups (all P>0.05). Conclusions: The onset age of ABM in children is usually within 1 year of age, especially <3 months. The common pathogens in infants <3 months of age are Escherichia coli and Streptococcus agalactiae, and the dominant pathogen in infant ≥3 months is Streptococcus pneumoniae. Subdural effusion and (or) empyema and hydrocephalus are common complications. ABM should not be excluded even if CSF white blood cell counts is within normal range. Standardized bacteriological examination should be paid more attention to increase the pathogenic detection rate. Non-culture CSF detection methods may facilitate the pathogenic diagnosis.
Adolescent ; Brain Abscess ; Child ; Child, Preschool ; Escherichia coli ; Female ; Humans ; Hydrocephalus ; Infant ; Infant, Newborn ; Male ; Meningitis, Bacterial/epidemiology* ; Retrospective Studies ; Streptococcus agalactiae ; Streptococcus pneumoniae ; Subdural Effusion ; beta-Lactamases