Background Prenatal chronic psychological stress may increase the risk of allergic diseases in children, and eczema is the most common allergic disease in children, the pathogenesis of which is not yet fully understood. Objective To preliminarily clarify the changes in offspring intestinal flora after chronic stress exposure during pregnancy in rats that increases offspring immune imbalance and eczema susceptibility. Methods Thirty SPF-grade adult female SD rats were selected and randomly divided into a model group and a control group (n=15). Sixteen male rats were randomly divided into a model mating group and a control mating group (n=8). A 28-day chronic unpredictable mild stress (CUMS) model during pregnancy was established. On the 7th day of stress, male and female rats were caged in a ratio of 3:1. Blood samples were collected from female rats in each group via angular vein on the 1st day before stress, and on the 7th, 14th, 21st, and 28th days after stress. The content of plasma corticosterone during pregnancy was determined by enzyme-linked immunosorbent assay (ELISA). For the offspring rats, an eczema model was constructed using 2,4-dinitrochlorobenzene (DNCB). The number of scratching times of the offspring rats within 5 min was recorded. The offspring rats were divided into 4 groups: DNCB-CUMS group (MM), DNCB-control group (MC), solvent control-CUMS group (CM), and blank control group (CC), with 8 rats in each group. The eczema was induced once every 3 days, and the induction period was 12 d. The expression level of immunoglobulin E (IgE) in the serum of offspring rats after the eczema induction experiment were determined by ELISA. The concentrations of tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin-2 (IL-2), interleukin-4 (IL-4), and interleukin-13 (IL-13) in the serum were quantified by multi-parameter flow cytometry. The composition and abundance of intestinal microbiota in the feces of offspring rats were detected by 16S rRNA high-throughput sequencing technology. Results The plasma corticosterone concentrations in the model group were higher than those in the control group on the 7th and 21st days of stress (P<0.05). On the 14th and 21st days of stress, the 1% sucrose preference percentages of female rats in the model group were lower than that in the control group. On the 7th, 14th, and 21st days of stress, the horizontal movement scores of female rats in the model group and the vertical movement scores on the 7th and 14th days were lower than those in the control group (P<0.05). After 6, 9, and 12 d of model building, the scratching frequencies in the MC group and MM group were significantly higher than those in the CC group and CM group (P<0.05). Moreover, there were differences in the contents of cytokines including IFN-γ, IL-2, TNF-α, IL-4, IL-13, and IgE among the offspring rat groups (P<0.05). The CM group and MM group led to an increase in the contents of TNF-α, IL-4, IL-13, and IgE cytokines (P<0.05), while the MM group caused a decrease in the contents of IFN-γ and IL-2 (P<0.05). After the eczema induction experiment, the α-diversity analysis showed that the Simpson index and Shannon index in the CM were higher than those in the CC (P<0.05), indicating that CUMS during the pregnancy of female rats could increase the species abundance of their offspring. The abundances of Prevotella and Lactobacillus in the CM group decreased (P<0.05). Conclusion Intestinal dysbiosis in offspring due to chronic prenatal psychological stress, which may be one of the mechanisms linking maternal stress to immune imbalance and increased susceptibility to eczema in offspring.

Background: Whether there is a causal relationship between childhood obesity and increased risk of chronic kidney disease (CKD) remains controversial. This study sought to explore how body size in childhood and adulthood independently affects CKD risk in later life using a Mendelian randomization (MR) approach. Methods: Univariate and multivariate MR was used to estimate total and independent effects of body size exposures. Genetic associations with early-life and adult body size were obtained from a genome-wide association study of 453,169 participants in the U.K. Biobank, and genetic associations with CKD were obtained from the CKDGen and FinnGen consortia. Results: A larger genetically predicted early-life body size was associated with an increased risk of CKD (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.14 to 1.41; P= 1.70E-05) and increased blood urea nitrogen (BUN) levels (β=0.010; 95% CI, 0.005 to 0.021; P=0.001). However, the association between the impact of early-life body size on CKD (OR, 1.12; 95% CI, 0.95 to 1.31; P=0.173) and BUN level (β=0.001; 95% CI, –0.010 to 0.012;P= 0.853) did not remain statistically significant after adjustment for adult body size. Larger genetically predicted adult body size was associated with an increased risk of CKD (OR, 1.37; 95% CI, 1.21 to 1.54; P= 4.60E-07), decreased estimated glomerular filtration rate (β=–0.011; 95% CI, –0.017 to –0.006; P=5.79E-05), and increased BUN level (β= 0.010; 95% CI, 0.002 to 0.019; P= 0.018). Conclusion Our research indicates that the significant correlation between early-life body size and CKD risk is likely due to maintaining a large body size into adulthood.

Background: Whether there is a causal relationship between childhood obesity and increased risk of chronic kidney disease (CKD) remains controversial. This study sought to explore how body size in childhood and adulthood independently affects CKD risk in later life using a Mendelian randomization (MR) approach. Methods: Univariate and multivariate MR was used to estimate total and independent effects of body size exposures. Genetic associations with early-life and adult body size were obtained from a genome-wide association study of 453,169 participants in the U.K. Biobank, and genetic associations with CKD were obtained from the CKDGen and FinnGen consortia. Results: A larger genetically predicted early-life body size was associated with an increased risk of CKD (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.14 to 1.41; P= 1.70E-05) and increased blood urea nitrogen (BUN) levels (β=0.010; 95% CI, 0.005 to 0.021; P=0.001). However, the association between the impact of early-life body size on CKD (OR, 1.12; 95% CI, 0.95 to 1.31; P=0.173) and BUN level (β=0.001; 95% CI, –0.010 to 0.012;P= 0.853) did not remain statistically significant after adjustment for adult body size. Larger genetically predicted adult body size was associated with an increased risk of CKD (OR, 1.37; 95% CI, 1.21 to 1.54; P= 4.60E-07), decreased estimated glomerular filtration rate (β=–0.011; 95% CI, –0.017 to –0.006; P=5.79E-05), and increased BUN level (β= 0.010; 95% CI, 0.002 to 0.019; P= 0.018). Conclusion Our research indicates that the significant correlation between early-life body size and CKD risk is likely due to maintaining a large body size into adulthood.

Background: Whether there is a causal relationship between childhood obesity and increased risk of chronic kidney disease (CKD) remains controversial. This study sought to explore how body size in childhood and adulthood independently affects CKD risk in later life using a Mendelian randomization (MR) approach. Methods: Univariate and multivariate MR was used to estimate total and independent effects of body size exposures. Genetic associations with early-life and adult body size were obtained from a genome-wide association study of 453,169 participants in the U.K. Biobank, and genetic associations with CKD were obtained from the CKDGen and FinnGen consortia. Results: A larger genetically predicted early-life body size was associated with an increased risk of CKD (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.14 to 1.41; P= 1.70E-05) and increased blood urea nitrogen (BUN) levels (β=0.010; 95% CI, 0.005 to 0.021; P=0.001). However, the association between the impact of early-life body size on CKD (OR, 1.12; 95% CI, 0.95 to 1.31; P=0.173) and BUN level (β=0.001; 95% CI, –0.010 to 0.012;P= 0.853) did not remain statistically significant after adjustment for adult body size. Larger genetically predicted adult body size was associated with an increased risk of CKD (OR, 1.37; 95% CI, 1.21 to 1.54; P= 4.60E-07), decreased estimated glomerular filtration rate (β=–0.011; 95% CI, –0.017 to –0.006; P=5.79E-05), and increased BUN level (β= 0.010; 95% CI, 0.002 to 0.019; P= 0.018). Conclusion Our research indicates that the significant correlation between early-life body size and CKD risk is likely due to maintaining a large body size into adulthood.

Objective To investigate the safety and feasibility of modified gasless trans-subclavian approach endoscopic total thyroidectomy for papillary thyroid carcinoma(PTC).Methods We retrospectively analyzed the clinical data of consecutive 82 patients with PTC who underwent the modified gasless trans-subclavian approach endoscopic total thyroidectomy in the Department of Head and Neck Surgery,Sir Run Run Shaw Hospital,Affiliated with the Zhejiang University School of Medicine,from March 2022 to June 2023.Results All operations were successfully completed under endoscopy approach without transfer to open surgery.The maximum diameter of PTC was(6.6±5.4)mm.The operation duration was(156.5±32.7)min,and the number of lymph nodes in the central compartment was(12.3±6.4).The postoperative hospital stay was(3.3±1.2)d.Postoperative complications included two cases of transient hypoparathyroidism and six cases of transient recurrent laryngeal nerve injury.All the patients recovered in one month.One case of postoperative bleeding was observed.No permanent laryngeal nerve injury,permanent hypoparathyroidism or incision infection occurred.Conclusion The gasless trans-subclavian approach endoscopic total thyroidectomy is a feasible and safety approach in selected PTC patients.The lymph nodes in the central compartment are thoroughly dissected.This approach has obvious advantages in functional protection of the anterior cervical region,and has clinical application value.

Objective To investigate the effects of different dosages of atorvastatin, rosuvastatin, and simvastatin in elderly patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). Methods A total of 180 patients with STEMI undergoing PCI were prospectively selected as study subjects and divided into group A, group B, group C, group D, group E, and group F using a random number table method, with 30 patients in each group. The group A received low-dose simvastatin orally, the group B received high-dose simvastatin orally, the group C received low-dose atorvastatin orally, the group D received high-dose atorvastatin orally, the group E received low-dose rosuvastatin orally, and the group F received high-dose rosuvastatin orally. The levels of serum inflammatory factors[interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP)], myocardial injury markers[creatine kinase isoenzyme (CK-MB), cardiac troponin T (cTnT), N-terminal pro-brain natriuretic peptide (NT-proBNP)], cardiac function indicators[left ventricular ejection fraction (LVEF), cardiac index (CI), cardiac output (CO)], as well as the ST-segment resolution, occurrence of adverse cardiovascular events, and adverse reactions were compared among the groups. Results At 1 day and 1 month postoperatively, the levels of IL-6, hs-CRP, and TNF-α decreased successively in groups A, B, C, D, E, and F(P < 0.05). At 1 day and 1 month postoperatively, the levels of cTnT, CK-MB, and NT-proBNP also decreased successively in the groups A, B, C, D, E, and F (P < 0.05). At 1 month postoperatively, the LVEF, CO, and CI increased successively in the groups A, B, C, D, E, and F (P < 0.05). The proportions of patients with ST-segment resolution successively increased in the groups A, B, C, D, E, and F (P < 0.05). There were no statistically significant differences in the total incidence of adverse cardiovascular events and adverse reactions among the groups (P>0.05). Conclusion Both low-dose and high-dose atorvastatin, rosuvastatin, and simvastatin can effectively relieve inflammation reactions, improve myocardial function, and promote ST-segment resolution in elderly patients with STEMI undergoing PCI, with high-dose rosuvastatin showing the best effect.

Objective To evaluate the application effect of a novel hemodialysis catheter fixing strap in clinical hemodialysis. Methods A total of 199 hemodialysis patients from the Second Affiliated Hospital of Anhui Medical University between May and July 2023 were enrolled in this study. Employing the self-controlled study design, patients were initially fixed with conventional adhesive tape (fixation method A) for their dialysis tubing from May 20 to June 20, 2023. Subsequently, from June 21 to July 21, 2023, patients were transitioned to a novel hemodialysis catheter fixing belt (fixation method B) for the fixation of their dialysis tube. The incidence of puncture needle, central venous catheter displacement, the stability of fixation, and the satisfaction levels of nurses and patients were compared between the two fixation methods. Results The rate of puncture needle/central venous catheter displacement with method B was significantly lower than that with method A (P < 0.001). No statistically significant difference was observed in the puncture needle/central venous catheter displacement between the two methods (P>0.05). The stability of fixation with method B was significantly higher than that with method A (P < 0.001). Patients' satisfaction with fixation method B (in favor of mobility and comfort) was significantly higher than that with fixation method A (P < 0.001); similarly, nurses'satisfaction with fixation method B (in favor of cleaning and convenient operation) was markedly superior to that with fixation method A (P < 0.001). Conclusion Compared with the traditional adhesive tape fixation method, the novel hemodialysis catheter securing strap effectively secures the catheter with improved safety and significantly enhances the satisfaction of both nurses and patients.

Objective To investigate the correlations between IgM deposition levels,glomerular ultra-structural and clinicopathological features in primary IgA nephropathy(IgAN).Methods Data from 155 IgAN patients were categorized into three cohorts by IgM deposition levels.We assessed differences in glomerular ultra-structure,clinical indices,MEST-C scores,and factors influencing IgM deposition levels.Results The marked IgM cohort showed higher urinary protein,IgG deposition,and T scores,with reduced serum albumin and lympho-cyte counts(P<0.05).Logistic regression identified FPE and T score as independent factors for IgM deposition.Conclusions IgM deposition correlates with FPE severity in IgAN,suggesting its utility in assessing renal dam-age and guiding treatment strategies.

Glycogen storage disease (GSD) is a rare autosomal recessive inherited disease in clinic. The paper reported a case of GSD Ⅰ a diagnosed by genetic testing, who had been experiencing numerous joint pains for 4 years, and had increased serum creatinine and severe high lactic acid metabolic acidosis. The serum creatinine declined and acidosis recovered after active fluid therapy and acidosis correction. The paper summarized the characteristics of this GSD patient with renal insufficiency and the relevant literature contents, to improve the understanding of clinicians on the disease and treatment effect.

Objective:To study the safety and feasibility of gasless transoral endoscopic thyroidectomy though vestibular approach using self-retaining retractor for papillary thyroid carcinoma.Methods:The clinical data of 39 papillary thyroid carcinoma patients undergoing gasless transoral endoscopic thyroidectomy were collected at Department of Head and Neck Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from Nov 2020 to Jun 2021.Results:All cases successfully underwent laparoscopic surgery without conversion to open surgery. The mean duration of operation was (142±35) min, and the postoperative mean hospital stay was (4.1±0.8) days. The mean maximum diameter of the tumor was (8.5±4.5) mm, and the mean number of lymph node harvest of by central compartment dissection was 7.7±5.9. Postoperative complications were transient hypoparathyroidism in 2 cases but recovered in 1 month. Scalp hydrop in 1 patient,fading subsequently. Transient sensory change around the lower lip in 3 cases, which recovered in 6 months. No patient suffered from recurrent laryngeal nerve palsy or hematoma, no permanent hypoparathyroidism occurred, nor of the postoperative bleeding .Conclusion:The gasless transoral endoscopic thyroidectomy viaoral vestibular approach is a feasible approach in selected papillary thyroid carcinoma patients.