The esophagus is referred to as the conduit for food and drink.It can be categorized into three distinct phases:an era characterized by written descriptions,a phase marked by anatomical illustrations,and a period of integration between Chinese and Western medical practices.In the initial phase of written descriptions,seminal texts such as The Yellow Emperor's Inner Classic and The Classic of Difficult Issues documented aspects regarding both length and function of the esophagus;however,these accounts were relatively succinct.The subsequent phase saw advancements in anatomical illustrations that refined our comprehension of esophageal structure and functionality.During the period of the integration of Chinese and Western medicine,insights from Western anatomy prompted a reevaluation within Chinese medicine concerning both anatomy and physiology related to the esophagus;concurrently,clini-cal cases involving esophageal disorders emerged prominently.Consequently,Chinese medicine's grasp on esophageal physiology,pa-thology,anatomy,and function became increasingly comprehensive over time.Choosing the esophagus as the starting point for observ-ing the theory of viscera in Chinese medicine is intended to illustrate that Chinese medicine's understanding of life,health and disease is based on the observation and continuous improvement of the anatomical functions of the viscera,integrating the physiological func-tions to form a highly integrated system with functional states,so as to facilitate the use of natural medicines for regulation and treatment.This is a distinctive feature different from Western medicine,and it can keep pace with the times and absorb modern re-search results,and continuously improve the theory and treatment system,so as to obtain strong vitality and benefit mankind.

Objective: To investigate the current situation and influencing factors of knowledge, attitude and practice (KAP) of fall prevention among the elderly in Huzhou City, Zhejiang Province, so as to provide the evidence for the development of fall intervention for the elderly. Methods: The permanent residents aged 60 years and over in Huzhou City were selected using multi-stratified cluster sampling method from March to April 2023. Demographic information, activity of daily living (ADL), fall risk, and KAP of fall prevention was collected using questionnaire surveys. Factors affecting KAP of fall prevention were identified using a multivariable logistic regression model. Results: Totally 2 160 questionnaires were allocated, and 2 104 valid questionnaires were recovered, with an effective recovery rate of 97.41%. There were 1 063 males (50.52%) and 1 041 females (49.48%), and 861 residents aged 60 to <70 years (40.92%). The awareness of fall prevention knowledge was 84.13%, the percentage of attitude towards fall prevention was 85.88%, and the percentage of practice of fall prevention was 14.59%. Multivariable logistic regression analysis showed that age, educational level, exercise duration and fall risk were associated with the awareness of fall prevention knowledge; age, educational level, marital status, exercise duration, ADL and fall risk were associated with the attitude towards fall prevention; gender, age, educational level, marital status, exercise duration, chronic diseases, ADL and fall risk were associated with the practice of fall prevention (all P<0.05). The desired access to fall prevention knowledge was mainly dominated by medical personnel, accounting for 75.51% (589/780). Conclusions The practice towards fall prevention among the elderly is relatively low in Huzhou City. The KAP of fall prevention is related to age, educational level, exercise duration and fall risk.

Objective:To evaluate alteration of autograft function by pathological types after total parathyroidectomy (tPTX) plus autotransplantation (AT) in patients of hyperthyroidism.Methods:A total of 51 patients with end-stage chronic renal failure who underwent total parathyroidectomy with autologous forearm transplantation from Mar 2017 to Feb 2021 were divided into chief cell type (CC) and oxyphil cell type (OC) according to dominating graft cell type. iPTH, calcium, phosphorus and ALP levels were compared between the two groups from the perioperative period to 6 months and the 3D ultrasonography was performed at 6 months to cocalculate the size of the autograft.Results:Between the two groups, there were no statistically significant differences in iPTH, blood calcium, blood phosphorus, or ALP levels pre-,and 30 minutes, one month post surgery (all P>0.05). On three months, there was no significant difference in ALP levels [CC group: (99±23) U/L, OC group: (89±35) U/L, t=0.776, P=0.442]. At 6 months the PTH level [CC group: (290±77) pg/ml, OC group: (246±59) pg/ml, t=2.034, P=0.047], and blood calcium [CC group: (2.62±0.65) mmol/L, OC group: (2.21±0.20) mmol/L, t=2.531, P=0.015] blood phosphorus [CC group: (1.38±0.28) mmol/L, OC group: (1.68±0.34) mmol/L; t=-3.269, P=0.002], were all in favor of CC group. By 3D ultrasnography at 6 months the size of autograft was larger in CC group than in OC group [V cc=(2.17±0.37) cm 3,V oc=(1.85±0.29) cm 3, t=3.172, P<0.05]. Recurrences at 1 year after surgery were not significantly different between the two groups ( ncc=3, noc=1, t=0.277, P>0.05). Conclusion:The biological activity of CC-type grafts is higher than that of OC suggesting a longer functioning period as a parathyroid autograft.

Objective:To explore the development, application and practical experience of investigator-initiated integrated clinical research information platform.Methods:The process of developing and constructing an integrated clinical research platform in a tertiary hospital in Beijing was introduced, the functions and advantages of the platform were described and displayed, and the main problems and risk points in the development and construction process were analyzed.Results:The integrated clinical research platform meets the management requirements of clinical research initiated by investigators, and the standardized management of the whole life cycle of the project can be realized through the platform, and the key issues of data security, information capture, sharing and interoperability need to be further explored in terms of platform docking.Conclusions:The integrated clinical research platform effectively improves the standardization, management quality and efficiency of investigator-initiated clinical research.

Ferroptosis is a novel form of cell death with iron dependence,which has been confirmed to play an important role in the pathophysiology of various diseases.This review summarizes the main metabolic pathways of ferroptosis,including iron metabolic pathways,lipid metabolic pathways and the classic GSH/GPX4 metabolic pathways.At the same time,this review discusses the regulatory effect and mechanism of ferroptosis metabolism on ulcerative colitis,aiming to provide new ideas and research directions for the treatment of ulcerative colitis.

Objective:To compare the laboratory diagnostic methods of Mycoplasma pneumonia(MP) and evaluate its clinical value.Methods:A prospective study.Throat swabs and double sera of children with MP infection were collected from December 2016 to January 2017 in Shengjing Hospital Affiliated to China Medical University; throat swab samples of healthy children aged 3 to 5 in Chaoyang District, Beijing were collected from March to May 2017.Passive agglutination (PA) was used to detect the double serum.Taking the 4-fold increase or decrease of the specific antibody titer of the double serum as the gold standard, the receiver operating characteristic curve (ROC) was drawn, and the laboratory methods for detecting MP infection were compared and evaluated.Results:(1)A total of 93 children with MP infection were clinically diagnosed, including 42 males (45.2%) and 51 females (54.8%), with an average age of 5.5 years.Sixty cases (64.5%) of MP infection were diagnosed.There were 349 healthy children, 198 males and 151 females, with an average age of 4.3 years.The positive rate of throat swab culture was 0.6% (2 cases), and the positive rate of fluorescent quantitative PCR(qPCR) was 18.9% (66 cases). (2) The culture specificity was the highest (100.0%) and the sensitivity was the lowest (65.0%). PA and enzyme linked immunosorbent assay (ELISA) were used to detect a single serum in the acute phase, the sensitivity was 71.7% and 86.5% respectively.ROC curve suggested that the current clinical diagnostic threshold MP specific antibody IgM ≥ 1∶160 was not the best diagnostic threshold.Molecular biological diagnostic methods were the most sensitive, RNA simultaneous and testing (SAT) was 85.0% and qPCR was 93.0%; while the specificity was low, 75.7% (SAT) and 63.6% (qPCR), respectively.(3) At the same time, MP nucleic acid (SAT, PCR) of throat swabs and a single serum (ELISA, PA) of children in acute phase were detected, the sensitivity was increased to 95.0%-100.0%, and the specificity was 63.6%-75.7%.Conclusions:Molecular biology is highly sensitive in diagnosing MP infection.It has asymptomatic infection or is carried after infection.Whether it needs treatment needs to be combined with clinical practice, when MP detection is positive.The detection of a single serum in the acute phase with a course of about 1 week has high sensitivity and is of reference value for the diagnosis of MP infection, but the diagnosis needs to be combined with clinical practice.The sensitivity and accuracy of detecting MP infection by single serological test combined with SAT in acute phase are higher than that by single application.

Objective:To validate the performance of cardiovascular risk prediction models based on the Sweden National Diabetes Register (NDR) and Diabetes Lifetime-perspective prediction (DIAL) model for assessing risks of 5-year and 10-year cardiovascular disease (CVD) among Chinese patients with type 2 diabetes.Methods:Based on the Chinese Electronic Health Records Research in Yinzhou study, 83 503 patients with type 2 diabetes aged 30-75 years without a history of CVD at baseline were included from January 1, 2010 to December 31, 2020. Recalibrated NDR model was used to estimate 5-year risk, while the recalibrated DIAL model was used to predict 5-year and 10-year risks. The competing events adjusted Kaplan-Meier analysis was used to obtain the observed cardiovascular events. Discrimination C statistics evaluated model accuracy, calibration χ2 value, and calibration plots. Results:Through a median follow-up of 7.0 years, 7 326 cardiovascular events, and 2 937 non-vascular deaths were identified among a total of 83 503 subjects. The recalibrated NDR model overestimated 5-year risk by 39.4% in men and 8.6% in women, whereas the overestimation for the recalibrated DIAL model was 14.6% in men and 50.1% in women. The DIAL model had a better discriminative ability ( C-statistic=0.681, 95% CI: 0.672-0.690) than NDR model ( C-statistic=0.667, 95% CI: 0.657-0.677) in 5-year risk prediction for men, and the models had a similar ability for women ( C-statistic=0.699, 95% CI: 0.690-0.708 for NDR and C-statistic=0.698, 95% CI: 0.689-0.706 for DIAL). The prediction accuracy of the DIAL model was improved in the 10-year risk, with the underestimation being 1.6% for men and the overestimation being 12.8% for women. Conclusions:Both recalibrated NDR and DIAL models overestimated 5-year cardiovascular risk in Chinese patients with type 2 diabetes, while the higher overestimation was shown using the DIAL model. However, the improvement was found in predicting 10-year CVD risk using the DIAL model, which suggested the value of lifetime risk prediction and indicated the need for research on the lifetime risk prediction model for cardiovascular risk assessment in Chinese patients with type 2 diabetes.

To investigate the effects of interleukin (IL)-17-mediated autophagy on the TNF receptor associated factor (TRAF6)/extracellular signal-regulated kinase (ERK)/p38 pathway and osteoclast differentiation. Mouse bone marrow-derived macrophages (BMM) were cultured with a medium containing 30 ng/mL macrophage colony stimulating factor and 50 ng/mL receptor activator of nuclear factor-kappa B ligard (RANKL), and IL-17 (0.01, 0.1, 1.0, 10 ng/mL) was added for intervention (IL-17 group). Tartrate-resistant acid phosphatase (TRAP) staining was used to observe TRAP positive multinucleated cells; phalloidin fluorescent staining was used to detect actin ring circumference; toluidine blue staining was used to analyze bone resorption lacuna formation. To further examine the mechanism of the effect of IL-17-mediated autophagy on the differentiation of osteoclasts, the control group used RANKL medium to culture mouse macrophage RAW264.7 cells, while the IL-17 group was treated with IL-17 (0.01, 0.1, 1.0, /mL). Western blot was used to detect the expression of autophagy-related proteins Beclin-1, microtubule-associated protein 1 light chain 3 (LC3) and osteoclast-related proteins c-fos and nuclear factor of activated T cell 1 (NFATc1) after treatment with different concentrations of IL-17. The expression of LC3, NFATc1, TRAF6/ERK/p38 signaling pathway related proteins were detected in IL-17 and autophagy inhibitor 3-MA group. The number of TRAP positive multinucleated cells, the circumference of the actin ring and the area of bone resorption lacuna in IL-17 group treated with IL-17 (0.01, 0.1, were significantly higher than those in the control group. In IL-17 treated RAW264.7 cells, the expression of c-fos, NFATc1, Beclin-1, LC3, TRAF6, p-ERK, and p-p38 was all significantly up-regulated (all 0.05). After treatment with the autophagy inhibitor 3-MA, the expression levels of LC3, NFATc1, TRAF6, p-ERK, and p-p38 all decreased significantly (all 0.05). IL-17 can promote the expression of autophagy proteins and enhance the differentiation ability of osteoclast precursor cells, and the TRAF6/ERK/p38 signaling pathway may be involved in this process.
Animals ; Autophagy ; Bone Resorption ; Cell Differentiation ; Extracellular Signal-Regulated MAP Kinases ; Interleukin-17 ; Mice ; NFATC Transcription Factors/metabolism* ; Osteoclasts/metabolism* ; RANK Ligand/metabolism* ; TNF Receptor-Associated Factor 6

Urinary tract infection is one of the most common infectious disease in children.With the wide usage of antibiotics, the risk of antibiotic-resistant is gradually increasing.Main mechanisms of probiotics include competitive exclusion of pathogens and bacteriocin production, modulation of enzymatic activities, immune system and regulation of anti-inflammatory cytokines.It is approved that probiotics could inhibit the growth, cell adhesion and invasion of pathogens in vitro and in animal experiments, as well as in preventing UTI in mice.Moreover, several linical trials have evaluated the effectiveness of probiotics in reducing the risk of recurrent UTI in children with normal urinary tract or with vesicoureteral reflux.Therefore, probiotics could be used as candidates in non-antibiotic prophylaxis and treatment of UTI in chilren.

BACKGROUND: Little was known about the association among time in range (TIR), time above range (TAR), time below range (TBR), and cancer mortality among patients with type 2 diabetes. We aimed to investigate the association among TIR, TAR, TBR, and the risk of cancer mortality among patients with type 2 diabetes. METHODS: A total of 6225 patients with type 2 diabetes were prospectively recruited in Shanghai, China. TIR was measured with continuous glucose monitoring at baseline and was defined as the average percentage of time in the target glucose range during a 24 h period. Cox proportion hazard regression analysis was used to determine the association between TIR and the risk of cancer mortality. RESULTS: During a mean follow-up of 7.10 years, we confirmed 237 death events related to cancer. The multivariable-adjusted hazard ratio (HR) for cancer mortality was 1.32 (95% confidence interval [CI]: 1.01-1.75) in patients with TIR ≤70% compared with those with TIR >70%. When TIR was considered as a continuous variable, the multivariable-adjusted HR for cancer mortality associated with each 10% decrease in TIR was 1.07 (95% CI: 1.02-1.14). In the site-specific analysis, a significant association between TIR as a continuous variable and the risk of hepatocellular cancer was found (HR: 1.24; 95% CI: 1.09-1.41). However, no relationship between hemoglobin A1c and cancer mortality was observed (HR: 1.04; 95% CI: 0.97-1.10). CONCLUSIONS The present study found an inverse association of TIR with the risk of cancer mortality among patients with type 2 diabetes. New evidence of TIR was added into the clinical practice that TIR may be an optimal target of glycemic control among patients with type 2 diabetes.
Blood Glucose ; Blood Glucose Self-Monitoring ; China ; Diabetes Mellitus, Type 2/complications* ; Humans ; Neoplasms ; Prospective Studies