Liver diseases cannot be easily detected in the early stage， and although invasive diagnostic methods， such as liver biopsy， are relatively accurate， they tend to have a low degree of acceptance， which greatly limits the improvement in diagnosis and treatment techniques for liver diseases. Therefore， it is of great importance to search for new biomarkers and therapeutic targets. As an emerging biomarker for liquid biopsy， tRNA-derived small RNA （tsRNA） is abnormally expressed in various liver diseases including viral hepatitis， fatty liver disease， liver injury， and liver cancer， and it can affect the development and progression of liver diseases by regulating the biological functions such as gene expression， epigenetic regulation， and protein translation. This article reviews the origin， classification， and biological function of tsRNA， as well as the research advances in tsRNA as biomarkers and potential therapeutic targets for liver diseases， so as to provide ideas for the early diagnosis and treatment of liver diseases.

Objective: To investigate the characteristics of mortality of injury among residents in Gusu District, Suzhou City, Jiangsu Province from 2013 to 2023, so as to provide the evidence for developing targeted measures of injury prevention and control. Methods: Gender, age and underlying cause of deaths due to injury in Gusu District were collected through Death Reporting Information System of Chinese Disease Prevention and Control Information System and Jiangsu Death Reporting Information System from January 1, 2013 to December 31, 2023. The crude mortality, Chinese-standardized mortality and world-standardized mortality of injury were analyzed, and the trend in mortality was analyzed using annual percent change (APC). Results: Totally 4 217 deaths due to injury were reported in Gusu District from 2013 to 2023. The crude, Chinese-standardized and world-standardized mortality rates were 51.58/105, 23.24/105 and 21.98/105, respectively, all showing a tendency towards a rise (APC=6.802%, 2.688% and 2.823%, all P<0.05). The crude mortality rate of injury was higher in women than in men (54.61/105 vs. 48.41/105, P<0.05). The five most common causes of injury included fall (32.99/105), traffic accidents (6.03/105), suicide (4.23/105), drowning (3.00/105) and asphyxia (2.16/105), accounting for 93.86% of the total number of deaths. The crude mortality rates of fall, suicide and asphyxia appeared a tendency towards a rise (APC=9.724%, 6.333% and 5.638%, all P<0.05). The crude mortality rates of injury among men, women and overall residents appeared a tendency towards a rise with age (all P<0.05). Fall was the primary cause of injury death among residents aged 65 years and above, and suicide was the primary cause of injury death among residents aged 15 to 44 years. Conclusions The crude mortality of injury appeared a tendency towards a rise in Gusu District from 2013 to 2023. The main causes of death were fall, traffic accidents, suicide, drowning and asphyxia, with the crude mortality of fall, suicide and asphyxia showing an upward trend.

Objective To investigate the current situation of long-term care needs of the elderly with home-based disabil-ity in Beiliu City,and provide data support for the development of Internet plus care services in Beiliu City.Methods A ques-tionnaire survey method was used to design and distribute a survey questionnaire titled"Survey Questionnaire on Home Care Serv-ice Needs of Disabled Elderly People",to investigate the nursing service methods and home care needs of disabled elderly people in Beiliu City.Results Disabled elderly people mainly choose home-based nursing services,with a high demand for basic care,comfortable care,rehabilitation care,psychological care,and other aspects.Conclusion Home care is of great significance for improving the quality of life of disabled elderly people,and requires policy support such as medical insurance to promote the sup-ply of nursing services and meet the care needs of disabled elderly people.

Objective This study aimed to investigate the potential relationship between urinary metals copper (Cu), arsenic (As), strontium (Sr), barium (Ba), iron (Fe), lead (Pb) and manganese (Mn) and grip strength. Methods We used linear regression models, quantile g-computation and Bayesian kernel machine regression (BKMR) to assess the relationship between metals and grip strength.Results In the multimetal linear regression, Cu (β=-2.119), As (β=-1.318), Sr (β=-2.480), Ba (β=0.781), Fe (β= 1.130) and Mn (β=-0.404) were significantly correlated with grip strength (P < 0.05). The results of the quantile g-computation showed that the risk of occurrence of grip strength reduction was -1.007 (95％ confidence interval:-1.362, -0.652; P < 0.001) when each quartile of the mixture of the seven metals was increased. Bayesian kernel function regression model analysis showed that mixtures of the seven metals had a negative overall effect on grip strength, with Cu, As and Sr being negatively associated with grip strength levels. In the total population, potential interactions were observed between As and Mn and between Cu and Mn (Pinteractions of 0.003 and 0.018, respectively).Conclusion In summary, this study suggests that combined exposure to metal mixtures is negatively associated with grip strength. Cu, Sr and As were negatively correlated with grip strength levels, and there were potential interactions between As and Mn and between Cu and Mn.

Objective To study the pharmacokinetic characteristics of the test formulation of compound lidocaine cream and reference formulation of lidocaine and prilocaine cream in Chinese healthy subjects and to evaluate whether there is bioequivalence between the two formulations.Methods A single-center,single-dose,randomized,open-label,two-period,two-sequence,crossover design was used.This study included 40 healthy subjects,and in each period,test formulation or reference formulation 60 g was applied to the skin in front of both thighs(200 cm2 each side,a total of 400 cm2)under fasting conditions,and the drug was left on for at least 5 h after application.The concentrations of lidocaine and prilocaine in plasma were determined using liquid chromatography-tandem mass spectrometry(LC-MS/MS)method.Pharmacokinetic parameters were calculated using WinNonlin 8.0 software to evaluate the bioequivalence of the two formulations.Results After the application of the test formulation compound lidocaine cream and the reference formulation lidocaine and prilocaine cream on both thighs of the subjects,the pharmacokinetic parameters of lidocaine in plasma were as follows:Cmax were(167.27±91.33)and(156.13±66.86)ng·mL-1,AUC0-t were(1 651.78±685.09)and(1 636.69±617.23)ng·mL-1·h,AUC0-∞ were(1 669.85±684.65)and(1 654.37±618.30)ng·mL-1·h,the adjusted geometric mean ratios were 104.49％,101.88％and 101.89％,respectively,with 90％confidence intervals of 98.18％-111.20％,97.80％-106.13％and 97.87％-106.07％,all within the range of 80.00％-125.00％.The pharmacokinetic parameters of prilocaine in plasma were as follows:Cmax were(95.66±48.84)and(87.52±39.16)ng·mL-1,AUC0-t were(790.86±263.99)and(774.14±256.42)ng·mL-1·h,AUC0_m were(807.27±264.67)and(792.84±254.06)ng·mL-1 h,the adjusted geometric mean ratios were 107.34％,103.55％and 102.98％,respectively with 90％confidence intervals of 101.69％-113.31％,99.94％-107.30％and 99.65％-106.43％,all within the range of 80.00％-125.00％.Conclusion The test formulation compound lidocaine cream and the reference formulation lidocaine and prilocaine cream are bioequivalent.

Background::Carotid intima-media thickness (IMT) and diameter, stiffness, and wave reflections, are independent and important clinical biomarkers and risk predictors for cardiovascular diseases. The purpose of the present study was to establish nationwide reference values of carotid properties for healthy Chinese adults and to explore potential clinical determinants.Methods::A total of 3053 healthy Han Chinese adults (1922 women) aged 18-79 years were enrolled at 28 collaborating tertiary centers throughout China between April 2021 and July 2022. The real-time tracking of common carotid artery walls was achieved by the radio frequency (RF) ultrasound system. The IMT, diameter, compliance coefficient, β stiffness, local pulse wave velocity (PWV), local systolic blood pressure, augmented pressure (AP), and augmentation index (AIx) were then automatically measured and reported. Data were stratified by age groups and sex. The relationships between age and carotid property parameters were analyzed by Jonckheere-Terpstra test and simple linear regressions. The major clinical determinants of carotid properties were identified by Pearson’s correlation, multiple linear regression, and analyses of covariance.Results::All the parameters of carotid properties demonstrated significantly age-related trajectories. Women showed thinner IMT, smaller carotid diameter, larger AP, and AIx than men. The β stiffness and PWV were significantly higher in men than women before forties, but the differences reversed after that. The increase rate of carotid IMT (5.5 μm/year in women and 5.8 μm/year in men) and diameter (0.03 mm/year in both men and women) were similar between men and women. For the stiffness and wave reflections, women showed significantly larger age-related variations than men as demonstrated by steeper regression slopes (all P for age by sex interaction <0.05). The blood pressures, body mass index (BMI), and triglyceride levels were identified as major clinical determinants of carotid properties with adjustment of age and sex. Conclusions::The age- and sex-specific reference values of carotid properties measured by RF ultrasound for healthy Chinese adults were established. The blood pressures, BMI, and triglyceride levels should be considered for clinical application of corresponding reference values.

Objective:To discuss the effect of cold exposure on nociception in the rats and its regulatory mechanism on transient receptor potential(TRP)ion channels in the sensory neurons,and to provide the basis for clarifying the biological mechanism of cold-sensitive pain.Methods:Sixteen female SD rats were divided into control group(n=8)and cold group(n=8).The rats in control group were exposed to the environment of(24±2)℃,and the rats in cold group were exposed to low temperature(4 ℃±1 ℃)in an artificial intelligence climate chamber for 4 h daily,for one week.Von Frey filaments were used to detect the mechanical withdrawal threshold(MWT)of the rats in two groups;immunofluorescence staining was used to observe the expression levels of TRPA1,TRPM8,TRPV1,and TRPV4 in dorsal root ganglion(DRG)tissue of the rats in two groups,the expression levels of calcitonin gene-related peptide(CGRP)and substance P(SP)in DRG tissue of the rats in two groups,and the expression levels of TRPA1,TRPM8,TRPV1,and TRPV4 in synovial tissue of the rats in two groups.Results:Compared with control group,the MWT of the rats in cold group was significantly decreased(P＜0.05),the expression levels of TRPA1 and TRPM8 in DRG tissue were significantly increased(P＜0.05),the expression level of TRPV1 was significantly decreased(P＜0.05),there was no significant difference in the expression level of TRPV4(P＞0.05),and the expression levels of CGRP and SP were significantly increased(P＜0.05).Compared with control group,the expression level of TRPA1 in synovial tissue of the rats in cold group was significantly increased(P＜0.05),while the expression levels of TRPM8,TRPV1,and TRPV4 were significantly decreased(P＜0.05).Conclusion:Short-term cold exposure can induce the hyperalgesia of the rats,and its mechanism may be associated with the changes in the expression of TRP ion channels in DRG and synovial tissues.TRPA1 sensory neurons play an important role in local joint cold pain.

Objective To observe the improvement of motor dysfunction and serum levels of C-reactive protein(CRP),blood glucose and blood lipid in post-stroke patients treated with scalp acupuncture at different needle retention time.Methods A total of 120 patients with motor dysfunction after stroke were randomly divided into control group,observation group 1 and observation group 2,with 40 cases in each group.The patients in the 3 groups were treated with scalp acupuncture,body acupuncture and routine rehabilitation exercise,once a day and 6 times a week,lasting for 2 weeks.The control group was given scalp acupuncture with retaining of needles for 30 minutes,the observation group 1 was given scalp acupuncture with retaining of needles for one hour,and the observation group 2 was given scalp acupuncture with retaining of needles for 2 hours.Before and after treatment,the 3 groups were observed in the changes of the scale scores of National Institutes of Health Stroke Scale(NIHSS),Fugl-Meyer Assessment(FM A),Berg Balance Scale(BBS)and modified Barthel Index(MBI),and the levels of laboratory indicators of peripheral blood CRP,fasting plasma glucose(FPG),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C).After treatment,the clinical safety of the three groups was evaluated.Results(1)After treatment,the scale scores of NIHSS in the three groups were lower(P＜0.01)and the scale scores FMA,BBS and MBI were higher than those before treatment(P＜0.05 or P＜0.01).The comparison of post-treatment scale scores showed that the differences among the three groups were statistically significant(P＜0.01).The intergroup comparison showed that the decrease of NIHSS score and the increase of FMA,BBS and MBI scores in the observation group 2 were significantly superior to those in the control group and the observation group 1(P＜0.01);the improvement of FMA score in the observation group 1 was significantly superior to that in the control group(P＜0.01),while the improvement of NIHSS,BBS and MBI scores tended to be superior to that in the control group without statistically significant differences(P＞0.05).The results indicated that the curative effect of scalp acupuncture plus exercise regimen was positively correlated with the duration of needle retention for scalp acupuncture.(2)After treatment,the laboratory indicator levels of CRP and FPG in the peripheral blood of the three groups,the levels of TG and LDL-C in the two observation groups and the level of HDL-C in the observation group 2 were improved compared with those before treatment(P＜0.05 or P＜0.01).Statistically significant differences were presented in the post-treatment levels of CRP and TG in peripheral blood among the three groups(P＜0.05 or P＜0.01).The intergroup comparison showed that the improvement of CRP and TG levels in the observation group 2 was significantly superior to that in the control group,and the improvement of CRP level in the observation group 2 was significantly superior to that in the observation group 1,the differences being statistically significant(P＜0.05 or P＜0.01).The TC level in the three groups after treatment did not differ from that before treatment,and there was no significant difference in TC level after treatment among the three groups either(P＞0.05).(3)During the treatment,no adverse reactions such as fainting,needle breaking and hematoma occurred in the three groups,the vital signs of the patients were stable,and there were no obvious abnormal changes in pulse,blood pressure and respiratory rate.Conclusion Scalp acupuncture can effectively improve the motor function of post-stroke patients in a pasitive time-effect relationship with the needle retention,and better the curative effect can be achieved by retaining of the needle for 2 h.

Objective:To investigate the clinical characteristic and genetic variants of children with carnitine palmitoyltransferase 2(CPT2)deficiency.Methods:The clinical and genetic data of 6 children with CPT2 deficiency were retrospectively analyzed.The blood acylcarnitines and genetic variants were detected with tandem mass spectrometry and whole-exon gene sequencing,respectively.Results:There were 4 males and 2 females with a mean age of 32 months(15 d-9 years)at diagnosis.One case was asymptomatic and with normal laboratory test results,2 had delayed onset,and 3 were of infantile type.Three cases were diagnosed at neonatal screening,and 3 cases presented with clinical manifestations of fever,muscle weakness,and increased muscle enzymes.Five children presented with decreased free carnitine and elevated levels of palmitoyl and octadecenoyl carnitines.CPT2 gene variants were detected at 8 loci in 6 children(4 harboring biallelic mutations and 2 harboring single locus mutations),including 3 known variants(p.R631C,p.T589M,and p.D255G)and 5 newly reported variants(p.F352L,p.R498L,p.F434S,p.A515P,and c.153-2A>G).It was predicted by PolyPhen2 and SIFT software that c.153-2A>G and p.F352L were suspected pathogenic variants,while p.R498L,p.F434S and p.A515P were variants of unknown clinical significance.Conclusions:The clinical phenotypes of CPT2 deficiency are diverse.An early diagnosis can be facilitated by neonatal blood tandem mass spectrometry screening and genetic testing,and most patients have good prognosis after a timely diagnosis and treatment.

Objective To explore the application value of low-flow rate and-contrast injection scheme for pulmonary artery computed tomography angiography(CTA)in the elderly patients.Methods Sixty elderly patients undergoing pulmonary artery CTA in some hospital from April 2020 to January 2023 were selected and divided into a control group(30 cases)and an experimental group(30 cases)according to the contrast agent injection schemes.A conventional contrast injection scheme was used for the control group,and an optimized contrast injection scheme with low flow rate and low contrast dose was designed for the experimental group.The two gorups were observed and subjectively scored in terms of the degree of pulmonary artery enhancement,the display of pulmonary artery trunks and branches and the sharpness of image vessel edges,and objectively evaluated for the degree of contrast sclerosis artifacts in the superior vena cava and the enhancement CT values of the pulmonary artery trunks and the left and the right pulmonary veins.The extravasation of the contrast agent was recorded for the patients in the 2 groups.SPSS 25.0 software was used for statistical analysis.Results The two groups had no significant differences in score pulmonary artery CTA image quality(P＞0.05);the experimental group had the socre of contrast sclerosis artifacts in the superior vena cava statistically lower than that of the control group(P＜0.05).The two groups had no obvious differences in the CT values of the pulmonary artery trunks and the left and the right pulmonary veins(P＞0.05).There were no patients with the extravasation of the contrast agent found in the experimental group,while there one case with severe extravasation and 4 cases with mild or moderate extravasation in the control group.Conclusion Low-flow rate and-contrast injection scheme for pulmonary artery CTA of the elderly patients contributes to avoiding contrast agent extrava-sation while ensuring image quality,enhancing patient experience and safety.[Chinese Medical Equipment Journal,2024,45(10):66-70]