Objective:To analyze clinical data related to mineral and bone disorder(MBD)in elderly maintenance hemodialysis patients and provide a basis for the development of precise clinical treatment strategies.Methods:A total of 267 patients receiving regular hemodialysis at Beijing Huairou Hospital and Huairou District Hospital of Traditional Chinese Medicine between April 2022 and June 2022 were selected and divided into an elderly group(age≥60 years)with 129 patients and a younger group(age<60 years)with 138 patients.Patients' general information, medication use, and laboratory data including routine blood work, blood calcium, blood phosphorus, and intact parathyroid hormone were collected, and a survey questionnaire was conducted to collect data on hyperphosphatemia patients' knowledge about diet and medication use.Differences in the rate of meeting calcium and phosphorus target ranges, medication use, and questionnaire scores were compared between patients in the two groups.Results:(1)The rates of controlled Ca(2.3±0.2)mmol/L, P(1.9±0.6)mmol/L and iPTH[213.5(93.5, 359.9)ng/L]levels in the elderly group were 65.1%(84/129), 43.4%(56/129)and 51.2%(66/129), respectively.There were no statistically significant differences compared with the younger group(all P>0.05). The prevalence of hyperphosphatemia in the elderly group(66/129, 51.2%)was lower than that in the younger group(90/138, 65.2%)( χ2=5.422, P=0.020). (2)Compared with the younger group, the elderly group had lower levels of serum creatinine[(796.6±225.2)μmol/L vs.(1025.6±281.4)μmol/L], uric acid[(416.9±97.0)μmol/L vs.(445.0±106.6)μmol/L], albumin[(37.9±2.9)g/L vs.(39.0±3.0)g/L]and serum phosphorus[(1.9±0.6)mmol/L vs.(2.1±0.6)mmol/l]( t=7.289, 2.238, 2.941, 2.820, P<0.05), and a higher blood glucose level[6.9(5.2, 9.8)mmol/L vs.6.1(4.9, 8.2)mmol/l, Z=2.314, P=0.015]. (3)Compared with the younger group, the elderly group had significantly lower utilization rates of calcium-free phosphate binders[12.4%(16/129) vs.23.9%(33/138)]and calcimimetics[2.3%(3/129) vs.10.9%(15/138)]( χ2=5.895, 7.742, P<0.05, respectively). (4)Compared with the younger group, the elderly group had a lower total questionnaire score(36.8±6.6 vs.39.5±6.0), a lower hyperphosphatemia knowledge score(4.7±3.1 vs.6.0±2.8), a lower diet knowledge score(2.8±2.2 vs.4.0±1.9)and a lower medication knowledge score(2.1±1.9 vs.3.1±1.8, t=3.442, 3.694, 4.677, 4.398, respectively, P<0.05 for all), but had a higher compliance score(17.3±1.9 vs.16.4±2.4, t=3.390, P=0.001). (5)Multivariate Logistic regression analysis indicated that pre-dialysis blood urea nitrogen( OR=1.082, 95% CI: 1.011-1.159, P=0.024)and serum creatinine( OR=1.002, 95% CI: 1.001-1.005, P=0.036)were independent predictors of hyperphosphatemia in elderly hemodialysis patients. Conclusions:Compared with the younger group, the serum albumin and phosphorus levels were lower, the utilization rates of calcium-free phosphate binders and calcimimetics were lower, and the total score of the hyperphosphatemia questionnaire was also lower in the elderly group.However, the compliance score was significantly higher in the elderly group.We should focus on the relevant weak links to bolster diet education and medication management for elderly hemodialysis patients.

Blau syndrome is a rare genetic disorder characterized by the a mix of granulomatous arthritis, uveitis, and dermatitis. Patients typically manifest multisystem involvement, including ocular, skin, and skeletal abnormalities. Blau syndrome is extremely rare, with a global incidence of less than one in a million among children. In this multidisciplinary consultation, we present a case of a 21-year-old young female patient having multisystemic involvement since early childhood. She was presented with multiple joint swelling, skin lesions, increased eye discharge, and accompanied by hypertension and arterial abnormalities, and received a diagnosis of uveitis. The patient had been receiving steroid treatment since the age of 6 and has tried various medications, with some improvement in joint swelling and ocular symptoms. Through this rare disease multidisciplinary consultation, we aim to provide guidance in the molecular diagnosis of the patient, multisystem assessment, and the selection and formulation of treatment plans. Additionally, we hope that by reporting this case, clinical physicians can gain a better understanding of the diagnosis and comprehensive treatment strategies for Blau syndrome, thereby improving the management and treatment of rare diseases.

Inflammatory diseases are key contributors to high mortality globally and adversely affect the quality of life. Current treatments include corticosteroids or nonsteroidal anti-inflammatories that may cause systemic toxicity and biologics that may increase the risk of infection. Composite nanoparticles that bear not only the drug payload but also targeting ligands for delivery to inflammation sites at lowered systemic toxicity are established in the nanomedicine field, but their relatively large size often leads to systemic clearance. Metal-based nanoparticles with intrinsic anti-inflammatory properties represent attractive alternatives. They are not only designed to be compact for crossing biological barriers (with the nanoparticle serving as a dual carrier and drug), but also support label-free tracking of their interactions with cells. The review commences with an outline of the common inflammatory diseases, inflammatory pathways involved, and conventional drug-loaded nanoparticles for anti-inflammation. Next, the review features the emerging applications of self-therapeutic metal-based nanoparticles (e.g., gold, coper oxide, platinum, ceria, and zinc oxide) for managing inflammatory diseases in animals over the past three years, focusing on therapeutic outcomes and anti-inflammatory mechanisms. The review concludes with an outlook on the biodistribution, long-term toxicity, and clinical translation of self-therapeutic metal-based nanoparticles.

Objective:To evaluate the value of p16 INK4a detected by p16 INK4a immunostaining as a new generation of cervical cytology for primary screening and secondary screening in population-based cervical cancer screening, and in improving cytological diagnosis. Methods:Between 2016 and 2018, 5 747 non-pregnant women aged 25-65 years with sexual history were recruited and underwent cervical cancer screening via high-risk (HR)-HPV/liquid-based cytological test (LCT) test in Shenzhen and surrounding areas. All slides were immuno-stained using p16 INK4a technology, among them, 902 cases were offered p16 INK4a detection during primary screening, and the remaining 4 845 cases were called-back by the virtue of abnormal HR-HPV and LCT results for p16 INK4a staining. Participants with complete LCT examination, HR-HPV test, p16 INK4a staining and histopathological examination results were included in this study. The performance of p16 INK4a in primary and secondary screening, and in assisting cytology to detect high grade squamous intraepithelial lesion [HSIL, including cervical intraepithelial neoplasia (CIN) Ⅱ or Ⅲ] or worse [HSIL (CIN Ⅱ) + or HSIL (CIN Ⅲ) +] were analyzed. Results:(1) One-thousand and ninety-seven cases with complete data of p16 INK4a and histology were included. Pathological diagnosis: 995 cases of normal cervix, 37 cases of low grade squamous intraepithelial lesion (LSIL), 64 cases of HSIL and one case of cervical cancer were found. Among them, 65 cases of HSIL (CIN Ⅱ) + and 34 cases of HSIL (CIN Ⅲ) + were detected. The positive rate of p16 INK4a in HSIL (CIN Ⅱ) + was higher than that in CINⅠ or normal pathology (89.2% vs 10.2%; P<0.01). (2) p16 INK4a as primary screening for HSIL (CIN Ⅱ) + or HSIL (CIN Ⅲ) + was equally sensitive to primary HR-HPV screening (89.2% vs 95.4%, 94.1% vs 94.1%; P>0.05), but more specific than HR-HPV screening (89.8% vs 82.5%, 87.7% vs 80.2%; P<0.05). p16 INK4a was equally sensitive and similarly specific to cytology (≥LSIL; P>0.05). (3) The specificity of LCT adjunctive p16 INK4a for detecting HSIL (CIN Ⅱ) + or HSIL (CIN Ⅲ) + were higher than that of LCT alone or adjunctive HR-HPV ( P<0.01), while the sensitivity were similar ( P>0.05). (4) p16 INK4a staining as secondary screening: p16 INK4a was significantly more specific (94.1% vs 89.7%, 91.9% vs 87.4%; P<0.01) and comparably sensitive (84.6% vs 90.8%, 88.2% vs 91.2%; P>0.05) to cytology for triaging primary HR-HPV screening. HPV 16/18 to colposcopy and triage other HR-HPV with p16 INK4a was equally sensitive (88.2% vs 94.1%; P=0.500) and more specific (88.3% vs 83.0%; P<0.01) than HPV 16/18 to colposcopy and triage other HR-HPV with LCT≥ atypical squamous cells of undetermined significance (ASCUS), and the referral rate decreased (14.0% vs 19.4%; P=0.005). Conclusions:For primary screening, p16 INK4a is equally specific to cytology and equally sensitive to HR-HPV screening. p16 INK4a alone could be an efficient triage after primary HR-HPV screening. In addition, p16 INK4a immunostaining could be used as an ancillary tool to cervical cytological diagnosis, and improves its accuracy in cervical cancer screening.

Objective:To investigate the use of p16 INK4a immuno-stained cytology as the primary screening for cervical cancer prevention. Methods:From March to August 2018, 902 women from Shenzhen and surrounding area were recruited for cervical cancer screening with ThinPrep Cytologic Test (TCT), cobas4800 HPV test, and p16 INK4a co-test. Colpo/biopsies were performed using the point of interest biopsy protocol of directed and random cervical biopsies plus endocervical curettage for all women, any of whose tests was positive. Two senior cytopathologists interpreted TCT and p16 INK4a test. The performance of p16 INK4a for early detection of CIN2+ and inter-observer reproducibility of the interpretation of p16 INK4a were evaluated. Results:The positive rates of HPV test, p16 INK4a co-test and TCT diagnosed as LSIL/AGC or higher grade were 8.1% (73/902), 6.8% (61/902) and 4.7% (42/902), respectively. Colposcopy referring rate was 79.6% (109/137), among which 10 cases were diagnosed as CIN2+ (5 cases of CIN2 and 5 cases of CIN3). The sensitivity and specificity for CIN2+ of p16 INK4a test, TCT (LSIL/AGC or higher grade) and HPV test were 90.0%, 80.0%, 100.0% and 90.9%, 91.9%, 82.5%, respectively. Compared to TCT and HPV test, there was no significant difference in sensitivity and specificity between p16 INK4a and TCT/HPV test ( P>0.05). The Kappa value of the 2 cytopathologists in interpreting p16 INK4a and TCT was 0.944 and 0.425, respectively ( P<0.05). Conclusions:p16 INK4a for cervical cancer screening is equally sensitive to HPV test and specific to TCT while subjective difference of cytopathologists′ interpretation of p16 INK4a is small. Therefore, p16 INK4a can be used as a new cervical cancer screen method for its better diagnostic performance.

Objective To explore the relationship between cervical lesions and high risk HPV (HR-HPV) viral load reflected by the cycle threshold (Ct) values of Cobas 4800 HPV (Cobas 4800) system. Methods From August 2016 to September 2017, 7 000 women from Shenzhen, were recruited for cervical cancer screening with Cobas 4800 system and cytology co-test. Colposcope biopsies were performed on women who were positive of HPV 16, 18, and positive of HPV types other than 16, 18 with cytology [≥atypical squamous cell of undetermined signification (ASCUS)], or HPV negative but abnormal of cytology [≥low grade squamous intraepithelial lesion (LSIL)]. The Ct values of HPV 16, 18 and all combined other types coming from Cobas 4800 system were used as an indicator of viral load to analyze the relationship between type-specific HPV load and the cervical lesions. Results (1) Among the 7 000 screening women, 370 cases were positive for cervical cancer screening, 325 of them underwent colposcope biopsies, and coloposcopy referred rate was 87.8% (325/370). Among 325 women undergoing cervical biopsy, pathological diagnosis was 119 cases of normal cervical cervix, 151 cases of LSIL, and 55 cases of high-grade squamous intraepithelial lesion (HSIL) and above (HSIL+; including 53 cases of HSIL, 1 case of cervical adenocarcinoma, and 1 case of cervical squamous cell carcinoma). (2) The Ct value of HPV 16 was inversely correlated with the upgrading of the lesions (r=-0.617, P=0.000), and significant different among normal cervix,LSIL and HSIL+(35.4±4.5 vs 31.0±6.0 vs 26.5±4.0; F=25.537, P=0.000). There was no correlation between Ct value of HPV 18 and cervical lesions (r=-0.021, P=0.902). The Ct value of other 12 HPV types was statistically difference among normal normal cervix , HSIL+and cervicitis (33.0±5.3 vs 29.9±7.2 vs 29.8±5.8; F=5.087, P=0.007). Among them, LSIL and HSIL+ were significantly lower than normal cervix (P<0.05), but there was no significant difference between LSIL and HSIL+(P>0.05). Conclusion The Ct value of HPV 16 detecting in Cobas 4800 system as an indicator of virus load obviously correlates with different grades of cervical lesions, therefore could be a reference of cervical lesion existence and an indicator of lesion prognosis.

Objective To investigate the value of lung ultrasound scores ( LUS ) combined with echocardiography for evaluation of the state of preterm neonatal respiratory distress syndrome ( RDS ). Methods Lung ultrasound and echocardiography were conducted on 43 preterm newborns with RDS. The echocardiographic parameter included the area and velocity of tricuspid regurgitation, patent ductus arteriosus ( PDA ) and pulmonary artery systolic pressure ( PASP ). Correlational analyses of LUS and PASP,or X-ray grading were conducted. LUS difference was compared between the groups with PDA and without PDA. Results ① There was positive correlations between LUS and PASP ( r ＝ 0.647, P ＜0.05),LUS and X-ray grade ( r ＝0.770, P ＜0.05). ②LUS was significant different in different X-ray grade( F ＝ 31.460, P ＜ 0.05). ③ Significant difference was found between the groups with PDA and without PDA( t ＝3.08, P ＜0.05). Conclusions LUS combined with echocardiography can be used as an effective method for early diagnosis,condition assessment and prognosis of RDS,and it is more direct,fast and without radiation.

Objective:To evaluate the clinical effect and safety of periodontal-orthodontic treatment in patients with aggressive periodontitis (AgP) and malocclusion.Methods:A retrospective analysis was conducted in 25 AgP patients,who had received periodontal-orthodontic treatment in Peking University School and Hospital of Stomatology.Clinical indexes,including probing depth (PD),bleeding index (BI) and percentage of sites with bleeding on probing (BOP％) were evaluated at three time points:Baseline (T0);active periodontal treatment finished and before orthodontic treatment (T1);and after orthodontic treatment (T2).Also changes of ratio of the residual alveolar bone height (RBH) and the occurrence of root resorption were evaluated by periapical radiographs.Results:(1) Compared with T0,all the clinical parameters including PD,BI,BOP％ and percentage of sites with PD ＞ 3 mm were significantly improved (P ＜0.001).(2) Significant difference was observed in the average RBH between T0 (68.37％ ± 15.60％ and T2 (70.27％ ± 14.23％).RBH in upper incisors [(58.79％ ± 16.71％ at T0,65.54％ (55.74％,78.13％) at T2],upper canines [77.62％ (66.06％,87.17％) at T0,79.57％ (69.75％,86.52％) at T2] and upper molars [74.30％ (61.69％,84.45％) at T0,76.76％ (68.12％,85.09％) at T2] showed significant increase (P ＜ 0.05).(3) After orthodontic treatment,varying degrees of root resorption occurred in (23.94％ ± 13.45％) of teeth per capita,among which the lower and upper incisors showed the highest incidence (68.48％ and 65.31％ in homogeneous teeth,respectively).Conclusion:After active periodontal treatment,orthodontic treatment in AgP patients had not aggravated inflammation and alveolar bone resorption;root resorption occurred in two-thirds of incisors approximately.

Hypertension is the leading risk factor for death resulted from cardiovascular diseases.According to the statistics,the number of patients with hypertension in China is 270 million.At present,15 classes and 69 drugs have been approved for the treatment of hypertension,however,the treatment rate and the control rate remain low.Therefore,the research tocusing on new antihypertensive drugs are how to effectively reduce the blood pressure in patients with refractory hypertension,reduce the target organ damage in patients with complications,and reduce adverse drug reactions.This paper summarized the recent research progress of anti-hypertensive drugs on the market or in development,so as to provide references for development and application of antihypertensive drugs.

Isatidis Radix,the root of Isatis indigotica Fort.(Cruciferae),is a representitive herb widely used for clearing away heat-toxin in traditional Chinese medicine (TCM).Lariciresinol is a representitive component of lignans and an important efficacious substance with the antiviral effect.This review elucidated the progress on its biosynthetic pathways,the screening of key regulatory genes and metabolic engineering of lignans components in Isatidis Radix,providing a favorable reference for the full understanding of biosynthesis of antiviral active components,the quality improvement of Isatidis Radix and the sustainable utilization of TCM resources.