Objective To explore the mediating role of activities of daily living (ADL) in pain and depressive symptoms in the elderly in China. Methods Utilizing the data from 2020 China Health and Retirement Longitudinal Study, 4403 Chinese elderly individuals aged ≥ 60 years old were selected as the research subjects. Depression Scale (CES-D 10) of the Center for Epidemiological Survey and ADL scale were used in the study. The PROCESS4.1 macro was used to test the mediating effect of daily living activities between pain and depressive symptoms, and the Bootstrap method was applied for verification of the mediating variables. Results A total of 2368 cases of depressive symptoms were detected in the elderly in China, with a detection rate of 53.78%. Pain was positively correlated with depressive symptoms (r=0.27, P<0.01), and activities of daily living were negatively correlated with pain and depressive symptoms (r=-0.27, -0.337, P<0.01). The results showed that the total effect value of pain on depressive symptoms was 0.33, the direct effect value was 0.24, and the mediating effect value of daily living activities was 0.09, accounting for 27.27%. Conclusion Pain and activities of daily living are important factors influencing depressive symptoms in the elderly, and activities of daily living play a partial mediating role in the relationship between pain and depressive symptoms in the elderly.

Objective To investigate the changing trend and epidemiological characteristics of the incidence and mortality of chronic kidney disease (CKD) with age, period and birth cohort in Chinese population. Methods Based on the data of incidence and mortality of CKD in Chinese population aged 20-80 years from 1990 to 2019 in GHDx database, joinpoint regression model was used to analyze the incidence and mortality trend of CKD. An age-period-cohort model was constructed to analyze the effects of age, period, and birth cohort on the trend of CKD incidence and mortality. Results Joinpoint regression analysis showed that the standardized incidence rate of chronic kidney disease in Chinese population increased from 146.37/100 000 in 1990 to 161.52/100 000 in 2019, while the standardized mortality rate decreased from 12.98/100 000 in 1990 to 11.23/100 000 in 2019. The APC model analysis showed that the risk of CKD incidence and death in the Chinese population increased with age, while the risk of CKD incidence increased with the increase of period. The risk of death did not change significantly with the increase of period. The cohort born later had a lower risk of CKD incidence and death compared to the cohort born earlier. Conclusion At present, the age effect and period effect of the incidence and death risk of chronic kidney disease in China are dominant. It is important to take effective measures and intervene in a timely manner, especially to strengthen the protection of older high-risk groups born earlier.

Objective:To analyze the relationship between T lymphocytes and blood rheology test results in patients with non-small cell lung cancer (NSCLC) and their chemotherapy outcomes.Methods:A total of 108 patients with NSCLC who received treatment in the Affiliated Hospital of Shaanxi University of Chinese Medicine between May 2021 and May 2023 were included in the observation group. A total of 108 participants who concurrently underwent physical examinations were included in the control group. T lymphocyte subsets and blood rheology indices were tested in both groups. In the observation group, T lymphocyte subsets and blood rheology indices were compared before and after chemotherapy. Additionally, T lymphocyte subsets and blood rheology indices were compared between the chemotherapy-effective group and the chemotherapy-ineffective group. The risk factors for ineffective chemotherapy in patients with NSCLC were analyzed.Results:The CD 4+ and CD 4+/CD 8+ levels in the observation group were significantly lower than those in the control group, and whole blood viscosity in high-, medium-, and low-shear rates as well as CD 8+ level in the observation group were significantly higher than those in the control group ( t = 22.64, 32.29, 28.72, 24.53, 28.29, 18.72, all P < 0.001). After chemotherapy, whole blood viscosity at high-, medium-, and low-shear rates, as well as CD 8+ levels, significantly decreased in the observation group compared with pre-chemotherapy levels. Conversely, CD 4+ and CD 4+/CD 8+ levels significantly increased ( t = 16.85, 27.15, 19.15, 16.03, 21.10, 13.50, all P < 0.001). In the chemotherapy-ineffective group, whole blood viscosity in high-, medium-, and low-shear rates as well as CD 8+ level were (6.08 ± 0.67) mPa·s, (10.45 ± 1.09) mPa·s, (15.59 ± 1.61) mPa·s, (25.58 ± 2.61)%, respectively. These values were significantly higher than those in the chemotherapy-effective group [(4.86 ± 0.51) mPa·s, (8.12 ± 0.91) mPa·s, (11.86 ± 1.28) mPa·s, (23.14 ± 2.41)%, t = 10.24, 11.36, 11.52, 4.65, all P < 0.001]. CD 4+ and CD 4+/CD 8+ levels in the chemotherapy-ineffective group were (37.82 ± 3.96)% and (1.48 ± 0.15), respectively, which were significantly lower than those in the chemotherapy-effective group [(40.05 ± 4.14)%, (1.73 ± 0.19), t = 2.56, 6.55, both P < 0.001]. Multivariate analysis revealed that whole blood viscosity at high-, medium-, and low-shear rates, as well as CD 8+ levels, were independent risk factors for ineffective chemotherapy in patients with NSCLC ( OR = 1.425, 1.697, 1.705, 1.719, all P < 0.05). Conversely, CD 4+ and CD 4+/CD 8+ levels were identified as protective factors against NSCLC (both P < 0.05). Conclusion:Patients with NSCLC have obvious T lymphocyte subset disorders and hemorrheological abnormalities. T lymphocyte subsets and hemorrheological indicators are factors that affect the effectiveness of chemotherapy and can be used to evaluate the effectiveness of chemotherapy in patients with NSCLC.

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 explore the clinical efficacy of internal fixation with a reduction plate assisted by our self-designed lower extremity fracture traction reduction device for tibial plateau fractures of Schatzker type Ⅵ.Methods:A retrospective study was conducted of the 32 patients with tibial plateau fracture of Schatzker type Ⅵ who had been treated at Orthopaedic Department, Mindong Hospital Affiliated to Fujian Medical University from April 2018 to July 2021. Depending on their treatments, they were divided into 2 groups. In the control group of 16 cases subjected to open reduction and internal fixation with manual traction, there were 9 males and 7 females with an age of 50.0±11.7 years; in the observation group of 16 cases subjected to internal fixation with a reduction plate assisted by our self-designed lower extremity fracture traction reduction device, there were 8 males and 8 females with an age of 54.6±11.1 years. The operation time, fracture reduction time, total incision length, intraoperative blood loss, Rasmussen knee function score and maximum active range of knee motion were compared between the 2 groups.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability between the groups ( P>0.05). The operation time [(158.6±26.0) min], fracture reduction time [(61.6±9.6) min], and total incision length [16.0 (13.3, 17.0) cm] in the observation group were significantly shorter than those in the control group [(199.9±60.9) min, (73.8±17.2) min, and 20.0 (17.0, 21.8) cm]; the intraoperative blood loss [175.0 (100.0, 200.0) mL] in the observation group was significantly less than that in the control group [200.0 (162.5, 387.5) mL]; the maximum active ranges of knee motion at one week and one month in the observation group were 94.9°±12.0° and 113.8°±14.1°, significantly larger than those in the control group (78.3°±14.6° and 96.8°±11.4°) (all P<0.05). Fractures achieved bony union at one year after operation in both groups. At 12 months after operation, there was no significant difference in the maximum active range of knee motion or the Rasmussen knee function score between the 2 groups ( P>0.05). Conclusion:In the treatment of Schatzker type Ⅵ tibial plateau fractures, compared with manual traction and open reduction, internal fixation with a reduction plate assisted by our self-designed lower extremity fracture traction reduction device can shorten operation time and total incision length, reduce intraoperative blood loss, and facilitate postoperative functional recovery of the knee for the patients.

The aim of this study was to develop a diagnostic strategy for esophageal squamous cell carcinoma(ESCC) that combines plasma metabolomics with machine learning algorithms.Plasma-based untargeted metabolomics analysis was performed with samples derived from 88 ESCC patients and 52 healthy controls.The dataset was split into a training set and a test set.After identification of differential me-tabolites in training set,single-metabolite-based receiver operating characteristic (ROC) curves and multiple-metabolite-based machine learning models were used to distinguish between ESCC patients and healthy controls.Kaplan-Meier survival analysis and Cox proportional hazards regression analysis were performed to investigate the prognostic significance of the plasma metabolites.Finally,twelve differential plasma metabolites (six up-regulated and six down-regulated) were annotated.The pre-dictive performance of the six most prevalent diagnostic metabolites through the diagnostic models in the test set were as follows:arachidonic acid (accuracy:0.887),sebacic acid (accuracy:0.867),indoxyl sulfate (accuracy:0.850),phosphatidylcholine (PC) (14:0/0:0) (accuracy:0.825),deoxycholic acid(accuracy:0.773),and trimethylamine N-oxide (accuracy:0.653).The prediction accuracies of the ma-chine learning models in the test set were partial least-square (accuracy:0.947),random forest (accu-racy:0.947),gradient boosting machine (accuracy:0.960),and support vector machine (accuracy:0.980).Additionally,survival analysis demonstrated that acetoacetic acid was an unfavorable prognostic factor(hazard ratio (HR):1.752),while PC (14:0/0:0) (HR:0.577) was a favorable prognostic factor for ESCC.This study devised an innovative strategy for ESCC diagnosis by combining plasma metabolomics with machine learning algorithms and revealed its potential to become a novel screening test for ESCC.

Objective To observe the expression of triggering receptor expressed on myeloid cells (TREM),Caspase-3 and interleukin (IL)-6 in optic nerve tissue of ischemic optic neuropathy (ION).Methods Twenty Sprague-Dawley rats were randomly divided into control group and model group,10 rats in each group.The permanent ligation of bilateral internal carotid arteries (BICA) was performed for 14 days to establish subacute ION model as model group.The control group were separated BICA without ligation.The expressions of TREM-1,TREM-2,Caspase-3 and IL-6 in rat retina were detected by reverse transcription PCR and Western blot,respectively.Results Compared with the control group,the expressions of TREM-1,Caspase-3,IL-6mRNA (t=6.058,7.86,6.055) and protein (t=9.671,9.524,14.501) in the optic nerve tissue of the model group were increased,while the expression ofTREM-2 mRNA and protein (t=9.283) was decreased,and the difference was statistically significant (P＜0.05).Conclusion In ischemic optic nerve tissue,TREM-1 mRNA and protein were significantly expressed,the expressions of TREM-2 mRNA and protein decreased significantly.

Malignant mesothelioma(MM) is a rare but highly invasive carcinoma associated with asbestos exposure.Its incidence is in rising trend and most cases occur in pleura and peritoneum.The majority of patients diagnosed at late stage with poor prognosis that the median overall survival is only 12 months.Accurate diagnosis depends on the histopathology combined with immunohistochemistry.At present, the treatment of MM is mainly based on the tumor reduction or resection surgery combined with chemotherapy and radiotherapy.The potential molecular target needs to be further investigated.In this paper, we summary the incidence, diagnosis and treatment of MM, which will benefit the diagnosis and treatment of MM in China.

Objective To study whether the effects of bone mineral density by a kidney-tonifying herbal fufang treatment in senile osteoporosis mice (P6) is by the mechanism of improving the expression level of GH mRNA and IGF-1 mRNA. Methods The experimental points four groups as following:SAMR1 mice which feed saline lavage,SAMP6 divid as saline lavage group,subcutaneous injection of rhGH group and a kidney-tonifying herbal fufang treatment group. All intervention is one time everyday. After 3 months and 6 months intervention,we measure the BMD and the expression level of the GH mRNA and of IGF-1 mRNA. Results After 3 months intervention,the BMD of R1 group and the Kidney group were higher than the P6 blank group;but there is no difference in BMD between RhGH group and the P6 blank group. The effect of GH mRNA and IGF-1 mRNA expression levels:the R1 group,rhGH and kidney group were higher than the P6 blank group. After six months intervention,the BMD of the rhGH group and kidney group are higher than the P6 blank group. GH mRNA and IGF-1 mRNA expression levels:GH group and kidney group are higher than the P6 blank group. The expression level of GH mRNA and IGF-1 mRNA in four groups has positive correlation. After six months intervention ,we found the positive correlation between the expression level of GH mRNA and IGF-1 mRNA and each part of the whole body BMD. Conclusion A kidney-tonifying herbal fufang can improve the bone mineral density of P6,and its mechanism may be related to improve expression level of GH mRNA and IGF-1 mRNA.

Objective: To investigate the expression of BRCA-associated protein 1 (BAP1) in malignant mesothelioma, non-small cell lung cancer and carcinosarcoma, and its application in the differential diagnosis. Methods: Twenty-two cases of malignant mesothelioma including 17 epithelioid type, 2 sarcomatoid type and 3 biphasic type were collected.As the study control, 80 non-small cell lung cancers infringement pleural membrane(including 40 lung adenocarcinomas and 40 lung squamous cell carcinomas) and 15 carcinosarcomas were included. BAP1 expression was detected using immunohistochemical method. A differential diagnosis antibody panel, including calretinin, WT1, CK5/6, D2-40, CAM5.2, CEA, TTF1, Napsin A, p63 and p40 was tested in all cases. Results: All 80 cases of non-small cell lung cancer and 15 cases of carcinosarcoma were BAP1 positive. In contrast, 64% (14/22) of malignant mesotheliomas lost BAP1 expression (P<0.01). Addition of BAP1 to the mesothelioma marker panel, the diagnostic accuracy of malignant mesothelioma was enhanced to 93%. Focal expression of BAP1 in tumors suggested multiclonal evolution of mesothelioma. Conclusions Loss of BAP1 expression helps to confirm the diagnosis of malignant mesothelioma whereas all non-small cell lung cancer expresses BAP1. It is therefore recommended that BAP1 can be used in conjunction with other immunohistochemical markers to improve the diagnostic accuracy of malignant mesothelioma.