Traditional Chinese medicine （TCM） has unique advantages in alleviating the symptoms of diabetic kidney disease （DKD） and slowing its progression. However， traditional clinical trials often use the occurrence of end-stage renal disease as the end point， requiring long-term follow-up， which increases trial complexity and costs， thereby limiting the feasibility of TCM clinical studies. This paper suggested that in clinical trials of TCM for DKD， both the estimated glomerular filtration rate （eGFR） change rate （≥30%） and eGFR slope can serve as potential surrogate outcome measures. If the intervention course is short （＜1 year）， the eGFR change rate （≥30%） is recommended as a surrogate outcome measure， whereas in long-term interventional studies （≥1 year）， the eGFR slope may be more appropriate. Furthermore， based on biochemical indicators such as eGFR slope and urinary albumin-to-creatinine ratio （UACR） change rate， integrating TCM symptom evaluation， TCM syndrome evaluation， and quality of life scales can help develop internationally recognized patient-reported outcome measures （PROMs） for TCM clinical trials， which will be a key step in enhancing the evaluation system for the effectiveness of TCM in treating DKD.

Objective:To explore the efficacy and safety of endovascular intervention combined with preoperative laparoscopic exploration in the treatment of patients with acute mesenteric artery ischemia.Methods:This was a prospective cohort study (NCT04686981). The study enrolled 31 patients with acute mesenteric artery ischemia from Oct 1, 2020 to Oct 1, 2022. Among them, 26 patients (84%) were male, with a mean age of (67±13) years and a mean time to onset of (21±8) hours. All patients underwent laparoscopic exploration in the hybrid operating room. If the presence of intestinal necrosis or suspected necrosis was clearly determined, the patient would undergo open surgery (mesenteric artery embolization, intestinal resection and intestinal double stoma) as the treatment by gastrointestinal surgeon. If intestinal necrosis or suspected necrosis was not found by laparoscopy, the patient would undergo endovascular intervention by vascular surgeon. The primary observational endpoints of this study were the proportion of patients who were not dependent on total parenteral nutrition and all-cause mortality within 30 days after operation. The secondary observational endpoints were the rate of mesenteric vascular patency within 30 days and the proportion of interventions that were converted to open surgery.Results:Six patients underwent open surgery and 25 patients underwent endovascular intervention, including 13 cases of thrombus reduction alone, 3 cases of stent implantation during the same period after reduction, and 9 cases of stent implantation alone. Twenty-four patients (77%) were completely weaned from the TPN within 30 days after the procedure, and all-cause mortality was observed in 3 cases (9.7%). The patency rate of the mesenteric artery within 30 days after the procedure was 82.1%. The rate of conversion to open surgery after intervention was 16%.Conclusions:Endovascular intervention combined with preoperative laparoscopic exploration can clarify intestinal ischemia in acute mesenteric patients as early as possible, and individualized treatment strategies for each patient by multidisciplinary care team can potentially improve the prognosis of such patients.

"Fostering virtue through education"is the fundamental task of higher medical education.Specialized curriculum is the basic carrier of ideological and political education construction.Microbiology and Immunology is a basic course of medicine,which is closely related to people's health,clinical diagnosis and treatment.Based on the professional knowledge system of the curriculum,teaching team carried out the exploration of ideological and political education in both theoretical and experimental teaching.In order to train socialist medical qualified personnel with both virtue and ability,we integrated ideological and political education into all aspects of teaching and the whole process,such as teachers'teaching ability,curriculum teaching objectives,teaching content,teaching methods,etc.

Objective To construct a diagnostic model for the phlegm-dampness obstruction syndrome in patients with coronary heart disease stable angina pectoris(CSAP);To provide a reference for clinical syndrome differentiation.Methods Totally 305 patients'clinical data were collected from the Department of Cardiology,Dongying Hospital Affiliated to Shandong University of Traditional Chinese Medicine,from May 2022 to January 2024.The least absolute shrinkage and selection operator(LASSO)was used to select features,and multiple models were constructed and compared using machine learning(ML)algorithms.The optimal ML model was selected for training,validation,and testing.Finally,the operational logic of the optimal model was explained using Shapley Additive Explanations(SHAP),and two typical examples were provided to help users understand the model's operational logic.Results LASSO regression identified chest pain,body mass index(BMI),limb heaviness,drinking history,age,triglycerides(TG),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL-C)as features included in the model.After comparing multiple models,the Gaussian Naive Bayes(GNB)model demonstrated the best performance.The final constructed GNB model achieved an average AUC of 0.938(95%CI:0.903-0.972)in the training set,an average AUC of 0.927(95%CI:0.851-0.992)in the validation set,and an AUC of 0.856(95%CI:0.751-0.961)in the test set.The learning curve showed that the error between the training and validation sets in the model converged as the number of training samples increased.The calibration curve showed that the model had good consistency in predicting the probability of observed phlegm-dampness obstruction syndrome patients.The clinical decision curve(DCA)showed that the model could provide clinical benefits for patients at a decision threshold below 0.7.The features ranked by SHAP importance in order were chest pain,BMI,LDL-C,TG,limb heaviness,TC,drinking history and age.Conclusion The diagnostic model for CSAP phlegm-dampness obstruction syndrome constructed in this study can assist physicians in the syndrome differentiation of patients,thereby enabling the formulation of integrated clinical treatment plans combining traditional Chinese and Western medicine,and aiding patients in achieving better clinical therapeutic outcomes.

Organoids are in vitro-cultured three-dimensional (3D) miniature structures derived from human pluripotent stem cells or adult stem cells from healthy individuals or patients. Compared to traditional two-dimensional (2D) cell lines or animal models, organoids are regarded as more promising high-fidelity models, possessing unique advantages in terms of disease modeling, drug development, the establishment of living biobanks, and the exploration of personalized treatment. Over recent years, the rapid development of organoid technology has brought new hopes for innovating preclinical experimental tumor models and promoting clinical personalized diagnosis and treatment. This review is intended to introduce the development status and latest progress of organoids in the field of radiotherapy for tumors, explore the advantages and limitations of organoid models for cancer, and prospect for its application in the field of radiotherapy.

Objective To investigate the effect of probiotics in patients with chronic heart failure (CHF) and its impact on intestinal microecology. Methods A total of 112 patients with CHF were selected as research subjects and randomly divided into study group and control group, with 56 patients in each group. The control group received angiotensin-converting enzyme inhibitors (ACEI) combined with angiotensin Ⅱ receptor blockers (ARB) for treatment, while the study group received bifidobacterium viable capsules on the basis of treatment in the control group. The levels of myocardial fibrosis markers[type Ⅰ collagen precursor C-propeptide (PⅠCP), type Ⅲ collagen precursor N-propeptide (PⅢNP), PⅠCP/PⅢNP, type Ⅰ collagen carboxyl-terminal peptide (ⅠCTP)], cardiac function indicators[leftventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular end-systolic volume (LVESV)], intestinal flora abundance, plasma trimethylamine oxide (TMAO) levels, and serum tumor necrosis factor-α(TNF-α) and interleukin-1β(IL-1β) levels were measured in both groups. The therapeutic effects, drug safety, re-hospitalization rate, and mortality rate within 3 months after discharge were observed in both groups. Results The total effective rate in the study group was 71.43 %, which was higher than 51.79 % in the control group (P < 0.05). After treatment, the LVEF in the study group was higher than that in the control group, while LVEDD, LVESD, and LVESV were lower than those in the control group (P < 0.05). After treatment, the PⅠCP/PⅢNP in the study group was higher than that in the control group, while the ⅠCTP level was lower than that in the control group (P < 0.05). After treatment, the abundances of Proteobacteria, Actinobacteria, Firmicutes, and Fusobacteria in the study group were lower than those in the control group, while the abundance of Bacteroidetes was higher than that in the control group (P < 0.05). After treatment, the levels of TMAO, TNF-α, and IL-1β in the study group were lower than those in the control group (P < 0.05). No serious adverse reactions occurred in either group after treatment. Within 3 months after discharge, the re-hospitalization rate in the study group was 12.50 %, which was lower than 30.36 %in the control group (P < 0.05). The mortality rates in the study group and the control group were 1.79 % and 7.14 %, respectively, but no statistically significant difference was observed(P>0.05). Conclusion The combination of probiotics with ACEI and ARB can effectively reduce myocardial fibrosis in patients with CHF and improve intestinal microecology and prognosis.

Animals ; SARS-CoV-2 ; Antibodies, Neutralizing ; Macaca mulatta ; COVID-19/prevention & control* ; Antibodies, Viral ; Vaccines

Objective: To understand the status quo of school bullying among middle school students in Anhui Province and its correlation with family environment and education methods of students related to school bullying, so as to provide corresponding prevention and controlling measures against school bullying. Methods: The investigation has been conducted on the occurrence of school bullying among middle school students ranging from junior grade one to senior grade three in Hefei, Wuhu, Fuyang of Anhui Province, during which up to 1 826 students information has been gathered through Questionnaire Atar Platform using the school bullying scale and self designed questionnaire. SPSS 26.0 statistical software has been applied for data analysis. Results: The incidence of bullying was 41.40%, and among them, 14.46% were reported to bully others, 39.59% of them were of being bullied, and 12.65% of them were reported of bullying others and being bullied at the same time. Multivariate Logistic regression corrected model showed that quiet relationship with mother ( OR=1.76, 95%CI =1.22-2.53) was a risk factor for the bully, quiet relationship with father( OR=1.89, 95%CI=1.47-2.43 ), reorganized family ( OR=2.28, 95%CI =1.22-4.29) were the risk factors for the bullied, quiet/poor relationship between parents ( OR=1.52, 95%CI=1.06-2.17; OR=3.15, 95%CI =1.79-5.57) was a risk factor for the bully-bullied; Punishment and abuse( OR=1.45, 95%CI=1.10-1.90; OR=1.82, 95%CI=1.48-2.23; OR=1.47, 95%CI = 1.10- 1.96) were risk factors for the above three behaviors( P <0.05). Conclusion The incidence of school bullying is influenced by family environment and rearing style. In daily life, parents should be mindful of maintaining a good family relationship, fostering active communication with child, which can reduce the occurrence of school bullying.

OX40 is a costimulatory receptor that is expressed primarily on activated CD4⁺, CD8⁺, and regulatory T cells. The ligation of OX40 to its sole ligand OX40L potentiates T cell expansion, differentiation, and activation and also promotes dendritic cells to mature to enhance their cytokine production. Therefore, the use of agonistic anti-OX40 antibodies for cancer immunotherapy has gained great interest. However, most of the agonistic anti-OX40 antibodies in the clinic are OX40L-competitive and show limited efficacy. Here, we discovered that BGB-A445, a non-ligand-competitive agonistic anti-OX40 antibody currently under clinical investigation, induced optimal T cell activation without impairing dendritic cell function. In addition, BGB-A445 dose-dependently and significantly depleted regulatory T cells in vitro and in vivo via antibody-dependent cellular cytotoxicity. In the MC38 syngeneic model established in humanized OX40 knock-in mice, BGB-A445 demonstrated robust and dose-dependent antitumor efficacy, whereas the ligand-competitive anti-OX40 antibody showed antitumor efficacy characterized by a hook effect. Furthermore, BGB-A445 demonstrated a strong combination antitumor effect with an anti-PD-1 antibody. Taken together, our findings show that BGB-A445, which does not block OX40-OX40L interaction in contrast to clinical-stage anti-OX40 antibodies, shows superior immune-stimulating effects and antitumor efficacy and thus warrants further clinical investigation.
Mice ; Animals ; Receptors, Tumor Necrosis Factor/physiology* ; Receptors, OX40 ; Membrane Glycoproteins ; Ligands ; Antibodies, Monoclonal/pharmacology* ; Antineoplastic Agents/pharmacology*

Objective: To explore the role of mobile phone addiction and anxiety symptoms in the relationship between childhood psychological abuse and depressive symptoms among college students, in order to provide a basis for mental health promotion. Methods: From February to May 2023, a stratified random sampling method was used to select 1 799 freshmen to juniors from a university in Wuhu City, Anhui Province. The questionnaire survey was conducted using the 2-item Patient Health Questionnaire (PHQ-2), Child Psychological Maltreatment Scale (CPMS), Mobile Phone Addiction Tendency Scale (MPATS), 2-item General Anxiety Disorder (GAD-2). Correlations among each variable were analyzed, and the chain mediating effect of mobile phone addiction and anxiety symptoms was explored. Results: The detection rate of depressive symptoms among college students was 9.7%, and the positive detection rate of childhood psychological abuse was 28.6%. Depressive symptoms were positively correlated with childhood psychological abuse, mobile phone addiction and anxiety symptoms ( r =0.28, 0.32, 0.27, P <0.01). Childhood psychological abuse was positively correlated with mobile phone addiction and anxiety symptoms ( r =0.29, 0.71, P <0.01). Mobile phone addiction and anxiety symptoms were positively correlated ( r =0.30, P <0.01). Childhood psychological abuse could effectively predict depressiove symptoms, mobile phone addiction and anxiety symptoms ( β =0.08, 0.06, 0.66, P <0.01). Mobile phone addiction and anxiety symptoms had a chain mediating effect between childhood psychological abuse and depression symptoms, with a total indirect mediating effect (effect=25.27%, P <0.05), accounting for 72.44% of the total effect. Conclusions Mobile phone addiction and anxiety symptoms play a chain mediating role between childhood psychological abuse and depressive symptoms. Focusing on childhood psychological abuse, mobile phone addiction and anxiety among college students are beneficial for depression symptoms prevention.