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Previous studies have reported different opinions regarding the association between abdominal obesity and diabetic retinopathy (DR) in patients with diabetes mellitus (DM). In this study, we aimed to investigate this problem through a systematic review and meta-analysis to provide a basis for clinical interventions. A comprehensive search was conducted in the PubMed, Embase, and Web of Science databases up to May 1, 2022, for all eligible observational studies. Standardized mean differences (SMD) and 95% confidence intervals (CI) were evaluated using a random-effects model in the Stata software. We then conducted, publication bias assessment, heterogeneity, subgroup and sensitivity analyses. A total of 5596 DR patients and 17907 non-DR patients were included from 24 studies. The results of the meta-analysis of abdominal obesity parameters showed statistically significant differences between DR and non-DR patients in both type 1 and type 2 diabetes. Waist circumference (WC) was higher in patients with DR than in the non-DR patients. In the waist-hip ratio (WHR) subgroup, the level of WHR was higher in patients with DR than that in non-DR patients. The association between abdominal obesity and mild to moderate nonproliferative DR or vision-threatening DR groups did not show any statistical difference. Subgroup analysis according to ethnicity showed that Caucasians had higher levels of combined abdominal obesity parameters than Asians. We found that abdominal obesity measured by WC and WHR is associated with DR in patients with type 1 and type 2 diabetes. This association is stronger in Caucasians than in Asians, where isolated abdominal obesity might be more related to DR. However, no correlation was found between abdominal obesity and varying degrees of diabetic retinopathy. Further prospective cohort studies with larger sample sizes are yet to be conducted to clarify our findings.

BackgroundHCW9218 is a bifunctional protein complex comprising dimeric extracellular domains of human transforming growth factor beta (TGF-β) receptor II and interleukin-15 (IL-15). HCW9218 1) stimulates immune effector cells and 2) sequesters soluble immunosuppressive TGF-β.1 2 The objectives of our pre-clinical and first-in-human studies are to explore the antitumor mechanism of action (MOA) and determine the RP2D.MethodsTwo syngeneic mouse tumor models were used to explore the MOA of HCW9218. A phase I dose escalation study (NCT05322408) of HCW9218 monotherapy (Q3W, subcutaneous) has been completed in adult patients (n=12) with refractory advanced/metastatic solid tumors and is expanding at the highest dose level (1.2mg/kg).3 Correlative analyses included pharmacokinetics, serum cytokines, blood lymphocytes, and cellular/molecular profiling of tumors.ResultsIn B16F10 melanoma and 4T1 breast cancer murine models, HCW9218 promotes proliferation and activation of progenitor exhausted (Tpex) and exhausted transitory effector (Tem) CD8+ T cells in draining lymph nodes, and CD8+ memory T cells and NK cells in peripheral blood. HCW9218 increases tumor infiltrating Tpex, Tem, and memory CD8+ T cells and enhances antitumor potency of immune checkpoint blockade therapy, likely due to stimulation of Tpex and Tem cells. HCW9218 protein localizes in tumors and significantly lowers TGF-β levels and increases proinflammatory cytokines. In the first-in-human clinical trial, there were no dose limiting toxicities. The most common adverse events are grade 1–2 injection site reactions and transient lymphopenia. Patients receiving ≥0.25 mg/kg HCW9218 exhibit robust NK cell and CD8+ T cell proliferation through day 15 and recurred with each treatment cycle, a biologic effect beyond what has been previously observed with other IL-15 agonists. At ≥0.5 mg/kg HCW9218, serum TGF-β1 levels decrease to baseline through day 8. Immunofluorescent staining of patients’ tumors show that HCW9218 increases CD8+ T cell infiltration with elevated tumor Tpex and/or fully differentiated memory CD8+ T cells correlating with disease stabilization. Single-cell RNA-seq tumor analysis demonstrates that HCW9218 reduces expression of genes associated with tumor invasion, immunosuppression, and inflammation and upregulates genes involved in differentiation of Tpex, TCR signaling, and inflammatory response, while downregulating proinflammatory response genes of tumor lymphocytes. HCW9218 has a serum half-life of ~25h in patients.ConclusionsRepeated HCW9218 administration at ≥0.5 mg/kg in heavily pretreated advanced solid tumor patients resulted in immune cell activation, proliferation, and infiltration into the tumor microenvironment without causing unacceptable toxicity. HCW treatment presents a promising approach to enhancing the antitumor activity of immune checkpoint inhibitors in patients with solid tumors.Trial RegistrationNCT05322408ReferencesLiu B, Zhu X, Kong L, et al. Bifunctional TGF-beta trap/IL-15 protein complex elicits potent NK cell and CD8(+) T cell immunity against solid tumors. Mol Ther 2021;29:2949–62.Chaturvedi P, George V, Shrestha N, et al. Immunotherapeutic HCW9218 augments anti-tumor activity of chemotherapy via NK cell-mediated reduction of therapy-induced senescent cells. Mol Ther 2022;30:1171–87.Geller M, Patel M, Wong H, et al. A phase I study of HCW9218, a bifunctional TGF-β antagonist/IL-15 protein complex, in advanced solid tumors. J Immunother Cancer 2022;10. doi: 10.1136/jitc-2022-SITC2022.0724Ethics ApprovalThis study was approved by the University of Minnesota’s Institutional Review Board; approval number: 00015102.ConsentWritten informed consent was obtained from the patients included in the clinical trial for publication of this abstract and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.

Background We report five patients with Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS), four of whom presented with precocious puberty and one with growth hormone deficiency (GHD. Our five children add to the growing endocrine data base of MRKHS. Case presentation We retrospectively reviewed clinical data of 5 MRKHS patients from 2017 to 2020. The clinical features, hormonal profiles, radiological imaging and genetic analyses were collated. The age range of the 5 patients at diagnosis was 6.7–9.1 years. Four presented with premature thelarche, and one presented with short stature. External genitalia were normal in all patients. Gonadotropin-releasing hormone stimulation tests for the 5 patients revealed peak luteinizing hormone and follicular stimulating hormone levels of 3.57, 6.24, 11.5, 4.44 and 4.97 IU/L and 9.41, 16.7, 13.8, 14.2 and 10.3 mIU/mL, respectively. Growth hormone stimulation for one patient with short stature was consistent with GHD with a peak level of GH was 7.30 ng/mL. Imaging disclosed advanced bone age in four patients and no skeletal abnormalities in any of the patients. Ultrasonography of the abdomen revealed bilateral polycystic kidneys in one patient. Pelvic magnetic resonance imaging confirmed no uterus in five patients. All of the patients had a normal karyotype (46, XX). In one patient, whole-exome sequencing detected a deletion of 17q12(chr17:36,046,434–36,105,050, hg19) encompassing the HNF1B gene. Conclusions We report the unusual co-occurrence of precocious puberty and GHD in patients with MRKHS, highlighting that abnormal puberty and growth development may represent initial unexplained manifestations. Whether the deletion of 17q 22 begat GHD is unclear.

Primary gastric malignant melanoma (PGMM) is an exceedingly rare non-epithelial tumor. Only a limited number of cases have been documented, posing significant diagnostic and therapeutic challenges. A 75-year-old man presented with cough and sputum. Computed tomography (CT) suggested a malignant tumor with multiorgan metastasis. Gastroscopy revealed multiple polypoid lesions, and histopathology confirmed melanoma. After multidisciplinary discussion, primary gastric melanoma was diagnosed. Despite aggressive treatment, the disease progressed rapidly, and the patient died six months after diagnosis. This case highlights the importance of early endoscopy in patients with metastatic tumors of unknown origin. Although outcomes remain poor, this report contributes to the understanding of PGMM diagnosis and management.

This study aimed to analyze the molecular characteristics of gastric adenocarcinoma of the fundic-gland type (GAFG) and explore the possible mechanism of tumor development. Samples from 10 Chinese patients with GAFG were collected at the Peking University International Hospital and Liaocheng People's Hospital between January 2015 and March 2022. The nucleic acid sequence of Epstein Barr virus-encoded RNA (EBV-EBER) was detected by in situ hybridization. Genetic mutation information for GNAS, KRAS, NRAS, BRAF, PIK3CA, TP53, APC, CTNNB1, HER2, MLH1, MSH2, MSH6, and PMS2 was obtained by Next-Generation Sequencing, and the relevant literature was reviewed. A total of eight instances of missense mutations were detected, consisting of seven cases with GNAS mutations, two cases with KRAS mutations, and one case with a TP53 mutation. Additionally, two patients had simultaneous missense mutations in GNAS and KRAS. Nonsynonymous mutations in APC, CTNNB1, NRAS, BRAF, PIK3CA, HER2, MLH1, MSH2, MSH6, or PMS2 were not observed in any cases. In addition, all tumors were EBER-negative. GAFG exhibits diversity at the molecular level, and GNAS mutations are more common than KRAS mutations, TP53 mutations, and microsatellite instability. To date, no association between EBV/HER2 and GAFG has been found.

Background Many studies have investigated the impact of nursing interventions on psychological factors such as anxiety and depression in infertile women undergoing assisted reproductive technology (ART). However, the results have been inconsistent, and the effectiveness of these nursing interventions on the physiological status of these patients varies. Therefore, it is of the utmost importance to summarize and compare the outcomes of these studies across different types of nursing interventions. We performed a systematic review and meta-analysis to evaluate the effectiveness of various nursing interventions on anxiety and depression in infertile women undergoing assisted reproductive technology (ART). Methods A systematic search was done in the six valid databases (Cochrane, Scopus, PubMed, Medline, Embase, and Web of Science) applying two sets of keywords up to June 2025, following the PRISMA approach. The database searches were performed independently by two reviewers. Mean scores for anxiety and depression, along with 95% confidence intervals (CIs), were calculated using a random-effects model in STATA. Funnel plot was generated to examine publication bias; Egger’s Begg’s tests were applied to evaluate any asymmetry. The quality of the selected studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. Results A total of 44 studies were reviewed in the current analysis, encompassing 5,008 infertile women. Forty of these studies reported favorable outcomes regarding depression and anxiety levels in infertile females following various interventional approaches. These interventions included mind-body programs such as Eastern body-mind-spirit therapy, mindfulness-based program for infertility (MBPI), integrative body-mind-spirit therapy, and mind-body therapeutic programs; cognitive behavioral therapy (CBT); targeted nursing care programs; group psychotherapy; Hatha yoga (HY) practice; acupuncture; stress management programs; music therapy; nursing crisis intervention programs; positive psychological interventions; drug and supplementation therapies; and positive reappraisal coping intervention (PRCI) programs. The interventions specifically targeted the psychological well-being of the patients. Both depression and anxiety levels decreased after intervention, with an overall pooled standardized mean difference (SMD) of -3.16 (95% CI: -4.38, -1.94) for depression and − 1.23 (95% CI: -1.70, -0.76) for anxiety. Subgroup analysis indicated that implementing interventions before ART was more effective than during or after ART. Conclusion A comprehensive, evidence-based nursing intervention targeting infertile women undergoing ART should be developed, particularly prior to the initiation of ART.

Aim Guided by the 2020 AHA quality targets for chest compressions, we used a manikin model to assess the effects of compression angle (90° vs. 100°) and audiovisual feedback on compression quality and rescuer fatigue. Methods This was a randomised, crossover, controlled trial. Four experimental groups were included: CCA90°, CCA90° with audiovisual feedback, CCA100°, and CCA100° with audiovisual feedback. Twenty-nine participants, following standardized training, performed 2-minute chest compression sessions on a manikin under each condition, with the order of scenarios randomized by lottery. Heart rate, blood pressure, and Borg Rating of Perceived Exertion (RPE) were recorded immediately before and after each session. Results Significant differences in mean chest compression depth were observed among the four groups (CCA90°: 49.6 ± 7.6 mm; CCA90° with audiovisual feedback: 51.3 ± 3.2 mm; CCA100°: 50.7 ± 8.3 mm; CCA100° with audiovisual feedback: 55.1 ± 4.5 mm; P  < 0.001). However, both the CCA100° and CCA100° with audiovisual feedback groups had comparable medians (100%) but a lower overall distribution for Correct recoil rate (100 [92.8, 100]% and 98.5 [74.3, 100]%, respectively; P  < 0.001) and for Correct hand position ratio (91.9 [23.7, 99.4]% and 89.1 [59.5, 99.8]%,respectively; P  < 0.001) compared to the conventional CCA90° group. Changes in heart rate ( P  = 0.02) and RPE scores ( P  < 0.001) were greatest in the CCA100° with audiovisual feedback group, indicating a higher level of rescuer fatigue. No significant differences were observed among the four groups in terms of mean chest compression rate, accurate compression rate ratio, or change in mean arterial pressure. Conclusion The forward-leaning (100°) posture during CPR enhances chest compression depth; however, it may compromise correct hand positioning and complete chest recoil.

Renal fibrosis is a hallmark and the final outcome of chronic kidney disease (CKD). Jingtian Granule (JT), a traditional formula used in the clinical treatment of CKD for many years. However, the mechanism of action of JT against renal interstitial fibrosis remain unknown. This study aimed to explore the potential effects and mechanisms of JT on adenine - diet - induced CKD in mice. Renal interstitial fibrosis was induced in mice by adenine - diet and treated with JT. Renal function was assessed by measuring blood urea nitrogen and serum creatinine levels. Masson's staining and type I collagen expression were used to evaluate renal collagen deposition. RNA sequencing was used to analyze the expression levels of mRNA in mouse kidney samples after JT treatment. The levels of glutathione (GSH) and malondialdehyde (MDA) were measured to assess lipid peroxidation in the kidneys. Iron metabolism levels were detected by Prussian blue staining and measurement of iron content. The protein levels of SIRT3, P53, glutathione peroxidase 4 (GPX4), and solute carrier family 7 member 11 (SLC7A11) were detected by Western blot. Subsequently, under the premise of SIRT3 knockout, renal function, fibrosis level, iron metabolism level, and lipid peroxidation level were detected, and mitochondrial damage was observed by transmission electron microscope (TEM). In addition, human proximal tubule epithelial cells (HK - 2) were treated with Erastin to induce ferroptosis, followed by exposure to JT. The levels of reactive oxygen species (ROS) were detected. JT significantly reduced collagen deposition in the kidneys. RNA sequencing identified 20 mRNAs that were differentially expressed in response to JT treatment. Bioinformatics analysis revealed that SIRT3 was a key mRNA regulated by JT. JT activated SIRT3 in fibrotic kidneys to inhibit the acetylation of P53. Under the premise of SIRT3 knockout, JT did not show significant therapeutic effects in inhibiting ferroptosis and fibrosis. experiments also showed that JT promoted the downregulation of ROS. SIRT3 is the key ferroptosis - related mRNA regulated by JT. The ability of JT to modulate the SIRT3/P53 signaling pathway may be a viable approach for the treatment of renal interstitial fibrosis.

Copper powder is prepared by electrolysis, and additives Sodium dodecyl benzene sulfonate (SDBS) and polyvinyl pyrrolidone (PVP) are added to the electrolyte. Through the synergy effect of the two additives, the shielding effect between metal atoms is enhanced, and as a consequence the microscopic morphology is changed and it the powder performance is improved. Scanning electron microscopy (SEM), x-ray diffraction (XRD) and Electrochemical Impedance Spectroscopy (EIS) are used to characterize the copper powder. The results show that when the content of SDBS and PVP is 5 g l −1 and 1.5g l −1 respectively, the new type of thin and long dendrite copper powder can be obtained by electrolysis.

Sports injuries have been a common concern during athlete training as the number of Chinese athletes and their training intensity have increased. These injuries frequently impact critical locations, including the waist, shoulder, and wrist, impeding training progress and intensity. Inadequate training levels, a lack of understanding of preventive measures, inappropriate movements, insufficient warm-up exercises, low physical condition, and an inability to adjust to the environment all contribute to sports injuries. As a result, athlete training and recovery suffer. To address these issues, this study presents a neural network-based sports injury risk analysis system that uses blockchain and the Internet of Things (IoT). The suggested system combines a multi-sensor data fusion technique based on blockchain and IoT to evaluate and analyze sports injuries completely. The system has three unique roles: coach, team doctor, and athlete, each with its functional modules. Sensors collect data on athletes’ recovery from sports injuries by collecting and analyzing inputs inside the human action system. The system then establishes the output values of a neural network and a risk level table, allowing for the estimation of athletes’ risk levels based on the given table. Comparing the traditional technique and the sports injury rehabilitation monitoring system demonstrates that the technology can reliably detect players’ injury locations in as little as 0.2 s. Furthermore, a thorough examination of the system’s tracking and analysis accuracy reveals a recovery rate of approximately 94.39%, demonstrating minimal fluctuations and improved stability. The experimental findings reveal that combining blockchain, IoT, and neural network technologies makes the proposed sports injury rehabilitation monitoring system useful in quickly recognizing damage positions and enabling accurate tracking and analysis.