First Teaching Hospital of Tianjin University of Traditional Chinese Medicine

Diabetic nephropathy (DN) represents a major complication of diabetes mellitus (DM) with limited early diagnostic biomarkers. This study investigated the clinical significance and molecular mechanism of long non-coding RNA (lncRNA) VCAN-AS1 in DN pathogenesis. The patients with diabetes mellitus, including 85 with DN and 66 without nephropathy, were enrolled, along with 62 healthy controls. Serum VCAN-AS1 levels were detected using qRT-PCR. Clinical parameters and renal injury markers were analysed for correlations with VCAN-AS1. Invitro, high glucose-treated human renal tubular cells (HK-2) underwent genetic interventions including VCAN-AS1 knockdown and miR-205-5p inhibition. Functional assessments encompassed cell viability, oxidative stress, fibrosis and inflammation. Dual-luciferase reporter assays validated molecular interactions. Serum VCAN-AS1 expression showed a progressive increase across healthy controls, diabetes mellitus patients and DN patients. It exhibited strong diagnostic efficacy for DN with an AUC of 0.879. Elevated VCAN-AS1 correlated with deteriorated renal function parameters. VCAN-AS1 was identified as an independent risk factor for diabetes mellitus progression to DN. High glucose exposure up-regulated VCAN-AS1 in HK-2 cells, promoting cellular injury phenotypes. Rescue experiments confirmed that miR-205-5p inhibition reversed the protective effects of VCAN-AS1 knockdown. Mechanistically, VCAN-AS1 directly bound miR-205-5p, suppressing its expression and consequently enhancing vascular endothelial growth factor A (VEGFA) expression. VCAN-AS1 serves as a potential diagnostic biomarker for DN and promotes disease pathogenesis through the miR-205-5p/VEGFA axis, highlighting its potential as a therapeutic target.

Falls threaten the physical and mental health of older persons. Studies of the relationship between oral health and falls were fragmented in their selection of oral health indicators. We aimed to analyze whether and to what extent self-reported oral health was associated with falls among community-dwelling older adults in China. A cross-sectional study was conducted using data from physical examination and questionnaire survey for older adults in Tianjin, China. 2150 community-dwelling individuals aged 60 and older were included. Self-reported history of falls during the past year and oral health were collected using questionnaires. In the oral health index, fewer missing teeth, wearing dentures, no toothache, no bleeding gums, and brushing teeth at least twice a day were assigned as a score of 1, respectively. Oral health index was calculated by summing the scores of each item and ranged from 0 to 5, with higher scores indicating better oral health status. Logistic regression controlled for potential confounders was employed to analyze the association between oral health and falls. The prevalence of fall within the previous year was 12.6%. Logistic regression model showed that participants with higher oral health index (≥ 4) had a 26% lower fall rate than those with lower scores (OR = 0.71; 95% CI: 0.52 to 0.97) after adjusting for age, sex, health status and behaviors, and muscle status. Specifically, older adults who had lost 3–5 teeth (OR = 1.72; 95% CI: 1.01 to 2.69) and gingival bleeding (OR = 1.95; 95% CI: 1.20 to 3.17) had a higher fall prevalence rate compared with those losing 2 or fewer teeth and no gingival bleeding, respectively. Older adults with worse oral health, particularly more missing teeth and gingival bleeding, might be more vulnerable to falls. More attention paid to oral health may be helpful for fall prevention.

To identify the research status, major contributors, and emerging frontiers in acupuncture randomized controlled trials (RCTs) through bibliometric analysis, assisting clinicians, researchers, and policymakers in rapidly capturing valuable research hotspots and potential directions. Articles related to acupuncture RCTs published between January 1, 2010, and December 31, 2024, were retrieved 1,908 articles from the Web of Science Core Collection and Scopus. Multiple software tools (Origin 2021, CiteSpace, and VOSviewer) have been integrated to comprehensively visualize relationships among authors, journals, keywords, institutions, and countries. The number of acupuncture RCTs grew steadily from 59 articles in 2010 to a peak of 205 in 2022, later stabilizing at 160. China led in output (1,096 articles), followed by the United States (263) and South Korea (216). Leading institutions included Beijing University of Chinese Medicine (166 articles; 2,084 citations) and Kyung Hee University (112 articles; top non-Chinese institution). Chinese scholars Liu Zhishun (most publications) and Liu Cunzhi (most citations) were the most prolific and highly cited researchers, respectively. The keywords of greatest interest were "Acupuncture" (1,188 times) and "Randomized Controlled Trial" (439 times). The next three most frequent keywords were "Electroacupuncture" (409 times), "Management" (291 times), and "Pain" (277 times). Burst keywords were "guidelines," "sleep," and "diagnosis" (2021-2022). Trials (274 articles) and Acupuncture in Medicine (H-index 26/2,099 citations) were the primary publishing journals. This study conducted a multidimensional analysis of the current state of acupuncture RCT research, revealing key research domains, hotspots, and potential trends. Building on these findings, we propose the following directions for future investigations: (1) identifying potential conditions for acupuncture through four classification approaches: conditions with conflicting research findings, conditions for which a body of evidence is emerging but has not yet reached a broad consensus, conditions for which modern medicine currently has no superior treatment options, and conditions where acupuncture can further expand its application; (2) key factors influencing acupuncture efficacy, such as acupoint prescription, core acupuncture parameters and the dose-effect relationship should be explored; (3) research quality and reliability should be ensured by adhering to rigorous methodological design and reporting standards, including appropriate selection of control groups and outcome measures.

Though rare, complications associated with intrauterine devices (IUDs) can present with atypical symptoms, leading to diagnostic challenges. This case report describes a 36-year-old multiparous woman with a history of IUD insertion who presented with intermittent light bleeding menstrual periods for 1 year, in the without abdominal pain or dysmenorrhea. Imaging studies (including pelvic X-ray and ultrasound) revealed complete uterine perforation and IUD displacement into the pelvic cavity. The IUD was successfully removed through a combined hysteroscopic and laparoscopic procedure. This case emphasizes that severe complications, such as IUD perforation and displacement, may manifest solely as minor abnormal uterine bleeding. This finding suggests that even in the absence of pain, patients with persistent irregular bleeding patterns should remain highly vigilant for IUD-related complications. Since ultrasonography remains the gold standard for assessment, timely diagnosis of these complications is crucial to prevent potential long-term sequelae.

Cardiac ageing is characterized by endothelial dysfunction and associated cardiovascular pathologies, often involving endothelial-to-mesenchymal transition (EndoMT) in cardiac endothelial cells. While the transcription factor Ets2, a member of the Ets family, is known to regulate endothelial cell survival and function, its role in EndoMT and cardiac ageing remains poorly understood. To investigate this, we utilized single-nucleus RNA sequencing (snRNA-Seq) in Ets2-super-enhancer (Ets2-SE)-deficient mice to examine the regulation of Ets2 expression across various cardiac cell types. We assessed the relationship between Ets2 expression and heart ageing and evaluated the characteristics of cardiac ageing in Ets2-SE-deficient mice. Furthermore, we generated endothelial cell-specific Ets2 knockout mice (ECKO) to investigate the role of Ets2 in EndoMT of cardiac endothelial cells both in vitro and in vivo. Our results establish a link between decreased Ets2 expression and the development of ageing-associated cardiac pathological remodelling. Through data analyses, we identified a super-enhancer (Ets2-SE) that regulates Ets2 expression in the heart. Ets2-SE-deficient mice exhibited significantly lower Ets2 expression in cardiac tissues and displayed advanced ageing phenotypes, including increased cardiac fibrosis and dysfunction, compared to wild-type controls. SnRNA-Seq analyses revealed a remarkable downregulation of Ets2 in endothelial cells, correlating with the activation of EndoMT. Furthermore, endothelial-specific deletion of Ets2 exacerbated ageing and myocardial infarction-induced cardiac fibrosis and heart dysfunction. Mechanistic studies demonstrated that silencing ETS2 in human umbilical vein endothelial cells promotes EndoMT by transcriptionally suppressing the endothelial marker gene TIE1. This transition is accompanied by endothelial cell senescence and the activation of the senescence-associated secretory phenotype, which contributes to myocardial fibrosis and cardiac ageing, partially mediated by Serpine1. These findings identify Ets2 as a critical regulator of EndoMT in the context of cardiac ageing. Our findings reveal that the Ets2 super-enhancer regulates Ets2 expression in cardiac endothelial cells, modulating heart ageing and EndoMT. Ets2's regulation of endothelial marker genes, especially TIE1, plays a pivotal role in mitigating EndoMT and preventing senescence in cardiac vascular endothelial cells, suggesting potential therapeutic targets for addressing cardiovascular ageing.

Background: Atherosclerosis is the primary cause of cardiovascular disease. Trimethylamine N-oxide (TMAO) is gut microbiota derived metabolite that contributes to atherogenesis. Formononetin is an isoflavonoid compound that exhibits potential anti-atherogenic properties, but there are no reports of its role in mitigating atherosclerosis by modulating gut microbiota to reduce TMAO production. In this study, formononetin demonstrated anti-atherosclerotic effects by modulating the gut microbiota to reduce TMAO production. Methods: Eight-week-old male LDLR -/- mice were fed on a high-fat diet to induce atherosclerosis, Oil Red O staining was used to assess whether formononetin attenuated atherosclerosis. Fecal transplantation was used to determine whether the anti-atherosclerotic effect of formononetin was mediated by modulation of the gut microbiota. Metagenomic sequencing of the mouse gut microbiota and enzyme-linked immunosorbent assay were used to evaluate whether formononetin reduced TMAO production by modulating gut microbiota. Results: Formononetin significantly reduced the plaque area in the entire aorta and aortic root and increased plaque stability. Fecal transplantation confirmed that the anti-atherosclerotic effect of formononetin was associated with modulation of the gut microbiota. Metagenomic sequencing of the mouse gut microbiota showed that formononetin reduced the relative abundance of Firmicutes, increased the relative abundance of Bifidobacteria, and reduced serum TMAO levels. Moreover, formononetin reduced the expression of the cutC gene in the mouse gut microbiota. Conclusion: Formononetin reduced TMAO production by modulating the gut microbiota, thus contributing to its anti-atherosclerotic effects. Modulation of the gut microbiota to reduce TMAO production may represent one of the mechanisms by which formononetin mitigates atherosclerosis. Graphical abstract: http://links.lww.com/AHM/A211

To establish a method for in vivo acquisition of acupuncture manipulation (AM) waveforms and objective quantitative analysis of acupuncture parameters based on the motion trajectory of filiform needle by applying an optical positioning system, so as to evaluate the accuracy of AM waveforms acquisition and feasibility of quantitative analysis performed by the method. Firstly, the Ruitong SE optical positioning system and a customized marking ball that can be connected to an acupuncture needle were employed to construct an in vivo AM acquisition method. The AM waveforms acquired by the optical positioning system and the AM parameter-measuring instrument were respectively compared and analyzed. Then, the waveforms of 6 types of AMs, namely, the lifting-thrusting uniform reinforcing-reducing method, lifting-thrusting reinforcing method, lifting-thrusting reducing method, twirling reinforcing-reducing method, twirling reinforcing method and twirling reducing method, were recorded in real time by stimulating Zusanli (ST36) in healthy volunteers. The AM parameters including the displacement and velocity of lifting and thrusting manipulations and the twisting angle and angular velocity of the twirling method were quantitatively analyzed. The AM waveforms recorded by the optical positioning system were similar to the waveforms recorded by the AM parameter measuring instrument, which had a positive correlation (P<0.01). There was no significant difference between the upward and downward displacements in the lifting-thrusting manipulations, and the clockwise and counterclockwise rotation angles in twirling manipulations. However, a significant difference was found in the movement velocity, that is, 1) the downward movement speed of the lifting-thrusting reinforcing method was greater than that of the lifting speed (P<0.001), while the reduction method was opposite (P<0.001);and 2) the clockwise twisting angle speed of the twirling reinforcing method was higher than that of the counterclockwise twisting angle speed (P<0.001), and the reverse was true for the reduction method (P<0.001). The AM waveforms recorded in vivo by using the optical positioning system are accurate, and can also be used for quantitative analysis of the AM parameters, which is applicable in the objective quantitative study of AMs.