People 's Hospital of Jilin Province

The Body Roundness Index (BRI) is an anthropometric index for predicting the proportion of body fat and visceral adipose tissue, yet its association with survival in maintenance hemodialysis (MHD) patients remains unclear. Therefore, this study aims to investigate the relationship between BRI and the risk of all-cause and cardiovascular disease (CVD) mortality in MHD patients. This is a secondary analysis of a multicenter prospective cohort study included 1034 MHD patients aged over 18 years. Participants were stratified into groups by BRI quartile. Cox models and multivariable-adjusted restricted cubic spline (RCS) were performed to analyze the association of BRI with all-cause and CVD mortality after adjusting for confounding factors. C-statistic, net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were utilized to evaluate the predictive performance of BRI. During a median follow-up of 4.4 years, we observed a total of 548 all-cause deaths and 297 CVD deaths. The analysis revealed significant positive associations between BRI and both all-cause and CVD mortality. After adjusting for confounding factors, each 1-standard deviation (SD) increase in BRI was associated with a 27% higher risk of all-cause mortality (HR=1.27,95% CI:1.22, 1.42) and a corresponding 40% increased risk of CVD mortality (HR=1.40, 95% CI:1.18, 1.67). In the combined analysis with BMI, individuals with normal BMI (<24.0kg/m²) but elevated BRI (≥3.99) exhibited the highest risk of all-cause mortality, a trend that was similarly observed for CVD mortality. Moreover, the model integrating BRI with BMI demonstrated superior predictive performance compared to the baseline model and models with either variable alone, as assessed by the C-statistic, NRI, and IDI. High BRI independently predicted all-cause and CVD mortality in MHD patients. The combined assessment of BRI and BMI facilitates the early identification of high-risk patients and may enable more personalized patient management.

To investigate the safety and efficacy of ERCP combined with single-operator cholangioscopy (SOC) for the management of common bile duct stones and transpapillary gallbladder polyps. In this retrospective case series, we analyzed 10 patients with common bile duct (CBD) stones and gallbladder polyps who were treated with ERCP combined with SOC between May 2022 and September 2024. The technical and clinical success rates, polyp resection rate, methods of cystic duct cannulation, total procedure time, polyp resection time, and the complication rate were recorded and analyzed. Both the technical success rate and the clinical success rate of SOC-guided gallbladder polyp removal were 100%. Among the 10 patients, gallbladder access was achieved using guidewire-assisted SOC in 3 patients and direct SOC entry into the cystic duct in 7 patients. The mean overall procedure time was 53.0 ± 14.2min, and the mean polyp resection time was 20.80 ± 11.02min. The diameter of the polyps ranged from 2 to 8mm. Pathological examination revealed 5 inflammatory polyps, 1 adenomatous polyp, and 4 cholesterol polyps. No intraoperative or postoperative complications occurred. During a follow-up period of 3 to 28months, no recurrence of gallbladder polyps was observed. Transpapillary gallbladder polyp resection using ERCP combined with SOC represents a minimally invasive technique that appears to be technically feasible and safe. This approach has the potential for broader clinical adoption.

Primitive neuroectodermal tumors (PNETs) are rare and aggressive, typically occurring in bones and soft tissues. This report describes a 12-year-old Chinese girl with primary pulmonary PNET invading the left atrium. She presented with right chest pain, shortness of breath, and dry cough for two months. Contrast-enhanced CT and PET-CT revealed a lung mass involving the left atrium. Transthoracic echocardiography showed a heterogeneous mass extending into the left atrium via the right inferior pulmonary vein. Needle biopsy diagnosed primary pulmonary PNET. Combination chemotherapy, monitored by echocardiography, reduced the tumor size, followed by surgical resection. Five years post-diagnosis, there was no recurrence.

Coronary microembolization (CME) is a serious cardiovascular complication that causes severe cardiac dysfunction and arrhythmias. Glutathione (GSH) exhaustion-induced oxidative stress is a key contributor to CME. Here, we explore the molecular mechanisms underlying GSH imbalance during CME. We show that CME induces myocardial injury by disturbing GSH homeostasis, which is ameliorated by glutamate-cysteine ligase modifier subunit (GCLM) or glutaminase (GLS) overexpression. Lysine-specific histone demethylase 1A (KDM1A) removes H3K9me1/2 from the promoter regions of GCLM and GLS to promote their epigenetic expression, thereby maintaining GSH homeostasis in CME. KDM1A is ubiquitinated at the K355 site during CME via inhibiting ubiquitin-specific peptidase 16 (USP16)-mediated deubiquitination. Inducible nitric oxide synthase (iNOS) facilitates S-nitrosylation (SNO) of USP16 at the C731 site, contributing to KDM1A ubiquitination and causing GSH imbalance during CME. Altogether, SNO-USP16 inhibition stabilizes the KDM1A protein to epigenetically activate GCLM and GLS, thus maintaining GSH homeostasis and relieving CME-induced myocardial injury.

BackgroundXeligekimab is a novel immunoglobulin G4 (IgG4) monoclonal antibody targeting interleukin-17A (IL-17A). In a phase III trial in patients with plaque psoriasis, xeligekimab showed efficacy and safety consistent with other IL-17A inhibitors, supporting its potential application in the treatment of spondyloarthritis.ObjectiveThis phase III trial aimed to investigate the efficacy and safety of xeligekimab in patients with radiographic axial spondyloarthritis (r-axSpA).MethodsThis was a phase III study conducted at multiple centers in China. Eligible patients were randomly assigned (1:1:1) to receive xeligekimab 100 mg, xeligekimab 200 mg, or placebo. Randomization was stratified by medication history (biologic-experienced vs. biologic-naïve) and weight (≥ 70 kg vs. < 70 kg). The primary endpoint was the proportion of patients achieving an Assessment of SpondyloArthritis International Society 20 (ASAS20) response at week 16. A key secondary endpoint was the ASAS40 response rate at the same time point.ResultsA total of 465 patients were recruited. A significantly higher proportion of patients receiving xeligekimab 200 mg (n = 114 (74.0%); p < 0.001, 95% confidence interval (CI) 28.5–48.4) and xeligekimab 100 mg (n = 102 (65.8%); p < 0.001, 95% CI 19.4–41.0) achieved an ASAS20 response compared to the placebo group (n = 56 (35.9%)) at week 16. Similarly, a significantly higher ASAS40 response rate was observed in the xeligekimab 100 mg group (n = 62 (40.0%); p < 0.001) and the xeligekimab 200 mg group (n = 64 (41.6%); p < 0.001) compared to placebo. Adverse events were similar across all groups, with serious adverse events occurring in 1.6% of the treatment group during the core treatment period. No unexpected safety signals were reported through week 48.ConclusionXeligekimab demonstrated significant efficacy in improving the signs and symptoms of active r-axSpA in Chinese patients at week 16, with sustained effects observed through week 48 and no new safety signals identified.Trial RegistrationClinicalTrials.gov identifier: NCT05881785 (Date: 21 May 2023).Supplementary InformationThe online version contains supplementary material available at 10.1007/s40259-025-00750-0.

BackgroundAlthough the triglyceride-glucose (TyG) index-diabetes association has been widely studied, its relationship in normolipidemic populations remains poorly understood.MethodsA retrospective cohort of 60,103 normolipidemic Chinese adults was included from routine health screening programs conducted across 32 healthcare institutions in China. Data collection included demographic characteristics, anthropometric measurements, serum biochemical parameters, smoking and alcohol consumption history, and family history of diabetes. We employed multivariable Cox regression, restricted cubic spline analysis, threshold effect analysis, stratified analysis, and interaction tests to comprehensively assess the association between the TyG index and incident diabetes.ResultsMultivariable-adjusted Cox regression revealed a robust positive association between the TyG index and incident diabetes in normolipidemic subjects (HR: 10.10, 95% CI: 7.94–12.84, P < 0.001). Restricted cubic spline analysis detected a nonlinear relationship, with a critical threshold at TyG ≥ 8.53, beyond which diabetes risk increased exponentially (HR: 51.84, 95% CI: 24.83–108.24, P < 0.001). Despite consistent findings across subgroups, a significant interaction with age was detected (P for interaction < 0.05).ConclusionsIn normolipidemic individuals, the TyG index demonstrated a nonlinear positive association with diabetes risk, particularly above 8.53. It can serve as an early warning signal for diabetes risk in normolipidemic individuals, facilitating personalized prevention strategies for diabetes prevention and control.

Abstract The First Total Synthesis of Atricephenol A and Its Derivatives Has Been Developed Using Commercially Available Starting Materials. Key Steps in the Synthesis of Atricephenol A Include MOM Protection, Methylation, Hydrolysis, Esterification, and Acid‐mediated Deprotection. Additionally, Derivatives of Atricephenol A Were Synthesized via One‐step Methylation and Acetylation Reactions Starting From Atricephenol A.