Second Hospital of Tianjin Medical University

Cardiovascular disease currently holds the highest morbidity and mortality rates globally. The survival of patients with coronary artery disease (CAD) complicated by chronic kidney disease (CKD) remains a significant threat, posing challenges in management and timely treatment. This study aims to explore the relationship between the Albumin-Corrected Anion Gap (ACAG) and the prognosis of patients with CKD Receiving Percutaneous Coronary Intervention. This was a single-center, retrospective study including 973 patients who underwent percutaneous coronary intervention (PCI) at Tianjin Medical University Second Hospital from January 2019 to June 2023, all with an estimated glomerular filtration rate (eGFR) of less than or equal to 60 mL/min/1.73 m2. Follow-up was completed in June 2023. The primary efficacy endpoint was the time-to-first occurrence of major adverse cardiovascular events (MACE), defined as the composite of cardiovascular death, recurrent myocardial infarction (MI), or non-fatal stroke. The key secondary endpoint was all-cause mortality, Additional secondary endpoints included (1) the individual components of the primary composite, (2) recurrent MACE (i.e., events after the first occurrence), and (3) any repeat revascularization. After a follow-up of 918.0 ± 364.7 days, 205 MACEs were recorded. Receiver Operating Characteristic (ROC) curve analysis identified the optimal cutoff value for trial subjects. Compared to the low-ACAG group, the high-ACAG group exhibited a higher incidence of MACEs (29.65% vs. 15.78%, P < 0.001) and all-cause mortality (29.92% vs. 11.96%, P < 0.001). The Kaplan-Meier survival curve indicated that the low-ACAG group had a higher survival rate. Restricted cubic spline (RCS) analysis suggested that ACAG was positively correlated with MACE events. Univariate and multivariate Cox regression analysis indicated that a high ACAG level (HR: 1.820;95%CI: 1.300-2.546, P < 0.001) and the use of diuretics during hospitalization (HR: 1.653;95%CI: 1.195-2.286, P = 0.002) were independently associated with the occurrence of MACEs in patients with CAD and CKD. After adding ACAG and eGFR to the traditional risk model, Decision Curve Analysis (DCA) pointed out that DCA could improve the clinical net benefit within a certain range. Among patients undergoing PCI treatment for chronic kidney disease, elevated ACAG levels are closely related to the patient's cardiac mortality and all-cause mortality rates. Additionally, the use of diuretics in patients with CAD and CKD requires caution and should optimize treatment strategies.

The Pan-Immune-Inflammation Value (PIV), a novel inflammatory marker primarily studied in cancer, remains underinvestigated in elderly PCI patients. This study evaluates PIV’s prognostic value for risk stratification and personalized treatment in this population. In this study, we enrolled elderly patients undergoing PCI who were aged 75 years or older between the years 2019 and 2023. Patients were divided into low- and high-PIV groups based on the median value of the cohort. The primary endpoint was the incidence of major adverse cardiovascular events (MACE), comprising cardiac death, recurrent myocardial infarction, and target vessel revascularization. Secondary endpoints included the individual components of MACE. Cox regression and ROC analyses were employed to evaluate the independent prognostic value of PIV. Patients in the high-PIV group presented with a higher burden of comorbidities and worse cardiac function at baseline. During a median follow-up of 362 days, the high-PIV group experienced a significantly higher incidence of MACE (10.8% vs. 5.1%, P < 0.001), cardiac death (7.1% vs. 2.8%, P < 0.001), and all-cause mortality (10.8% vs. 4.5%, P < 0.001). Multivariable Cox regression confirmed PIV as an independent predictor of MACE after adjusting for confounders (Model 3: HR 1.572, 95% CI 1.040,2.377, P = 0.032). ROC analysis showed that PIV had superior predictive ability for MACE (AUC = 0.641) compared to models combining PIV with age ≥ 80 years. PIV serves as a simple, potent, and independent prognostic biomarker for MACE in elderly patients following PCI. Its integration into clinical risk stratification could help identify high-risk patients who may benefit from more intensive management.

Microsatellites stability (MSS) colon cancer patients exhibit a significant suppressive immune status, and the functional status of tumor NLRP3 immunosomes plays an important role in regulating the tumor immune microenvironment, but whether they are involved in the regulation of immunosuppression in MSS patients is unclear. Therefore, further exploration of the relevant molecular mechanisms is urgently needed. The Cancer Genome Atlas-Colorectal Cancer (TCGA-COAD) Masked Somatic Mutation data, clinicopathological data were obtained, analyzed, and visualized using the 'maftools' in R package. Tissue microarray (TMA) used for this study includes 100 unselected, non-consecutive, primary, and sporadic CRCs treated between April 2006 and October 2010 in Tianjin Medical University General Hospital and 60 adjacent noncancerous tissues. Demographic and clinicopathological variables were collected, and the clinical value and prognostic impact of NLRP3 expression were analyzed. Tissue immunofluorescence (IF) was applied to investigate the colocalization expression of NLRP3 and ASC in tumor cells. The Vectra 3.0 Automated Quantitative Pathology Imaging System was used to obtain spectral information the NLRP3-ASC colocalization was analyzed by the Fiji Plugin "Coloc2". Cytotoxic T lymphocytes and M2 macrophages in tumor tissue were evaluated by immunohistochemistry. In patients with MSS-CRC, aberrant activation of NLRP3 immunosome was significantly associated with lymph node metastasis of tumors. It is also closely related to the polarization of M2 macrophages in the tumor microenvironment, and further affects the infiltration of CD8+T lymphocytes, thereby creating a suppressive immune microenvironment.

Patients with moderate-to-severe allergic rhinitis (AR) often experience a heavy clinical burden and require more medications to alleviate nasal symptoms. The aim of this study was to evaluate the efficacy and safety of GSP301, a fixed-dose combination nasal spray containing olopatadine hydrochloride and mometasone furoate, in patients with seasonal AR (SAR). In this multicenter, randomized, double-blind, parallel-group study, moderate-to-severe SAR patients were assigned at a 1:1:1 ratio to receive intranasal GSP301, olopatadine hydrochloride (OLO), or mometasone furoate (MF) for 14 days. The primary endpoint was the change from baseline in the average A.M. and P.M. 12-hour reflective total nasal symptom score (rTNSS). Secondary endpoints included changes in the instantaneous TNSS (iTNSS), individual nasal symptoms, reflective total ocular symptom score (rTOSS), instantaneous total ocular symptom score (iTOSS), individual ocular symptoms, and rhinoconjunctivitis quality-of-life questionnaire (RQLQ). Exploratory endpoints and adverse events were also analyzed. Among the 534 subjects, the GSP301 group demonstrated statistically significant improvements in the average rTNSS compared with the OLO group [posterior least square mean difference (LSMD) = -0.56; P < 0.0001] and the MF group (posterior LSMD = -0.43; P < 0.0001). Consistent benefits were observed across secondary endpoints, including iTNSS, rTOSS, RQLQ, and individual nasal and ocular symptoms (all P < 0.05). Additionally, GSP301 reduced the levels of interleukin (IL)-5 and eosinophilic cationic protein (ECP) in nasal secretions. Treatment-emergent adverse events (TEAEs) occurred in 11.2%, 13.5%, and 11.3% of patients in the GSP301, OLO, and MF groups, respectively. Compared with OLO and MF, GSP301 demonstrated superior efficacy, safety, and potential advantages in alleviating local inflammation in patients with moderate-to-severe SAR.

765 Background: As a special subtype of upper tract urothelial carcinoma (UTUC), lower segment ureteral carcinoma (LSUC) is common. Its unique location makes it resectable via distal ureterectomy (DU) while preserving the kidney. However, the high recurrence rate of UTUC makes this treatment strategy potentially risky. Nevertheless, programmed death receptor-1 immune checkpoint inhibitors is becoming a potential option for UTUC. Moreover, given frequent HER-2 expression in UTUC, combining anti-HER-2 antibody–drug conjugates (ADC) with PD-1 ICIs may achieve better treatment efficacy and outcomes. Therefore, to explore efficacy and safety of the new kidney-sparing strategy that neoadjuvant tislelizumab, a type of PD-1 ICIs, combined with Disitamab Vedotin (RC48), a kind of anti-HER-2 ADC, followed by DU for pts with LSUC, we evaluated it in the single-arm, phase II, single-center TRUCE-UTUC01 trial. Methods: In this study, pts with HER-2 expressing (IHC 2+/3+ at baseline pathological specimen) cT1-4N0-2M0 LSUC were enrolled and received 2-3 cycles of neoadjuvant RC48 2.0mg/kg and Tislelizumab 200mg intravenously on days 1, Q3W, followed by distal ureterectomy (DU). The primary endpoint is pathological complete response (pCR, defined as no residual lesions found in the pathological specimen from DU). Secondary endpoints include objective response (OR, including CR and PR according to RECIST 1.1), overall survival (OS), relapse-free survival (RFS), and progress-free survival (PFS). Treatment-related adverse events (TRAEs) are evaluated according to CTCAE v5.0. This trial is registered with ClinicalTrials.gov number, NCT05837806, and is ongoing. Results: 10 pts were enrolled, comprising 7(70%) males, with a median age of 71(IQR 65-77) years. Baseline Her-2 expression was 2+ in 7 (70%) pts, and 3+ in 3 (30%) pts. 1 pts withdrew from the study for refusing surgery. All pts have received no less than 2 cycles of treatment, then completed imaging evaluation, while 9 pts completed pathological assessment. 4 of 9 (44%) pts achieved pCR, 4 of 10 pts achieved ICR, and 7 of 10 pts achieved IOR. The median follow-up time was 51.6 weeks as of October 2025, with no deaths reported. Only 1 pts suffered recurrence and progression. The median RFS/PFS has not yet been reached. The TRAEs of any grade with the highest incidence were alopecia (50%), pruritus (40%) and fatigue (30%). Only 1 (10%) pts experienced grade 3 TRAEs, including fatigue and alanine aminotransferase increase. Conclusions: The neoadjuvant tislelizumab + RC48 followed by DU demonstrates favourable efficacy in HER-2 expressing LSUC with acceptable TRAEs. Our approach indicates that this kidney-sparing strategy for LSUC is feasible and holds potential. Clinical trial information: NCT05837806 .

BackgroundSuicide remains a leading cause of death among young adults, yet traditional mediation models often oversimplify the complex and interactive processes linking childhood psychological abuse, stress, and suicidal behavior.ObjectiveThis study applied a network analytical framework to examine the inter-factor associations among dimensions of childhood psychological abuse, life-event stress responses, and suicidal behavior in Chinese college students.MethodsA total of 693 first-year college students completed validated self-report measures of childhood psychological abuse, stress responses to negative life experiences, and suicidal behavior. Gaussian graphical models were estimated using EBICglasso, and bridge centrality indices were computed to identify key nodes linking abuse, stress, and suicidality. Network comparison tests were conducted to examine gender differences in network structure and global connectivity.ResultsThe estimated network showed dense within- and cross-domain connections among psychological abuse, stress responses, and suicidal behavior. Neglect, intrusion, and arousal emerged as prominent bridge nodes linking early psychological abuse and suicidal outcomes through stress-related pathways. Network structure was invariant across genders; however, males exhibited significantly higher global network strength than females (p < 0.05), indicating stronger overall connectivity among network components.ConclusionThese findings suggest that suicide risk emerges from dynamic interactions among interrelated psychological systems rather than from linear causal pathways. By identifying bridge nodes—particularly arousal and intrusive stress responses—this study highlights potential leverage points for targeted, trauma-informed, and culturally sensitive suicide prevention efforts among college students.

Radiation enteritis is a common complication in patients undergoing abdominal radiotherapy. Current management strategies face significant limitations: clinical agents like amifostine are hindered by systemic side effects and demanding administration; direct supplementation with radioprotective metabolites such as propionate suffers from low bioavailability and transient action; and conventional probiotics lack targeted therapeutic output. To address these challenges, we engineered Escherichia coli Nissle 1917 to function as a living therapeutic that continuously produces and delivers propionate directly in the gut. This propionate-engineered probiotic achieved a production yield of 181.33 ± 4.27mg/L in vitro. In a mouse model of abdominal irradiation, this engineered bacterium alleviated radiation-induced intestinal damage by continuously releasing propionate and enhancing intestinal epithelial barrier function. Multi-omics analysis revealed that the engineered bacterium could restore intestinal microbiota homeostasis, enhancing the abundance of advantageous bacteria with radioprotective properties (e.g., Dubosiella, Akkermansia). Moreover, it modulated intestinal microbiota metabolism, influencing the metabolism of ascorbic acid, aldoses, and other metabolites. Additionally, it protected the intestinal mucosal barrier from radiation-induced damage, which was associated with the modulation of the SOCS1/JAK2/STAT3 signaling pathway. This study introduces a novel biological therapy to mitigate the side effects of radiotherapy and could open new avenues for preventing and treating radiation-induced intestinal injury.