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The surge in interest regarding the next generation of optical fiber transmission has stimulated the development of digital signal processing (DSP) schemes that are highly cost-effective with both high performance and low complexity. As benchmarks for nonlinear compensation methods, however, traditional DSP designed with block-by-block modules for linear compensations, could exhibit residual linear effects after compensation, limiting the nonlinear compensation performance. Here we propose a high-efficient design thought for DSP based on the learnable perspectivity, called learnable DSP (LDSP). LDSP reuses the traditional DSP modules, regarding the whole DSP as a deep learning framework and optimizing the DSP parameters adaptively based on backpropagation algorithm from a global scale. This method not only establishes new standards in linear DSP performance but also serves as a critical benchmark for nonlinear DSP designs. In comparison to traditional DSP with hyperparameter optimization, a notable enhancement of approximately 1.21 dB in the Q factor for 400 Gb/s signal after 1600 km fiber transmission is experimentally demonstrated by combining LDSP and perturbation-based nonlinear compensation algorithm. Benefiting from the learnable model, LDSP can learn the best configuration adaptively with low complexity, reducing dependence on initial parameters. The proposed approach implements a symbol-rate DSP with a small bit error rate (BER) cost in exchange for a 48% complexity reduction compared to the conventional 2 samples/symbol processing. We believe that LDSP represents a new and highly efficient paradigm for DSP design, which is poised to attract considerable attention across various domains of optical communications.

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Objective@#The association between school bullying and attention deficit hyperactivity disorder (ADHD) symptoms among students in primary schools and the moderating role of gender was explored to provide scientific evidence for the prevention and control of school bullying.@*Methods@#A total of 4 764 students from 2 primary schools in Wuhan were selected using the convenience sampling method in March 2023. The Olweus Bully/Victim Questionnaire and Strengths and Difficulties Questionnaire were used. A Pearson χ 2 test was used to compare differences in school bullying rates among children with and without ADHD symptoms. Pearson correlation analysis and Process 3.3 were used to analyse the association between ADHD symptoms, and school bullying behaviour and the moderating role of gender.@*Results@#The reported rate of bullying victims in primary schools was 24.2% and the rate of bullying perpetration was 3.8%. The rate of ADHD symptom detection among primary school students was 5.9%. ADHD symptoms were positively associated with bullying and bullying victim behaviour ( r =0.16, 0.27, P <0.01). Specifically, the association between ADHD symptoms and bullying behavior tended to be stronger among boys than girls ( β boy =0.17, t =11.13; β girl =0.07, t =4.11, P <0.01).@*Conclusions@#ADHD symptoms are an important factor influencing school bullying behaviors in students, and gender moderates the association. In the process of preventing and controlling school bullying, ADHD symptoms and gender differences should be emphasized and comprehensive interventions should be implemented.

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OBJECTIVE: To verify the safety of three dimensional printing percutaneous guide plate assisted percutaneous kyphoplasty(PKP) in the treatment of osteoporotic vertebral compression fractures(OVCFs). METHODS: The clinical data of 60 patients with OVCFs treated by PKP from November 2020 to August 2021 were retrospectively analyzed. There were 24 males and 36 females, aged from 72 to 86 years old with an average of (76.5±7.9) years. Routine percutaneous kyphoplasty was performed in 30 cases (conventional group) and three dimensional printing percutaneous guide plate assisted PKP was performed in 30 cases (guide plate group). Intraoperative pedicle puncture time (puncture needle to posterior vertebral body edge) and number of fluoroscopy, total operation time, total number of fluoroscopy, amount of bone cement injection, and complication (spinal canal leakage of bone cement) were observed. The visual analogue scale (VAS) and the anterior edge compression rate of the injured vertebra were compared before operation and 3 days after operation between two groups. RESULTS: All 60 patients were successfully operated without complication of spinal canal leakage of bone cement. In the guide plate group, the pedicle puncture time was(10.23±3.15) min and the number of fluoroscopy was(4.77±1.07) times, the total operation time was (33.83±4.21) min, the total number of fluoroscopy was(12.27±2.61) times;and in the conventional group, the pedicle puncture time was (22.83±3.09) min and the number of fluoroscopy was (10.93±1.62) times, the total operation time was(44.33±3.57) min, the total number of fluoroscopy was(19.20±2.67) times. There were statistically significant differences in the pedicle puncture time, intraoperative number of fluoroscopy, the total operation time, and the total number of fluoroscopy between the two groups(P<0.05). There was no significant difference in amount of bone cement injection between the two groups(P>0.05). There were no significant differences in VAS and the anterior edge compression rate of the injured vertebra at 3 days after operation between two groups(P>0.05). CONCLUSION: Three dimensional printing percutaneous guide plate assisted percutaneous kyphoplasty is safe and reliable, which can reduce the number of fluoroscopy, shorten the operation time, and decrease the radiation exposure of patients and medical staff, and conforms to the concept of precise orthopaedic management.

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Objective:To explore the effect of cold-strap endoscopic mucosal resection (CS-EMR) in patients with colorectal polyps.Methods:A prospective randomized clinical trial was conducted to 320 selected patients with colorectal polyps diagnosed by Shenzhen Luohu District People′s Hospital from May 2019 to June 2021. The patients were randomly divided into CS-EMR group and HS-EMR group with 160 cases each, using a random number table generated by Excel 2007. The main parameters for statistical analysis contain the process indicators of the two groups of surgical methods, the complete polypectomy rate of patients after surgery, the degree of postoperative pain and the recovery of gastrointestinal function, and the differences in surgical complications.Results:The polypectomy time of CS-EMR group was shorter than that of HS-EMR group: (4.11 ± 1.20) min vs. (4.42 ± 0.98) min, with a statistically significant difference ( P<0.05). The score of visual analogue pain scale (VAS) in CS-EMR group was lower than that in HS-EMR group at 4 and 12 hours after operation: (3.11 ± 0.78) scores vs. (3.48 ± 0.80) scores, (3.38 ± 0.80) scores vs. (3.61 ± 0.92) scores, with a statistically significant difference ( P<0.05). The first anal exhaust time and first defecation time in CS-EMR group were lower than those in HS-EMR group: (27.83 ± 5.01) h vs. (29.66 ± 4.84) h, (43.73 ± 7.80) h vs. (47.28 ± 8.14) h, with a statistically significant difference ( P<0.05). The complications in CS-EMR group were significantly lower than those in HS-EMR group: 5.63% (9/160) vs. 12.50% (20/160), with a statistically significant difference ( P<0.05). Conclusions:The effect of CS-EMR in the treatment of colorectal polyps is not different from that of HS-EMR, but the former has the advantages of short resection time, rapid recovery of gastrointestinal function after operation, light pain and less complications.

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AIM: To investigate the visual fatigue of patients with accommodative asthenopia and the difference in scores before and after treatment by using the asthenopia survey scale(ASS), and to evaluate its reliability, validity and responsiveness in this population.METHODS: A total of 112 patients with accommodative asthenopia were admitted to the department of ophthalmology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine and recruited online were investigated using the ASS questionnaire, and 48 subjects were randomly selected and retested 1wk later. A variety of reliability, validity and responsiveness indicators were used to evaluate the scale.RESULTS: The overall Cronbach's α coefficients of the scale entries was 0.91; The split-half reliability coefficients was 0.86; Repeated measurement correlation coefficient of the scale total score was 0.74, there was no significant difference before and after(P&#x003E;0.05); The results of confirmatory factor analysis showed that the absolute fit index of the three-factor structural model was χ2/df&#x003C;2.0, RMSEA=0.08; The correlation coefficients of each dimension's total score and the scale's total score were 0.92, 0.90 and 0.83 respectively; The standard association validity analysis showed statistically significant differences between groups(P&#x003C;0.01). Response analysis was statistically significant before and after treatment(P&#x003C;0.01).CONCLUSION: The ASS has high reliability, validity and responsiveness in the clinical evaluation of accommodative asthenopia, and it's an effective tool for clinical research and screening of asthenopia in this population.

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Vascular endothelial growth factor-A (VEGF-A) is a critical angiogenic factor which is mainly secreted from podocytes and epithelial cells in kidney and plays an important role in renal pathophysiology. In recent years, functions of different isoforms of VEGF-A and the new secretion approach via extracellular vesicles (EVs) have been identified. Thus, further understanding are needed for the role of VEGF-A and its isoforms in renal injury and repair. In this review, we summarized the expression, secretion and regulation of VEGF-A, its biological function, and the role of different isoforms of VEGF-A in the development of different renal diseases. Meanwhile, the research progress of VEGF-A as diagnostic marker and therapeutic target for renal diseases were discussed.

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Extracellular vesicles (EVs) are lipid bilayer-enclosed structures containing diverse bioactive cargoes that play a major role in intercellular communication in both physiological and pathological conditions. Currently, the field of EV-based therapy has been rapidly growing, and two main therapeutic uses of EVs can be surmised: (i) exploiting stem cell-derived EVs as therapeutic agents; and (ii) employing EVs as natural therapeutic vectors for drug delivery. This review will discuss the recent advances in EV-based therapy in the treatment of renal disease.

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Objective:Based on UPLC-Q-TOF/MS, to screen a panel of plasma metabolite biomarkers for TB diagnosis and evaluate its diagnostic efficacy.Methods:102 active TB patients [49 males, 53 females, age 40.0(24.0, 48.5) years] from Shanghai Pulmonary Hospital and Shanghai East Hospital from January 2017 to January 2018, 100 TB-IGRA positive patients [55 males, 45 females, age 44.0(37.0, 52.0) years] and 96 healthy controls [55 males, 41 females, age 43.0(32.2, 52.8) years] from Shanghai East Hospital were randomly enrolled. UPLC-Q-TOF/MS technology was used to detect small molecule metabolites in plasma. Combined with multivariate statistical methods VIP and univariate statistic analysis Student's t-test, the main differential metabolites in the plasma of patients with active tuberculosis were filtered. The ROC curve was analyzed for the differential metabolites, and the AUC value, specificity, and sensitivity for diagnosis were used to screen metabolic biomarkers with diagnostic potential. Results:All the samples examined resulted in 10 266 variables, and 1 153 substances were identified by qualitative retrieval through the human metabolome database. After pairwise comparison of samples from the three groups, differential metabolites that simultaneously satisfied VIP > 1 and P<0.05 were plotted into a Venn diagram, and the resulting intersection set contained 38 major differential metabolites. The ROC curve analysis of 38 major metabolites showed that the area under the curve of lactic acid, dopamine, 9-pentadecenoic acid, and 12,13-dihydroxy octadecadienoic acid in the diagnosis of active tuberculosis were 0.92, 0.98, 0.94, and 0.94, respectively, the specificity was both more than 90% and the sensitivity was both more than 80%. The specificity and sensitivity of four metabolites in the combined diagnosis of active tuberculosis were both 94%. Conclusion:Lactic acid, dopamine, 9-pentadecenoic acid, and 12, 13-dihydroxy octadecadienoic acid can be used as potential metabolic biomarkers for tuberculosis diagnosis.

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Objective:To explore the effect of changes in BMI (ΔBMI) on left ventricular function in early breast cancer patients undergoing anthracycline chemotherapy.Methods:The clinical data of 170 breast cancer patients treated in the Lianyungang Oriental Hospital from January 2018 to October 2021 were retrospectively analyzed. The clinicopathological data and cardiac color doppler ultrasound examination results of the patients were collected. Single-factor and multiple-factor were used to analyze the risk factors of cardiotoxicity in patients after chemotherapy. ΔBMI was calculated and the receiver operating characteristic (ROC) curve was drawn; the cut-off value of the ΔBMI was measured to obtain the diagnostic accuracy.Results:Compared with before chemotherapy, the mean values of BMI, left ventricular end-diastolic volume (EDV), left ventricular end-systolic volume (ESV), left ventricular end-diastolic diameter (LVD), and left ventricular end-systolic diameter (LVS) were increased after chemotherapy, while left ventricular ejection fraction (LVEF) value was decreased. Before and after chemotherapy, the differences between BMI [(22.30±1.88) kg/m 2 vs. (23.59±2.32) kg/m 2] and LVEF [(63.69±4.69)% vs. (59.08±4.28)%] were statistically significant ( t = 3.40 and 4.98, all P < 0.05). The range of ΔBMI was 0-41.3%, and the range of the change of LVEF (ΔLVEF) was 0-15.9%. There was a significant correlation between ΔLVEF and ΔBMI ( r = 0.709, P < 0.001). The incidence of cardiotoxicity was 21.2% (36/170). Logistic regression analysis showed that BMI( OR = 1.639, 95% CI 1.263-2.127, P = 0.000) and ΔBMI ( OR = 1.147, 95% CI 1.071-1.228, P = 0.000) were independent risk factors for cardiotoxicity in early breast cancer patients undergoing anthracycline chemotherapy. According to the cardiotoxicity, the area under the ROC curve of ΔBMI and BMI was 0.757 and 0.687, respectively. When the ΔBMI value was 4.28%, the maximum Youden index was 0.399, the sensitivity was 0.750, and the specificity was 0.649. Conclusion:For breast cancer patients treated with anthracycline chemotherapy, ΔBMI can be used as an effective indicator for predicting cardiotoxicity; when ΔBMI exceeds 4.28%, the risk of cardiotoxicity is high.

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Polymyxin B (PMB) is considered as the last line of antibiotic defense available to humans. The environmental effects of the combined pollution with PMB and heavy metals and their interaction mechanisms are unclear. We explored the effects of the combined pollution with PMB and arsenic (As) on the microbial composition of the soil and in the earthworm gut, as well as the spread and transmission of antibiotic resistance genes (ARGs). The results showed that, compared with As alone, the combined addition of PMB and As could significantly increase the bioaccumulation factor and toxicity of As in earthworm tissues by 12.1% and 16.0%, respectively. PMB treatment could significantly increase the abundance of Actinobacteria in the earthworm gut (from 35.6% to 45.2%), and As stress could significantly increase the abundance of Proteobacteria (from 19.8% to 56.9%). PMB and As stress both could significantly increase the abundance of ARGs and mobile genetic elements (MGEs), which were positively correlated, indicating that ARGs might be horizontally transferred. The inactivation of antibiotics was the main resistance mechanism that microbes use to resist PMB and As stress. Network analysis showed that PMB and As might have antagonistic effects through competition with multi-drug resistant ARGs. The combined pollution by PMB and As significantly promoted the relative abundance of microbes carrying multi-drug resistant ARGs and MGEs, thereby increasing the risk of transmission of ARGs. This research advances the understanding of the interaction mechanism between antibiotics and heavy metals and provides new theoretical guidance for the environmental risk assessment and combined pollution management.

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Objective: To evaluate the application of island flap and combined flap in one-stage reconstruction of nasal alae defects after external nasal tumor resection. Methods: Data of 11 patients with perforating or full-thickness defects of the alae after nasal tumor resection in XuanWu Hospital, Capital Medical University between June 2016 and February 2021 were analyzed retrospectively. There were 7 males and 4 females, and the ages ranged from 51 to 89 years. Island flap, island flap combined with nasolabial flap or V-Y advancement flap, and island flap combined with bilobed flap were applied according to the range of defects. Descriptive statistical method was applied to analyze the treatment effects. Results: All flaps of the 11 patients were successful survival and the incisions were primary healing. Being followed up for 5 to 59 months, the patients had satisfying appearance and ventilation function, and no tumor relapsed. Conclusion: For the patients with nasal alae defects after external nose tumor resection, selecting suitable island skin flap or combined skin flap can be used to reconstruct the ideal nasal appearance and function of the nose.

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Angelicae Sinensis Radix， derived from a medicinal and edible plant Angelica sinensis， is one of the traditional bulk Chinese medicines. In addition to gynecological blood stagnation and deficiency， its indications also include dysmenorrhea， deficiency and cold-induced abdominal pain， and rheumatoid arthritis. With the in-depth study of Angelicae Sinensis Radix， its anti-inflammatory and analgesic activities have attracted widespread attention. However， there has been no systemic report. The present study comprehensively reviewed the anti-inflammatory and analgesic activities of Angelicae Sinensis Radix （including its compositions， extracts， and different processed products） and mechanisms published in recent 30 years. The anti-inflammatory effect of Angelicae Sinensis Radix was achieved mainly by blocking the expression of proteins and genes in nuclear factor-κB （NF-κB）， mitogen-activated protein kinases （MAPK）， and Janus kinase （JAK）/signal transducer and activator of transcription （STAT） signaling pathways， inhibiting the release of inflammatory mediators including tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， nitric oxide （NO）， prostaglandin E2 （PGE2） and IL-1β， and maintaining the high sensitivity of immune cells in the host to external stimuli. The mechanism of analgesic effect may be related to the suppression of the production of algesic substances （such as inflammatory factors and chemokines） or blocking of the amplification and transmission of pain perception in cascade reaction. Furthermore， the study also pointed out some problems in modern research and proposed suggestions on its future research to provide references for investigation and clinical applications of Angelicae Sinensis Radix.

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OBJECTIVE@#The present study was to evaluate the anti-tumor effects of acidic RNA protein complex (FA-2-b-β) extracted from the wild edible Qinba mushroom in inducing of apoptosis and immunoregulation of tumor cell.@*METHODS@#Cell proliferation inducing rate of FA-2-b-β to K562 cell was measured using CCK-8. Apoptosis rate was detected by using flow cytometry. Chronic myeloid leukemia model was developed by tail vein injection/subcutaneous inoculation of K562 cells in NCG mice. The tumor burden of mice was observed. The general condition of the mice was monitored twice daily. The peripherivcal full blood counts of mice was tested daily. RT-qPCR and Western blot was FA-2-b-β performed to determine involvement of apoptotic-related gene and protenin, Immunofluorescence and immunohistochemistry was used to detected the expression of CD3, CD4 and CD8.@*RESULTS@#The proliferation and apoptosis of K562 cell could be inhibitied and induced by FA-2-b-β, there was 100% successful in the tumor formation in vivo, after treated by drug for 21 days there were significantly increased peripheral leucocytes, but decreased hemoglobin of mice treated by FA-2-b-β as compared with those in control group. The CD3, CD4 and CD8 showed positive in mice, and the propotation was imbalance, but it showed reserved after treated by FA-2-b-β.@*CONCLUSION@#FA-2-b-β is strong anti-leukemia effect in vitro and in vivo, suggesting the traditional Chinese medicine maybe contribute to the anti-cancer and immunoregulation research.

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This study aimed to prepare evodiamine-glycyrrhizic acid(EVO-GL) micelles to enhance the anti-hepatic fibrosis activity of evodiamine. Firstly, EVO-GL micelles were prepared with use of thin film dispersion method. With particle size, encapsulation efficiency, loading capacity of micelles and the solubility of evodiamine as the indexes, the effect of different factors on micelles was observed to screen the optimal preparation methods and process. Then the pharmaceutical properties and the therapeutic effects of EVO-GL micelles prepared by optimal process were evaluated on CCl_4-induced hepatic fibrosis. The results showed that the micelles prepared by the thin film dispersion method had an even size, with an average particle size of(130.80±12.40)nm, Zeta potential of(-41.61±3.12) mV, encapsulation efficiency of 91.23%±1.22%, drug loading of 8.42%±0.71%, high storage stability at 4 ℃ in 3 months, and slow in vitro release. Experimental results in the treatment of CCl_4-induced hepatic fibrosis in rats showed that EVO-GL micelles had a synergistic anti-hepatic fibrosis effect, which significantly reduced the liver function index of hepatic fibrosis rats. In conclusion, the EVO-GL micelles prepared with glycyrrhizic acid as a carrier would have a potential application prospect for the treatment of hepatic fibrosis.

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Tobacco stalk, a common agricultural waste derived from the harvest of tobacco, caused serious environmental pollution in China. In this study, the performance of biomethane production and characteristics of four varieties of tobacco stalk were investigated for the first time. The results showed that the highest cumulative methane yield of 130.2 mL/g-VS was obtained from Nicotiana tabacum L., Yunyan114, which had lower lignin content than other varieties of tobacco stalk. Moreover, different kinetic models were used to describe the biomethane production process, and it was found that the modified Gompertz model was more suitable to simulate the anaerobic digestion (AD) of tobacco stalk. The findings of this study not only showed a feasible method for minimizing the pollution issues of tobacco stalk waste but also gave fundamental information for future AD application.

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BACKGROUND: Breast MRI is a sensitive imaging technique to assess breast cancer but its effectiveness still remains to be improved. PURPOSE: To evaluate the diagnostic performance of diffusion-weighted imaging (DWI), diffusion kurtosis imaging (DKI), and quantitative dynamic contrast-enhanced (DCE)-MRI in differentiating malignant from benign breast lesions independently or jointly and to explore whether correlations exist among these parameters. STUDY TYPE: Retrospective. POPULATION: In all, 106 patients with breast lesions (47 malignant, 59 benign). SEQUENCE: DKI sequence with seven b values and quantitative DCE sequence on 3.0T MRI. ASSESSMENT: Diffusion parameters (mean diffusivity [MD], mean diffusivity [MK], and apparent diffusion coefficient [ADC]) from DKI and DWI and perfusion parameters from DCE (Ktrans , kep , ve , and vp ) were calculated by two experienced radiologists after postprocessing. Disagreement between the two observers was resolved by consensus. STATISTICAL TESTS: The parameters in benign and malignant lesions were compared by Student's t-test. The diagnostic performances of DKI and quantitative DCE, either alone or in combination, were evaluated by receiver operating characteristic (ROC) analysis. The Spearman correlation test was used to evaluate correlations among the diffusion parameters and perfusion parameters. RESULTS: MK, MD, ADC, Ktrans , and kep values were significantly different between breast cancer and benign lesions (P < 0.05). MK from DKI demonstrated the highest AUC of 0.849, which is significantly higher than ADC derived from conventional DWI (z = 3.345, P = 0.0008). The specificity of DCE-MRI-derived parameters was improved when combining diffusion parameters, such as ADC and MK. The highest diagnostic specificity (93.2%) was obtained when kep and ADC were combined. kep was correlated moderately positively with MK (r = 0.516) and moderately negatively with MD (r = -0.527). Ktrans was weakly positively correlated with MK with an r of 0.398 and weakly negatively correlated with MD with an r of -0.450. DATA CONCLUSION: DKI is more valuable than conventional DWI in distinguishing between benign and malignant breast lesions. DKI exhibits promise as a quantitative technique to augment quantitative DCE-MRI. Diffusion parameters derived from DKI were statistically correlated with perfusion parameters from quantitative DCE-MRI. LEVEL OF EVIDENCE: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1358-1366.

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fMRI with high spatial resolution is beneficial for studies in psychology and neuroscience, but is limited by various factors such as prolonged imaging time, low signal to noise ratio and scarcity of advanced facilities. Compressed Sensing (CS) based methods for accelerating fMRI data acquisition are promising. Other advanced algorithms like k-t FOCUSS or PICCS have been developed to improve performance. This study aims to investigate a new method, Dual-TRACER, based on Temporal Resolution Acceleration with Constrained Evolution Reconstruction (TRACER), for accelerating fMRI acquisitions using golden angle variable density spiral. Both numerical simulations and in vivo experiments at 3T were conducted to evaluate and characterize this method. Results show that Dual-TRACER can provide functional images with a high spatial resolution (1×1mm2) under an acceleration factor of 20 while maintaining hemodynamic signals well. Compared with other investigated methods, dual-TRACER provides a better signal recovery, higher fMRI sensitivity and more reliable activation detection.

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Sesquiterpenoid is a kind of compound widely distributed in nature, which has a wide range of biological activities, such as anti-inflammatory, anti-tumor and immunomodulatory activities. This paper would review the anti-inflammatory mechanism of sesquiterpenoid. The mechanism is mainly by inhibiting the activation of nuclear factor (NF-κB), mitogen-activated protein kinase (MAPKs) and signal transducers and activators of transcription (STAT) signaling pathways and down-regulating the inflammatory gene expression including tumor necrosis factor- (TNF-), prostaglandin E₂ (PGE₂), nitric oxide (NO), interleukin-1(IL-1), IL-6, IL-8 and other inflammatory factors. Thereby, the production and release of inflammatory cytokines are reduced to exert anti-inflammatory effect. This review is intended to provide reference for related research.

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A case-control study was conducted to investigate associations between organophosphate pesticide (OP) exposure, aggression, impulsivity, and attempted suicide. The purpose of this study was to explore whether genomic polymorphisms in the alpha 1(XI) collagen gene (COL11A1) were associated with the risk and severity of Kashin-Beck disease (KBD). Twenty-two single nucleotide polymorphisms (SNPs) in COL11A1 were genotyped in 274 KBD cases and 249 healthy controls using the Sequenom MassARRAY system. The expression of type XI collagen (COL11A) in the knee articular cartilage of 22 KBD patients and 21 controls was analyzed by immunohistochemistry. Our results showed that the frequency distribution of genotypes of the rs2229783 polymorphism in COL11A1 was significantly different between the KBD and control groups (P = 0.0003). Moreover, the expression level of COL11A in cartilage was significantly lower in the KBD group than in the controls (t = 2.637, P = 0.02). However, no association was found between the rs2229783 and the severity of KBD, suggesting a role of COL11A1 in the susceptibility to but not the severity of KBD.

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Chronic kidney disease (CKD) is becoming an alarming health burden worldwide, however, there is still lack of early biomarkers and effective treatment options. Thus, in the upcoming era of precision medicine, searching for the sensitive, non-invasive biomarkers has been the cornerstone and major challenge in the management of CKD. Urine contains rich biological information which could be an ideal source for non-invasive biomarkers of CKD. This review will discuss the recent advances in biomarker study from urine sediment, urine supernatant and urinary extracellular vesicles with special interest in gene transcript (miRNA, mRNA) biomarkers. Besides, the challenges and future directions for urinary gene transcript biomarker study will be discussed.

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