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Zhifeng Chen,1– 4,* Yulin Shang,5,* Binaya Wasti,6 Yanru Ou,1– 4 Subo Gong,7 Xudong Xiang,8 Ruoyun Ouyang1– 4 1Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People’s Republic of China; 2Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, 410011, People’s Republic of China; 3Clinical Medical Research Center for Pulmonary and Critical Care Medicine in Hunan Province, Changsha, Hunan, 410011, People’s Republic of China; 4Diagnosis and Treatment Center of Respiratory Disease in Hunan Province, Changsha, Hunan, 410011, People’s Republic of China; 5Ophthalmology and Otorhinolaryngology, Zigui Country Hospital of Traditional Chinese Medicine, Yichang, Hubei, 443600, People’s Republic of China; 6B & C Medical College, Teaching Hospital and Research Center, Birtamode, 57204, Nepal; 7Department of Geriatrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People’s Republic of China; 8Department of Emergency, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ruoyun Ouyang, Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, 139 Middle Renmin Road, Changsha, Hunan, 410011, People’s Republic of China, Email ouyangruoyun@csu.edu.cnObjective: In the real clinical world, both surgery and medication are used to treat pulmonary aspergillosis (PA), but the prognosis of different treatments is unclear. The purpose of this study was to investigate the diagnosis and treatment, follow-up results and prognostic factors of PA patients in the real world, so as to deepen our understanding of PA and improve the prognosis of PA patients.Materials and Methods: Eligible patients with pathologically diagnosed PA (n = 125) were retrospectively enrolled and followed up. Further comparisons and subgroup analyses were performed between patients receiving surgical and nonsurgical treatments. Univariate and multivariate logistic regression analyses were used to investigate the factors associated with treatment failure.Results: A total of 125 patients with PA were included in the study. Of these, 49 (39.2%) received surgical treatment (25 of whom also received postoperative antifungal therapy), while 76 (60.8%) received antifungal therapy alone. The median age was 59 years (46.5– 67 years). Compared with the nonsurgical group, the surgical group had lower inflammatory cell counts and less inflammatory response, and higher hemoglobin and albumin levels. Multivariate logistic regression analysis showed that white blood cell (WBC) levels > 9.5× 109/L and C-reactive protein (CRP) levels > 8 mg/L were independent predictors linked to treatment failure.Conclusion: PA patients with severe inflammation and poor general health are usually treated with antifungal drugs only. Risk factors including elevated WBC levels and high CRP levels can help identify PA patients who may have a less favorable response to treatment at an early stage. It should be noted that increasing the dose and duration of antifungal therapy may improve patient prognosis.Keywords: pulmonary aspergillosis, antifungal treatment, surgery, treatment failure, prognosis

Zhifeng Chen,1– 4 Yulin Shang,5 Yanru Ou,1– 4 Li Zhou,1– 4 Ting Liu,1– 4 Subo Gong,6 Xudong Xiang,7 Yating Peng,1– 4 Ruoyun Ouyang1– 4 1Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People’s Republic of China; 2Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, 410011, People’s Republic of China; 3Clinical Medical Research Center for Pulmonary and Critical Care Medicine in Hunan Province, Changsha, Hunan, 410011, People’s Republic of China; 4Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan, 410011, People’s Republic of China; 5Ophthalmology and Otorhinolaryngology, Zigui Country Hospital of Traditional Chinese Medicine, Yichang, Hubei, 443600, People’s Republic of China; 6Department of Geriatrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People’s Republic of China; 7Department of Emergency, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People’s Republic of ChinaCorrespondence: Yating Peng; Ruoyun Ouyang, Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University 139 Middle Renmin Road, Changsha, Hunan, 410011, People’s Republic of China, Email pengyating2011@csu.edu.cn; ouyangruoyun@csu.edu.cnBackground: OSA can cause cognitive impairment (CI). The aim of this study was to investigate whether miR-20a-5p in exosomes derived from bEnd3 cells with IH mediates intercellular crosstalk and induces CI through hippocampal neuronal cell pyroptosis.Materials and Methods: BEnd3-derived exosomes were isolated from the normal oxygen control group (NC-EXOS) and IH group (IH-EXOS). In vitro, exosomes were cocultured with HT22 cells. Meanwhile, in vivo, exosomes were injected into mice via the caudal vein. The spatial memory ability of mice was tested by MWM method to evaluate the effect of exosomes on the cognitive function of mice. Adults diagnosed with OSA underwent the MoCA and ESS tests to assess cognitive function and daytime sleepiness. Spearman’s rank correlation analysis was used to evaluate the correlation between miR-20a-5p and candidate proteins and clinical parameters. Transfection using small interfering RNAs, miRNA mimics, and plasmids to evaluate the role of miR-20a-5p and its target genes. Dual luciferase reporter gene assay was used to confirm the binding of miR-20a-5p to its target gene.Results: IH could cause pyroptosis and inflammation in bEnd3 cells, and promote the expression of miR-20a-5p. Isolated IH-EXOS induced increased pyroptosis and activation of inflammatory response in vitro and in vivo, accompanied by increased expression of miR-20a-5p. In addition, IH-EXOS led to decreased learning and memory ability in mice. Interestingly, AHI was higher and MoCA scores were lower in severe OSA compared to healthy comparisons. In addition, miR-20a-5p and GSDMD were positively correlated with AHI but negatively correlated with MoCA in severe OSA. IH-induced exosomes were rich in miR-20a-5p, and these exosomes were found to deliver miR-20a-5p to HT22 cells, playing a key role in the induction of OSA-CI by directly targeting MFN2.Conclusion: Exosome miR-20a-5p from IH-stimulated bEnd3 cells can promote OSA-CI by increasing HT22 cells pyroptosis through its target MFN2.Keywords: exosome, OSA, cognitive impairment, miR-20a-5p, MFN2, GSDMD

Yating Peng,1– 3 Wei Cheng,1– 3 Jiaxi Duan,1– 3 Yiyang Zhao,1– 3 Zijing Zhou,1– 3 Aiyuan Zhou,1– 3 Minhua Deng,1– 4 Hong Peng,1– 3 Ruoyun Ouyang,1– 3 Yan Chen,1– 3 Ping Chen1– 3 1Department of Pulmonary and Critical Care Medicine, Second Xiang Ya Hospital, Central South University, Changsha, Hunan, 410011, People’s Republic of China; 2Institute of Respiratory Disease, Central South University, Changsha, Hunan, 410011, People’s Republic of China; 3Hunan Centre for Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, 410011, People’s Republic of China; 4Department of Respiratory, PLA Rocket Force Characteristic Medical Center, Beijing, 100088, People’s Republic of ChinaCorrespondence: Ping Chen, Email pingchen0731@csu.edu.cnBackground: Prohibitin has been identified to play roles in cell survival and apoptosis. Here, this study aimed to clarify the role of prohibitin in cigarette smoke extract (CSE)-induced endothelial cell apoptosis.Methods: The protein level of prohibitin was assessed by Western blot in lung tissues from emphysema and control mice. CSE-induced human pulmonary microvascular endothelial cells (hPMECs) were applied to mimic smoke-related cell apoptosis in vitro. Prohibitin was overexpressed in hPMECs with or without CSE. Mitochondrial function was analyzed by JC-1 staining and ATP assay kits. Oxidative stress was assessed by flow cytometry, fluorescence staining and immunocytochemistry. Apoptosis was analyzed by flow cytometry, Western blot and caspase-3 activity assays. In addition, the expression of inflammatory markers was assessed by Western blot and real-time polymerase chain reaction (PCR). The secretion of inflammatory cytokines was measured by ELISA.Results: Prohibitin was downregulated in emphysema mouse tissues compared with control experiments. Consistently, CSE inhibited both the protein and RNA levels of prohibitin in hPMECs in a dose-dependent manner. Gain-of-function experiments indicated that CSE induced collapse of mitochondrial membrane potential (MMP) and loss of ATP, while prohibitin improved mitochondrial function. CSE induced robust ROS production and oxidative DNA damage, while prohibitin decreased this damage. Upregulation of prohibitin protected the apoptosis of hPMECs from CSE. Overexpression of prohibitin significantly reduced the levels of the main proinflammatory cytokines. Finally, prohibitin inhibited nuclear factor-kappa B (NF-κB) p65 accumulation and IκBα degradation induced by CSE.Conclusion: The current findings suggest that CSE-mediated mitochondrial dysfunction, oxidative stress, cell apoptosis and inflammation in hPMECs were reduced by overexpression of prohibitin. We identified prohibitin as a novel regulator of endothelial cell apoptosis and survival in the context of CSE exposure.Keywords: prohibitin, hPMECs, CSE, apoptosis, mitochondrial, inflammation

Yating Peng,1– 3 Jiaxi Duan,1– 3 Xin Li,4 Yuqin Zeng,1– 3 Zijing Zhou,1– 3 Minghua Deng,1– 3,5 Ruoyun Ouyang,1– 3 Yan Chen,1– 3 Shan Cai,1– 3 Ping Chen1– 3 1Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 2Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, People’s Republic of China; 3Hunan Centre for Evidence-Based Medicine, Changsha, Hunan, People’s Republic of China; 4Division of Occupational Lung Disease, Hunan Prevention and Treatment Institute for Occupational Diseases, Changsha, Hunan, People’s Republic of China; 5Department of Respiratory, PLA Rocket Force Characteristic Medical Center, Beijing, People’s Republic of ChinaCorrespondence: Ping Chen Email pingchen0731@csu.edu.cnBackground: Pneumoconiosis has high prevalence of chronic obstructive pulmonary disease (COPD), respiratory morbidity, and mortality.Objective: The aim of the present study was to examine patient characteristics and adherence to inhaled therapy among pneumoconiosis with COPD in a real-world clinical setting.Methods: A cohort of pneumoconiosis patients with COPD prescript with at least one type of long-acting inhaled drug was followed for adherence for 2 years. Demographic and COPD-related characteristics were collected in baseline.Results: In baseline, after adjusting for age, dust exposure duration positively correlated with number of acute exacerbation (AE) frequency in the last year. There were close associations among COPD Assessment Tool (CAT) score, modified Medical Research Council Dyspnea Scale (mMRC) grade, number of AE, and pre-FEV1 value. Of 296 participants originally recruited, 213 participants finished the 2-year follow-up for adherence. 122 (57.28%) were non-adherent to inhaled therapy. The most common reason for non-adherence was “relief of symptoms after short-term controller medication use” (53.28%). Patients who were non-adherent reported higher body mass index (BMI), less AE events in the last year, higher pre-FEV1 value, higher post-FEV1 value and low CAT, mMRC scores compared to adherent in baseline. High pre-FEV1 value (OR = 1.04, CI = 1.018– 1.064) and low mMRC scores (OR = 0.406, CI = 0.214– 0.771) were risk factors found associated with non-adherence.Conclusion: A majority of pneumoconiosis patients complicated with COPD have suboptimal inhaled therapy adherence. Evidence-based, adherence-enhancing interventions should be targeted on less severe subjects.Keywords: adherence, inhaled therapy, pneumoconiosis, COPD

We detected the expressions of hsa_circRNA_000121 and hsa_circRNA_ 004183 in papillary thyroid microcarcinoma (PTMC) and explored their relationship with the invasiveness of PTMC. PTMC patients with (n = 30; metastasis group) and without lymph node metastasis (n = 30; nonmetastasis group) were included. The levels of hsa_circRNA_000121, hsa_circRNA_004183, hsa-miR-4763, hsa-miR-6775, sarcoma gene (SRC), and MMP-14 were detected with real-time polymerase chain reaction. Receiver-operating characteristic (ROC) analyzed the diagnostic value of hsa_circRNA_000121 and hsa_circRNA_004183. Binary logistic regression analysis evaluated the relationship of gene expression with PTMC invasiveness. In PTMC tissue samples, compared with the metastasis group, the expression of hsa_circRNA_000121, hsa_circRNA_004183, SRC, and MMP-14 in the nonmetastasis group decreased, while the expression of hsa-miR-4763 and hsa-miR-6775 increased. In peripheral blood, compared with the metastasis group, the expression of hsa_circ_000121 and hsa_circRNA_004183 in the nonmetastasis group decreased. Both hsa_circRNA_000121 and hsa_circRNA_004183 had good sensitivity and specificity for diagnosing PTMC lymph node metastasis, with a cut-off value of 0.796 and 0.938, respectively. However, the gene expressions were not significantly associated with PTMC lymph node metastasis. Hsa_circRNA_000121 may upregulate SRC expression through hsa-miR-4763, while hsa_circRNA 000121 may upregulate MMP-14 expression through hsa-miR-6775, thereby promoting the aggressiveness of PTMC and ultimately leading to cervical lymph node metastasis. hsa_circRNA_000121 and hsa_circRNA_004183 may become potential biomarkers of PTMC aggressiveness.

The study of urban building combinations is necessary to achieve sustainable urban development, as through such a study we can better grasp the process of urban development and evolution, guide the direction of future urban development, optimize the urban ecological environment, and improve urban livability. With the acceleration of China's urbanization process, the development and evolution of building combinations in China's urban areas are also gaining momentum. Therefore, it is of tremendous practical use to explore the laws related to mixed developments in urban areas to guide rational urban planning and the study of urban microclimates. The analysis is an important foundation for the development of urban landscapes and provides important scientific support for the optimization of the urban ecological environment and the improvement of livability levels. From the data on individual buildings in Guangzhou in 2017, this paper determined basic building combinations in the main urban area using two indexes for building height and building spacing, identified building combinations on a wider scale using a hot-spot analysis, and analyzed the spatial distribution of building combinations and the influence of macro and micro factors. Nine building combinations were identified on the basis of average height and spacing of building convergence surface. As the basic units, the nine basic types were further divided into different combinations to form complex and diverse three-dimensional representations of buildings in the main urban area. Building convergence surface with a scale of hundreds of meters constitute the basic unit of building combination in the main urban area, and are dominated by mixed land use types. The basic types, mainly composed of high-rise buildings, played an obvious role in indicating land use with differences in combinations of each functional area. The basic types of main urban areas have prominent circle differentiation, but the laws for the different types differ. Land price was the core constraining factor for the decrease in urban building height and population density from the urban center to the periphery, as well as the background factor related to differences in urban building combinations. The influence of green spaces, the Pearl River, and the main road on the type, height, and density of the building combination at a micro level complicated building combinations.

As e-commerce has revolutionized the habits and methods of mass consumption, the reliance of the real economy on the Internet for advertising and marketing has become more and more pronounced, and this phenomenon has been exacerbated by the COVID-19 pandemic. Many municipal governments in China have introduced policies to encourage the development of nighttime economy as an important means to revive urban vitality, stimulate mass consumption and promote economic development. This essay takes four established nighttime economy gathering places in Guangzhou as examples, and studies the symbolic consumption process in them from the theoretical perspectives of cultural economy, leisure economy, symbolic economy and cultural capital, thus pointing out the problems of cultural change and cultural vulgarization in the nighttime economy neighborhoods and giving constructive solutions and suggestions for improvement.

Epigenetic modification may affect the expression of multiple inflammatory genes in lungs of patients with chronic obstructive pulmonary disease (COPD). Major epigenetic events include DNA methylation and various post-translational modifications of histones, such as histone methylation, acetylation, phosphorylation, ubiquitination, and sumoylation. Enzymes which regulate these epigenetic modifications can be activated by smoking. Both environmental and genetic factors play significant effect in development of COPD which have been reported by most references; however, little is known about the epigenetic pathways involved in the disease. Understanding the epigenetic mechanisms can help us clarify the pathogenesis of COPD and identify novel targets for developing new therapies for patients with COPD. [ABSTRACT FROM AUTHOR]

Objective To construct a three-dimensional finite element model of human maxillofacial structures to dynamically simulate blast injuries in different maxillofacial regions and analyze the biomechanical characteristics of skull base injuries caused by maxillofacial blast injuries. Methods The head CT data were acquired from a normal male adult and a three-dimensional finite element model of the maxillofacial bones was constructed using finite element modeling software. Using the same parameters of blast yield and distance, we dynamically simulated blast injuries in different maxillofacial regions on this model and analyzed the biomechanical data at 15 selected landmarks in the skull base. Results We successfully simulated the dynamic process of maxillofacial fractures and stress distribution and conduction in the skull base using the constructed model. In the events of an explosion at precisely 5 cm from the front of the nasal bone tip and one at 5 cm from the front of the edge of the right orbit, the stress values of Von Mises at the medial foramen ovale, hypophyseal fossa, clivus and posterior wall of the foramen magnum were greater than those at the other landmarks; when the explosion occurred at 5 cm from the front of the right zygomatic arch, the right greater wing of the sphenoid bone, right medial foramen ovale, hypophyseal fossa, clivus and posterior wall of the foramen magnum sustained greater stress values of Von Mises. Conclusion Finite element modeling is capable of simulating the process of maxillofacial blast injuries. Blast wave impact in different maxillofacial regions results in stress concentration in different areas in relation not only to the structure of skull base but also to the stress conduction pathway.

This study simulated and predicted the runoff of the Aksu River Basin, a typical river basin supplied by snowmelt in an arid mountain region, with a limited data set and few hydrological and meteorological stations. Two hydrological models, the snowmelt-runoff model (SRM) and the Danish NedbØr-AfstrØmnings rainfall-runoff model (NAM), were used to simulate daily discharge processes in the Aksu River Basin. This study used the snow-covered area from MODIS remote sensing data as the SRM input. With the help of ArcGIS software, this study successfully derived the digital drainage network and elevation zones of the basin from digital elevation data. The simulation results showed that the SRM based on MODIS data was more accurate than NAM. This demonstrates that the application of remote sensing data to hydrological snowmelt models is a feasible and effective approach to runoff simulation and prediction in arid unguaged basins where snowmelt is a major runoff factor.

Purpose: To explore the self-perceived illness cognition and perception status, as well as the relevant factors among lymphangioleiomyomatosis (LAM) patients., Methods: A web-based questionnaire survey was conducted in September 2023. A total of 121 LAM patients participated (including 16 patients with TSC-LAM), and the survey collected general demographic information, responses to a disease cognition questionnaire, and a simplified disease perception questionnaire., Results: LAM patients have a higher level of negative illness cognition and a lower level of positive illness cognition, specifically characterized by helplessness (15.74 ± 4.68 points), acceptance (16.00 ± 3.28 points), and perceived benefits (16.92 ± 3.86 points). Single-factor analysis of variance found significant correlations between cultural level, age, family average monthly income, use of rapamycin, use of home oxygen therapy, hospitalization frequency, disease duration, severity of respiratory distress, activity limitation, and the helplessness score of LAM patients (p ≤ 0.05); the number of children was significantly associated with acceptance scores of LAM patients (p ≤ 0.05); and whether surgery had been performed was significantly associated with acceptance and perceived benefits scores of LAM patients (p ≤ 0.05). Disease duration and activity limitation entered the regression equation for helplessness dimension, while whether surgery had been performed entered the regression equation for perceived benefits dimension, but no factor entered the regression equation for acceptance dimension. Applying the same analysis to disease perception, we found that the average score of the Illness Perception Questionnaire was 45.43 ± 8.97, with lower scores in the reverse-scored items of individual control, treatment, and understanding., Conclusions: LAM patients exhibit higher levels of helplessness, particularly among those with longer disease duration and greater activity limitations, leading to a more negative perception of the disease. Additionally, patients who have undergone surgical procedures tend to perceive fewer benefits. Furthermore, there is a significant correlation between illness perception and factors such as rapamycin usage, home oxygen therapy, disease duration and activity limitations caused by LAM. This indicates that clinical healthcare providers should pay more attention to LAM patients and their associated groups, providing both informational and psychological support., Competing Interests: Declarations. Ethics approval and consent to participate: The study received approval from the Ethics Committee of the Second Xiangya Hospital of Central South University (LYEC2024-0141). Consent for publication: Consent for publications were obtained from all participants. Competing interests: The authors declare no conflict of interest., (© 2025. The Author(s).)

Unique rhenium disulfide/reduced graphene oxide (ReS 2 /rGO) nanoframeworks were synthesized with a hierarchical layered and porous structure for the ultrasensitive electrochemical detection of microRNA-21 (miRNA-21) by empowering multi-signal amplification strategy of catalytic hairpin self-assembly-hybridization chain reaction (CHA-HCR). The layered and porous nanostructures endowed ReS 2 /rGO with a larger specific surface area and more active sites through connecting vertical ReS 2 with rGO which was preferable for promoting the electron transfer over electrode surface because of a conductive network. This nanoframework facilitated the loading of adequate gold nanoparticles to fix the capture probe via Au-S bond. In the presence of the target miRNA-21, the CHA-HCR double amplification reaction could be triggered to generate a long double strand with methylene blue (MB) embedded inside. The electrochemical sensing platform was thus empowered by the unique ReS 2 /rGO nanoframeworks to detect miRNA-21 in the range 1 fM ~ 100 pM with the remarkably enhanced sensitivity through detecting the significantly amplified signal from the REDOX reaction of MB inside the long chain. The verification of the miRNA-21 detection in real blood samples further proved the great potential of this new method with the limit of detection reduced down to 0.057 fM and opens a new window for ReS 2 in developing sensitive biosensors for early clinical cancer diagnosis., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

Background: In a previous study, we proposed a modified technique for gasless transaxillary endoscopic total thyroidectomy (ETT) for patients with bilateral papillary thyroid carcinoma (PTC) using a single incision. Whether this method shows non-inferiority to the conventional open approach (COT) remains unclear. This study aims to investigate the safety and feasibility of ETT compared to COT in patients with PTC., Methods: We retrospectively analyzed the medical records of cT1-2 PTC patients who underwent total thyroidectomy between April 2020 and December 2022. All patients were diagnosed with bilateral PTC and categorized into ETT and COT groups based on the type of surgery. Propensity score matching (PSM) using nine clinicopathological characteristics was employed to compare the technical safety and short-term oncologic outcomes of ETT and COT, generating 45 pairs of matched patients to reduce potential selection bias. This study was followed by STROBE guideline., Result: After PSM, 90 patients who underwent ETT (n = 45) or COT (n = 45) were included. Age, sex, tumor size, BMI, Hashimoto's thyroiditis, multifocality, extrathyroidal extension, T-stage, and central compartment lymph node metastasis were not different between both groups. Both groups showed similar surgical outcomes, including lymph node yield, complications, and total medical costs. A few patients in each group experienced transient complications, all of which resolved within 6 months. No patients had permanent complications., Conclusion: Compared to COT, ETT with a modified technique offers excellent safety and acceptable short-term oncological outcomes in a selected cohort of patients with bilateral papillary thyroid carcinoma. ETT is a safe and feasible alternative to COT., Competing Interests: Declarations. Disclosures: Drs. Shi Tong Yu, Ruitian Ouyang, Guobin Miao, Junna Ge, Zhigang Wei, Baihui Sun, Tingting Li, Zhicheng Zhang, Weisheng Chen, and Shangtong Lei have no conflicts of interest or financial ties to disclose. Ethical approval: The study was approved by the Ethics Committees of Nanfang Hospital with the number: NFEC-2021-324, and all patients were fully informed and provided written consent., (© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Ternary heterojunction Bi 2 S 3 /MoS 2 /Bi 2 MoO 6 was designed as a signal probe to develop a dual signal amplification strategy empowered electrochemical biosensor for sensitive miRNA-21 detection by combining with catalytic hairpin assembly (CHA). The combination of the Bi 2 S 3 /MoS 2 /Bi 2 MoO 6 heterojunction as a tracer indication probe and the CHA amplification strategy not only took fully use of the highly dense nanowire interwoven structure and superior active region of the probe, but also endowed the ability to improve the molecular hybridization efficiency by collision, which significantly avoided the cumbersome chain design and greatly simplified the step-by-step construction of the electrode surface. Hairpin H1 was first added dropwise to the gold nanoparticle-decorated electrode surface, and then opened by the introduced miRNA-21 to initiate the specific hybridization. Once the H2-MB/Bi 2 S 3 /MoS 2 /Bi 2 MoO 6 heterojunction was added, more sensitive and rapid detection of miRNA-21 would be achieved through the introduction of methylene blue since the cocatalysis of hairpin assembly and ternary heterojunction Bi 2 S 3 @MoS 2 @Bi 2 MoO 6 . Finally, the constructed biosensor demonstrated effective performance in the detection of miRNA-21 within the linear range of 1 fM to 100 pM with a detection limit of 0.31 fM. The satisfactory analysis of human blood samples further validated the preferable reliability and practicability of this new strategy for the ultrasensitive detection of miRNA., Competing Interests: Declarations. Yuqing Miao received the Science and Technology Project of China Minmetals Corporation (2022ZXA02). Ruizhuo Ouyang received the Medical-Engineering Interdisciplinary Project of University of Shanghai for Science and Technology (1021341405, 1022310503), Open Research Fund of School of Chemistry and Chemical Engineering, Henan Normal University (2024Y12). Baolin Liu received Shanghai Collaborative Innovation Center of Energy Therapy for Tumors. Yuqin Jiang received the Technical Innovation Team of Henan Normal University (2022TD03), and the Special Project for Fundamental Research in University of Henan Province (23ZX009). Xiaoqing Zhang received the Honghu Program of International Peace Maternal and Child Health Hospital of China Welfare Society (HHJH2415). Conflict of interest: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

Obstructive sleep apnea (OSA) patients have varying degrees of cognitive impairment, but the specific pathogenic mechanism is still unclear. Meanwhile, poor compliance with continuous positive airway pressure (CPAP) in OSA prompts better solutions. This study aimed to identify differentially expressed genes between the non-obese OSA patients and healthy controls, and to explore potential biomarkers associated with cognitive impairment. Cohorts of healthy control (n = 20) and non-obese, treatment-naïve OSA patients (n = 20) were recruited. We collected their peripheral blood mononuclear cells and neutrophils, and their cognitive performances were evaluated by the Montreal Cognitive Assessment (MoCA). The differentially expressed genes were identified by bioinformatic analysis and confirmed by PCR. Imbalanced immune cell proportions were assessed by Cibersort. Biomarkers related to enriched cellular pathways were measured by ELISA. OSA patients showed a significant decline in overall cognitive function and were associated with higher daytime sleepiness scores. Multiple signaling pathways were enriched in the non-obese OSA cohort, including upregulation of neutrophil-degranulation. Increased monocyte proportion and decreased NK cell proportion were figured out. The relevant genes, including upregulated defensin alpha 4 (DEFA4), haptoglobin (HP), survivin (BIRC5), and suppressed interferon gamma (IFNG) expression were detected. The relative expression of DEFA4 was significantly correlated with the MoCA score and sleep parameters. Biomarkers such as myeloperoxidase (MPO), H 2 O 2 , and lipocalin-2, as representatives of neutrophils' activation, elevated significantly in the OSA group. The data demonstrated a positive correlation between MPO and oxygen desaturation index (ODI) and a negative correlation between MPO and lowest oxygen saturation (LSaO 2 ). The level of Lipocalin-2 was positively correlated with apnea-hypopnea index (AHI) and ODI and negatively correlated with LSaO 2 and MoCA score. We also observed a negative correlation between H 2 O 2 and mean oxygen saturation (MSaO 2 ). Degranulation of neutrophils was activated in non-obese OSA patients without other complications. The process is related to OSA severity and cognitive impairment, implying its role in pathogenesis., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: This study protocol was reviewed and approved by the medical ethics Committee of the Second Xiangya Hospital of Central South University, approval number [Acceptance no. 2019 − 215]. This study was conducted according to the Declaration of Helsinki, and informed consent was obtained from all enrolled individuals., (© 2025. The Author(s).)

Objective: The objective of this study was to delineate synaptic density alterations in multiple system atrophy (MSA) and explore its potential role as a biomarker for MSA diagnosis and disease severity monitoring using [ 18 F]SynVesT-1 positron emission tomography / computed tomography (PET CT)., Methods: In this prospective study, 60 patients with MSA (30 patients with MSA-parkinsonian [MSA-P] subtype and 30 patients with MSA-cerebellar [MSA-C] subtype), 30 patients with Parkinson's disease (PD), and 30 age-matched healthy controls (HCs) underwent [ 18 F]SynVesT-1 PET/CT for synaptic density assessment. Visual, voxel, and volumetric region of interest (VOI) analyses were used to elucidate synaptic density patterns in the MSA brain and establish diagnostic criteria. The diagnostic performances of both visual and VOI-based diagnostics were evaluated using receiver operating characteristic (ROC) analysis. Spearman correlation analyses were conducted to investigate the relationship between brain synaptic density and disease severity RESULTS: Patients with MSA displayed extensive reductions in synaptic density throughout the brain, notably affecting both primary VOIs (the cerebellum and putamen) and secondary VOIs including the medulla oblongata, ventral tegmental area, and pons. Notably, patients with MSA-C exhibited a remarkable decrease in cerebellar synaptic density, whereas patients with MSA-P demonstrated significant synaptic loss within the posterior putamen. Compared with patients with PD, the patients with MSA show a more pronounced reduction in synaptic density in infratentorial brain regions. VOI-based diagnosis significantly outperformed visual analysis in diagnosing and differentiating MSA and its subtypes. Synaptic density in primary and multiple secondary VOIs correlated significantly with motor scales in patients with MSA., Interpretation: Our study identified widespread synaptic density reductions in MSA, particularly in the basal ganglia and infratentorial region, suggesting [ 18 F]SynVesT-1 PET as a potential biomarker for diagnosing and evaluating the disease, and guiding synaptic restoration trials. ANN NEUROL 2025., (© 2025 American Neurological Association.)

Objective: This randomized controlled trial aimed to compare the efficacy of negative-pressure wound therapy with advanced moist wound therapy in managing diabetic foot ulcers., Methods: A total of 450 participants with diabetic foot ulcers were randomized to receive either negative-pressure wound therapy (n = 204) or advanced moist wound therapy (n = 246) over 18 months. The primary outcome was complete ulcer closure, with secondary outcomes including time to closure, wound size reduction, infection rates, recurrence, and amputation rates. Wound dimensions were measured using digital planimetry, and Kaplan-Meier survival analysis was applied to assess time to closure., Result: Analysis revealed statistically significant differences in clinical outcomes between treatment modalities. In the negative-pressure wound therapy group (n = 204), complete ulcer closure was achieved in 177 patients (87%), which was significantly greater than the advanced moist wound therapy group (n = 246) with 72 patients (29%) (P < .001). Although the mean time to wound closure was marginally extended in the negative-pressure wound therapy group (73 ± 45 days vs 64 ± 49 days; P = .045), this cohort demonstrated substantially more significant wound area reduction (48% ± 15 vs 25% ± 30; P < .001). Secondary outcome analysis revealed that negative-pressure wound therapy was associated with markedly reduced adverse events: wound infection (40 patients [20%] vs 95 patients [39%]; P < .001), ulcer recurrence (40 patients [20%] vs 113 patients [46%]; P < .001), and amputation rates (30 patients [15%] vs 132 patients [54%]; P < .001). Longitudinal assessment through Kaplan-Meier survival analysis demonstrated significantly greater wound closure probability and reduced complication risk in the negative-pressure wound therapy group throughout the follow-up period (log-rank P < .001)., Conclusion: Negative-pressure wound therapy is significantly more effective than advanced moist wound therapy in treating diabetic foot ulcers, demonstrating superior outcomes in wound closure, infection control, and amputation prevention. This study highlights negative-pressure wound therapy as the preferred treatment option for complex diabetic foot ulcers, warranting further research into its long-term benefits and cost-effectiveness., Competing Interests: Conflict of Interest/Disclosure The authors have no conflicts of interest to declare., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: The Fontan procedure is a surgical intervention designed for patients with single ventricle physiology, wherein the systemic venous return is redirected into the pulmonary circulation, thereby facilitating passive pulmonary blood flow without the assistance of ventricular propulsion. Consequently, long-term follow-up of individuals who have undergone the asymptomatic Fontan procedure is essential., Objectives: The aims of this investigation were to: 1) examine the impact of flow components and kinetic energy (KE) parameters on hemodynamic disturbances in asymptomatic Fontan patients and control group; 2) Assess left ventricular diastolic dysfunction through the analysis of 4D flow parameters across different Fontan sub-groups; 3) Compare intracardiac flow parameters among Fontan sub-groups based on morphological features of the left ventricle (LV) and right ventricle (RV)., Methods: Twenty-five Fontan patients (mean age: 10 ± 3 years, male/female: 15/10) and fourteen control subjects (mean age: 10 ± 2 years, male/female: 8/6) were recruited retrospectively for the study. The Fontan patients were further categorized into three groups based on their ventricular function: left ventricular (LV), right ventricular (RV), and biventricular (BiV). Each participant underwent cardiovascular magnetic resonance (CMR) imaging, including cine and 4D flow sequences on a 3.0 T scanner. Ventricular flow components and KE were assessed using 4D flow. The study utilized cine images to analyze cardiac function and inter-ventricular mechanical dyssynchrony. Echocardiography evaluated functional ventricular diastolic dysfunction., Results: Fontan patients had a higher median functional single ventricle (FSV) residual volume compared to controls (28 % vs. 23 %, P = 0.034), with lower median FSV direct flow (32 % vs. 40 %, P = 0.005) and delayed ejection flow (17 % vs. 24 %, P = 0.024). The parameters of FSV normalized to the ventricular end-diastolic volume (KEi EDV ) were found to be significantly lower in Fontan patients (all P < 0.05). In both left ventricle (LV) and biventricular (BiV) Fontan subgroups, direct flow was identified as an independent predictor of LV diastolic dysfunction (AUC=0.76, Sensitivity=86 %, Specificity=70 %). Furthermore, residual volume and E-wave KEi EDV were observed to be significantly different between LV and right ventricle (RV) Fontan subgroups., Conclusions: The altered flow pattern and reduced kinetic energy observed in Fontan patients may indicate hemodynamic disturbances and compromised ventricular filling. Reduced direct flow is associated with LV diastolic dysfunction in LV and BiV Fontan subgroups. Systemic LV exhibited a more efficient intracardiac flow pattern compare with systemic RV in Fontan patients., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2025 The Authors.)

The Tibetan Plateau is home to numerous glaciers that are important for freshwater supply and climate regulation. These glaciers, which are highly sensitive to climatic variations, serve as vital indicators of climate change. Understanding glacier-fed hydrological systems is essential for predicting water availability and formulating climate adaptation strategies. This study investigated the dynamic fluctuations in the water level of the Blue Moon Lake Valley (BMLV), supplied by meltwater from Baishui River Glacier No. 1 on Yulong Snow Mountain. We focused on the lake pulse phenomenon-subtle yet significant water level fluctuations that have often been overlooked in prior research. By employing fast Fourier transform (FFT), multivariate regression (MVR), and random forest (RF) models, we examined the interactions among glacier melt dynamics, climatic variables, and hydrological responses. Our analysis indicates that the rate of change (ROC) in the water level fluctuates between - 0.006 and 0.01 m/min, with a median ROC of - 7.24E-06 m/min, highlighting the significant variability influenced by glacier melt and precipitation. The maximum cumulative sum (CS) value of 0.09 m suggests a net increase in the water level, predominantly due to increased precipitation, decreased evaporation, and increased glacier melting. We demonstrate that temperature critically influences glacier melt rates and water level variations, alongside solar radiation, rainfall, atmospheric pressure, and wind speed. The ROC of Baishui River Glacier No. 1 melt ranges from - 0.0016 to 0.0015 m/min, reflecting substantial variation with significant downstream implications for water availability during dry seasons. The mean interval between consecutive glacier melt peaks is approximately 2.87 h, with a strong positive linear trend R 2  = 0.99, indicating frequent melt events. Conversely, water level peaks occur approximately every 6.5 h, with a strong positive trend R 2  = 0.99, indicating a slower recurrence rate. The transit time for meltwater from Baishui River Glacier No. 1 to BMLV is estimated at approximately 4.16 h. Additionally, we quantify the water flux from BMLV across various timescales, highlighting the substantial contribution of glacial meltwater. This novel study systematically examines the hydrological dynamics of BMLV. This study has the potential to reveal broader implications for water resource management, ecosystem dynamics, and climate change adaptation in regions dependent on glacier-fed lakes., (© 2024. The Author(s).)

Sodium antiperovskite materials (APs) are a promising class of solid-state electrolytes owing to their high structural tolerance and good formability. However, few APs have been synthesized experimentally, indicating the necessity of exploring potential chemical spaces with higher ionic conductivities. Herein, through a combined particle swarm optimization algorithm, high-throughput first-principles calculations, ab initio molecular dynamics, and long time-scale machine-learning molecular dynamics simulations, strategies based on site-exchanging and anion clusters are shown to simultaneously enhance the thermal stability and sodium diffusivity in the designed APs. Among these APs, the highest theoretical ionic conductivity of 39.05 mS/cm is achieved with Na 3 BrSO 4 at room temperature due to the strong coupling of cluster rotation and sodium migration. We highlight that not only the rotation dynamics but also its coupling with Na diffusion contribute to the high ionic conductivity, as confirmed by the proposed local difference frequency center to evaluate the coupling degree. Our work designs promising site-exchanging APs and offers insights into the coupling between anion rotation and cation migration, which can effectively guide the design of superionic conductors with cluster rotation dynamics.

Objective: This study aimed to develop a nomogram that combines intratumoral and peritumoral radiomics based on multi-parametric MRI for predicting the postoperative pathological upgrade of high-risk breast lesions and sparing unnecessary surgeries., Methods: In this retrospective study, 138 patients with high-risk breast lesions (January 1, 2019, to January 1, 2023) were randomly divided into a training set (n=96) and a validation set (n=42) at a 7:3 ratio. The best-performing MRI sequence for intratumoral radiomics was selected to develop individual and combined radiomics scores (Rad-Scores). The best Rad-Score was integrated with independent clinical and radiological risk factors by a nomogram. The diagnostic performance of the nomogram was evaluated using the area under the curve (AUC) of the receiver operating characteristic curve, along with accuracy, specificity, and sensitivity analysis., Results: The nomogram based on the combined intratumoral and peritumoral Rad-Score of the dynamic contrast-enhanced MRI and clinical-radiological features achieved superior diagnostic efficacy in the training (AUC=0.914) and validation set (AUC=0.867) compared to other models. It also achieved a specificity and accuracy of 85.1% and 82.3% during training and 66.7% and 76.2% during validation., Conclusion: The nomogram encapsulating the combined intratumoral and peritumoral radiomics demonstrated superior diagnostic efficacy in postoperative pathological upgrades of high-risk breast lesions, enabling clinicians to make more informed decisions about interventions and follow-up strategies., Competing Interests: YD was employed by Yizhun Medical AI Co. Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Liao, Yang, Lin, Ouyang, Deng and Ma.)

This study proposes a practical approach to assessing the need for and determining the transitioning parameters from age-specific to size-specific dose protocols in paediatric head computed tomography examinations. It was designed to begin with the two different age-specific protocols currently applied on paediatric patients of 1 y ≤ age ≤ 6 y (21.34 mGy) and those of age >6 y (34.73 mGy). One characteristic size (HDthreshold) was found by measuring anteroposterior head diameter on historical topograms and used with age to set 135 cases into four groups for investigation (A, ≤6y, ≤HDthreshold; B, ≤6y, >HDthreshold; C, >6y, ≤HDthreshold; and D, >6 y, >HDthreshold). The image quality was compared in both subjective and objective manners. Results suggest patients in Group C may have received a potential overdose (38%), while the exposure setting for Group D may replace that for B. The proposed strategy was sufficient to assess the necessity and determine the transitioning parameters from age- to size-specific dose protocols., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Background: The classification of Breast Imaging Reporting and Data System (BI-RADS) category 4A lesions in mammography is complicated by subjective interpretations and unclear criteria, which can lead to potential misclassifications and unnecessary biopsies. Thus, more accurate assessment methods need to be developed. This study aimed to improve the classification prediction of BI-RADS 4A positive lesions in mammography by combining deep learning (DL) technology with relevant clinical factors., Methods: A retrospective analysis of 590 patients diagnosed with BI-RADS 4A at Shenzhen People's Hospital and Shenzhen Luohu People's Hospital was conducted, and a multi-faceted approach was employed to construct a robust predictive model. The patients were divided into training, validation, and external validation sets. The classification results from a DL system applied to mammography were recorded, and data on relevant clinical factors were collected. Univariate and multivariate logistic regression analyses were performed to identify the independent predictive factors. A predictive model and nomogram integrating these factors were developed. Assessment metrics, such as the areas under the curve (AUCs), calibration curves, and a decision curve analysis (DCA), were employed to evaluate the diagnostic performance, calibration, and clinical net benefit of the model. External validation was conducted to assess the generalization ability of the model., Results: Four independent predictive factors (i.e., age, nipple discharge, ultrasound BI-RADS assessment, and DL system classification results) were identified and included in the predictive model. The model showed commendable diagnostic performance with AUC values of 0.85, 0.82, and 0.84 for the training, validation, and external validation sets, respectively. There were no statistically significant differences in the AUCs of the predictive model between the training set, and the internal and external validation sets (P=0.543 and 0.842, respectively). The calibration curves showed excellent calibration in the training, validation, and external validation sets, indicating a minimal deviation between the predicted and actual positive risk probabilities (P=0.906, 0.890, and 0.769, respectively). The DCA results illustrated the clinical net benefit of the model for risk thresholds greater than 0.15 and less than 0.70 in both the internal validation and external validation sets., Conclusions: Our predictive model, which incorporated age, nipple discharge, ultrasound BI-RADS assessment, and DL system classification results, emerged as a powerful tool for accurately predicting BI-RADS 4A positive lesions. Its application holds significant promise in helping radiologists enhance diagnostic precision and reduce unnecessary biopsies in BI-RADS 4A positive lesion cases., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-24-1075/coif). The authors have no conflicts of interest to declare., (2024 AME Publishing Company. All rights reserved.)

The study was undertaken to determine the mechanism of miR-372-3p activating hepatic stellate cell (HSC). Transforming growth factor-β1 (TGF-β1) induced LX-2 cells were transfected with miR-372-3p mimics and/or RhoC overexpression vector (oe-RhoC), after which the miR-372-3 and RhoC expressions were detected and the biological functions of transfected cells were assessed. The relation between miR-372-3p and RhoC predicted online was validated using the dual-luciferase assay. Protein level of Collagen I (COL I), α-smooth muscle actin (α-SMA), and key proteins in the RhoC/ROCK pathway were determined using western blot. Activated LX-2 cells had decreased miR-372-3p and increased RhoC expression. Overexpression of miR-372-3p led to inhibited LX-2 cell proliferation, accelerated apoptosis, and decreased protein level of COL I and α-SMA, while such an expression pattern can be partially reversed by RhoC overexpression. miR-372-3p can bind and target RhoC expression. miR-372-3p inhibited RhoC expression to block the activation of the Rho/ROCK pathway and thus mediate LX-2 cell proliferation and apoptosis. miR-372-3p mediated RhoC/ROCK pathway to inhibit HSC activation., Competing Interests: Competing interestThe authors declare no competing interests., (© The Author(s), under exclusive licence to Springer Nature B.V. 2025. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

The metal-support interaction is one of the most important pillars in heterogeneous catalysis, but developing a fundamental theory has been challenging because of the intricate interfaces. Based on experimental ‎data, interpretable machine learning, theoretical derivation, and first-principles simulations, we established a ‎general theory of metal-oxide interactions grounded in ‎metal-metal and metal-oxygen interactions. The theory applies to metal nanoparticles and atoms on oxide supports and oxide films on metal supports. We found that for late-transition metal catalysts, metal-metal interactions dominated the oxide support effects and suboxide encapsulation over metal nanoparticles. A principle of strong metal-metal interactions for encapsulation occurrence is formulated and substantiated by extensive ‎experiments including 10 metals and 16 ‎oxides. The valuable insights revealed on (strong) metal-support interaction advance the interfacial design of supported metal catalysts.