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Abstract Objective The purpose of this study is to construct an organ system-centered undergraduate nursing professional training model and explore its application effect. Methods This study is divided into two steps. In the early stage, literature review and expert consultation were used to establish the training mode (curriculum and assessment standard) of nursing undergraduate specialty based on organ system reform. Secondly, a cross-sectional survey method was used to investigate the training quality of nursing students who graduated from Jinzhou Medical University from 2007 to 2017 under this model. Results A five-module curriculum system was established, including general courses, public basic courses, professional education courses, expanding elective courses and concentrated practical teaching. Under the teaching reform of organ system, the nursing graduates of Jinzhou Medical University, who are mainly employed in public hospitals, are generally not satisfied with their jobs, salaries, contents and prospects. Their overall satisfaction with their alma mater is very high; Graduates have certain independent core competence; Employers are basically satisfied with graduates. Conclusion The training mode of undergraduate nursing specialty based on organ system reform basically meets the training requirements and objectives.

Abstract Background To investigate the cross-sectional and longitudinal associations between depressive symptoms and the prevalence of frailty and its components in a nationally representative sample of middle-aged and older Chinese adults. Method The China Health and Retirement Longitudinal Study (CHARLS) provided data on 2581 (after inclusion and exclusion criteria) adults aged ≥ 45 years. Every two years, face-to-face, computer-aided personal interviews (CAPI), and structured questionnaires were used to follow up with the respondents. The Chinese version of the Center for Epidemiologic Studies-Depression Scale (CES-D) was used to evaluate depressive symptoms, and the Fried criteria were used to measure frailty. The odds ratio (OR) and 95% confidence interval (CI) for the association of exposure (depressive symptoms at baseline) with the onset of the outcome (frailty and its components) in the individuals at baseline were analyzed by binary logistic regression. Results At baseline, 11.62% of participants had frailty, and 57.92% had depressive symptoms. In the cross-sectional analysis, depressive symptoms (OR = 5.222, 95%CI 3.665–7.442) were associated with frailty. In the longitudinal analysis, after adjusting for the full set of covariates among participants free of baseline frailty, depressive symptoms were significantly associated with incident frailty during the short term (OR = 2.193, 95%CI 1.324–3.631) and the long term (OR = 1.926, 95%CI 1.021–3.632). Meanwhile, depressive symptoms were associated with an increased risk of weakness (OR = 1.990, 95%CI 1.250–3.166), slowness (OR = 1.395, 95%CI 1.044–1.865), and exhaustion (OR = 2.827, 95%CI 2.150–3.719) onset during the short-term. Depressive symptoms were associated with an increased risk of exhaustion (OR = 2.869, 95%CI 2.004–4.109) onset during the long-term. Conclusion Among middle-aged and older adults, depressive symptoms could predict frailty during 2 years of follow-up and 4 years of follow-up. When considering potential confounding factors, depressive symptoms were considered a predictor of weakness, slowness, and exhaustion. Interventions aimed at preventing depressive symptoms may be beneficial in reducing frailty and its components.

Abstract The teaching objectives of traditional approaches in higher education emphasize mostly students’ mastery of knowledge and have insufficient directionality to social needs. In this study, we developed a BOPPPS (Bridge-in, Objectives, Pre-assessment, Participatory Learning, Post-assessment and Summary) teaching model combined with the OBE (Outcome Based Education) concept to enhance the teaching outcomes. Firstly, based on the graduation requirements and professional training objectives of students, we divided the course objectives into three dimensions (knowledge, ability and quality), and further specified into index points. Then, the teaching content of each chapter was set to correspond with the index points. Finally, the BOPPPS teaching model was used to meet each requirement. Clinical biochemistry testing course was used as a model to assess the effects of the teaching reform. After the class, the teaching effect was analyzed based on the questionnaire surveys from the students and their scores of both the chapter and final examinations. The results showed that compared with the traditional approach, the BOPPPS teaching model combined with the OBE concept has demonstrated a notable enhancement in student engagement, and significant improvement of their mastery of knowledge, application skills, and problem-solving abilities. The examination scores of the BOPPPS group were markedly higher than those of the traditional group. Moreover, the difference between the two groups diverse assessment scores was much bigger than that between the two group examination scores. Our study indicates that the BOPPPS teaching model combined with the OBE concept is a highly effective teaching model for enhancing the learning effectiveness of students.

Abstract Background The high recurrence rate after liver resection emphasizes the urgent need for neoadjuvant therapy in hepatocellular carcinoma (HCC) to enhance the overall prognosis for patients. Immune checkpoint inhibitors, camrelizumab combined with an anti-angiogenic tyrosine kinase inhibitor (TKI) apatinib, have emerged as a first-line treatment option for patients with unresectable HCC, yet its neoadjuvant application in combination with transarterial chemoembolization (TACE) in HCC remains unexplored. Therefore, this study aims to investigate the efficacy and safety of sequential TACE, camrelizumab, and apatinib as a neoadjuvant therapy for single, huge HCC. Methods This multi-center, open-label randomized phase 3 trial will be conducted at 7 tertiary hospitals. Patients with single huge (≥ 10 cm in diameter), resectable HCC will be randomly assigned in a 1:1 ratio to arm of surgery alone or arm of neoadjuvant therapy followed by surgery. In the neoadjuvant therapy group, patients will receive TACE within 1 week after randomization, followed by camrelizumab (200 mg q2w, 4 cycles), along with apatinib (250 mg qd, 2 months). Patients will receive liver resection after neoadjuvant therapy unless the disease is assessed as progressive. The primary outcome is recurrence-free survival (RFS) at 1 year. The planned sample size of 60 patients will be calculated to permit the accumulation of sufficient RFS events in 1 year to achieve 80% power for the RFS primary endpoint. Discussion Synergistic effects provided by multimodality therapy of locoregional treatment, TKI, and anti-programmed cell death 1 inhibitor significantly improved overall survival for patients with unresectable HCC. Our trial will investigate the efficacy and safety of the triple combination of TACE, camrelizumab, and apatinib as a neoadjuvant strategy for huge, resectable HCC. Trial registration www.chitr.org.cn ChiCTR2300078086. Registered on November 28, 2023. Start recruitment: 1st January 2024. Expected completion of recruitment: 15th June 2025.

Abstract To investigate the screening and predicting functions of obesity- and lipid-related indices for type 2 diabetes (T2D) in middle-aged and elderly Chinese, as well as the ideal predicted cut-off value. This study's data comes from the 2011 China Health and Retirement Longitudinal Study (CHARLS). A cross-sectional study design was used to investigate the relationship of T2D and 13 obesity- and lipid-related indices, including body mass index (BMI), waist circumference (WC), waist–height ratio (WHtR), visceral adiposity index (VAI), a body shape index (ABSI), body roundness index (BRI), lipid accumulation product (LAP), conicity index (CI), Chinese visceral adiposity index (CVAI), triglyceride- glucose index (TyG index) and its correlation index (TyG-BMI, TyG-WC, TyG-WHtR). The unadjusted and adjusted correlations between 13 indices and T2D were assessed using binary logistic regression analysis. The receiver operating characteristic curve (ROC) was used to determine the usefulness of anthropometric indices for screening for T2D and determining their cut‑off value, sensitivity, specificity, and area under the curve (AUC). The study comprised 9488 people aged 45 years or above in total, of whom 4354 (45.89%) were males and 5134 (54.11%) were females. Among them were 716 male cases of T2D (16.44%) and 870 female cases of T2D (16.95%). A total of 13 obesity- and lipid-related indices were independently associated with T2D risk after adjusted for confounding factors (P

Abstract Background Chronic lung and heart diseases are more likely to lead an intensive end point after stroke onset. We aimed to investigate characteristics and outcomes of endovascular thrombectomy (EVT) in patients with acute large vessel occlusion stroke (ALVOS) and identify the role of comorbid chronic cardiopulmonary diseases in ALVOS pathogenesis. Methods In this single-center retrospective study, 191 consecutive patients who underwent EVT due to large vessel occlusion stroke in neurological intensive care unit were included. The chronic cardiopulmonary comorbidities and several conventional stroke risk factors were assessed. The primary efficacy outcome was functional independence (defined as a mRS of 0 to 2) at day 90. The primary safety outcomes were death within 90 days and the occurrence of symptomatic intracranial hemorrhage(sICH). Univariate analysis was applied to evaluate the relationship between factors and clinical outcomes, and logistic regression model were developed to predict the prognosis of ALVOS. Results Endovascular therapy in ALVOS patients with chronic cardiopulmonary diseases, as compared with those without comorbidity, was associated with an unfavorable shift in the NHISS 24 h after EVT [8(4,15.25) versus 12(7.5,18.5), P = 0.005] and the lower percentage of patients who were functionally independent at 90 days, defined as a score on the modified Rankin scale of 0 to 2 (51.6% versus 25.4%, P = 0.000). There was no significant between-group difference in the frequency of mortality (12.1% versus 14.9%, P = 0.580) and symptomatic intracranial hemorrhage (13.7% versus 19.4%, P = 0.302) or of serious adverse events. Moreover, a prediction model showed that existence of cardiopulmonary comorbidities (OR = 0.456, 95%CI 0.209 to 0.992, P = 0.048) was independently associated with functional independence at day 90. Conclusions EVT was safe in ALVOS patients with chronic cardiopulmonary diseases, whereas the unfavorable outcomes were achieved in such patients. Moreover, cardiopulmonary comorbidity had certain clinical predictive value for worse stroke prognosis.

Abstract Background Depressive symptoms are one of the most common psychiatric disorders, with a high lifetime prevalence rate among middle-aged and elderly Chinese. Obesity may be one of the risk factors for depressive symptoms, but there is currently no consensus on this view. Therefore, we investigate the relationship and predictive ability of 13 obesity- and lipid-related indices with depressive symptoms among middle-aged and elderly Chinese. Methods The data were obtained from The China Health and Retirement Longitudinal Study (CHARLS). Our analysis includes individuals who did not have depressive symptoms at the baseline of the CHARLS Wave 2011 study and were successfully follow-up in 2013 and 2015. Finally, 3790 participants were included in the short-term (from 2011 to 2013), and 3660 participants were included in the long-term (from 2011 to 2015). The average age of participants in short-term and long-term was 58.47 years and 57.88 years. The anthropometric indicators used in this analysis included non-invasive [e.g. waist circumference (WC), body mass index (BMI), and a body mass index (ABSI)], and invasive anthropometric indicators [e.g. lipid accumulation product (LAP), triglyceride glucose index (TyG index), and its-related indices (e.g. TyG-BMI, and TyG-WC)]. Receiver operating characteristic (ROC) analysis was used to examine the predictive ability of various indicators for depressive symptoms. The association of depressive symptoms with various indicators was calculated using binary logistic regression. Results The overall incidence of depressive symptoms was 20.79% in the short-term and 27.43% in the long-term. In males, WC [AUC = 0.452], LAP [AUC = 0.450], and TyG-WC [AUC = 0.451] were weak predictors of depressive symptoms during the short-term (P 0.05). Conclusion The research indicates that in the middle-aged and elderly Chinese, most obesity- and lipid-related indices have statistical significance in predicting depressive symptoms, but the accuracy of these indicators in prediction is relatively low and may not be practical predictors.

Abstract The purpose of the study was to determine whether changes in body mass index (BMI) and waist circumference (WC) in middle-aged and elderly Chinese are associated with metabolic syndrome. In this cohort investigation, 3697 middle-aged and elderly people aged 45 or over were recruited from the China Health and Retirement Longitudinal Study (CHARLS). The National Cholesterol Education Program Adult Treatment Panel III (2005) defined metabolic syndrome (MetS). With Cox regression analysis, we calculated hazard ratio (HR) and 95% confidence intervals (CIs) for MetS based on BMI-WC change categories. To assess the prevalence of MetS, the changes in BMI and WC levels were classified into four quartiles based on their relative and absolute changes. In subjects whose BMI and WC decreased (HR = 0.338; 95% CIs 0.264, 0.433) as well as those whose BMI increased and their WC decreased (HR = 0.375; 95% CIs 0.228, 0.499), metabolic syndrome risk was significantly lower compared with those with increases in both BMI and WC. Regarding the absolute changes in BMI, the lowest percentile of BMI was significantly lower in both males (HR = 0.302; 95% CIs 0.204, 0.448) and females (HR = 0.486; 95% CIs 0.354, 0.667) for the risk of metabolic syndrome. Similar results were observed in the absolute changes in WC, with the lowest quantile of WC having a significant impact on MetS risk in males (HR = 0.170; 95% CIs 0.107, 0.270) and females (HR = 0.303; 95% CIs 0.217, 0.424). The risk of metabolic syndrome was significantly associated with changes in BMI and WC in middle-aged and elderly Chinese. A reduced BMI and WC are associated with lower metabolic syndrome risks in middle-aged and elderly people.

Abstract Systemic therapy is typically the primary treatment choice for hepatocellular carcinoma (HCC) patients with extrahepatic metastases. Some patients may achieve partial response (PR) or complete response (CR) with systemic treatment, leading to the possibility of their primary tumor becoming resectable. This study aimed to investigate whether these patients could achieve longer survival through surgical resection of their primary tumor. We retrospectively collected data from 150 HCC patients with extrahepatic metastases treated at 15 different centers from January 1st, 2015, to November 30th, 2022. We evaluated their overall survival (OS) and progress-free survival (PFS) and analyzed risk factors impacting both OS and PFS were analyzed. Patients who received surgical treatment had longer OS compared to those who did not (median OS 16.5 months vs. 11.3 months). However, there was no significant difference in progression-free survival between the two groups. Portal vein invasion (P = 0.025) was identified as a risk factor for poor prognosis in patients, while effective first-line treatment (P = 0.039) and surgical treatment (P = 0.005) were protective factors. No factors showed statistical significance in the analysis of PFS. Effective first-line treatment (P = 0.027) and surgical treatment (P = 0.006) were both independent protective factors for prolonging patient prognosis, while portal vein invasion was an independent risk factor (P = 0.044). HCC patients with extrahepatic metastases who achieve PR/CR with conversion therapy may experience longer OS through surgical treatment. This study is the first to analyze the clinical outcomes of patients receiving surgical treatment for HCC with extrahepatic metastases.

AbstractWe conducted an analysis of the complete mitochondrial genome of Rhipicephalus haemaphysaloides, a tick species known for transmitting various bacteria and viruses. The mitochondrial genome of R. haemaphysaloides has a length of 14,739 bp and consists of 13 protein-coding genes (PCGs), 22 transfer RNA genes (tRNAs), 2 ribosomal RNA genes (rRNAs), and 2 control regions. By utilizing the maximum likelihood method, we established the phylogenetic relationship among R. haemaphysaloides and other species within the Rhipicephalus genus of the Ixodidae family. This analysis revealed that R. haemaphysaloides and other Rhipicephalus species belong to the same clade, further affirming the taxonomic placement of R. haemaphysaloides within the Rhipicephalus genus. Furthermore, we compared the mitochondrial genomes of R. haemaphysaloides isolates from Changning, Yunnan Province, China, with isolates from Yangxin, Ganzhou, and Yingtan, Hubei Province, China. In summary, our investigation offers genetic proof endorsing the taxonomic categorization and phylogenetic placement of Ixodidae by assessing the entire mitochondrial genome of R. haemaphysaloides.

Abstract Background Hypertension is prevalent in China. Hypertensive patients suffer from many health problems in life. Hypertension is a common chronic disease with long-term and lifelong characteristics. In the long run, the existence of chronic diseases will affect the patient’s own health beliefs. However, people’s health beliefs about Hypertension are not explicit. Therefore, it is vital to find a suitable instrument to comprehend and improve the health beliefs of hypertensive patients, thus, better control of blood pressure and improvement of patient’s quality of life are now crucial issues. This study aimed to translate the Hypertension Belief Assessment Tool (HBAT) into Chinese and examine the psychometric properties of the Chinese version of the Hypertension Belief Assessment Tool in hypertensive patients. Methods This is a cross-sectional study. We translated the HBAT into Chinese and tested the reliability and validity of the Chinese version among 325 hypertensive patients. Results The Chinese version of the scale contains 21 items. The Exploratory Factor Analysis (EFA) revealed six factors and explained 77.898% of the total variation. A six-factor model eventually showed acceptable fit indices in the Confirmatory Factor Analysis (CFA). With modified Confirmatory Factor Analysis, the fit indices were Chi-square/Degree of Freedom (CMIN/DF) = 2.491, Comparative Fit Index (CFI) = 0.952, Incremental Fit Index (IFI) = 0.952, Root-mean-square Error of Approximation (RMSEA) = 0.068, Tucker Lewis Index (TLI) = 0.941. The HBAT exhibits high internal consistency reliability (0.803), and the scale has good discriminant validity. Conclusion The results suggest that the HBAT is a reliable and valid instrument for assessing the beliefs of Chinese hypertensive patients.

Abstract Background Sleep-disordered breathing (SDB) during childhood is common and includes a range of breathing abnormalities that range from primary snoring (PS) to obstructive sleep apnea syndrome (OSAS).Studies have shown that not only OSAS, but also PS, which is originally considered harmless, could cause cardiovascular, cognitive, behavioral, and psychosocial problems. Many researches are focused on the relation of OSA and serum lipid levels. However, little studies are focused on PS and serum lipid levels in children.We evaluated whether serum lipid (total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C)) concentrations were associated with specific components of SDB, including indices of oxygen reduction index, lowest oxygen saturation, mean oxygen saturation. And we explored whether serum lipid levels were associated with different degree sleep disordered (PS and OSA group) and obese. Methods This was a cross-sectional study. Children who were complained by their guardians with habitual snoring and(or) mouth breathing were collected in the SDB group. Normal children without sleep problem were matched in the control group. Subjects in the SDB group underwent polysomnography. The serum lipid profiles of all the children included TC, TG, HDL-C and LDL-C concentrations were measured by appropriate enzymatic assays. Results A total of 241 with Apnea/Hypopnea Index ≥ 5 (AHI) were assigned to the OSAS group and the remaining 155 with normal AHI were assigned to the PS group. The values of TC, TG, LDL-C and LDL/HDL were significantly higher in the OSAS group than in the PS group, and the values in the PS group were significantly higher than the control group. Multiple regression analysis revealed serum TG only correlated negatively with lowest oxygen saturation. Body mass index-z score has a positive effect on TG in all the 1310 children (P = 0.031) and in SDB 396 children(P = 0.012). The level of serum TG in obese group was significantly higher than that in non-obese group. Conclusions SDB had a very obvious effect on blood lipids, whereas PS without apnea and hypoxia. Obese only affects the aggregation of TG. Trial registration ChiCTR1900026807(2019.10.23).

Alzheimer′s disease(AD) is a widely recognized chronic neurodegenerative condition.Drosophila, with its well-defined genetic structure, straightforward experimental methodologies, and the presence of human disease-related genes or highly similar homologous genes, serves as an advantageous model organism.The utilization of Drosophila′s renowned Galactose-regulated Upstream Promoter Element 4-Upstream Activating Sequence(GAL4-UAS) system has led to the development of various AD models.These models facilitate the exploration of AD′s molecular mechanisms and the advancement of drug discovery efforts.This paper reviews the foundational principles, methodologies, and diverse applications of different AD Drosophila models, offering insights and innovative approaches for AD research utilizing Drosophila.

Abstract Background Aerobic training is the primary method of rehabilitation for improving respiratory function in patients with chronic obstructive pulmonary disease (COPD) in remission. However, the mechanism underlying this improvement is not yet fully understood. The use of transcriptomics in rehabilitation medicine offers a promising strategy for uncovering the ways in which exercise training improves respiratory dysfunction in COPD patients. In this study, lung tissue was analyzed using transcriptomics to investigate the relationship between exercise and lung changes. Methods Mice were exposed to cigarette smoke for 24 weeks, followed by nine weeks of moderate-intensity treadmill exercise, with a control group for comparison. Pulmonary function and structure were assessed at the end of the intervention and RNA sequencing was performed on the lung tissue. Results Exercise training was found to improve airway resistance and lung ventilation indices in individuals exposed to cigarette smoke. However, the effect of this treatment on damaged alveoli was weak. The pair-to-pair comparison revealed numerous differentially expressed genes, that were closely linked to inflammation and metabolism. Conclusions Further research is necessary to confirm the cause-and-effect relationship between the identified biomarkers and the improvement in pulmonary function, as this was not examined in the present study.

Abstract Background Nurses play an important role in healthcare development. The increasing demands for nurses mean that nursing schools at the undergraduate level have the responsibility to ensure patient safety and quality care through a well-designed curriculum. This research aimed to evaluate the effect of the teaching method combined with situational awareness and case-based seminars in a comprehensive nursing skills practice course on the level of self-directed learning, professional identity, academic self-efficacy, theoretical scores, practical scores, teaching satisfaction, and student competence among nursing students. Methods The research population comprised was of the grades of 2019 and 2020 at Wannan Medical College in Anhui Province, China (n = 169, response rate 77.88%). The observation group from grade 2020 used the teaching method combined with situational awareness and case-based seminars, whereas the control group from grade 2019 used the traditional teaching mode. General information, self-directed learning, a professional identity, and academic self-efficacy were compared between the two groups. This research used means and standard deviations, chi-square, the Shapiro–Wilk test, and an independent sample t-test for statistical analyses. Results Compared with the control group, the total scores for self-directed learning, professional identity, and academic self-efficacy were higher in the observation group (78.80 ± 7.89 vs 60.21 ± 7.44, 63.39 ± 7.87 vs 52.35 ± 7.68, and 22.31 ± 3.30 vs 21.28 ± 2.31, respectively, with P 0.05). Conclusion The teaching method combined with situational awareness and case-based seminars in a comprehensive nursing skills practice course has the potential to improve the level of self-directed learning, professional identity, and academic self-efficacy, and it increases theoretical scores, practical scores, teaching satisfaction, and student competence.

Abstract Background Liver fibrosis contributes to significant morbidity and mortality in Western nations, primarily attributed to chronic hepatitis C virus (HCV) infection. Hypoxia and immune status have been reported to be significantly correlated with the progression of liver fibrosis. The current research aimed to investigate the gene signature related to the hypoxia-immune-related microenvironment and identify potential targets for liver fibrosis. Method Sequencing data obtained from GEO were employed to assess the hypoxia and immune status of the discovery set utilizing UMAP and ESTIMATE methods. The prognostic genes were screened utilizing the LASSO model. The infiltration level of 22 types of immune cells was quantified utilizing CIBERSORT, and a prognosis-predictive model was established based on the selected genes. The model was also verified using qRT-PCR with surgical resection samples and liver failure samples RNA-sequencing data. Results Elevated hypoxia and immune status were linked to an unfavorable prognosis in HCV-induced early-stage liver fibrosis. Increased plasma and resting NK cell infiltration were identified as a risk factor for liver fibrosis progression. Additionally, CYP1A2, CBS, GSTZ1, FOXA1, WDR72 and UHMK1 were determined as hypoxia-immune-related protective genes. The combined model effectively predicted patient prognosis. Furthermore, the preliminary validation of clinical samples supported most of the conclusions drawn from this study. Conclusion The prognosis-predictive model developed using six hypoxia-immune-related genes effectively predicts the prognosis and progression of liver fibrosis. The current study opens new avenues for the future prediction and treatment of liver fibrosis.

Maintaining the health of coastal aquaculture ecosystems is crucial for sustainable development. Therefore, establishing a specific ecosystem health assessment index system for aquaculture bays is paramount. This system allows for the evaluation of the health status of these bays and aids in the planning and restoration of fishery habitats. Utilizing the well-known “Pressure-State-Response” framework, a comprehensive evaluation index system with 14 indicators was developed. Additionally, the analytic hierarchy process and entropy weight methods were employed to assess the ecosystem health of Sansha Bay, a representative aquaculture bay in Fujian Province, China. The results revealed variations in health status across four zones in 2020, categorized as “good” or “excellent”. However, the security index was more spatially distributed and classified from “fair” to “safety”. Key indicators critical to sustaining the health of the aquaculture bay ecosystem included the regional environmental risk index, the proportion of industrial discharge outlets, the zooplankton species diversity index, the phytoplankton species diversity index, the molar ratio of phosphorus to nitrogen, and the size of nature reserves. According to the assessments of ecosystem health and ecological security, vigorous endeavors in aquatic ecology are paramount to ensure the enduring sustainability of aquaculture, with a specific emphasis on Zoning 1 and Zoning 4. These findings not only enhance and expand the methods for assessing the health of aquaculture bay ecosystems but also provide a scientific basis for the conservation of fishery habitats and the green, high-quality development of the aquaculture industry in Sansha Bay.

Background: Most glycated hemoglobin A1c (HbA1c) analytical reagents used were obtained from the analyzer's manufacturer. However, clinical laboratories need more choices for HbA1c analytical reagents to overcome the limitations of dedicated reagents for special analyzers. We developed new mobile phase buffers as HbA1c diagnostic reagents and evaluated their analytical performance for the HbA1c assay. Methods: Different mobile phase buffers used as HbA1c diagnostic reagents were prepared using different concentrations of sodium salts. According to the Clinical and Laboratory Standards Institute (CLSI) recommendation guidelines, the analytical performances of the newly developed mobile phase buffers were evaluated on an ARKRAY HA-8160 Analyzer. Both quality controls and clinical blood samples were used in these experiments. To assess the quality of the newly developed mobile phase buffers, precision, accuracy, linearity, carryover, interference, bias, correlation with commercial reagents, and stability were analyzed. Results: The CVs of intra-assay precision and interassay precision of quality control and clinical.There were fewer than 1.00 % blood sample assays using the newly developed mobile phase buffer. The RDs of accuracy were less than 1.00 %. Linearity: R2 = 0.9998 in the concentration range of 4.40%–17.30 %. Carryover: 0.00 %. Reagent comparison revealed that the Pearson regression equation was Y = 0.9884x+0.05692 (R2 = 0.9977), and the Bland-Altman mean difference was −0.02650 % (CI: −0.2121 %–0.1591 %) between the two analytical reagents. Stability was also acceptable within 12 months. This mobile phase buffer showed good anti-interference ability. Conclusion: The newly developed mobile phase buffers demonstrated good analytical performance and were suitable for clinical HbA1c assays on an ARKRAY HA-8160 Analyzer.

Objective: Preeclampsia is a serious pregnancy complication that jeopardizes the health of both the mother and the fetus. Platelet parameters are closely linked to the severity of preeclampsia. This study aimed to assess the diagnostic potential of platelet parameters in the early second trimester for the detection of preeclampsia. Methods: A total of 840 participants from the Affiliated Hospital of Jining Medical College were included in the study, consisting of 327 healthy pregnant women, 209 with mild preeclampsia, and 304 with severe preeclampsia. General clinical data and platelet parameters for these three groups of pregnant women were collected, and differences among them were compared. In addition, univariate analysis and logistic regression were used to identify preeclampsia risk factors, and receiver operating characteristic curve analysis was conducted to assess the predictive value of platelet parameters. Results: Platelet count was not found to significantly differ between the healthy and preeclampsia groups. However, mean platelet volume, platelet distribution width (PDW), and platelet?large cell ratios (P-LCR) were observed to be significantly higher in the preeclampsia group than the healthy group. After adjusting for confounding factors (such as age, gestational week at blood sampling, systolic and diastolic blood pressure, and body mass index during the second trimester), it was determined that PDW and P-LCR could be considered effective predictors of preeclampsia. Conclusion: In clinical practice, P-LCR and PDW hold potential predictive value for preeclampsia.

BackgroundCutaneous phosphorylated alpha-synuclein (p-α-syn) deposition is an important biomarker of idiopathic Parkinson’s disease (iPD). Recent studies have reported synucleinopathies in patients with common genetic forms of PD.ObjectiveThis study aimed to detect p-α-syn deposition characteristic in rare genetic PD patients with CHCHD2 or RAB39B mutations. Moreover, this study also aimed to describe peripheral alpha-synuclein prion-like activity in genetic PD patients, and acquire whether the cutaneous synucleinopathy characteristics of genetic PD are consistent with central neuropathologies.MethodsWe performed four skin biopsy samples from the distal leg (DL) and proximal neck (C7) of 161 participants, including four patients with CHCHD2 mutations, two patients with RAB39B mutations, 16 patients with PRKN mutations, 14 patients with LRRK2 mutations, five patients with GBA mutations, 100 iPD patients, and 20 healthy controls. We detected cutaneous synucleinopathies using immunofluorescence staining and a seeding amplification assay (SAA). A systematic literature review was also conducted, involving 64 skin biopsies and 205 autopsies of genetic PD patients with synucleinopathy.ResultsP-α-syn was deposited in the peripheral cutaneous nerves of PD patients with CHCHD2, LRRK2, or GBA mutations but not in those with RAB39B or PRKN mutations. There were no significant differences in the location or rate of α-syn-positive deposits between genetic PD and iPD patients. Peripheral cutaneous synucleinopathy appears to well represent brain synucleinopathy of genetic PD, especially autosomal dominant PD (AD-PD). Cutaneous α-synuclein SAA analysis of iPD and LRRK2 and GBA mutation patients revealed prion-like activity.ConclusionP-α-syn deposition in peripheral cutaneous nerves, detected using SAA and immunofluorescence staining, may serve as an accurate biomarker for genetic PD and iPD in the future.

Abstract Background Although obesity and heart rate (HR) were closely related to the prevalence and development of type 2 diabetes mllitus (T2DM), few studies have shown a co‐association effect of them on T2DM. We aimed at assessing the interactive effects of HR and obesity with prevalence of T2DM in Chinese population, providing the exact cutpoint of the risk threshold for blood glucose with high HR. Materials and Methods In the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal study (REACTION) cohorts (N = 8398), the relationship between HR and T2DM was explored by linear regression, logistic regression, and restricted cubic spline, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Interaction terms between HR and body mass index (BMI) and HR and waist circumference (WC) were introduced into the logistic regression model. Results In those with HR > 88.0 beats/min, fasting plasma glucose and oral glucose tolerance tests were significantly correlated with HR, and the prevalence of T2DM was highly correlated with HR (all p 88 beats/minute.

Abstract Objective To translate the Academic Goals Orientation Questionnaire (AGOQ) into Chinese and to determine the validity and reliability of the (AGOQ) in Chinese nursing students based on SEM and IRT multidimensional models. Methods The participants were 654 nursing students with an age range of 17–26 years (mean age 21.61 ± 1.73 years). The psychometric properties of AGOQ were investigated based on a dual analytical perspective of structural equation modeling (SEM) and item response theory (IRT). Results The Cronbach’s α value of the questionnaire is 0.895. A four-factor model was obtained by exploratory factor analysis, which explained the variance of 71.892%. With confirmatory factor analysis, a new four-factors model was built and showed an acceptable goodness-of-fit, chi-square/degree of freedom (CMIN/DF) = 4.008, goodness of fit index (GFI) = 0.932, adjusted goodness of fit index (AGFI) = 0.905, comparative fit index (CFI) = 0.952, incremental fit index (IFI) = 0.952, Tucker Lewis index (TLI) = 0.941. In the analysis part of IRT, according to the comparison between Akek’s information criterion (AIC) and Bayesian information criterion (BIC), we choose the Graded Response Model (GRM) for analysis. The results show that the difficulty value is monotonically increasing, and the discrimination of all items is greater than 0.19, which shows that 16 items can be retained. Conclusions This study tested the psychometric characteristics of AGOQ of nursing students in China. The results confirmed that the Chinese version of AGOQ has good psychometric characteristics and can be used to measure the academic goal orientation of nursing students in China.

Abstract Background Severe pain after lumbar spine surgery can delay recovery in elderly patients. We explored the efficacy of T12 erector spinal plane block (ESPB) in elderly patients who underwent lumbar spine surgery. Methods A total of 230 patients undergoing lumbar spine surgery were divided and randomly allocated to ultrasound-guided ESPB (n = 115) and control (n = 115) groups. The ESPB group received 20 mL of 0.4% ropivacaine bilaterally at the T12 level after intubation, whereas the control group did not receive a block. The primary outcome was the numeric rating scale (NRS) score at 12 h after surgery. Secondary outcomes included the NRS score and tramadol use within 72 h postoperatively, intraoperative remifentanil use, incidence of postoperative delirium (POD), complications of ESPB, ambulation time, and length of hospitalization after surgery. Results The12-hour NRS (median (IQR)) score was remarkably lower in the ESPB group than in the control group (2 (1–3) vs. 3 (2–4), p = 0.004), as well as NRS score within 48 h (P 0.05). The ambulation time and length of hospitalization after surgery were shorter in the ESPB group than in the control group (P

Abstract Purpose To investigate the distribution of the incidence and genotypes of human papillomavirus (HPV) among women with cervical cancer (CC) and precancerous cervical lesions in Yueyang City, China, to develop prevention and control strategies for CC. Methods A total of 3674 patients with cervical lesions and cervical cancer who attended 7 hospitals in Yueyang City between September 2019 and September 2022 were included. They included 1910 cervical intraepithelial neoplasia (CIN) I, 718 CIN II, 576 CIN II and 470 CC, respectively. The HPV genotyping of the above patients was detected by Real time-PCR in the laboratory department of each hospital. Results The total HPV prevalence was 74.69% (95% CI 73.28–76.09%) in 3674 patients. The incidence of high- and low-risk HPV was 73.46% and 7.21%, respectively. The prevalence of HPV in CIN I, CIN II, CIN III, and invasive CC (ICC) groups was 66.65% (1273/1910, 95% CI 64.53–68.77%), 80.78% (580/718, 95% CI 77.89–83.67%), 83.88% (483/576, 95% CI 80.84–86.87%), and 86.81% (408/470, 95% CI 83.74–89.88%), respectively. The top three HPV subtypes in ICC are HPV16, HPV52, and HPV58. The prevalence of HPV 16 increased with increasing disease severity, with this genotype being present in 12.57%, 20.89%, 36.98%, and 50.85% of CIN I, CIN II, CIN III, and ICC cases, respectively (p

Abstract Objective To improve the quality of community nursing teaching practice and cultivate undergraduate nursing students who meet the quality accreditation standards of our nursing profession, and to explore the establishment of an undergraduate nurse practice model. Methods Using the methods of literature review, survey, expert consultation, and discussion, we established the steps and contents of community practice teaching for undergraduate nursing students, and implemented them for the students of Grades 2014, 2015, and 2016, and evaluated the “community-hospital-community” practice model through various forms, such as student self-evaluation, faculty evaluation, exit examination, and evaluation by certified experts. Result A three-stage community nursing practice model of “community-hospital-community” was established for undergraduate nursing students. After three stages of practice, nursing undergraduates successfully passed the practical assessments and achieved excellent grades in each stage that met the requirements of the training program. In the first stage (community probation), community probation emphasizes a fundamental understanding of the community, using free clinics, health education, and home visits as entry points to effectively cultivate students’ job competence and proficiency in nursing operations and nurse-patient communication skills. In the second stage (internship in the hospital), through nursing internships in various systems, students are trained to integrate theoretical knowledge with practical skills and consolidate their understanding of fundamental knowledge, theory, and techniques. They are capable of preventing, diagnosing, intervening, and providing health education for common, frequent, urgent and critical complications in various clinical systems. They can formulate nursing plans and implement whole-person care. In the third stage (returning to the community for internship), students can master basic skills such as nursing operations and patient communication skills, and then they can enter the community internship. Conclusion The community nursing practice model of “community- hospital- community” for undergraduate nursing students can systematically train undergraduate nursing students’ ability to work in the community.

Abstract Background Although some factors, such as stigma and empowerment, influence the complex relationship between psychological resilience and quality of life, few studies have explored similar psychological mechanisms among patients with diabetes. Therefore, this study explored the mediating role of stigma and the moderating role of empowerment in the psychological mechanisms by which psychological resilience affects quality of life. Methods From June to September 2022, data were collected by multi-stage stratified sampling and random number table method. Firstly, six tertiary hospitals in Wuhu were numbered and then selected using the random number table method, resulting in the First Affiliated Hospital of Wannan Medical College being selected. Secondly, two departments were randomly selected from this hospital: endocrinology and geriatrics. Thirdly, survey points were set up in each department, and T2DM patients were randomly selected for questionnaire surveys. In addition, we used the Connor-Davidson Elasticity Scale (CD-RISC) to measure the psychological resilience of patients, and used the Stigma Scale for Chronic Illness (SSCI) to measure stigma. Empowerment was measured by the Diabetes Empowerment Scale (DES). Quality of Life was assessed by the Diabetes Quality of Life Scale (DQoL). We used SPSS (version 21) and PROCESS (version 4.1) for data analysis. Results (1) Psychological resilience was negatively correlated with stigma and quality of life, and positively correlated with empowerment. Stigma was positively associated with empowerment and quality of life. Empowerment was negatively correlated with quality of life. (2) The mediation analysis showed that psychological resilience had a direct predictive effect on the quality of life, and stigma partially mediated the relationship; Empowerment moderates the first half of "PR → stigma → quality of life"; Empowerment moderates the latter part of "PR → stigma → quality of life." Conclusions Under the mediating effect of stigma, psychological resilience can improve quality of life. Empowerment has a moderating effect on the relationship between psychological resilience and stigma, and it also has a moderating effect on the relationship between stigma and quality of life. These results facilitate the understanding of the relationship mechanisms between psychological resilience and quality of life.

Background: This meta-analysis explores alterations in the gut microbiota of patients with Multiple Sclerosis (MS) using 16S ribosomal RNA (rRNA) gene sequencing. Methods: Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, our comprehensive review spanned major databases, including PubMed, Web of Science, Embase, Cochrane, and Ovid, targeting observational studies that implemented 16S rRNA gene sequencing on fecal specimens. The quality of these studies was meticulously evaluated using the Newcastle-Ottawa scale. Results: Our search yielded 26 relevant studies conducted between 2015-2022, encompassing 2885 participants. No significant differences were observed in alpha diversity indices (Shannon, Chao1, Operational Taxonomic Units (OTU), and Simpson) between MS patients and controls in general. Nonetheless, subgroup analyses according to disease activity using the Shannon index highlighted a significant decrease in microbial diversity during MS’s active phase. Similarly, an evaluation focusing on MS phenotype revealed diminished diversity in individuals with relapsing-remitting MS (RRMS). Microbial composition analysis revealed no consistent increase in pro-inflammatory Bacteroidetes or decrease in anti-inflammatory Firmicutes within the MS cohort. Conclusion: The gut microbiome’s role in MS presents a complex panorama, where alterations in microbial composition might hold greater significance to disease mechanisms than diversity changes. The impact of clinical factors such as disease activity and phenotype are moderately significant, underscoring the need for further research to elucidate these relationships. Prospective research should employ longitudinal methodologies to elucidate the chronological interplay among gut microbiota, disease evolution, and therapeutic strategies.

Objective MicroRNA-related single-nucleotide polymorphisms (miR-SNPs) can alter microRNA (miRNA) expression profiles, thereby influencing the risk of rheumatic diseases. Herrin a case control study, six miR-SNPs in miRNA processing machinery genes, namely RAN (rs14035), XPO5 (rs11077), Dicer (rs3742330), GEMIN3 (rs197412), GEMIN4 (rs2740348), and TNRC6B (rs9623117), were genotyped to assess their correlation with the risk of systemic lupus erythematosus (SLE). Methods We included 119 patients with SLE and 130 healthy controls. The genotypes of the six miR-SNPs were determined using polymerase chain reaction (PCR). Serum cytokine levels were assessed using a cytometric bead array, and fluorescent probe technology was used to determine plasma reactive oxygen species (ROS) levels. Results The AA genotype of Dicer was correlated with a 0.566-fold decreased risk of SLE compared with that of the AG + GG genotype (odds ratio, 0.566; 95% CI, 0.342–0.935; p = .026), and the rs3742330 A allele was associated with a significantly decreased risk of SLE ( p = .035) compared with that of the rs3742330G allele. Additionally, AA genotype carriers exhibited lower levels of interleukin-6 (IL-6) in the blood ( p = .013). Subsequent analysis revealed increased ROS production in patients with SLE than that in the controls (621.042 ± 425.285 vs 499.966 ± 302.273, p = .011). Conclusion Our findings suggest that ROS generation participates in SLE pathogenesis. The identification of Dicer gene SNP rs3742330 as a potential modifier of SLE risk via mediating IL-6 overproduction suggests a potential avenue for targeted interventions to manage SLE and its associated immune dysregulation.

Technological innovation is crucial for creating sustainable corporate value and shaping competitive advantage in the market. ESG, as an indicator of corporate value practices, plays a significant role in enterprise technological innovation. However, there is little empirical evidence to support this claim. This study analyzes the relationship between ESG performance and technological innovation in Chinese A-share listed enterprises from 2011 to 2021. The statistical data shows that strong ESG performance has a significant positive impact on corporate technological innovation. ESG performance can promote corporate technological innovation through external mechanisms, such as enhancing corporate network location and increasing institutional shareholding. Additionally, internal mechanisms, such as reducing labor costs and easing financing constraints, can also promote corporate technological innovation. The impact of ESG performance on corporations exhibits heterogeneity, with ESG performance promoting innovation more strongly among labor-intensive firms, non-state-owned firms, highly competitive industries, and mature firms. Based on the study results, it is recommended that enterprises actively practice ESG development concepts, optimize their equity structure, strengthen information communication with stakeholders, and alleviate problems such as information asymmetry to improve their technological innovation. The government should focus on enterprise characteristics, improve ESG development policies, and promote enterprise innovation through ESG performance.

BackgroundSchizophrenia (SCZ) is a heritable disorder with a polygenic architecture, and the gut microbiota seems to be involved in its development and outcome. In this study, we investigate the interplay between genetic risk and gut microbial markers.MethodsWe included 159 first-episode, drug-naïve SCZ patients and 86 healthy controls. The microbial composition of feces was characterized using the 16S rRNA sequencing platform, and five microbial α-diversity indices were estimated [Shannon, Simpson, Chao1, the Abundance-based Eoverage Estimator (ACE), and a phylogenetic diversity-based estimate (PD)]. Polygenic risk scores (PRS) for SCZ were constructed using data from large-scale genome-wide association studies. Effects of microbial α-diversity, microbial abundance, and PRS on SCZ were evaluated via generalized linear models.ResultsWe confirmed that PRS was associated with SCZ (OR = 2.08, p = 1.22×10−5) and that scores on the Shannon (OR = 0.29, p = 1.15×10−8) and Simpson (OR = 0.29, p = 1.25×10−8) indices were inversely associated with SCZ risk. We found significant interactions (p

ObjectiveType 2 diabetes mellitus (T2DM) remains a major and widespread public health concern throughout the world. The prevalence of T2DM in the elderly has risen to the top of the list of public health concerns. In this study, obesity- and lipid-related indices were used to predict T2DM in middle-aged and elderly Chinese adults.MethodsThe data came from the China Health and Retirement Longitudinal Study (CHARLS), including 7902 middle-aged and elderly participants aged 45 years or above. The study assessed the association of obesity- and lipid-related indices and T2DM by measuring 13 indicators, including body mass index (BMI), waist circumference(WC), waist-height ratio (WHtR), conicity index(CI), visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP), a body shape index (ABSI), body roundness index (BRI), triglyceride glucose index (TyG-index) and its correlation index (TyG-BMI, TyG-WC, TyG-WHtR). The association of 13 obesity- and lipid-related indices with T2DM was investigated by binary logistic regression. Additionally, the predictive anthropometric index was evaluated, and the ideal cut-off value was established using the receiver operating characteristic (ROC) curve analysis and area under the curve (AUC).ResultsThe study included 7902 participants, of whom 3638(46.04) and 4264(53.96) were male and female. The prevalence of T2DM in mid-aged and old adults in China was 9.02% in males and 9.15% in females. All the above 13 indicators show a modest predictive power (AUC>0.5), which was significant for predicting T2DM in adults (middle-aged and elderly people) in China (P

The Shanghai Cooperation Organisation (SCO) is the most extensive and populous comprehensive regional cooperation organization in the world, covering about half of the world's population, with not only a huge consumer market, but also rich natural resources and strong productivity. As one of the important platforms for the implementation of the Green Belt and Road Initiative, it is an important opportunity for the SCO to actively participate in global governance and contribute to building a community of global life. To investigate the status of biodiversity conservation in the SCO countries, we used literature analysis approach. We surveyed the performance and international cooperation status of the SCO countries in the implementation of the Convention on Biological Diversity (CBD), listed facing problems and threats to biodiversity conservation, including not optimistic biodiversity conservation project implementation status, contradiction between ecological protection and economic development, impacts of human activities, lack of funds and talents, etc., and analyzed the biodiversity protection needs of the SCO countries from the perspectives of project and policy implementation status and international cooperation. According to the cooperation between China and the other SCO countries on biodiversity conservation and the post-2020 global biodiversity framework goals, we gave some recommendations: (1) promoting access to genetic resources and benefit-sharing; (2) integrating multiple funds and innovating the implementation of funding mechanism; (3) developing talent training and exchange programs and deepening multilateral cooperation; (4) strengthening cross-border cooperation and improving cooperation network; and (5) establishing a coordination mechanism for biodiversity conservation within the framework of the SCO.

In this study, persimmon wine was brewed with fresh persimmon pulp (S), frozen persimmon pulp (D), persimmon peel (P), and persimmon pulp treated with tannins (M) under the same conditions. Tannin content and the microbial community structure and diversity during fermentation were analyzed separately in order to analyze dynamic changes to the tannin content and microbial community during the fermentation of persimmon wine following pretreatment with different raw materials and to analyze the differences and correlations between the various raw materials in order to provide a theoretical basis for the later regulation of tannin content in persimmon wine. The results showed that, in all four pretreatments, the tannin content showed a trend of increasing and then gradually decreasing during fermentation, but the tannin content in persimmon wine made from persimmon pulp (M) treated with tannase was always at the lowest tannin content of all the pre-treatments. At the level of the bacterial community structure, the dominant phylum was cyanobacteria on the first day of fermentation, while the dominant phyla from the third day to the ninth day were Firmicutes and Proteobacteria. At the genus level, the dominant phyla varied, with the most frequent phyla being Pediococcus (S), Leuconostoc (D), Acinetobacter (P), Gluconobacter and Pediococcus (M), respectively. At the level of the fungal community, the Cysticercus phylum was dominant. At the genus level, the dominant genera was Saccharomycopsis for all treatments. Persimmon wine with different pre-treatments had a stronger similarity in terms of their fungi during fermentation than in terms of their bacteria. In addition, fresh persimmon pulp (S), frozen persimmon pulp (D), persimmon peel (P), and persimmon pulp fermented by tannase (M) showed significant correlations between tannin content and microbial genera in the fermentation of species 10, 5, 3, and 7, respectively, with different microbial genera. Preliminarily, the raw material pretreatment would affect the tannin content and microbial correlation during the fermentation of persimmon wine.

Abstract Objective Leukoencephalopathies are a group of heterogeneous disorders characterized by the degeneration of white matter, resulting in a variety of progressive neurological symptoms. To date, over 60 genes linked to genetic leukoencephalopathies have been discovered through whole‐exome sequencing (WES) and long‐read sequencing. Nonetheless, the genetic diversity and clinical variability of these disorders among various racial groups remain largely unknown. Therefore, this study aims to analyze the genetic spectrum and clinical features of Chinese adult leukoencephalopathies and compare the genetic profiles in different populations. Methods A total of 129 patients suspected of possible genetic leukoencephalopathy were enrolled and underwent WES and dynamic mutation analysis. Bioinformatics tools were used to predict the pathogenicity of these mutations. Skin biopsies were conducted for further diagnosis. Genetic data sources from different populations were collected from published articles. Results Genetic diagnosis was established in 48.1% of patients, with WES identifying 57 pathogenic or likely pathogenic variants in 39.5% of cases. NOTCH3 and NOTCH2NLC were the most common mutated genes, accounting for 12.4% and 8.5% of cases, respectively. Dynamic mutation analysis revealed NOTCH2NLC GGC repeat expansions in 8.5% of patients. Different mutations resulted in varying clinical symptoms and imaging findings. Comparisons of genetic profiles between different populations showed distinct mutational spectrums in adult leukoencephalopathies. Interpretation This study highlights the importance of genetic testing for accurate diagnosis and improved clinical management of these disorders. It also sheds light on the genetic heterogeneity of adult leukoencephalopathies across different races, emphasizing the need for further research on this topic.

Immune Checkpoint Inhibitors (ICIs) have dramatically revolutionized the therapeutic approaches by which we treat a series of cancers accompanied by immune-related adverse events (irAEs). Herein, we reported an intrahepatic cholangiocarcinoma male patient with a history of ankylosing spondylitis developing pulmonary arterial hypertension (PAH) under ICI combined therapy with pembrolizumab and lenvatinib. The indirect measurement of cardiac ultrasound showed a pulmonary artery pressure (PAP) of 72mmHg after 21 three-week cycles of ICI combined therapy. The patient partially responded to the treatment of glucocorticoid and mycophenolate mofetil. The PAP decreased to 55mmHg 3 months after the ICI combined therapy was discontinued, but increased to 90mmHg after the ICI combined therapy was rechallenged. We treated him with adalimumab -an antitumor necrosis factor-alpha (ani-TNF-α) antibody- combined with glucocorticoid and immunosuppressants under lenvatinib monotherapy. The patient responded again with PAP decreasing to 67mmHg after 2 two-week cycles of adalimumab. Accordingly, we diagnosed him to have irAE-related PAH. Our findings supported the use of glucocorticoid disease-modifying antirheumatic drugs (DMARDs) as a treatment option in refractory PAH.

Abstract Cryo-focused ion beam (cryo-FIB) milling technology has been developed for the fabrication of cryo-lamella of frozen native specimens for study by in situ cryo-electron tomography (cryo-ET). However, the precision of the target of interest is still one of the major bottlenecks limiting application. Here, we have developed a cryo-correlative light and electron microscopy (cryo-CLEM) system named HOPE-SIM by incorporating a 3D structured illumination fluorescence microscopy (SIM) system and an upgraded high-vacuum stage to achieve efficiently targeted cryo-FIB. With the 3D super resolution of cryo-SIM as well as our cryo-CLEM software, 3D-View, the correlation precision of targeting region of interest can reach to 110 nm enough for the subsequent cryo-lamella fabrication. We have successfully utilized the HOPE-SIM system to prepare cryo-lamellae targeting mitochondria, centrosomes of HeLa cells and herpesvirus assembly compartment of infected BHK-21 cells, which suggests the high potency of the HOPE-SIM system for future in situ cryo-ET workflows.

Abstract Background Currently, the study outcomes of anthropometric markers to predict the risk of hypertension are still inconsistent due to the effect of racial disparities. This study aims to investigate the most effective predictors for screening and prediction of hypertension (HTN) in the Chinese middle-aged and more elderly adult population and to predict hypertension using obesity and lipid-related markers in Chinese middle-aged and older people. Methods The data for the cohort study came from the China Health and Retirement Longitudinal Study (CHARLS), including 4423 middle-aged and elderly people aged 45 years or above. We examined 13 obesity- and lipid-related indices, including waist circumference (WC), body mass index (BMI), waist-height ratio (WHtR), visceral adiposity index (VAI), a body shape index (ABSI), body roundness index (BRI), lipid accumulation product index (LAP), conicity index (CI), Chinese visceral adiposity index (CVAI), triglyceride-glucose index (TyG-index) and their combined indices (TyG-BMI, TyG-WC, TyG-WHtR). To compare the capacity of each measure to forecast the probability of developing HTN, the receiver operating characteristic curve (ROC) was used to determine the usefulness of anthropometric indices for screening for HTN in the elderly and determining their cut-off value, sensitivity, specificity, and area under the curve (AUC). Association analysis of 13 obesity-related anthropometric indicators with HTN was performed using binary logistic regression analysis. Results During the four years, the incident rates of HTN in middle-aged and elderly men and women in China were 22.08% and 17.82%, respectively. All the above 13 indicators show a modest predictive power (AUC > 0.5), which is significant for predicting HTN in adults (middle-aged and elderly people) in China (P

Abstract Objective To clarify the expression of N6‐methyladenosine (m6A) modulators involved in the pathogenesis of type 2 diabetes mellitus (T2DM). We further explored the association of serum insulin‐like growth factor 2 mRNA‐binding proteins 3 (IGF2BP3) levels and odds of T2DM in a high‐risk population. Methods The gene expression data set GSE25724 was obtained from the Gene Expression Omnibus, and a cluster heatmap was generated by using the R package ComplexHeatmap. Differential expression analysis for 13 m6A RNA methylation regulators between nondiabetic controls and T2DM subjects was performed using an unpaired t test. A cross‐sectional design, including 393 subjects (131 patients with newly diagnosed T2DM, 131 age‐ and sex‐matched subjects with prediabetes, and 131 healthy controls), was carried out. The associations between serum IGF2BP3 concentrations and T2DM were modeled by restricted cubic spline and logistic regression models. Results Two upregulated (IGF2BP2 and IGF2BP3) and 5 downregulated (methyltransferase‐like 3 [METTL3], alkylation repair homolog protein 1 [ALKBH1], YTH domain family 2 [YTHDF2], YTHDF3, and heterogeneous nuclear ribonucleoprotein [HNRNPC]) m6A‐related genes were found in islet samples of T2DM patients. A U‐shaped association existed between serum IGF2BP3 levels and odds of T2DM according to cubic natural spline analysis models, after adjustment for body mass index, waist circumference, diastolic blood pressure, total cholesterol, and triglyeride. Multivariate logistic regression showed that progressively higher odds of T2DM were observed when serum IGF2BP3 levels were below 0.62 ng/mL (odds ratio 3.03 [95% confidence interval 1.23–7.47]) in model 4. Conclusion Seven significantly altered m6A RNA methylation genes were identified in T2DM. There was a U‐shaped association between serum IGF2BP3 levels and odds of T2DM in the general Chinese adult population. This study provides important evidence for further examination of the role of m6A RNA methylation, especially serum IGF2BP3 in T2DM risk assessment.

Abstract The integration of liposomes into hydrogels through direct soaking presents advantages such as facile formulation, enhanced drug stability, and controlled release kinetics. However, the feasibility of this approach is impeded by the difficulty of developing matching porous structures within hydrogels and achieving appropriate affinity with liposomes. To address these challenges, an alternative method is proposed for synthesizing macroporous hydrogels using thiolated hyaluronic acid and hyperbranched polyethylene glycol macromonomers in combination with a freezing‐induced secondary crosslinking process. This approach allows the locking of macropores formed by ice crystals during freezing and enables easy modification of the hydrogels with cholesterol groups to promote liposome association. Furthermore, these macroporous hydrogels can be crushed into granular hydrogels, which offer numerous benefits such as high loading capacity, injectability, self‐healing properties, and convenience in storage, dosing, and administration. Therefore, a liposome‐in‐hydrogel system can be formulated without any gelation or pre‐treatment, providing valuable insights for the further development of liposome‐based formulations for medical and cosmetic applications.

Under accelerated domestic economic cycle, it is significant to predict the embodied carbon transfer network (ECTNs) to identify key emission regions to improve emission reduction efficiency. Based on the existing China Multi-regional Input-Output Table (CMRIOs) for 2002, 2007, 2010, 2012, 2015 and 2017, the CMRIOs for 2002-2017 were updated, then the ECTNs were predicted and constructed from 2018 to 2025 through Particle Swarm Optimization- Support Vector Model. Finally, the spatial and temporal evolution trends of the ECTNs’ features were explored through complex networks analysis. The results showed that carbon leakage between provinces has been becoming increasingly serious. The small-world features of the ECTNs were becoming increasingly obvious. The distribution of provinces with great influence on carbon transfer was transferred from north to south, and then to the central region. Hebei, Jiangsu, Henan, Zhejiang, Inner Mongolia, and other resource-intensive and manufacturing provinces played an important "bridge" role in the trade between economic developed and developing provinces. Trade ties between non neighboring provinces have become increasingly close, which means the development of China’s integration has strengthened. This study provides a theoretical reference for the formulation of China’s overall carbon emission reduction policy.

Metal–support interaction (MSI) is considered a key effect of electronic and geometric structures of catalysts on tuning catalytic performance. The oxygen evolution reaction (OER) is a crucial process during energy conversion and storage. However, the OER process requires the help of noble metal catalysts to reduce the reaction overpotential, enhance reactivity with intermediates, and maintain good operating stability. Carbon–supported metal catalysts have been considered candidates for noble metal catalysts for OER. MSI occurs at the interface of carbon supports and metals, affecting the catalytic performance through electronic and geometric modulation. MSI can influence the catalytic performance and change reaction pathways from charge redistribution, electron transfer, chemical coordination and bonding, and steric effect. Connecting MSI effects with the OER mechanism can provide theoretical guidance and a practical approach to the design of efficient catalysts, including the modulation of particle size, morphology, heteroatom doping, defect engineering, and coordination atom and number. Advantage can be taken of MSI modulation between metal compounds and carbon supports to provide guidance for catalyst design.

A novel Ni doped carbon quantum dots (Ni-CQDs) fluorescence probe was synthesized by facile electrolysis of monoatomic Ni dispersed porous carbon (Ni–N–C). The obtained Ni-CQDs showed a high quantum yield of 6.3% with the strongest excitation and emission peaks of 360 nm and 460 nm, and maintained over 90% of the maximum fluorescence intensity in a wide pH range of 3–12. The metal ions detectability of Ni-CQDs was enhanced by Ni doping and functional groups modification, and the rapid and selective detection of Fe3+ and Cu2+ ions was achieved with Ni-CQDs through dynamic and static quenching mechanism, respectively. On one hand, the energy band gap of Ni-CQDs was regulated by Ni doping, so that excited electrons in Ni-CQDs were able to transfer to Fe3+ easily. On the other hand, the abundant functional groups promoted the generation of static quenching complexation between Cu2+ and Ni-CQDs. In metal ions detection, the linear quantitation range of Fe3+ and Cu2+ were 100–1000 μM (R2 = 0.9955) and 300–900 μM (R2 = 0.9978), respectively. The limits of detection (LOD) were calculated as 10.17 and 7.88 μM, respectively. Moreover, the fluorescence quenched by Cu2+ could be recovered by EDTA2− due to the destruction of the static quenching complexation. In this way, Ni-CQDs showed the ability to identify the two metal ions to a certain degree under the condition of Fe3+ and Cu2+ coexistent. This work paves the way of facile multiple metal ion detection with high sensitivity.

Abstract Background Studies indicate lower, comparable, and higher cardiovascular risks in women vs men in normal glucose regulation (NGR), prediabetes, and diabetes, respectively. However, this sex difference is uncertain and aging might play a part. We aimed to estimate sex differences in arterial stiffness in NGR, prediabetes, or diabetes and the potential modifications by age. Methods We used baseline data of 9618 participants aged ≥40 years in a large community‐based cohort study in Shanghai. Glycemic status was determined by history of diabetes, fasting and 2‐h post‐load glucose levels, and hemoglobin A1c levels. Arterial stiffness was examined by brachial‐ankle pulse wave velocity (ba‐PWV). Multivariable linear regression analysis was conducted to examine the associations between sex and ba‐PWV levels in glycemic and age categories. Results Before adjustment for age, women had lower, comparable, and higher ba‐PWV vs men in the NGR, prediabetes, and diabetes groups, respectively. In participants aged 40–59 years, women were associated with lower ba‐PWV levels in generally all glycemic strata after adjustment for age and other confounders. In participants aged ≥60 years, women were associated with significantly higher ba‐PWV levels (β coefficient = 71.5; 95% confidence interval = 23.4, 119.7) and the sex difference was attenuated in the groups of prediabetes and diabetes with a borderline significant interaction between sex and glycemic status (p for interaction = .068). Conclusions The sex difference in cardiovascular risks in adults with NGR, prediabetes, or diabetes was dependent on age. Our findings provide new evidence for prioritizing preventive treatment against atherosclerosis in men vs women with different glycemic status.

Abstract Objectives This study aimed to assess the epidemiological features and explore the potential risk factors for early neurological deterioration (END) in patients with acute single small subcortical infarction (SSSI) who underwent antiplatelet therapy without carotid artery stenosis. Materials & methods Patients with SSSI, as confirmed by cranial magnetic resonance imaging (MRI), who were hospitalized within 48 h after the onset of symptoms were enrolled. END was mainly defined as increment in the National Institutes of Health Stroke Scale (NIHSS) score of ≥ 2 points or any new neurological deficit. Poor functional outcome was defined as modified Rankin Scale (mRS) score of > 2 points at 3-month after the onset. The association of END with multiple indicators was assessed at the early stage of admission using multivariate logistic regression analysis, and adjusted odds ratios (aORs) were calculated. Results A total of 280 patients were enrolled from June 2020 to May 2021, of whom, END occurred in 44 (15.7%) patients (median age, 64 years; 70.5% male), while END occurred during sleep in 28 (63.6%) patients. History of hypertension (aOR: 4.82, p = 0.001), infarction in internal capsule (aOR: 3.35, p = 0.001), and elevated level of low-density lipoprotein cholesterol (LDL-C; aOR: 0.036, p = 0.0016) were significantly associated with the risk of END. Patients with END (aOR: 5.74, p = 0.002), history of diabetes (aOR: 2.61, p = 0.020), and higher NIHSS scores at discharge (per 1-score increase, aOR: 1.29, p = 0.026) were associated with the poor functional outcome at 3-month after the onset. Conclusion Patients with a history of hypertension, infarction in internal capsule or a higher level of LDL-C were found to be at a higher risk of END.

Adventitious root formation is a bottleneck during vegetative proliferation. Potassium (K+) is an essential macronutrient for plants. K+ accumulation from the soil and its distribution to the different plant organs is mediated by K+ transporters named K+ transporter (KT), K+ uptake (KUP), or high-affinity K+ (HAK). This study aimed to identify members of the HAK gene family in apples and to characterize the effects of K+ supply on adventitious root formation and on the expression of HAK genes and the genes that putatively control auxin transport, signaling, and cell fate during adventitious root formation. In this study, 34 HAK genes (MdHAKs) were identified in the apple (Malus × domestica ‘Golden Delicious’) genome. A phylogenetic analysis divided MdHAKs into four clusters (I, II, III, and IV), comprising 16, 1, 4, and 13 genes, respectively. The syntenic relationships revealed that 62.5% of the total MdHAK genes arise from genomic duplication events. Chromosome location, domain structure, motif analysis, and physico-chemical characteristics were subsequently investigated. Furthermore, the application of K+ indicated the emergence of adventitious roots at 8 d and produced more adventitious roots at 16 d than the K+-free control (CK) treatment. In addition, various MdHAKs showed root-specific expression in B9 apple rootstock stem cuttings and enhanced expression during the initiation and emergence stages of adventitious root formation in response to K+ treatment. Additionally, K+ treatment enhanced the expression levels of MdPIN1, MdPIN2, and MdAUX1. Further data indicated that a higher expression of MdWOX11, MdLBD16, and MdLBD29 and of cell cycle-related genes contributed to the auxin-stimulated adventitious root formation in response to K+.

Abstract Objective The aim of this study was to evaluate the effectiveness of metagenomic next-generation sequencing (mNGS) for the diagnosis of Pneumocystis jirovecii Pneumonia (PCP) in critically pediatric patients. Methods Seventeen critically pediatric patients with PCP and sixty patients diagnosed with non-PCP pneumonia who were admitted in pediatric intensive care unit between June 2018 and July 2021 were enrolled. Conventional methods and mNGS for detecting Pneumocystis jirovecii (P. jirovecii) were compared. The patients’ demographics, comorbidities, laboratory test results, antibiotic treatment response and 30 day mortality were analyzed. Result The mNGS showed a satisfying diagnostic performance with a sensitivity of 100% in detecting P. jirovecii compared with Gomori methenamine silver staining (5.9%), serum (1,3)-β-D-glucan (86.7%) and and LDH (55.6%). The diagnostic specificity of mNGS for PCP was higher than that of serum BDG (56.7%) and LDH (71.4%). In PCP group, over one thirds’ cases had mixed infections. Compared with survivors, non-survivors had higher stringently mapped read numbers (SMRNs) in bronchoalveolar lavage fluid (BALF) sample (P

This study sought to investigate the anti-amyloid β (Aβ) and anti-neuroinflammatory effects of catalpol in an Alzheimer’s disease (AD) mouse model. Methods: The effects of catalpol on Aβ formation were investigated by thioflavin T assay. The effect of catalpol on generating inflammatory cytokines from microglial cells and the cytotoxicity of microglial cells on HT22 hippocampal cells were assessed by real-time quantitative PCR, ELISA, redox reactions, and cell viability. APPswe/PS1ΔE9 mice were treated with catalpol, and their cognitive ability was investigated using the water maze and novel object recognition tests. Immunohistochemistry and immunofluorescence were used to probe for protein markers of microglia and astrocyte, Aβ deposits, and NF-κB pathway activity. Aβ peptides, neuroinflammation, and nitric oxide production were examined using ELISA and redox reactions. Results: Catalpol potently inhibited Aβ fibril and oligomer formation. In microglial cells stimulated by Aβ, catalpol alleviated the expression of the proinflammatory cytokines tumor necrosis factor-α (TNF-α), interleukin (IL)-6, and inducible nitric oxide synthase (iNOS) but promoted the expression of the anti-inflammatory cytokine IL-10. Catalpol alleviated the cytotoxic effects of Aβ-exposed microglia on HT22 cells. Treatment with catalpol in APPswe/PS1ΔE9 mice downregulated neuroinflammation production, decreased Aβ deposits in the brains and alleviated cognitive impairment. Catalpol treatment decreased the number of IBA-positive microglia and GFAP-positive astrocytes and their activities of the NF-κB pathway in the hippocampus of APPswe/PS1ΔE9 mice. Conclusion: The administration of catalpol protected neurons by preventing neuroinflammation and Aβ deposits in an AD mouse model. Therefore, catalpol may be a promising strategy for treating AD.

ObjectiveDepression in diabetes patients is caused by their own disease or the surrounding social environment. How to cope with changes in mentality and adjust psychological stress responses, especially under China’s dynamic zero COVID-19 policy, is worth further discussion. The researchers constructed a moderated mediation model to test the effect of psychological resilience during dynamic zero COVID-19 on depression in diabetes patients and the mediating role of stigma and the moderating effect of medication burden.MethodFrom June to September, 2022, data were collected in Jinghu District, Wuhu City, Anhui Province, by multi-stage stratified sampling. Firstly, we selected a tertiary hospital randomly in Jinghu District. Secondly, departments are randomly chosen from the hospital. Finally, we set up survey points in each department and randomly select diabetes patients. In addition, we used the Connor-Davidson Elasticity Scale (CD-RISC) to measure psychological resilience of patients, and used the Stigma Scale for Chronic Illness (SSCI) to measure stigma, medication burden was measured by the Diabetes Treatment Burden Scale (DTBQ), and depression was assessed by the Patient Health Questionnaire-9 (PHQ-9). We used SPSS (version 23.0) and PROCESS (version 4.1) for data analysis.Results(1) Psychological resilience was negatively correlated with stigma, medication burden, and depression. Stigma was positively associated with medication burden and depression. Medication burden and depression are positively correlated, (2) The mediation analysis showed that psychological resilience had a direct predictive effect on depression, and stigma partially mediated the relationship, and (3) Medication burden moderates the direct pathway by which psychological resilience predicts depression; Medication burden moderates the first half of “psychological resilience → stigma → depression.”ConclusionUnder the mediating effect of stigma, psychological resilience can improve depression. Medication burden has a moderating effect on the relationship between psychological resilience and depression, and it also has a moderating effect on the relationship between psychological resilience and stigma. These results facilitate the understanding of the relationship mechanisms between psychological resilience and depression.

ObjectiveHuman papillomavirus (HPV) infection is currently the main cause of cervical cancer and precancerous lesions in women. The aim of this study was to investigate the epidemiological characteristics of HPV genotypes among women in Yueyang city and to provide a basis for the prevention and treatment of cervical cancer in this city.MethodsA cross-sectional study was conducted on 125,604 women who had received treatment from eight hospitals in Yueyang city from September 2019 to September 2022. Analysis of the prevalence of HPV in patients.ResultsThe prevalence of HPV was 20.5% (95%CI: 20.2–20.7%), of which the high-risk type (HR-HPV) accounted for 17.5% (95%CI: 17.3–17.7%) and the low-risk type (LR-HPV) accounted for 5.0% (95%CI: 4.9–5.1%). Among the HR-HPV subtypes, the top five in prevalence, from the highest to the lowest, were HPV52 (5.1%), HPV16(2.7%), HPV58 (2.6%), HPV53 (2.4%), and HPV51 (1.7%). The main LR-HPV infection types were HPV81 (2,676 cases, OR = 2.1%; 95%CI, 2.0–2.1%). Among the infected patients, 19,203 cases (OR = 74.3%; 95%CI, 73.8–74.9%) had a single subtype, 4,673 cases (OR = 18.1%; 95%CI, 17.6–18.6%) had two subtypes, and 1957 cases (OR = 7.6%; 95%CI, 7.3–7.9%) had three or more subtypes. HPV prevalence is highest among women

This study aimed to investigate the relationship between ZNF582 promoter methylation (ZNF582m) level and radiosensitivity of cervical cancer and its biological basis. This was a prospective multicenter clinical study, comprising two independent cohorts of locally advanced cervical cancer patients. Exfoliated cervical cells were collected at 0, 24, 30, 36, 48, and 64 Gy to test ZNF582m levels. Radiotherapy response was evaluated according to RECIST Version. RT-PCR and WT were used to detect the mRNA and protein expression levels; MTT and flow cytometry were used to detect the cell viability and cell cycle, respectively. While clone formation and subcutaneous tumorigenesis in nude mice were used to detect the growth of HeLa cells with/without ZNF582 overexpression. In the first cohort, 22 cases achieved complete remission (CR) or partial response (PR), and the other 28 cases exhibited stable disease (SD). Radiotherapy reduced ZNF582m levels among all patients. Initial lever of ZNF582m was significantly higher in the Responder (CR + PR) group than in the SD group. Also, patients with higher initial lever ZNF582m were more sensitive towards radiotherapy than ZNF582m-low patients. The second cohort confirmed the above results. The amplitude of ZNF582m levels were related to the radiotherapeutic response; some patients of ZNF582m-low showed a transient increase in ZNF582m, and present greater radiosensitivity than other ZNF582m-low patients. In vitro, ZNF582 protein overexpression promoted cell cycle arrest in S phase. These results suggested that higher ZNF582m levels predicted greater radiosensitivity in clinical cervical cancer cases. Overexpressed ZNF582 conferred radioresistance by cell cycle arrest in vitro.