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Linmei Xiao,1,&ast; Jingjing Ma,2,&ast; Ruidong Chen,2,3,&ast; Jie Chen,4 Qiang Wang,5 Nana Tang,2 Xiaojing Zhao,2 Hongjie Zhang,2 Chunhua Jiao2 1Department of Liver Disease, Wuxi No.5 People’s Hospital Affiliated to Jiangnan University, Wuxi, People’s Republic of China; 2Department of Gastroenterology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China; 3Department of Gastroenterology, The Second Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China; 4Northern Jiangsu People’s Hospital/Northern Jiangsu People’s Hospital of Jiangsu Province, Yangzhou, Jiangsu Province, People’s Republic of China; 5Jiangsu Shengze Hospital, Suzhou, Jiangsu Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Chunhua Jiao; Hongjie Zhang, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu Province, 210029, People’s Republic of China, Tel +86 13913928581, Email jch0409@163.com; hjzhang06@163.comPurpose: Cytomegalovirus (CMV) infection exacerbates intestinal inflammation in ulcerative colitis (UC) patients, yet the effect of CMV infection on UC relapse has not been fully elucidated. This study aimed to investigate the impact of CMV infection on UC relapse and identify associated risk factors.Patients and Methods: This multicenter retrospective cohort study included UC patients who visited research centers from January 2016 to December 2020. Univariate and multivariate Cox regression analyses were conducted to explore risk factors for UC relapse. Propensity score matching was used to balance the differences in the clinical characteristics between the groups.Results: A total of 298 UC patients participated in this study, including 19 with CMV colitis, 37 with CMV viremia, and 242 CMV-negative patients. The 2-year cumulative recurrence rate was higher in patients with CMV colitis than that in CMV-negative patients (84.21% vs 51.65%, p = 0.01). Univariate and multivariate Cox regression analyses confirmed that fecal calprotectin ≥ 250 μg/g, Montreal classification E3, CMV colitis, duration > 48 months, and serum albumin < 30 g/L were independent risk factors for UC relapse at 2 years, whereas the use of biologics for induction of remission was identified as an independent protective factor.Conclusion: Our study suggests that the risk of relapse increases among UC patients with CMV colitis over two years. Risk factors for UC relapse at 2 years include fecal calprotectin ≥ 250 μg/g, Montreal classification E3, CMV colitis, UC duration > 48 months, and albumin < 30 g/L, whereas the use of biologics during induction is a protective factor.Plain Language Summary: Patients with ulcerative colitis and cytomegalovirus colitis are at a higher risk of relapse over a 2-year period than those who are CMV negative. Additionally, we identified several risk factors for UC relapse at 2 years, including fecal calprotectin ≥ 250 μg/g, Montreal classification E3, CMV colitis, duration of UC ≥ 48 months, and albumin < 30 g/L, whereas the administration of biologics during remission induction contributed to reducing UC relapse.Keywords: Ulcerative colitis, cytomegalovirus colitis, relapse, risk factors

Zhichao Zhu,&ast; Weiheng Zheng,&ast; Nan Tang, Weimei Zhong Human Resource Department, Shenzhen Children’s Hospital, Shenzhen, Guangdong, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Nan Tang; Weimei Zhong, Email phoebetn@outlook.com; zhongweimei_023@163.comAbstract: Background: Hospital manpower management (HRM) is vital for effective healthcare delivery. Unique challenges, such as managing diverse staff, ensuring clear communication, and optimizing resources, complicate HRM. Rising operational costs, workforce shortages, and employee burnout necessitate strategic approaches to manpower management. This review aims to provide a comprehensive understanding of manpower management in hospitals, focusing on identifying core components and discussing innovative strategies to address current challenges, particularly those related to workforce shortages. A literature review was conducted using databases such as PubMed, Scopus, and Google Scholar. Key terms included “hospital manpower management”, “HRM challenges in healthcare”, and “workforce shortages”, selected for their relevance to the core focus of this review. Relevant articles published from 2019 to 2023 were selected for analysis. The review identified core components of manpower management: recruitment and staffing, workforce planning, training and development, performance management, and compensation and benefits. Strategies to address workforce shortages included strategic hiring and enhancing employee engagement. The integration of technology and ongoing training emerged as critical for maintaining high-quality patient care. Effective manpower management is essential for the sustainability of healthcare systems. This review highlighted the importance of innovative HRM strategies to tackle workforce shortages and improve employee satisfaction. By focusing on comprehensive HRM practices, healthcare organizations could enhance workforce efficiency and provide better patient care. Future research should explore the long-term impacts of these strategies on healthcare.Keywords: hospital manpower management, workforce shortages, HRM challenges in healthcare, workforce planning

Shupeng Chen,1 Jie Liu,1 Guilian He,1 Nana Tang,2 Yingjian Zeng2 1School of Clinical Medicine, Jiangxi University of Chinese Medicine, Nanchang, 330004, People’s Republic of China; 2Hematology Department, Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, 330006, People’s Republic of ChinaCorrespondence: Yingjian Zeng, Jiangxi University of Traditional Chinese Medicine Affiliated Hospital, Hematology Department, Nanchang, 330006, People’s Republic of China, Email tcmdrc2023@outlook.comBackground: Cancer poses a major global health challenge, and immunotherapy, known as the third revolution in cancer treatment, has brought new hope to patients. The emerging field of immunometabolism has further enhanced the safety and efficacy of immunotherapy. Over the past two decades, this field has rapidly evolved in oncology, leading to numerous significant findings. This review systematically examines the literature on immunometabolism in cancer, visualizing research trends and identifying future directions.Methods: A comprehensive literature search was conducted in the Web of Science, PubMed, and Scopus databases, covering publications from January 2000 to December 2023. We employed tools like Citespace, VOSviewer, and RStudio for visual analysis of publication trends, regional contributions, institutions, authors, journals, and keywords.Results: A total of 3320 articles were published by 8090 authors across 1738 institutions, involving 71 countries. Leading contributors were China (n=469), the United States (n=361), and Germany (n=82). Harvard University was the most influential institution, while Frontiers in Immunology had the highest number of publications. The top research areas included glucose, lipid, and amino acid metabolism, the tumor microenvironment, and immune cell regulation.Conclusion: International collaboration and interdisciplinary efforts are advancing the field of cancer immunometabolism. Future research will likely focus on the interplay between metabolism and immunity, metabolic markers, immune cell reprogramming, and tumor-immune metabolic competition.Keywords: immunity, metabolism, tumor, metabolic reprogramming, immune evasion, bibliometrics

Nan Tang,1 Mengyue Pei,2 Huihui Liu,3 Jingru Chen,1 Youting Wang,1 Lei Xie,4 Junping Hu,3,5 Jing Wang,6 Yuan Gao1 1Department of Nursing, 1st Medical Centre of PLA General Hospital, Beijing, People’s Republic of China; 2School of Medicine, Henan Kaifeng College of Science Technology and Communication, Kaifei, Henan Province, People’s Republic of China; 3School of Nursing, Lanzhou University, Lanzhou, Gansu Province, People’s Republic of China; 4Renji Hospital, Shanghai Jiaotong University, Shanghai, People’s Republic of China; 5Department of Reproductive Medicine, The First Hospital of Lanzhou University, Lanzhou, Gansu Province, People’s Republic of China; 6Department of Gynecology, 1th Medical Centre of PLA General Hospital, Beijing, People’s Republic of ChinaCorrespondence: Jing Wang; Yuan Gao, Email wangjing353535@163.com; gaoyuanzd@163.comBackground: The purpose of this study was to explore the relationship between infertility-related stress and dyadic coping with quality of life (QoL) in couples with infertility issues, and verify gender differences and dyadic interactions in the associations between them.Methods: This cross-sectional study included 340 couples who were recruited from the First Affiliated Hospital of Lanzhou University between March 2022 and November 2022. The Fertility Problem Inventory, Dyadic Coping Inventory and FertiQoL were used to measure infertility-related stress, dyadic coping and QoL. The Actor-Partner Interdependence Model was used to analyze the effects of infertility-related stress and dyadic coping on the couple’s own QoL (actor effect) as well as on their partner’s QoL (partner effect).Results: Female patients perceived significantly lower levels of QoL and dyadic coping than those of husbands. There was no statistically significant difference in the infertility-related stress between wives and husbands. Husbands’ infertility-related stress had actor and partner effects on their own and their wives’ QoL, while wives’ infertility-related stress only had an actor effect on their own QoL. Husbands’ dyadic coping had both actor effect and partner effects on their own and their wives’ QoL, meanwhile wives’ dyadic coping had both actor effect and partner effects on their own and their husbands’ QoL.Conclusion: Husbands’ QoL was impacted by their own infertility-related stress, dyadic coping and their wives’ dyadic coping. Whereas wives’ QoL was influenced by infertility-related stress and dyadic coping from both their own and their spouses. Therefore, elevating the level of dyadic coping may contribute to improving QoL for both husbands and wives. Moreover, enhancing the ability to cope with infertility-related stress might be useful for husbands and indirectly contribute to wives’ QoL.Keywords: infertility, couple, infertility-related stress, dyadic coping, QoL

Ying Zhu,&ast; Yiyi Zhang,&ast; Miao Yang, Nie Tang, Limei Liu, Jichuan Wu, Yan Yang Department of Endocrinology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yan Yang, Department of Endocrinology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, People’s Republic of China, Email yangyan_2012@126.comPurpose: Diabetic nephropathy (DN), a major complication of diabetes mellitus, significantly impacts global health. Identifying individuals at risk of developing DN is crucial for early intervention and improving patient outcomes. This study aims to develop and validate a machine learning-based predictive model using integrated biomarkers.Methods: A cross-sectional analysis was conducted on a baseline dataset involving 2184 participants without DN, categorized based on their development of DN over a follow-up period of 36 months: DN (n=1270) and Non-DN (n=914). Various demographic and clinical parameters were analyzed. The findings were validated using an independent dataset comprising 468 participants, with 273 developing DN and 195 remaining as Non-DN over the follow-up period. Machine learning algorithms, alongside traditional descriptive statistics and logistic regression were used for statistical analyses.Results: Elevated levels of serum creatinine, urea, and reduced eGFR, alongside an increased prevalence of retinopathy and peripheral neuropathy, were prominently observed in those who developed DN. Validation on the independent dataset further confirmed the model’s robustness and consistency. The SVM model demonstrated superior performance in the training set (AUC=0.79, F1-score=0.74) and testing set (AUC=0.83, F1-score=0.82), outperforming other models. Significant predictors of DN included serum creatinine, eGFR, presence of diabetic retinopathy, and peripheral neuropathy.Conclusion: Integrating machine learning algorithms with clinical and biomarker data at baseline offers a promising avenue for identifying individuals at risk of developing diabetic nephropathy in type 2 diabetes patients over a 36-month period.Keywords: diabetic nephropathy, prediction, machine learning, biomarkers, risk stratification, type 2 diabetes

Nan Tang,1,&ast; Xiao-Ting Liu,2,&ast; Xiao-Li Lin,2 Wen-Xiu Yang,2 Qi-Lin Li,3 Guo-En Wang,2 Yan-Hua Wu1 1Departments of Traditional Chinese Medicine, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, 510220, People’s Republic of China; 2School of Chinese Materia Medica, Guangdong Pharmaceutical University, Guangzhou, Guangdong, 510006, People’s Republic of China; 3Departments of Dermatology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, 510220, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yan-Hua Wu, No. 396 Tongfu Zhong Road, Guangzhou, Guangdong Province, 510220, People’s Republic of China, Email wuyanhua368@163.com Guo-En Wang, No. 280, Waihuan East Road, University Town, Guangzhou, Guangdong Province, 510006, People’s Republic of China, Email wangge07@126.comPurpose: Vitiligo is an autoimmune disease that results in the loss of epidermal melanocytes. The treatments for patients with vitiligo remain lacking. Erzhiwan (EZW), a traditional Chinese Medicine composed of Ligustri Lucidi Fructus and Ecliptae Herba, was used to ameliorate depigmentation since ancient China. This study aims to investigate the effect of EZW on vitiligo-related depigmentation.Methods: A vitiligo-related depigmentation mouse model was induced by monobenzone and restraint stress. The experimental depigmentation mice were treated with EZW. Histological observation of skin was conducted. Cutaneous oxidative damage and inflammation were determined. A network pharmacology analysis was carried out.Results: EZW reduced depigmentation score (p< 0.01), cutaneous inflammatory infiltration (p< 0.01), and CD8α-positive expression (p< 0.01), and increased cutaneous melanin content in experimental depigmentation mice. EZW reduced stress reaction in experimental depigmentation mice (p< 0.01). EZW inhibited 8-hydroxy-2-deoxyguanosine (8-OHdG)-related DNA oxidative damage in the skin (p< 0.05, p< 0.01). In addition, EZW reduced cutaneous macrophage migration inhibitory factor (MIF)-CD74-NF-κB signaling (p< 0.01). The network pharmacology analysis demonstrated that EZW regulated necroptosis, apoptosis, and FoxO signaling pathways in vitiligo. An in vitro experiment showed that the main ingredient of EZW, specnuezhenide, protected against monobenzone and MIF-induced cell death in HaCaT cells (p< 0.01).Conclusion: EZW ameliorates restraint stress- and monobenzone-induced depigmentation via the inhibition of MIF and 8-OHdG signaling. The findings provide a data basis of an utilization of EZW in vitiligo.Keywords: vitiligo, 8-hydroxy-2-deoxyguanosine, Ligustri Lucidi Fructus, Ecliptae Herba, specnuezhenide

Nan Tang,1,2,&ast; Mengyue Pei,2,3,&ast; Lei Xie,2,4 Xueping Liang,2 Junping Hu,2,5 Yuan Gao1 1Department of Nursing, 1th Medical Centre of PLA General Hospital, Beijing, People’s Republic of China; 2School of Nursing, Lanzhou University, Lanzhou, Gansu, People’s Republic of China; 3Henan Kaifeng College of Science Technology and Communication, Kaifei, Henan, People’s Republic of China; 4Renji Hospital, Shanghai Jiaotong University, Shanghai, People’s Republic of China; 5The First hospital of Lanzhou University, Lanzhou, Gansu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Junping Hu; Yuan Gao, Email hjplandashengzhi@126.com; gaoyuanzd@163.comBackground: This study aims to examine the relationship between anxiety and depression and dyadic coping in infertile couples, exploring gender differences and dyadic interactions in these associations.Methods: A cross-sectional study was conducted involving 288 couples recruited from the First Affiliated Hospital of Lanzhou University between November 2021 and November 2022. The Dyadic Coping Scale, Anxiety Scale, and Depression Scale were utilized to measure dyadic coping, anxiety, and depression, respectively. The Actor-Partner Interdependence Model was used to analyze the actor effect and partner effect.Results: Wives exhibited significantly higher anxiety and depression scores compared to husbands (p< 0.001). No statistically significant difference was found in dyadic coping between wives and husbands. Positive dyadic coping in infertile couples had significant actor effects on anxiety and depression (p< 0.05) and partner effects (p< 0.05). Positive dyadic coping negatively predicted anxiety and depression of oneself and one’s partner. Negative dyadic coping in infertile couples also had significant actor effects on anxiety and depression (p< 0.05) and partner effects (p< 0.05). Negative dyadic coping positively predicted anxiety and depression of oneself and one’s partner.Conclusion: The dyadic coping style of infertile couples has both actor and partner effects on their own and their partner’s anxiety and depression. Anxiety and depression in infertile couples are influenced by their own and their partner’s dyadic coping style, respectively. Therefore, dyadic coping serves as an important indicator for predicting psychological outcomes in these couples.Keywords: infertility couple, dyadic coping, anxiety, depression

Dongning Lyu, Guangyu He, Kan Zhou, Jin Xu, Haifei Zeng, Tongyu Li, Ningbo Tang Department of Nephrology Clinic, Guangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, Guangxi, People’s Republic of ChinaCorrespondence: Dongning Lyu, Guangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine, No. 8 Qiuyue Road, Liangqing District, Nanning, Guangxi, 530200, People’s Republic of China, Tel +8613377191933, Email tsj757700@163.comPurpose: Uremia, which is characterized by immunodeficiency, is associated with the deterioration of kidney function. Immune-related genes (IRGs) are crucial for uremia progression.Methods: The co-expression network was constructed to identify key modular genes associated with uremia. IRGs were intersected with differentially expressed genes (DEGs) between uremia and control groups and key modular genes to obtain differentially expressed IRGs (DEIRGs). DEIRGs were subjected to functional enrichment analysis. The protein-protein interaction (PPI) network was constructed. The candidate genes were identified using the cytoHubba tool. The biomarkers were identified using various machine learning algorithms. The diagnostic value of the biomarkers was evaluated using receiver operating characteristic (ROC) analysis. The immune infiltration analysis was implemented. The biological pathways of biomarkers were identified using gene set enrichment analysis and ingenuity pathway analysis. The mRNA expression of biomarkers was validated using blood samples of patients with uremia and healthy subjects with quantitative real-time polymerase chain reaction (qRT-PCR).Results: In total, four biomarkers (PDCD1, NGF, PDGFRB, and ZAP70) were identified by machine learning methods. ROC analysis demonstrated that the area under the curve values of individual biomarkers were > 0.9, indicating good diagnostic power. The nomogram model of biomarkers exhibited good predictive power. The proportions of six immune cells significantly varied between the uremia and control groups. ZAP70 expression was positively correlated with the proportions of resting natural killer (NK) cells, naïve B cells, and regulatory T cells. Functional enrichment analysis revealed that the biomarkers were mainly associated with translational function and neuroactive ligand-receptor interaction. ZAP70 regulated NK cell signaling. The PDCD1 and NGF expression levels determined using qRT-PCR were consistent with those determined using bioinformatics analysis.Conclusion: PDCD1, NGF, PDGFRB, and ZAP70 were identified as biomarkers for uremia, providing a theoretical foundation for uremia diagnosis. Keywords: differential expression analysis, WGCNA, immune infiltration, nomogram, diagnosis

Chunlong Zhao,1,2,&ast; Zipeng Xu,1,&ast; Weidong Hu,1,&ast; Chen Ge,1 Zhengwei Zhang,1 Zhengxing Dai,3 Shuo Zhang,4 Neng Tang,4 Weiguo Wang,3 Jiayu Gu,3 Chaobo Chen,1,4,5 Songbing He2 1Department of General Surgery, Xishan People’s Hospital of Wuxi City, Wuxi, People’s Republic of China; 2Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China; 3Department of Interventional and Vascular Surgery, Xishan People’s Hospital of Wuxi City, Wuxi, People’s Republic of China; 4Department of Hepatic-Biliary-Pancreatic Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, People’s Republic of China; 5Department of Immunology, Ophthalmology & ORL, Complutense University School of Medicine, Madrid, Spain&ast;These authors contributed equally to this workCorrespondence: Chaobo Chen; Songbing He, Email bobo19820106@gmail.com; hesongbing1979@suda.edu.cnBackground: Laparoscopic cholecystectomy (LC) with laparoscopic common bile duct exploration (LCBDE) is convenient in treating cholelithiasis and choledocholithiasis due to its advantage of accelerated recovery. This retrospective study aimed to summarize the experience of cholelithiasis and choledocholithiasis treatment via three-port approach of LCBDE in Eastern China.Methods: Patients diagnosed with cholelithiasis and choledocholithiasis between July 2019 and October 2021 were included. Patients who received LC+LCBDE+primary suturing of the common bile duct (CBD) via a three-port approach were assigned to the LCBDE-P group, and those who received LC+LCBDE+T-tube drainage of CBD comprised the LCBDE-T group. The measurement data were compared between the two groups. P-values < 0.05 indicated statistical significance.Results: A total of 88 patients were divided into two groups: LCBDE-P (n=50) and LCBDE-T (n=38). Multiple logistic regression analysis showed that LCBDE-P is associated with a shorter length of stay (OR=0.115, 95% CI: 0.040– 0.329, P< 0.001) and lower hospitalization costs (OR=0.120, 95% CI: 0.041– 0.357, P< 0.001). No significant differences between the two groups were detected in the operation time, intraoperative hemorrhage, clearance rate of CBD stones, postoperative liver function, and postoperative complications (P> 0.05).Conclusion: The three-port approach of LCBDE is a safe and feasible strategy for managing cholelithiasis and choledocholithiasis. Compared to LCBDE-T, LCBDE-P reduces the length of hospital stay and medical costs during hospitalization.Keywords: cholelithiasis, choledocholithiasis, laparoscopic cholecystectomy, laparoscopic common bile duct exploration, primary suture, T-tube drainage

Tian-Shan Liang,1,&ast; Nan Tang,1,&ast; Ming-Hua Xian,2 Wei-Lun Wen,1 Chang-Jin Huang,1 Lan-Hua Cai,1 Qi-Lin Li,3 Yan-Hua Wu1 1Department of Traditional Chinese Medicine, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, 510220, People’s Republic of China; 2School of Chinese Materia Medica, Guangdong Pharmaceutical University, Guangzhou, Guangdong, 510006, People’s Republic of China; 3Department of Dermatology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, 510220, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yan-Hua Wu, Department of Traditional Chinese Medicine, Guangzhou Red Cross Hospital, Jinan University, 396 Tongfu Zhong Road, Guangzhou, Guangdong, 510220, People’s Republic of China, Tel +86-020-61883742, Email wuyanhua368@163.comObjective: Vitiligo is an autoimmune disease of the skin that targets pigment-producing melanocytes and results in patches of depigmentation that are visible as white spots. Recent research studies have yielded a strong mechanistic understanding of this disease. Fructus Ligustri Lucidi (FLL) has been used for premature graying of hair since ancient China and is currently used to treat vitiligo. However, the key biomarkers and mechanisms underlying FLL in vitiligo remain unclear. This study aimed to identify the potential biomarkers and mechanisms of FLL in vitiligo using network pharmacology analysis.Methods: The expression profiles of GSE65127 and GSE75819 were downloaded from the Gene Expression Omnibus database to identify differentially expressed genes (DEGs) between the vitiligo and healthy samples. Gene ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment of DEGs were performed using R analyses. We performed R to further understand the functions of the critical targets. Cytoscape tools have facilitated network topology analysis. Molecular docking was performed using Auto Dock Vina software.Results: The results showed that 13 DEGs were screened in vitiligo. Based on bioinformatics, network pharmacology and Western blot, we found that the critical targets of melanoma antigen recognized by 5,6-dihydroxyindole-2-carboxylic acid oxidase (TYRP1) may be related to the mechanism of action of FLL in the treatment of vitiligo.Conclusion: TYRP1, as a melanocyte molecular biomarker, may be closely related to the underlying mechanism of FLL in the treatment of vitiligo via the inhibition of melanocyte death.Graphical Abstract: Keywords: vitiligo, bioinformatics, molecular docking, biomarkers, Fructus Ligustri Lucidi

Nan Tang,1,&ast; Qing-An Huang,2,&ast; Lan-Hua Cai,1 Dong-Mei Deng,3 Mu Niu4 1Departments of Traditional Chinese Medicine, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, Guangdong, People’s Republic of China; 2Department of General Ward, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China; 3Health Management Center, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China; 4Department of Cosmetic Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Mu Niu, Department of Cosmetic Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, People’s Republic of China, Email 382219948@qq.com Dong-Mei Deng, Health Management Center, The Fifth People’s Hospital of Hainan Province, Haikou, People’s Republic of China, Email m15289975100@163.comAbstract: We describe a 39-year-old woman with a 1-month-old linear erythema diagnosed with cutaneous larva migrans by reflectance confocal microscopy (RCM). This case reveals that the great significance of diagnosing and treating cutaneous larva migrans (CLM) by RCM and dermoscopy, which might provide novel insights into dermatological clinical practice.Keywords: reflectance confocal microscopy, cutaneous larva migrans, linear erythema

Tao Rui,1,2 Kai Wang,1,2 Aizhai Xiang,1 Jufeng Guo,1 Ning Tang,1 Xin Jin,1 Yimou Lin,3 Jian Liu,1 Xiaobing Zhang1,2 1Department of Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People’s Republic of China; 2Key Laboratory of Integrated Oncology and Intelligent Medicine of ZheJiang Province, Zhejiang University School of Medicine, Hangzhou, 310003, People’s Republic of China; 3Department of Surgery, Collaborative Innovation Center for the Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University Hangzhou, Hangzhou, 310003, People’s Republic of ChinaCorrespondence: Tao Rui; Xiaobing Zhang, Email 11818248@zju.edu.cn; 11818341@zju.edu.cnBackground: Serum exosome-based liquid biopsy has significant advantages for screening and diagnosing hepatocellular carcinoma (HCC). P-element-induced wimpy testis (PIWI)-interacting RNAs (piRNAs) are novel small silencing RNAs that have been identified to function in cancer-related signalling pathways. However, studies on the presence of piRNAs in serum exosomes from HCC patients and their diagnostic values in HCC are not well reported. Our aim is to validate serum exosome-derived piRNAs as the valuable component of liquid biopsy for diagnosing HCC.Methods: We used small RNA (sRNA) sequencing to profile piRNAs from serum exosomes and describe the base distribution characteristics of serum exosome-derived piRNAs. Serum exosomes from 125 HCC patients and 44 nontumor donors were included in this study.Results: We found that piRNAs were components of serum exosomes from HCC patients. A total of 253 differentially expressed serum exosome-derived piRNAs were screened from HCC compared with the piRNAs from nontumor donors. Serum exosome-derived piRNAs from HCC displayed a distinctive base distribution. To further confirm the potential diagnostic value of serum exosome-derived piRNAs in HCC, we detected the levels of the top 5 upregulated piRNAs in our Chinese cohort. The training set and validation set both showed that all 5 piRNAs were dramatically increased in the serum exosomes from HCC compared with the piRNAs from non-tumour donors. The piRNAs could strongly identify HCC patients from non-tumour donors according to the area under the receiver operating characteristic (AUROC) model. Additionally, the piRNAs could also present significant values for the diagnosis of HCC with low tumour burden.Conclusion: piRNAs enriched the components of serum exosomes from HCC and could serve as promising biomarkers for HCC diagnosis.Keywords: biomarker, exosome, sRNA-seq, HCC, piRNA

Nana Tang,1 Han Chen,1 Ruidong Chen,2 Wen Tang,2 Hongjie Zhang1 1Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 2Department of Gastroenterology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People’s Republic of ChinaCorrespondence: Hongjie Zhang, Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, People’s Republic of China, Email hjzhang06@163.com Wen Tang, Department of Gastroenterology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, People’s Republic of China, Email louisetangwen@163.comPurpose: Mucosal healing (MH) has become a therapeutic end point for Crohn’s disease (CD). The purpose of this study was to identify potential risk factors responsible for a lower probability of mucosal healing in CD. It also aimed to create and validate a noninvasive tool for predicting mucosal healing in CD to aid clinical decision-making.Patients and Methods: We established a derivation cohort diagnosed with CD, in which endoscopic examination was performed before and after treatment at the First Affiliated Hospital of Nanjing Medical University between January 2010 and June 2021. Patient data including demographic and clinical characteristics and treatment details were collected. The achievement of mucosal healing (without ulceration on endoscopic examination) after treatment was the endpoint observed during follow-up. We performed logistic regression analysis to identify factors associated with mucosal healing. These factors were used to develop a model (CD mucosal healing prediction nomogram) to predict mucosal healing in CD. External validation was performed using a new cohort of 60 patients from the Second Affiliated Hospital of Soochow University between January 2012 and June 2021.Results: A total of 331 patients were included in the derivation cohort. We found the following factors to be independently associated with mucosal healing after treatment: disease course < 11 months, ulcer size < 0.5 cm, Harvey-Bradshaw Index score < 9, infliximab treatment, and non-exclusive use of 5-aminosalicylic acid. The model incorporating these factors achieved good discrimination, calibration, and clinical decision curve analysis results on internal validation (C-index: 0.788, 95% confidence interval [CI]: 0.74– 0.84). The external validation cohort also demonstrated good discrimination (C-index: 0.785, 95% CI: 0.68– 0.90) and calibration.Conclusion: The CD mucosal healing prediction nomogram model demonstrated good reliability and validated. It can potentially be developed into a simple and clinically useful tool for predicting mucosal healing in CD.Keywords: disease course, HBI scores, ulcer size, infliximab

Chen Z, Lian F, Wang X, Chen Y, Tang N. Int J Nanomedicine. 2016;11:4247–4259. The authors have advised Figure 5D on page 4256 is incorrect. Due to an error that occurred inadvertently at the time of figure assembly, the β-Actin row in parts C and D were duplicated. The correct Figure 5 is shown below. Figure 5 Continued. Figure 5 Effects of RGD-PEG-PAMAM on the synthesis of albumin and urea in Huh7 cells.Abbreviations: RGD, arginine–glycine–aspartic acid; PEG, polyethylene glycol; PAMAM, polyamidoamine.Notes: (A) Albumin level in the supernatant of different cells in cultivation for 1, 3, and 5 days. Group data represent mean ± standard deviation (n=3). *P

Background and aim: Digital interventions for depression and anxiety can be as effective as face-to-face therapy. One in six workers experience some form of mental health problems, making the workplace a potential avenue to deliver mental health interventions as part of a stepped care model. This study aimed to assess the acceptability, feasibility, and preliminary efficacy of a digital cognitive behavioural therapy (dCBT) on depression and anxiety for employees in the workplace. Methods: A mixed-methods evaluation of employees allocated to dCBT (n=25), or a waitlist control group (n=27) was used to assess five feasibility objectives related to recruitment of employers and employees, engagement, study procedure and preliminary efficacy of the intervention. Quantitative outcome measures and qualitative interviews at 8 weeks post-randomisation were used. Quantitative outcomes were also assessed within subject at 3-, 6-, and 12-month follow-up. Qualitative data was analysed using thematic and framework analysis in Nvivo, whilst quantitative outcomes were analysed using mixed effect linear models between and within subject in R and SPSS. Results: Thirty-Three businesses agreed to facilitate the delivery of three trials run by the University of Warwick in their workplaces. 52 participants consented into the REST trial. Adherence/usage of participants of the treatment platform was just over 50% across the whole sample. There was a reduction in depression and anxiety symptoms post-intervention and at follow-up timepoints across all participants and over time although there were no statistically significant between group differences. High acceptability and satisfaction of the intervention were reported by participants based on qualitative interview data at post-intervention. Conclusions: Results from this feasibility study suggests that the dCBT programme (REST) was acceptable and shows improvement in depression and anxiety symptoms, albeit not over and above the treatment effects in the control group. Recruitment of participants and engagement with the intervention made the feasibility of the delivery somewhat challenging. With better recruitment promotion and engagement strategies, as well as implementing the learnings from the feasibility trial, a fully powered study can inform the efficacy of the REST intervention. Trial registration: The study is registered in the BMC Springer Nature ISRCTN registry ISRCTN31161020 (registered on 08/06/2021). [ABSTRACT FROM AUTHOR]

Qing Zhao,1,&ast; Chaoji Huangfu,2,&ast; Junzheng Li,2 Huihui Liu,1 Nan Tang1 1School of Nursing, Lanzhou University, Lanzhou, Gansu, 730010, People’s Republic of China; 2Department of Infectious Disease Prevention and Control, Center for Disease Control and Prevention, Western Theater Command, Lanzhou, Gansu, 730020, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Nan Tang, Tel +86-18793111027, Email tangnan@lzu.edu.cnBackground: Stigma, social avoidance and distress may seriously affect the quality of life of infertility patients. Psychological resilience has been proved to effectively combat psychological stress. This study aimed to explore the mediating role of psychological resilience between stigma and social avoidance and distress (SAD) in females with an unfulfilled wish for a child.Methods: Stigma Scale, Social Avoidance and Distress Scale (SADS), and Psychological Resilience Scale were used to evaluate 266 females with infertility. Structural equation model was used to test the mediating effect of psychological resilience on the relationship between stigma and SAD.Results: The SADS, stigma scores, and psychological resilience scores of 266 females with infertility were 13.36 ± 5.77, 77.84 ± 16.91, and 58.84 ± 12.24 points, respectively. The stigma scores were positively correlated with SADS, and negatively correlated with psychological resilience scores. The psychological resilience scores were negatively correlated with SADS. Psychological resilience played a partially mediating role between the stigma and SAD of infertility patients, and the mediating effect accounted for 25.5% of the total effect.Conclusion: Psychological resilience had a partial mediating effect on the relationship between stigma and SAD, and could reduce the negative effect of stigma on the development of SADS. Therefore, positive psychological interventions improving psychological resilience might help to reduce stigma and improve SAD in infertility patients.Keywords: infertility, stigma, psychological resilience, social avoidance and distress, mediating effect

Neng Tang,1,2 Xiaolin Dou,1,2 Xing You,1,2 Guodong Liu,1,2 Zhenglin Ou,1,2,&ast; Hongyan Zai1,2,&ast; 1Department of General Surgery, Xiangya Hospital Central South University, Changsha, 410008, Hunan Province, People’s Republic of China; 2National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, 410008, Hunan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhenglin Ou; Hongyan ZaiDepartment of General Surgery, Xiangya Hospital Central South University, 87 Xiangya Road, Changsha, 410008, Hunan Province, People’s Republic of ChinaEmail zhenglinou@163.com; zaihy@csu.edu.cnPurpose: Adolescent and young adult (AYA) pancreatic ductal adenocarcinoma (PDAC) occurs in patients below 40 years old. Whether AYA patients have worse outcomes compared with older patients is still controversial. The purpose of this study is to compare the outcomes of AYA patients and older patients after radical surgery for PDAC.Methods: A single-center, retrospective, cohort study was conducted in patients who underwent radical surgery for PDAC in Xiangya Hospital Central South University from January 2007 to December 2019. The clinicopathological data and results of patients with PDAC were collected and analyzed retrospectively. They were divided into AYA group and older group based on age (< 40, AYA group; ≥ 40, older group). Based on all the considered covariates except age, we estimated 1:2 case propensity score matching (PSM).Results: A total of 1033 cases were enrolled, 46 cases (4.45%) in the AYA group. Both before and after PSM, the AYA patients have a higher preoperative CA19-9 than the older patients (P < 0.001) and (P < 0.001). Pathological results showed that AYA group had a higher microvascular invasion rate (P < 0.001 and P = 0.045) than older group. The median time of overall survival (OS) in AYA group and older group were 13 months (95% CI = 11.50– 14.50) and 14 months (95% CI = 13.50– 14.50), respectively. Additionally, AYA group have a worse 2-year OS rate than older group (8.70% vs 25.23%, P = 0.011 and 8.70% vs 25.00%, P = 0.023). According to the Log rank test, AYA group have a worse cumulative OS rate than older group (P = 0.002) and (P = 0.030), respectively.Conclusion: PDAC might be more aggressive in AYA, and the cumulative OS after radical PDAC surgery in AYA patients is worse than that in older patients.Keywords: adolescent and young adult, AYA, pancreatic ductal adenocarcinoma, PDAC, propensity score matching, PSM, total pancreaticoduodenectomy, TPD, overall survival, OS

Composited p-type electrodes with high reflectivity have been investigated in AlGaN-based ultraviolet light emitting diodes (UV-LEDs) to improve the light extraction efficiency, which are composed of a patterned ITO layer and an Al reflector. It is verified that the patterned ITO with a thickness of 30 nm can not only well form Ohmic contact with p-GaN capping layer, but also be nearly 90% transparent to ultraviolet light, and thus presenting a reflectivity of 73% at 280 nm when combined with an Al reflector. Further experimental efforts confirm that the performance of the UV-LEDs is dramatically improved with such p-type electrodes. The maximum light output power and wall plug efficiency in the current range of 0–100 mA are severally increased by 49.8% and 54.2% compared to the device with traditional Ni/Au electrodes. [ABSTRACT FROM AUTHOR]

The epidemiology and potential pathogenic roles of human papillomavirus (HPV) and Merkel cell polyomavirus (MCV) in keratinocyte cancers (KCs) arising in people living with HIV (PLWH) compared with HIV-negative individuals are poorly understood. These issues were investigated by a case–control study in which the presence of MCV and HPV DNA was identified by polymerase chain reaction in microdissected formalin-fixed paraffin-embedded tissue from PLWH and HIV-negative individuals. The samples comprised 190 cutaneous and genital KCs/precancers (actinic keratoses, n = 43; cutaneous squamous cell carcinoma (cSCC) in situ , n = 24; basal cell carcinoma, n = 78; cSCC, n = 34; penile carcinoma in situ , n = 9; penile SCC, n = 2 from 104 individuals (PLWH, n = 51; HIV-negative, n = 53). Almost one-quarter of samples were positive for MCV: this was not significantly associated with either HIV status (P = 0.06) nor lesion type. Overall, 36% (16/44) of MCV-positive lesions were coinfected with HPV; this was also not associated with HIV status. These findings indicate that if these viruses do contribute to the pathogenesis of KCs, it is likely to be independent of HIV status. [ABSTRACT FROM AUTHOR]