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The long-term use of aspirin for preventing cardiovascular disease has been recommended for decades. However, there is currently uncertainty regarding the long-term effects of aspirin use on the risk of all-cause, cardiovascular, and cancer mortality in cancer patients. The aim of this work was to analyze the connection between the prophylactic use of low-dose aspirin and the risk of all-cause death, cardiovascular death, and carcinoma death in carcinoma patients in the United States. A cohort study was conducted using National Health and Nutrition Examination Survey (NHANES) data (2011-2012, 2013-2014, 2015-2016, and 2017-2018) and associated mortality data. The 95% confidence intervals (CIs) and hazard ratios (HRs) between non-aspirin use and prophylactic low-dose aspirin use and the risk of death were measured via Cox proportional hazard regression models. A total of 1819 participants were included in the present research, of whom 945 were nonaspirin users and 874 were prophylactic aspirin users. Compared with non-aspirin users, prophylactic low-dose aspirin users had a decreased risk of all-cause death (HR = 0.647, 95% CI = 0.489-0.857). There was no statistically significant difference in the risk of cardiovascular death (HR = 0.623, 95% CI = 0.362-1.074) or cancer death (HR = 0.709, 95% CI = 0.410-1.226). Prophylactic use of low-dose aspirin may lower all-cause mortality in individuals with cancer but does not have a substantial effect on cardiovascular risk or cancer-specific mortality in this patient population., (© 2024. The Author(s).)

Mitochondria play an important role in pressure overload-induced cardiac hypertrophy. The present study aimed to investigate the role of mitochondrial transient receptor potential vanilloid 3 (TRPV3) in myocardial hypertrophy. A 0.7 mm diameter U-shaped silver clip was used to clamp the abdominal aorta of Sprague Dawley (SD) rats and establish an animal model of abdominal aortic constriction (AAC). Rat H9C2 myocardial cells were treated with angiotensin II (Ang II) to establish a hypertrophic myocardial cell model, and TRPV3 expression was knocked down using TRPV3 small interfering RNA (siRNA). JC-1 probe was used to detect mitochondrial membrane potential (MMP). DHE probe was used to detect ROS generation. Enzyme activities of mitochondrial respiratory chain complex I and III and ATP production were detected by assay kits. Immunofluorescence staining was used to detect TRPV3 expression in H9C2 cells. Western blot was used to detect the protein expression levels of β-myosin heavy chain (β-MHC), mitochondrial TRPV3 and mitochondrial NOX4. The results showed that, in the rat AAC model heart tissue and H9C2 cells treated with Ang II, the protein expression levels of β-MHC, mitochondrial TRPV3 and mitochondrial NOX4 were up-regulated, MMP was decreased, ROS generation was increased, mitochondrial respiratory chain complex I and III enzyme activities were decreased, and ATP production was reduced. After knocking down mitochondrial TRPV3 in H9C2 cells, the protein expression levels of β-MHC and mitochondrial NOX4 were down-regulated, MMP was increased, ROS generation was decreased, mitochondrial respiratory chain complex I and III enzyme activities were increased, and ATP production was increased. These results suggest that mitochondrial TRPV3 in cardiomyocytes exacerbates mitochondrial dysfunction by up-regulating NOX4, thereby participating in the process of pressure overload-induced myocardial hypertrophy.

Introduction and Aims: The histological and morphological differences in soft tissue between natural teeth and peri-implant may result in different clinical effectiveness to free gingival graft (FGG). This research aims to investigate the different efficacy of FGG in augmenting keratinized tissue width (KTW) between tooth and implant sites while evaluating its medium-term stability over a 2- to 5-year follow-up., Methods: In this study, 29 patients underwent FGG to address insufficient clinical scenarios when KTW <2 mm at the buccal aspect, including 37 implant sites and 33 natural teeth sites both in posterior regions were included. The KTW and gingival margin position (GMP) of these sites was assessed by measuring the intra-oral photographs which were taken at 0 days (T0), 3-month (T1), 6-month (T2), 12-month post-surgery (T3), and 2 to 5 years follow-up (T4)., Results: The results revealed that KTW increased significantly in both groups. However, the natural teeth group showed significantly less graft shrinkage (GS) than the implants group. (Teeth: 2.05 ± 0.51 mm and 25.42% ± 6.45%; Implants: 3.18 ± 0.65 mm and 38.92% ± 5.39%, P <.01). From T1 to T4. The gingival margin coronally advanced by 0.47 ± 0.51 mm and 0.18 ± 0.43 mm for the natural teeth and implants group, respectively (P<.05)., Conclusions: A greater KTW reduction after FGG was observed at implants versus natural teeth. And, the graft surrounding implants after crown restoration was stable for up to 2 to 5 years., Clinical Relevance: By comparing the changes in KTW around natural teeth and implants following FGG to investigate whether there are differences between them and the degree of differences. Additionally, this allows us to explore whether the restorations impact the effect of FGG. This research can assist clinicians in selecting an appropriate amount of soft tissue during surgery to achieve treatment goals, reduce postoperative discomfort for patients, and enhance predictability in clinicians' ability to increase keratinized tissue. Furthermore, by observing changes in the position of GMP around natural teeth and implants, the effectiveness of FGG in root coverage can be understood, thus improving the predictability of FGG for root coverage., Competing Interests: Conflict of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Objectives: The impact of internet usage on mortality is not widely known. This study intended to investigate the associations between regular internet usage and the risks of all-cause and cause-specific mortality, while also ascertaining potential factors that may modify these correlations., Design: A community-based prospective cohort study., Setting and Participants: The study included 21,481 individuals [mean (SD) age, 64.1 (11.0) years] from the Health and Retirement Study, with data collected between 2006 and 2020., Methods: The Cox proportional hazards regression model was used to evaluate the associations between regular internet usage and the risks of all-cause and cause-specific mortality, adjusting for demographic factors, lifestyle behaviors, and other potential confounding factors. Moreover, we explored the association between daily hours of internet usage and the risk of outcomes., Results: Regular internet usage was significantly associated with a lower risk of all-cause mortality (hazard ratio, 0.78; 95% CI, 0.74-0.83) and cardiovascular mortality (hazard ratio, 0.72; 95% CI, 0.64-0.82). No significant interaction effects were observed for age, sex, regular exercise, or current alcohol consumption (all P interactions > .05). Additionally, estimations for daily hours of usage indicated a U-shaped relationship with all-cause mortality. Adults who used 2.1 to 4 hours per day had the lowest risk; however, not all estimations showed their significance on account of the limited sample size., Conclusions and Implications: Regular internet usage was associated with a lower risk of all-cause and cardiovascular mortality, which may prompt consideration of the beneficial impact of internet usage on lifespan., Competing Interests: Disclosures The authors declare no conflicts of interest., (Copyright © 2024 Post-Acute and Long-Term Care Medical Association. Published by Elsevier Inc. All rights reserved.)

Importance: Epidemiological evidences regarding the association between whole grain intake and the risk of new-onset hypertension are still controversial., Objective: We aimed to investigate the relationship between whole grain intake and new-onset hypertension and examine possible effect modifiers in the general population., Methods: A total of 10,973 participants without hypertension from the China Health and Nutrition Survey were enrolled, with follow-up beginning in 1997 and ending in 2015. Whole grain intake was assessed by 3 consecutive 24-h dietary recalls combined with a household food inventory. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression model after adjusting for potential risk factors., Results: During a median follow-up of 7.0 years, 3,733 participants developed new-onset hypertension. The adjusted HRs (95% CIs) were as follows: for quartile 2 (HR: 0.52; 95% CI: 0.47-0.57), quartile 3 (HR: 0.46; 95% CI: 0.42-0.51), and quartile 4 (HR: 0.35; 95% CI: 0.31-0.38), compared with quartile 1. Different types of whole grain types, including wheat (adjusted HR, 0.35; 95% CI, 0.32-0.39), maize (adjusted HR, 0.50; 95% CI, 0.42-0.59), and millet (adjusted HR, 0.38; 95% CI, 0.30-0.48), showed significant associations with a reduced risk of hypertension. The association between whole grain intake and new-onset hypertension was stronger in individuals with older age (P for interaction < 0.001) and higher BMI (P for interaction < 0.001)., Conclusion: Higher consumption of whole grains was significantly associated with a lower risk of new-onset hypertension. This study provides further evidence supporting the importance of increasing whole grain intake for hypertension prevention among Chinese adults., (© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: To assess efficacy of Chinese medicine (CM) on insomnia considering characteristics of treatment based on syndrome differentiation., Methods: A total of 116 participants aged 18 to 65 years with moderate and severe primary insomnia were randomized to the placebo (n=20) or the CM group (n=96) for a 4-week treatment and a 4-week follow-up. Three CM clinicians independently prescribed treatments for each patient based on syndromes differentiation. The primary outcome was change in total sleep time (TST) from baseline. Secondary endpoints included sleep onset latency (SOL), wake time after sleep onset (WASO), sleep efficiency, Pittsburgh Sleep Quality Index (PSQI) and CM symptoms., Results: The CM group had an average 0.6 h more (95% confidence interval (CI): 0.3-0.9, P<0.001) TST and 34.1% (10.3%-58.0%, P=0.005) more patients beyond 0.5 h TST increment than that of the placebo group. PSQI was changed -3.3 (-3.8 to -2.7) in the CM group, a -2.0 (-3.2 to -0.8, P<0.001) difference from the placebo group. The CM symptom score in the CM group decreased -2.0 (-3.3 to -0.7, P=0.003) more than the placebo group. SOL and WASO changes were not significantly different between groups. The analysis of prescriptions by these clinicians revealed blood deficiency and Liver stagnation as the most common syndromes. Prescriptions for these clinicians displayed relative stability, while the herbs varied. All adverse events were mild and were not related to study treatment., Conclusion: CM treatment based on syndrome differentiation can increase TST and improve sleep quality of primary insomnia. It is effective and safe for primary insomnia. In future studies, the long-term efficacy validation and the exploratory of eutherapeutic clinicians' fixed herb formulas should be addressed (Registration No. NCT01613183)., (© 2024. The Chinese Journal of Integrated Traditional and Western Medicine Press and Springer-Verlag GmbH Germany, part of Springer Nature.)

Pulmonary fibrosis (PF) is a chronic and progressive pulmonary interstitial disease of unknown etiology and is also a sequela in severe patients with the Coronavirus Disease 2019 (COVID-19). Seven databases were systematically searched to evaluate the preclinical evidence of Tanshinone IIA (Tan IIA) on PF. The quality of the included studies was assessed using a 10-item risk of bias tool, and data were analyzed using RevMan 5.3 software. 22 experiments from 12 studies on a total of 248 animals were included. The results showed that PF phenotype, such as fibrotic score, collagen I (Col-I), collagen III (Col-III), hydroxyproline (Hyp), in the group treated with Tan IIA were significantly lower than those in the model group (p < 0.00001). The potential mechanisms of Tan IIA improvement of PF involve reducing inflammation, antioxidation, and suppressing activation of transforming growth factor beta 1 (TGF-β1). The subgroup analysis of different models, different rat species, and different dosage time showed significant reduction in fibrotic scores and Hyp levels with Tan IIA. The preclinical evidence indicated that Tan IIA might be a potent and promising agent for PF, but this conclusion should be further confirmed with more research.

Background : The causal association of specific gut microbiota with dementia remains incompletely understood. We aimed to access the causal relationships in which one or more gut microbiota account for dementia. Method : Using data from the MiBioGen and FinnGen consortia, we employed multiple Mendelian randomization (MR) approaches including two-sample MR (TSMR), multivariable MR (MVMR), and Bayesian model averaging MR to comprehensively evaluate the causal associations between 119 genera and dementia, and to prioritize the predominant bacterium. Result : We identified 21 genera that had causal effects on dementia and suggested Barnesiella (OR = 0.827, 95%CI = 0.722-0.948, marginal inclusion probability [MIP] = 0.464; model-averaged causal estimate [MACE] = -0.068) and Allisonella (OR = 0.770, 95%CI = 0.693-0.855, MIP = 0.898, MACE = -0.204) as the predominant genera for AD and all-cause dementia. Conclusions : These findings confirm the causal relationships between specific gut microbiota and dementia, highlighting the necessity of multiple MR approaches in gut microbiota analysis, and provides promising genera as potential novel biomarkers for dementia risk.

Objective: To investigate the association between gestational blood pressure and neurodevelopment in 2-year-old children. Methods: Based on the"Wuhan Healthy Baby Birth Cohort", 3 754 mother-infant pairs were enrolled in this study. Based on multiple blood pressure measurements during pregnancy, the mean, cumulative, and variability of blood pressure throughout the entire pregnancy and each trimester were calculated. Blood pressure variability was evaluated using standard deviation (SD), coefficient of variability (CV), and variability independent of mean (VIM). Follow-up testing of neurodevelopment in infants and young children at the age of two was conducted to obtain the Mental Development Index (MDI) and the Psychomotor Development Index (PDI). The multivariate linear regression and generalized estimation equation were used to analyze the association between gestational blood pressure data and neurodevelopmental index. Results: The age of 3 754 pregnant women was (29.1±3.6) years, with a pre-pregnancy BMI of (20.9±2.7) kg/m² and a gestational age of (39.3±1.2) weeks. The birth weight of 3 754 children was (3 330.9±397.7) grams, and the birth length was (50.3±1.6) centimeters. The results of the multivariate linear regression analysis showed that after adjusting for relevant confounding factors, the mean blood pressure, cumulative blood pressure, standard deviation of blood pressure, coefficient of variation of blood pressure, independent blood pressure variability of systolic blood pressure, diastolic blood pressure, and pulse pressure throughout pregnancy were negatively associated with the MDI and PDI scores of 2-year-old children. The analysis results of the generalized estimation equation showed that after adjusting for relevant confounding factors, the average systolic blood pressure in the first, second, and third trimesters was negatively associated with MDI/PDI. The negative association between cumulative blood pressure and MDI/PDI was only found in the first trimester. The negative association between blood pressure variation during pregnancy and MDI/PDI was mainly concentrated in the second and third trimesters. Conclusion: There is a negative association between gestational blood pressure and the neurodevelopmental index of 2-year-old children.

The causal association of circulating metabolites with dementia remains uncertain. We assessed the causal association of circulating metabolites with dementia utilizing Mendelian randomization (MR) methods. We performed univariable MR analysis to evaluate the associations of 486 metabolites with dementia, Alzheimer's disease (AD), and vascular dementia (VaD) risk. For secondary validation, we replicated the analyses using an additional dataset with 123 metabolites. We observed 118 metabolites relevant to the risk of dementia, 59 of which were lipids, supporting the crucial role of lipids in dementia pathogenesis. After Bonferroni adjustment, we identified nine traits of HDL particles as potential causal mediators of dementia. Regarding dementia subtypes, protective effects were observed for epiandrosterone sulfate on AD (OR = 0.60, 95% CI: 0.48-0.75) and glycoproteins on VaD (OR = 0.89, 95% CI: 0.83-0.95). Bayesian model averaging MR (MR-BMA) analysis was further conducted to prioritize the predominant metabolites for dementia risk, which highlighted the mean diameter of HDL particles and the concentration of very large HDL particles as the predominant protective factors against dementia. Moreover, pathway analysis identified 17 significant and 2 shared metabolic pathways. These findings provide support for the identification of promising predictive biomarkers and therapeutic targets for dementia.

Background: With an estimated 121 million abortions following unwanted pregnancies occurring worldwide each year, many countries are now committed to protecting women's reproductive rights., Aim: To analyze the impact of emotional management and care on anxiety and contraceptive knowledge mastery in painless induced abortion (IA) patients., Methods: This study was retrospective analysis of 84 patients with IA at our hospital. According to different nursing methods, the patients were divided into a control group and an observation group, with 42 cases in each group. Degree of pain, rate of postoperative uterine relaxation, surgical bleeding volume, and postoperative bleeding volume at 1 h between the two groups of patients; nursing satisfaction; and mastery of contraceptive knowledge were analyzed., Results: After nursing, Self-Assessment Scale, Depression Self-Assessment Scale, and Hamilton Anxiety Scale scores were 39.18 ± 2.18, 30.27 ± 2.64, 6.69 ± 2.15, respectively, vs 45.63 ± 2.66, 38.61 ± 2.17, 13.45 ± 2.12, respectively, with the observation group being lower than the control group ( P < 0.05). Comparing visual analog scales, the observation group was lower than the control group (4.55 ± 0.22 vs 3.23 ± 0.41; P < 0.05). The relaxation rate of the cervix after nursing, surgical bleeding volume, and 1-h postoperative bleeding volumes were 25 (59.5), 31.72 ± 2.23, and 22.41 ± 1.23, respectively, vs 36 (85.7), 42.39 ± 3.53, 28.51 ± 3.34, respectively, for the observation group compared to the control group. The observation group had a better nursing situation ( P < 0.05), and higher nursing satisfaction and contraceptive knowledge mastery scores compared to the control group ( P < 0.05)., Conclusion: The application of emotional management in postoperative care of IA has an ideal effect., Competing Interests: Conflict-of-interest statement: There are no conflicts of interest to report., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background: Identification of the unknown pathogenic factor driving atherosclerosis not only enhances the development of disease biomarkers but also facilitates the discovery of new therapeutic targets, thus contributing to the improved management of coronary artery disease (CAD). We aimed to identify causative protein biomarkers in CAD etiology based on proteomics and 2-sample Mendelian randomization (MR) design. Methods: Serum samples from 33 first-onset CAD patients and 31 non-CAD controls were collected and detected using protein array. Differentially expressed analyses were used to identify candidate proteins for causal inference. We used 2-sample MR to detect the causal associations between the candidate proteins and CAD. Network MR was performed to explore whether metabolic risk factors for CAD mediated the risk of identified protein. Vascular expression of candidate protein in situ was also detected. Results: Among the differentially expressed proteins identified utilizing proteomics, we found that circulating Golgi protein 73 (GP73) was causally associated with incident CAD and other atherosclerotic events sharing similar etiology. Network MR approach showed low-density lipoprotein cholesterol and glycated hemoglobin serve as mediators in the causal pathway, transmitting 42.1% and 8.7% effects from GP73 to CAD, respectively. Apart from the circulating form of GP73, both mouse model and human specimens imply that vascular GP73 expression was also upregulated in atherosclerotic lesions and concomitant with markers of macrophage and phenotypic switching of vascular smooth muscle cells (VSMCs). Conclusions: Our study supported GP73 as a biomarker and causative for CAD. GP73 may involve in CAD pathogenesis mainly via dyslipidemia and hyperglycemia, which may enrich the etiological information and suggest future research direction on CAD., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)

Background: The distal aspect of the second molar (d-M2) often exhibits infrabony defects due to the adjacent third molar. Although the defects can be treated by guided tissue regeneration (GTR) after removing the third molar, the optimal timing remains uncertain following third molar removal in clinical decision-making. This study aimed to compare delayed and immediate GTR treatments to assist in clinical decision-making., Methods: D-M2 infrabony defects with a minimum 1-year follow-up were collected and divided into three groups: Immediate GTR group, which underwent third molar extraction and received GTR simultaneously; Delayed GTR group, which underwent delayed GTR at least 3 months after third molar extraction; and Control group, which underwent only scaling and root planing during third molar extraction. The clinical and radiographic parameters related to the infrabony defect before GTR and post-surgery were evaluated using the Kruskal-Wallis test or one-way ANOVA, followed by post-hoc Dunn's test or the Bonferroni test for pairwise comparisons., Results: A total of 109 d-M2 infrabony defects were assessed. No significant differences were found between the two GTR groups, although both of them showed significant reductions in infrabony defect depth: the immediate GTR group (2.77 ± 1.97 mm vs. 0.68 ± 1.03 mm, p < 0.001) and the delayed GTR group (2.98 ± 1.08 mm vs. 0.68 ± 1.03 mm, p < 0.001) compared to the control group., Conclusion: GTR can effectively improve d-M2 infrabony defects when the third molar is removed, whether simultaneously or delayed. Patients may experience less discomfort with immediate GTR treatment as it requires only one surgery., (© 2024. The Author(s).)

Aims: Podocyte injury plays an essential role in the progression of diabetic nephropathy (DN). The associations between the ultrastructural changes of podocyte with proteinuria and the pathological classification of DN proposed by Renal Pathology Society (RPS) have not been clarified in patients with type 2 diabetic nephropathy (T2DN)., Methods: We collected 110 patients with kidney biopsy-confirmed T2DN at Peking University First Hospital from 2017 to 2022. The morphometric analysis on the podocyte foot process width (FPW) and podocyte detachment (PD) as markers of podocyte injury was performed, and the correlations between the ultrastructural changes of podocytes with severity of proteinuria and the RPS pathological classification of DN were analyzed., Results: Mean FPW was significantly broader in the group of T2DN patients with nephrotic proteinuria (565.1 nm) than those with microalbuminuria (437.4 nm) or overt proteinuria (494.6 nm). The cut-off value of FPW (> 506 nm) could differentiate nephrotic proteinuria from non-nephrotic proteinuria with a sensitivity of 75.3% and a specificity of 75.8%. Percentage of PD was significantly higher in group of nephrotic proteinuria (3.2%) than that in microalbuminuria (0%) or overt proteinuria (0.2%). FPW and PD significantly correlated with proteinuria in T2DN (r = 0.473, p < 0.001 and r = 0.656, P < 0.001). FPW and PD correlated with RPS pathological classification of T2DN (r = 0.179, P = 0.014 and r = 0.250, P = 0.001). FPW value was increased significantly with more severe DN classification (P for trend =0.007). The percentage of PD tended to increase with more severe DN classification (P for trend = 0.017)., Conclusions: Podocyte injury, characterized by FPW broadening and PD, was associated with the severity of proteinuria and the pathological classification of DN., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Objective: Cymbopogon citratus (DC.) Stapf is a medicinal and edible herb that is widely used for the treatment of gastric, nervous and hypertensive disorders. In this study, we investigated the cardioprotective effects and mechanisms of the essential oil, the main active ingredient of Cymbopogon citratus, on isoproterenol (ISO)-induced cardiomyocyte hypertrophy., Methods: The compositions of Cymbopogon citratus essential oil (CCEO) were determined by gas chromatography-mass spectrometry. Cardiomyocytes were pretreated with 16.9 µg/L CCEO for 1 h followed by 10 µmol/L ISO for 24 h. Cardiac hypertrophy-related indicators and NLRP3 inflammasome expression were evaluated. Subsequently, transcriptome sequencing (RNA-seq) and target verification were used to further explore the underlying mechanism., Results: Our results showed that the CCEO mainly included citronellal (45.66%), geraniol (23.32%), and citronellol (10.37%). CCEO inhibited ISO-induced increases in cell surface area and protein content, as well as the upregulation of fetal gene expression. Moreover, CCEO inhibited ISO-induced NLRP3 inflammasome expression, as evidenced by decreased lactate dehydrogenase content and downregulated mRNA levels of NLRP3, ASC, CASP1, GSDMD, and IL-1β, as well as reduced protein levels of NLRP3, ASC, pro-caspase-1, caspase-1 (p20), GSDMD-FL, GSDMD-N, and pro-IL-1β. The RNA-seq results showed that CCEO inhibited the increase in the mRNA levels of 26 oxidative phosphorylation complex subunits in ISO-treated cardiomyocytes. Our further experiments confirmed that CCEO suppressed ISO-induced upregulation of mt-Nd1, Sdhd, mt-Cytb, Uqcrq, and mt-Atp6 but had no obvious effects on mt-Col expression., Conclusion: CCEO inhibits ISO-induced cardiomyocyte hypertrophy through the suppression of NLRP3 inflammasome expression and the regulation of several oxidative phosphorylation complex subunits., (© 2024. Huazhong University of Science and Technology.)

Background: The relationship between whole grain intake and chronic kidney disease (CKD) remains uncertain., Objective: This study aimed to evaluate the association between whole grain intake and risk of CKD in Chinese adults., Methods: The present cross-sectional study used data from the China Health and Nutrition Survey conducted in 2009. Whole grain intake was measured using 3 consecutive 24-h dietary recalls and a household food inventory. A multivariable logistic regression model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for risk of CKD. In addition, a restricted cubic spline was used to investigate the dose‒response relationship between whole grain and risk of CKD., Results: A total of 6747 participants were included, 728 of whom had CKD. Compared with those in the lowest whole grain intake group, those in the higher grain intake group had an inverse association with risk of CKD (Q2: adjusted OR 0.70, 95% CI: 0.54, 0.89; Q3: adjusted OR 0.54, 95% CI: 0.42, 0.69; and Q4: adjusted OR 0.29, 95% CI: 0.21, 0.41). The association between whole grain intake and CKD seems to be stronger for individuals who were male (P for interaction = 0.008) or smokers (P for interaction = 0.013). In addition, the restricted cubic spline suggested an obvious L-shaped correlation., Conclusions: Increased whole grain intake was associated with a decreased risk of CKD in Chinese adults., (Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Ningxin-Tongyu-Zishen formula (NTZF) is a clinical experience formula for the treatment of premature ovarian insufficiency (POI) in traditional Chinese medicine (TCM), and the potential mechanism is unknown. For in vivo experiments, POI mouse models (C57BL/6 mice), were constructed by subcutaneous injection of D-galactose (D-gal, 200 mg/kg). After treatment of NTZF (10.14, 20.27, 40.54 g/kg;) or estradiol valerate (0.15 mg/kg), ovarian function, oxidative stress (OS) and protein expression of Sirt1/p53 were evaluated. For in vitro experiments, H2O2 (200 μM) was used to treat KGN to construct ovarian granulosa cells (OGCs) cell senescence model. Pretreatment with NTZF (1.06 mg/mL) or p53 inhibitor (Pifithrin-α, 1 μM) was performed before induction of senescence, and further evaluated the cell senescence, OS, mRNA and protein expression of Sirt1/p53. In vivo , NTZF improved ovarian function, alleviated OS and Sirt1/p53 signaling abnormalities in POI mice. In vitro experiments showed that NTZF reduced the level of OS and alleviated the senescence of H2O2-induced KGN. In addition, NTZF activated the protein expression of Sirt1, inhibited the mRNA transcription and protein expression of p53 and p21. Alleviating OGCs senescence and protecting ovarian function through Sirt1/p53 is one of the potential mechanisms of NTZF in the treatment of POI.

To study the effects of organic fertilizer combined with biochar on soil denitrification and denitrifying microbial community structure, this study took lemon orchard soil as the research object and adopted a pot experiment, setting up five fertilization treatments:no fertilization(CK), conventional fertilization(F), organic fertilizer(P), fertilizer+biochar(FP), and organic fertilizer+biochar(PP). The abundance and community structure of denitrifying microorganisms were studied using real-time quantitative PCR and T-RFLP. Redundancy analysis(RDA) was used to explore the environmental factors affecting the denitrifying microbial community structure, and PLS-PM analysis was used to explore the environmental factors affecting the denitrification potential of lemon orchard soil. The results showed as follows:① compared with that under the single fertilizer treatment(F), the organic fertilizer and biochar(P, FP, and PP) treatments significantly increased the denitrification potential of the soil, ranging from 147.8% to 1445.3%. The denitrification rate of soil treated with organic fertilizer combined with biochar was 23.8% lower than that treated with organic fertilizer alone. ② Compared with that in the CK treatment, fertilization treatment significantly increased the abundance of nirS and nirK denitrification microorganisms. Fertilizer treatments(F and FP) significantly reduced the abundance of nosZ denitrifying microorganisms. Biochar treatment significantly changed the diversity and uniformity of denitrifying microorganisms, but the specific law and mechanism quality remained unclear. ③ The results of RDA analysis showed that fertilization could affect the community structure of nirS , nirK , and nosZ denitrifying microorganisms by changing C/N, WC, NO 3 - -N, SOC, AK, and AP. ④ PLS-PM analysis showed that soil denitrification was positively correlated with pH and the abundance of nirK denitrification microorganisms, and NO 3 - -N indirectly affected soil denitrification by affecting the abundance of nirK denitrification microorganisms. In addition, the nirK microbial community was the dominant microbial community in soil denitrification in lemon orchards. In conclusion, organic fertilizer directly affected soil denitrification by regulating soil pH, whereas regulating NO 3 - -N content affected nirK denitrification microbial abundance, indirectly affecting soil denitrification. The application of organic fertilizer combined with biochar could slow down the improvement of soil denitrification caused by single application of organic fertilizer, which is more suitable for promotion in orchards in this region.

The effects of manure and chemical fertilizer combined with biochar on nitrification potential and ammonia oxidation microbial change characteristics of purple soils were studied to explore the effects of fertilization measures and soil environmental factors on nitrification potential and ammonia oxidation microbial change characteristics. In this study, purple soil was taken as the research object, and five treatments were set up:no fertilizer(CK), chemical fertilizer(F), manure(P), chemical fertilizer plus biochar(FP), and manure plus biochar(PP). PCR and T-RFLP methods were used to study the characteristics of soil AOA and AOB communities, and soil nitrification potential and environmental factors were measured at the same time to determine the effect of manure combined with biochar on the nitrification potential of purple soil. The results showed that:① compared with that in the CK treatment, the FP and PP treatments significantly increased soil nitrification potential( P <0.05). ② Compared with that in the CK treatment, the F, P, FP, and PP treatments significantly increased the number of copies of the AOA amoA gene in the soil by 78.17%-162.22%( P <0.05), and the F, FP, and PP treatments significantly increased the number of copies of the AOB amoA gene by 21.56%-78.32%( P <0.05). ③ Compared with that in the CK treatment, the PP treatment significantly improved the Shannon, richness, and evenness indices of the soil AOA community( P <0.05), and the combination of biochar(FP and PP treatments) could change the community structure of the soil AOB. ④ The chemical fertilizer and manure affected the AOA and AOB community structure by changing soil properties such as pH, TP, AP, C/N, SOM, NO 3 - -N, and NH 4 + -N. ⑤ Stepwise regression analysis further showed that AOB amoA gene abundance was the main factor affecting soil nitrification potential. Therefore, under the condition that chemical fertilizer and manure were applied together with biochar, the AOB community was the main driver of the ammonia oxidation process in acidic purple soil, and fertilization affected the ammonia oxidation process by regulating C/N and NO 3 - -N.

Background: Low back pain (LBP) is a prevalent and debilitating condition that poses a significant burden on healthcare systems. Acupuncture has been proposed as a promising intervention for LBP, but the evidence supporting its specific effect is insufficient, and the use of sham acupuncture as a control in clinical trials presents challenges due to variations in sham acupuncture techniques and the magnitude of the placebo effect., Objective: To investigate the magnitude of the placebo response of sham acupuncture in trials of acupuncture for nonspecific LBP, and to assess whether different types of sham acupuncture are associated with different responses., Methods: Four databases including PubMed, EMBASE, MEDLINE, and the Cochrane Library were searched through April 15, 2023, and randomized controlled trials (RCTs) were included if they randomized patients with LBP to receive acupuncture or sham acupuncture intervention. The main outcomes included the placebo response in pain intensity, back-specific function and quality of life. Placebo response was defined as the change in these outcome measures from baseline to the end of treatment. Random-effects models were used to synthesize the results, standardized mean differences (SMDs, Hedges'g) were applied to estimate the effect size., Results: A total of 18 RCTs with 3,321 patients were included. Sham acupuncture showed a noteworthy pooled placebo response in pain intensity in patients with LBP [SMD -1.43, 95% confidence interval (CI) -1.95 to -0.91, I 2 =89%]. A significant placebo response was also shown in back-specific functional status (SMD -0.49, 95% CI -0.70 to -0.29, I 2 =73%), but not in quality of life (SMD 0.34, 95% CI -0.20 to 0.88, I 2 =84%). Trials in which the sham acupuncture penetrated the skin or performed with regular needles had a significantly higher placebo response in pain intensity reduction, but other factors such as the location of sham acupuncture did not have a significant impact on the placebo response., Conclusions: Sham acupuncture is associated with a large placebo response in pain intensity among patients with LBP. Researchers should also be aware that the types of sham acupuncture applied may potentially impact the evaluation of the efficacy of acupuncture. Nonetheless, considering the nature of placebo response, the effect of other contextual factors cannot be ruled out in this study. (PROSPERO registration No. CRD42022304416)., (© 2023. The Chinese Journal of Integrated Traditional and Western Medicine Press and Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: The placebo response of sham acupuncture in patients with primary dysmenorrhea is a substantial factor associated with analgesia. However, the magnitude of the placebo response is unclear., Objective: This meta-analysis assessed the effects of sham acupuncture in patients with primary dysmenorrhea and the factors contributing to these effects., Search Strategy: PubMed, Embase, Web of Science, and Cochrane CENTRAL databases were searched from inception up to August 20, 2022., Inclusion Criteria: Randomized controlled trials (RCTs) using sham acupuncture as a control for female patients of reproductive age with primary dysmenorrhea were included., Data Extraction and Analysis: Pain intensity, retrospective symptom scale, and health-related quality of life were outcome measures used in these trials. Placebo response was defined as the change in the outcome of interest from baseline to endpoint. We used standardized mean difference (SMD) to estimate the effect size of the placebo response., Results: Thirteen RCTs were included. The pooled placebo response size for pain intensity was the largest (SMD = -0.99; 95% confidence interval [CI], -1.31 to -0.68), followed by the retrospective symptom scale (Total frequency rating score: SMD = -0.20; 95% CI, -0.80 to -0.39. Average severity score: SMD = -0.35; 95% CI, -0.90 to -0.20) and physical component of SF-36 (SMD = 0.27; 95% CI, -0.17 to 0.72). Studies using blunt-tip needles, single-center trials, studies with a low risk of bias, studies in which patients had a longer disease course, studies in which clinicians had < 5 years of experience, and trials conducted outside Asia were more likely to have a lower placebo response., Conclusion: Strong placebo response and some relative factors were found in patients with primary dysmenorrhea. PROSPERO registration number: CRD42022304215. Please cite this article as: Sun CY, Xiong ZY, Sun CY, Ma PH, Liu XY, Sun CY, Xin ZY, Liu BY, Liu CZ, Yan SY. Placebo response of sham acupuncture in patients with primary dysmenorrhea: A meta-analysis. J Integr Med. 2023; 21(5): 455-463., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Shanghai Changhai Hospital. Published by Elsevier B.V. All rights reserved.)

To clarify the effect of chemical fertilizer and manure combined with biochar on denitrifying microorganisms and denitrification potential of rhizosphere soil, a pot experiment growing lemon was conducted involving five treatments, namely no fertilization (CK), chemical fertilizer (CF), manure (M), chemical fertilizer combined with biochar (CFBC), and manure combined with biochar (MBC). We determined the characteristics of the rhizosphere soil nirS-, nirK- , and nosZ- type denitrifying bacteria populations; denitrification potential; and soil environmental factors to clarify the effects of chemical and manure combined with biochar on denitrification. Our results showed that compared with that in CK, the CF treatment reduced the rhizosphere soil denitrification potential by 47.7%, whereas the M and MBC treatments increased the denitrification potential by 2192.7% and 1989.9%, respectively. The M and MBC treatments increased the gene copy number of nirS and nosZ , the CF and CFBC treatments decreased the gene copy number of nirS and nosZ , and all four fertilization treatments increased the gene copy number of nirK. Stepwise regression analysis showed that pH was the main factor for the abundance of nirS -type denitrifying bacteria and SOM and NH + 4 -N were the main factors for the abundance of nirK -type denitrifying bacteria, whereas pH, NO - 3 -N, and N/P were main factors for the abundance of nosZ -type denitrifying bacteria. The results of partial least squares analysis indicated that the abundance of nirS-and nosZ- type denitrifying bacteria, pH, TN, and N/P were the main factors affecting rhizosphere denitrification potential. Therefore, in acidic purple soil, nirS- and nosZ- type denitrifying bacteria were the main drivers of the soil denitrification process in lemon rhizospheres under chemical fertilizer and pig manure combined with biochar, whereas fertilizer affected the rhizosphere soil denitrification process by regulating soil pH, TN, and N/P.

To clarify the effects of non-rhizosphere/rhizosphere soil functional microbes (nitrifiers, denitrifiers, and phosphorus-solubilizing microorganisms) on lemon yield and quality, the lemon fruit and non-rhizosphere/rhizosphere soil were selected as subjects. To explore the correlation between non-rhizosphere/rhizosphere soil functional microbes and lemon yield and quality under a chemical fertilizer reduction substitute with organic fertilizer, traditional fruit quality determination and multiple molecular techniques were used. The results showed that:① 30% chemical fertilizer reduction substitute with organic fertilizer increased the nitrification intensity and phosphatase activity but effectively controlled the denitrifying enzyme activity. ② The chemical fertilizer reduction substitute with organic fertilizer significantly decreased the abundances of nitrifiers and nirS/nirK -harboring denitrifiers and significantly increased the abundances of nosZ -harboring denitrifier and phoD -harboring microorganisms. However, the diversities of functional microbial community structure did not have clear regularity under chemical fertilizer reduction substitute with organic fertilizer. ③ Compared with that under the application of chemical fertilizer and organic fertilizer alone, lemon yield and quality were the highest under the 30% reduction of chemical fertilizer substitute with organic fertilizer. ④ Nitrogen and its related microbes significantly affected lemon yield through internal and external quality. Phosphorus and its related microbes affected lemon yield mainly through internal quality. In addition, the influence factors of non-rhizosphere soil and rhizosphere soil on lemon intrinsic quality were obviously different. Altogether, these results showed that the 30% reduction of chemical fertilizer substitute with organic fertilizer significantly affected soil nitrogen and phosphorus functional microorganisms and further improved lemon yield and quality.

The aim of this study was to examine the effects of different fertilization methods on the physicochemical properties and bacterial community structure of lemon rhizosphere/non-rhizosphere soil in order to provide theoretical basis for scientific and rational fertilization of orchards. A pot experiment was carried out, and six fertilization treatments were set up:control (CK), conventional fertilization (FM), organic fertilizer (P), fresh organic fertilizer (NP), 70% chemical fertilizer+30% organic fertilizer (70FP), and 50% chemical fertilizer+50% organic fertilizer (50FP). Chemical analysis, real-time fluorescence quantitative PCR, and terminal restriction fragment length polymorphism (T-RFLP) were used to study the effects of different fertilization treatments on the physicochemical properties of rhizosphere and non-rhizosphere soils, the abundance of the bacterial 16S rRNA gene, and bacterial community structure. Redundancy analysis (RDA) was used to explore the environmental factors affecting the bacterial community structure of lemon rhizosphere/non-rhizosphere soil. The results showed the following:① the pH and contents of organic matter, alkali-hydrolyzed nitrogen, available phosphorus, available potassium, and nitrate nitrogen in rhizosphere/non-rhizosphere soil were significantly increased by reducing the amount of chemical fertilizer and applying organic fertilizer (50FP and 70FP) ( P <0.05). Compared with conventional fertilization (FM) and single application of organic fertilizer (P and NP), the soil available P content, available K content, and nitrate nitrogen content increased by 24.76%-97.98%, 6.87%-45.11%, and 18.42%-55.82%, respectively. ② Fertilizer reduction combined with organic fertilizer significantly increased the abundance of soil bacteria and soil respiration intensity ( P <0.05), and the abundance of soil rhizosphere bacteria and soil respiration intensity under the 50FP treatment increased by 15.83%-232.98% and 8.0%-162.5% compared with that under conventional fertilization and organic fertilizer alone, respectively. The bacterial abundance of rhizosphere soil was positively correlated with the pH and contents of organic matter, total nitrogen, and total phosphorus. ③ The PCoA and RDA analysis results showed that the single organic fertilizer and organic fertilizer and chemical fertilizer de-weighting of rhizosphere bacterial community structure and not adding fertilizer had a bigger difference between processing, and the main environmental factors influencing the rhizosphere/non rhizosphere bacterial community structure were organic matter, total nitrogen, total phosphorus, total potassium, alkali solution nitrogen, nitrate nitrogen, and available potassium. Fertilizer reduction combined with organic fertilizer could significantly increase soil nutrient content, increase soil bacterial abundance, and change the bacterial community structure of rhizosphere soil, and the 50FP treatment yielded better results. Therefore, 50% Chemical fertilizer+50% organic fertilizer (50FP) was a better fertilization method to improve the physical and chemical properties of orchard soil, increase the abundance of soil bacteria, and improve the soil respiration intensity.

Background: The renal risk score (RRS) is a useful tool to predict end-stage renal disease (ESRD) in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). The current study aimed to validate the predictive performance of RRS and to further modify this model in Chinese AAV patients., Methods: Two hundred and seventy-two patients diagnosed with AAV confirmed by renal biopsies were retrospectively enrolled from a single center. The RRS was calculated based on 3 categorical variables, i.e., the proportion of normal glomeruli, the proportion of interstitial fibrosis and tubular atrophy (IF/TA), and eGFR at biopsy, classifying these patients into low-, medium-, and high-risk groups. In addition, a modified model was developed based on the RRS and was further validated in another independent cohort of 117 AAV patients. The predictive performance of each model was evaluated according to discrimination and calibration., Results: Patients were classified by the RRS into low- (26.5%), medium- (46.7%), and high-risk (26.8%) groups, with 120-month renal survival rates of 93.3%, 57.2%, and 18.4%, respectively (P < 0.001). The RRS showed good discrimination but less satisfactory calibration. Therefore, a modified model with improved discrimination and calibration was developed in Chinese AAV patients, with eGFR, proportion of normal glomeruli (both as continuous variables), and IF/TA (< 25%, 25-50%, > 50%) included. Internal and external validation of the modified model were performed. Finally, an online risk prediction tool was developed based on the modified model., Conclusions: The RRS was an independent predictor of ESRD of AAV patients. The modified model could predict the probability of ESRD for AAV patients with improved performance in Chinese AAV patients., (© 2023. The Author(s).)

Clustering analysis is an unsupervised learning method, which has applications across many fields such as pattern recognition, machine learning, information security, and image segmentation. The density-based method, as one of the various clustering algorithms, has achieved good performance. However, it works poor in dealing with multidensity and complex-shaped datasets. Moreover, the result of this method depends heavily on the parameters we input. Thus, we propose a novel clustering algorithm (called the MST-DC) in this paper, which is based on the density core. Firstly, we employ the reverse nearest neighbors to extract core objects. Secondly, we use the minimum spanning tree algorithm to cluster the core objects. Finally, the remaining objects are assigned to the cluster to which their nearest core object belongs. The experimental results on several synthetic and real-world datasets show the superiority of the MST-DC to Kmeans, DBSCAN, DPC, DCore, SNNDPC, and LDP-MST., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Qiang Gao et al.)

Cinnamomum species attract attentions owing to their scents, medicinal properties, and ambiguous relationship in the phylogenetic tree. Here, we report a high-quality genome assembly of Cinnamomum camphora , based on which two whole-genome duplication (WGD) events were detected in the C. camphora genome: one was shared with Magnoliales, and the other was unique to Lauraceae. Phylogenetic analyses illustrated that Lauraceae species formed a compact sister clade to the eudicots. We then performed whole-genome resequencing on 24 Cinnamomum species native to China, and the results showed that the topology of Cinnamomum species was not entirely consistent with morphological classification. The rise and molecular basis of chemodiversity in Cinnamomum were also fascinating issues. In this study, six chemotypes were classified and six main terpenoids were identified as major contributors of chemodiversity in C. camphora by the principal component analysis. Through in vitro assays and subcellular localization analyses, we identified two key terpene synthase (TPS) genes ( CcTPS16 and CcTPS54 ), the products of which were characterized to catalyze the biosynthesis of two uppermost volatiles (i.e. 1,8-cineole and (iso)nerolidol), respectively, and meditate the generation of two chemotypes by transcriptional regulation and compartmentalization. Additionally, the pathway of medium-chain triglyceride (MCT) biosynthesis in Lauraceae was investigated for the first time. Synteny analysis suggested that the divergent synthesis of MCT and long-chain triglyceride (LCT) in Lauraceae kernels was probably controlled by specific medium-chain fatty acyl-ACP thioesterase (FatB), type-B lysophosphatidic acid acyltransferase (type-B LPAAT), and diacylglycerol acyltransferase 2b (DGAT 2b) isoforms during co-evolution with retentions or deletions in the genome., (© The Author(s) 2022. Published by Oxford University Press on behalf of Nanjing Agricultural University.)

Acute liver failure (ALF) is an unfavorable condition characterized by the rapid loss of liver function and high mortality. Chrysophanol-8-O-glucoside (CPOG) is an anthraquinone derivative isolated from rhubarb . This study aims to evaluate the protective effect of CPOG on lipopolysaccharide (LPS)/D-GalN-induced ALF and its underlying mechanisms. LPS/D-GalN-induced mice ALF model and LPS treatment model in RAW 264.7 and LX2 cells were established. It was found that CPOG ameliorated LPS/D-GalN-induced liver injury and improved mortality as indicated by Hematoxylin-eosin (H&E) staining. Molecularly, qPCR and ELISA results showed that CPOG alleviated LPS/D-GalN-induced release of alanine aminotransferase and aspartate transaminase and the secretion of TNF-α and IL-1β in vivo . LPS/D-GalN-induced intracellular ROS production was also attenuated by CPOG in liver tissue. Further, CPOG attenuated ROS generation and inhibited the expression of p-IκB and p-p65 as well as the expression of TNF-α and IL-1β stimulated by LPS in RAW 264.7 cells. In addition, CPOG alleviated LPS-induced up-regulation of LC3B, p62, ATG5 and Beclin1 by attenuating ROS production and inhibiting MAPK signaling in LX2 cells. Taken together, our data indicated that the CPOG protected against LPS/D-GalN-induced ALF by inhibiting oxidative stress, inflammation response and autophagy. These findings suggest that CPOG could be potential drug for the treatment of ALF in clinic., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Wang, Lu, Qu, Xiong, Wu, Luo, Zhang, Han and Xie.)

Aims: In the current study, we aimed to investigate the predictive value of the Kimmelstiel-Wilson (K-W) nodule for the risk of ESKD in patients with type 2 diabetes mellitus (T2DM)., Methods: In the two-center retrospective study, clinical and pathological parameters were compared between DKD patients with and without K-W nodules. Furthermore, we used Cox regression analysis to explore the predictive value of the K-W nodule for the risk of ESKD., Results: Compared with DKD patients without K-W nodules, patients with K-W nodules had a significantly higher level of proteinuria [5.1(3.1, 8.0) g/24 hr vs. 2.4(1.1, 4.4) g/24 hr, p < 0.001]. Patients with K-W nodules had significantly higher interstitial fibrosis and tubular atrophy (IFTA) and arteriosclerosis scores than those without (p = 0.001 and p = 0.006). Kaplan-Meier analysis showed that the probability of developing ESKD was significantly higher in patients with K-W nodules than in those without (log-rank test, p < 0.001). However, after adjusting closer variables, the K-W nodule was not an independent predictor for the risk of ESKD (p > 0.05)., Conclusions: In T2DM patients with DKD, the K-W nodule was associated with a more severe phenotype, and to some extent, associated with poorer renal outcome, but might not be an independent risk factor for the progression of ESKD., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

BACKGROUND A flare, or flare-up, of systematic lupus erythematosus (SLE) is diagnosed by an increase in disease activity in one or more organs, new symptoms, or changes in laboratory measurements. A hematoma can occur in the sheath of the rectus abdominis following muscle trauma or rupture of an epigastric vessel, or it can occur spontaneously. This report is of a 28-year-old woman who presented with a clinical flare of SLE and abdominal pain due to rectus sheath hematoma. CASE REPORT A 28-year-old woman had been suspected of having SLE 9 years ago and had received glucocorticoid therapy combined with hydroxychloroquine. However, lupus flared after she discontinued glucocorticoids, and she was admitted with a 1-month history of marked generalized edema, abdominal distension, frothy urine, and massive ascites. During hospitalization, she abruptly developed a continuous, stabbing abdominal pain and a bulge over the right abdomen as a result of straining during a bowel movement. On examination, a well-demarcated round mass that measured 121 mm × 96 mm was detected in the right quadrant. Abdominal emergency computed tomography revealed a right rectus sheath hematoma (21.4×4.7 cm). After her condition improved, the patient underwent an ultrasound-guided renal biopsy and was diagnosed with class III (A/C) and class V lupus nephritis. CONCLUSIONS This case has shown that spontaneous rectus sheath hematoma can occur without a history of trauma in a patient with an exacerbation of SLE. This association appears to be rare, and the cause is unknown.

Background: Primary membranous nephropathy (MN) is a kidney-specific autoimmune disease. Human embryonic stem cells-derived immunity-and-matrix regulatory cells (hESC-IMRCs) have immunoregulatory functions. We hypothesized that hESC-IMRCs might have therapeutic effects on MN and be a potential treatment in clinical practice., Methods: Rats of Heymann nephritis were injected with sheep anti-rat Fx1A serum. hESC-IMRCs were intravenously administrated upon the detection of proteinuria, with 6 × 10 6 cells (high-dose) or 3 × 10 6 cells (low-dose) in 1 ml every other day. Splenocytes and IMRCs were co-cultured at different times and ratios. Cell types and cytokines were detected by flow cytometry and enzyme-linked immunosorbent assay., Results: The urinary protein of rats with Heymann nephritis was reduced remarkably to a level comparable to negative controls, in both low-dose (45.6 vs. 282.3 mg/d, P < 0.001) and high-dose (35.2 vs. 282.3 mg/d, P < 0.001) hESC-IMRC treatment groups. IgG and C3 deposit, glomerular basement membrane thickness and foot process effacement were alleviated and the reduced podocin was recovered in the kidneys. The proportions of CD4 + CD25 + T cells in circulation and spleen were increased, and the circulating level of IL-10 was increased, after IMRC interventions. IL-17 and TNF-α were reduced after IMRCs treatments. IL-10 increased remarkably in the co-culture supernatant of lymphocytes and IMRCs at 48 h with ratio 10:1., Conclusions: The intravenously delivered hESC-IMRCs alleviated proteinuria and kidney injuries of Heymann nephritis, by their immunosuppressive functions through regulatory T cells and IL-10. These pre-clinical results indicate that IMRCs worth careful consideration for human trials in the treatment of MN., (© 2022. The Author(s).)

Soil microorganisms have an important influence on the transformation of soil nutrients. As functional genes encoding phosphatase, phoC and phoD provide effective means for detecting the types, abundance, and community structure of microorganisms in the environment, and studying the changes in the diversity of phoC and phoD gene microbial communities in the rhizosphere and non-rhizosphere soil of the plant rhizosphere and non-rhizosphere soil under the treatment of chemical fertilizer and organic fertilizer combined with biochar can provide a scientific basis for the agricultural utilization of biochar. In this study, corn stalks and rice husk stalks were used as test materials, and the pot experiment method was used to set the following treatments:control (CK), traditional fertilization (F), chemical fertilizer+20 t·hm -2 rice husk biochar (FP), chemical fertilizer+10 t·hm -2 rice husk biochar+10 t·hm -2 corn biochar (FPM), organic fertilizer+20 t·hm -2 rice husk biochar (PP), and fresh organic fertilizer+20 t·hm -2 rice husk biochar (NPP). The community structure of phoC and phoD genes in rhizosphere and non-rhizosphere soil was analyzed by using T-RFLP and fluorescence quantitative PCR technology to clarify the response characteristics of phoC and phoD genes to the addition of biochar. The results showed that:① In rhizosphere soil and non-rhizosphere soil, the phoD gene community structure was more complicated than that of phoC , and the number of end restriction fragments of the phoC gene increased after chemical fertilizer and organic fertilizer were combined with biochar. ② The combined application of biochar with chemical fertilizer and organic fertilizer reduced the copy number of the phoC gene in non-rhizosphere soil compared with that in the CK. Compared with that in the CK, the copy number in the FP, FPM, PP, and NPP treatments decreased by 9.18%, 11.46%, 10.97%, and 13.76%, respectively. Organic fertilizer combined with biochar increased the copy number of the phoD gene in rhizosphere soil by 2.48% and 5.16% in the PP and NPP treatments, respectively, compared with that in the CK. ③ Total phosphorus in the soil was the main factor affecting the phoC gene microbial community structure in non-rhizosphere soil ( P <0.01), whereas the phoC gene microbial community structure in rhizosphere soil was regulated by a variety of environmental factors. pH was the most critical factor affecting the phoD gene copy number, and the copy number of phoD gene was significantly correlated with soil nitrate nitrogen and pH. The combined application of biochar with chemical fertilizers and organic fertilizers can promote the growth and reproduction of microorganisms that function in soil phosphorus conversion, which is of great significance for improving the utilization of phosphorus fertilizers.

The progress of Chinese clinical research on acupuncture and moxibustion in recent 10 years was reviewed and analyzed, and corresponding suggestions were put forward for the current problems. In the past 10 years, Chinese clinical research on acupuncture and moxibustion has made considerable progress, mainly in the following areas: a series of internationally recognized clinical research evidences have been published, a preliminary acupuncture clinical evaluation system has formed, sham/placebo acupuncture control is widely used internationally, acupuncture clinical research norms and standards have been initially established. However, the following issues still need to be paid attention to in follow-up research: focus on the overall layout and refinement of clinical research, further improvement of clinical evaluation system, developing relevant norms for sham/placebo acupuncture setting and reporting, strengthening data sharing and platform integration, building a smooth basic and two-way transformation clinical pathway, etc.

To study changes in phosphatase activity, we examined the diversity of phoC and phoD gene microbial communities in the rhizosphere and non-rhizosphere soil of plants under the treatment of chemical fertilizer and organic fertilizer combined with biochar. These results can provide a certain theoretical guidance for the conversion of insoluble phosphorus in the soil phosphorus pool to the inorganic phosphate ion that can be absorbed by plant roots and also provide a certain experimental basis for the improvement of the availability of phosphorus in the soil and the agricultural utilization of biochar. In this study, corn stalks and rice husk stalks were used as test materials, and the pot experimental method was adopted using the following treatments:set control (CK), traditional fertilization (F), chemical fertilizer+20 t·hm -2 rice husk biochar (FP), chemical fertilizer+10 t·hm -2 rice husk biochar+10 t·hm -2 corn biochar (FPM), organic fertilizer+20 t·hm -2 rice husk biochar (PP), and fresh organic fertilizer+20 t·hm -2 rice husk biochar (NPP). We determined the rhizosphere and non-rhizosphere soil acid phosphatase (ACP) activity and alkaline phosphatase (ALP) activity and used T-RFLP technology to analyze the diversity of phoC and phoD genes in order to clarify the impact of biochar on the micro-ecosystem formed by the plants, soil, and microorganisms. The results showed that:① the ALP and ACP activities of each treatment in the non-rhizosphere soil were lower than that of CK. In the rhizosphere soil, the ALP activity was significantly increased after the combined application of chemical fertilizer and organic fertilizer with biochar, and the ACP activity in the rhizosphere soil was higher than that in the non-rhizosphere soil. ② The combined application of biochar with chemical fertilizers and organic fertilizers significantly increased the diversity of phoC and phoD genes communities in rhizosphere and non-rhizosphere soils ( P <0.05); the diversity and richness of microbial communities in rhizosphere soil were higher than that in non-rhizosphere soils. ③ ACP activity was negatively correlated with phoC gene microbial community, and most ALP activity was positively correlated with phoD microbial community.

Background: Cystatin C (CysC) is a cysteine protease inhibitor involved in proteins catabolism and plays an essential role in human vascular pathophysiology. CysC may also increase the risk of aortic stenosis (AS), but limited studies have reported on this association. This study aimed to investigate if elevated serum CysC levels are associated with hemodynamically significant AS., Methods: Serum CysC levels were estimated in 4,791 participants, samples were collected in 1990-1992. The study population was divided into quintile groups. Follow-up continued in 2011-2013 when participants returned for echocardiography examination. Incidence of aortic valve disease (AVD) was ascertained by Doppler echocardiography through the end of 2013. AVD defined in hemodynamic progression was assessed and classified as aortic sclerosis, mild stenosis, and moderate-to-severe stenosis., Results: Overall, a total of 4,791 participants (mean age: 54.8 ± 5.0 years, females: 57.6%, blacks: 8.2%) were included in this study. During a follow-up of 21 years, we identified 736 cases (15.4%) of aortic sclerosis, 194 cases (4.0%) of mild stenosis, and 42 cases (0.7%) of moderate-to-severe stenosis. Compared with serum CysC levels within individual quintile groups, the odds ratio (OR) was per standard deviation associated with an increased incidence of AVD (OR = 1.15, 95% CI: 1.05-1.26, P = 0.002)., Conclusions: In this large population-based study, an increased serum CysC levels is independently associated with the incidence of hemodynamically significant AS. However, this association appears not to extend to patients with extremely high serum CysC levels and necessitate further investigation., (Copyright and License information: Journal of Geriatric Cardiology 2021.)

Exploration of new types of borates is important because of their promising applications in diverse fields. Two new boroselenites, namely, M(B(SeO 3 ) 3 )H 2 O (M = Al, Ga), which represent the first IIIA metal boroselenite, were synthesized by hydrothermal reactions. M(B(SeO 3 ) 3 )H 2 O (M = Al, Ga) possesses a unique sandwich like double-layer structure formed by two 2D [MSe 2 O 8 ] 5- layers interconnected by 1D [BSeO 5 ] 3- chains. More interestingly, both compounds display large band gaps (4.86/4.79 eV) and moderate birefringences (Δ n = 0.063/0.064 at 1064 nm) based on density functional theory (DFT) calculations.

The objective of this systematic review is to evaluate the safety ad feasibility of the totally implantable vascular access devices (TIVADs) flushed more than 4 weeks. We searched the following electronic databases from the date their build-up to February 2020: PubMed, EMBASE, The Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL. The final selection resulted in 14 trials fulfilling the inclusion criteria and being included in our review. A pooled frequency of port-related late complications with longer flushing intervals (>4 weeks) was 8.0%, and the pooled frequency of occlusions, infections, and mechanical complications was 5.0%, 2.0%, and 3.0%, respectively. Then, we compared the frequency of port-related complications between standard and longer flushing intervals. There were no differences between the group's changes in the frequency of total late complications, occlusions, infections, and mechanical complications. This systematic review and meta-analysis demonstrates that longer flushing intervals for ports are safe. However, more prospective, power appropriated randomized trials are needed to explore the specific flushing time for ports.

The electrochemical α-cyanation of tertiary and secondary amines has been developed by using a cheap cyanide reagent, azobisisobutyronitrile (AIBN). The CN radical, generated through n -Bu 4 NBr-meidated electrochemical oxidation, participates in a novel α-cyanation reaction under exogenous oxidant-free conditions.

Objective: Light chain cast nephropathy is the most common form of renal lesion in multiple myeloma. Kidney impairment caused by light chain cast nephropathy can be reversed and survival can be improved if early diagnosis is available. It is thus of imperative importance to develop a non-invasive method to diagnose light chain cast nephropathy once the kidney biopsy is not always applicable., Methods: We consecutively screened newly diagnosed multiple myeloma patients with kidney biopsies from 4 centers in China. Kidney pathologies were reviewed and clinical presentations were recorded. Then a diagnostic model was established by logistic regression and the predictive values were assessed., Results: Between 1 June 1999 and 30 June 2019, a kidney biopsy was performed in 94 patients with newly diagnosed multiple myeloma, and light chain cast nephropathy was the most common pattern, seen in 52% of biopsied patients. The diagnostic model was established by multivariate logistic regression analysis as P(z) = 1/(1 + e -z ) and z = - 0.093 Hemoglobin (g/L) + 0.421 Serum albumin (g/L) + 3.463 Acute kidney injury (0/1) - 9.207 High-density lipoprotein (mmol/L). If P(z) ≥ 0.55, the diagnosis pointed to light chain cast nephropathy; if P(z) < 0.55, the diagnosis favored non-light chain cast nephropathy. The area under the receiver operating characteristic curves was 0.981 (95% CI 0.959, 1.000). The model had a sensitivity of 93.9%, a specificity of 95.6%, a positive predictive value of 96.0%, a negative predictive value of 94.0%, and a total consistency of 95.0%., Conclusion: We built a novel, non-invasive diagnostic model through a multicenter study, which may be helpful in the diagnosis of light chain cast nephropathy in newly diagnosed multiple myeloma patients., (© 2021. Italian Society of Nephrology.)

Although remarkable improvement has been achieved in stretchable strain sensors, challenges still exist in aspects including intelligent sensing, simultaneous data processing, and scalable fabrication techniques. In this work, a strain-sensitive device is presented by fabricating a CsPbBr 3 quantum dots (QDs) floating-gate field-effect transistor (FET) sensing array on thin polyimide (PI) films. The FET exhibits an excellent on/off ratio (>10 3 ) and a large memory window (>2 V). With the introduction of CsPbBr 3 QDs as the trapping layer, an additional UV response is obtained because of the photogenerated charge carriers that significantly enhance the source-drain current ( I DS ) of the device. At each electrical state, the I DS varies with the strains and the sensing range is from compressive +12.5% to tensile -10.8%. Excellent data retainability and mechanical durability demonstrate the high quality and reliability of the fabricated sensors. Furthermore, synapse functions including long-term potentiation (LTP), long-term depression (LTD), etc., are emulated at the device level. Linearity factor changes of LTP/LTD in different sensing scenarios demonstrate the reliability of the device and further confirm the different sensing mechanisms with/without UV illumination. Our results exhibit the potential of transistor-based devices for multifunctional intelligent sensing.

The characteristics of dissolved organic carbon loss with different fertilization treatments were examined to derive the best nutrient management method for sloping farmland in the Three Gorges Reservoir area where maintaining the soil carbon balance and reducing environmental pollution caused by carbon loss is crucial. Experimental runoff plots were set up at the Experimental Station for Soil and Water Conservation and Environmental Research in the Three Gorges Reservoir Region, Chinese Academy of Sciences, involving the following five treatments:No fertilization (CK), conventional fertilization (conventional), optimum fertilization (optimum), biochar combined with 85% optimum fertilizer (biochar), and straw combined with 85% optimum fertilizer (straw). The effects of the five treatments on runoff flux, sediment yield, and soil organic carbon flux were monitored and evaluated. Results show that:①Subsurface flow accounted for 52.84%-92.23% of the runoff (both surface and subsurface flow) and the loss flux of dissolved organic carbon (DOC) in the subsurface accounted for 43.64%-87.35% of the total loss flux. Thus, in this sloping farmland, subsurface flow was the main pathway of runoff and dominated dissolved organic carbon transport. ②Compared with the optimum treatment, straw treatment reduced the surface runoff flux, sediment yield, surface loss flux of DOC, and loss flux of organic carbon in the sediment by 30.39%, 39.41%, 28.71%, and 23.97%, respectively, but increased the subsurface runoff flux and loss flux of DOC. Compared with the optimum treatment, the biochar treatment significantly increased the surface and subsurface runoff flux, sediment yield, loss flux of DOC in the surface and subsurface, and the loss flux of organic carbon in the sediment. ③The loss flux of DOC accounted for 99.31%-99.94% of the loss flux of soil organic carbon, and DOC was the major species of organic carbon in the organic carbon loss in this type of sloping farmland. The loss flux of DOC under the different fertilization treatments was ranked biochar > optimum > straw > conventional > CK. ④Compared to the optimum treatment, the straw treatment and biochar treatment increased the soil organic carbon (SOC) content by 95.79% and 32.16%, respectively. Based on these results, straw combined with 85% of optimum fertilizer is the best nutrient management method for this sloping farmland as it can reduce surface runoff flux, sediment yield, and the loss flux of soil organic carbon while increasing the soil organic carbon content.

Background: Acute kidney injury (AKI) was found in some patients with COVID-19 pneumonia and accompanied with poor outcomes. The objective of this study was to investigate the association of AKI with clinical outcomes in COVID-19 patients., Methods: In this cohort study, we reviewed electronic medical data from patients with COVID-19 in Shenzhen from January 11 to February 19, 2020. Clinical features and clinical outcomes in COVID-19 patients with and without AKI were analyzed. Further, we evaluated the association between AKI development and clinical outcomes., Results: In this study, 9.6% patients developed AKI during hospitalization. Those with AKI presented older age, severer pneumonia, more comorbidity and lower lymphocyte count. Totally, more patients (77.5%) had primary composite outcomes (intensive care unit (ICU) admission, use of high-flow nasal cannula (HFNC) and mechanical ventilation) in AKI group compared to non-AKI group (2.9%) during the observation period. The median length of stay (LOS) and ICU stay were longer among those with AKI. After adjusted for related covariates, AKI development was independently correlated with LOS (β (95% CI): 9.16 (3.87-14.46)), rather than primary outcomes (HR (95% CI): 1.34 (0.56-3.21)) in COVID-19 patients., Conclusions: The development of AKI was not one of the reasons for ICU admission, use of HFNC and mechanical ventilation, but a kind of manifestation of severe illness in COVID-19 hospitalized patients., Competing Interests: None., (AJTR Copyright © 2020.)

Introduction: Long-term changes of fasting blood glucose (FBG) in relation to lower-extremity peripheral artery disease (lower-extremity PAD) in people without diabetes has barely been reported. Our study aimed to investigate the association between FBG variability and the incidence of lower-extremity PAD in people without diabetes., Research Design and Methods: We included 7699 participants without prior lower-extremity PAD and diabetes from the Atherosclerosis Risk in Communities study in the final analysis. At least two measurements of FBG were required during follow-up. Variability of FBG was identified using SD, coefficient of variation (CV), variability independent of the mean (VIM) and average real variability. Lower-extremity PAD was defined as an ankle brachial index <0.9, or hospitalization with a lower-extremity PAD diagnosis. Cox regression model was used to calculate HR for incidence of lower-extremity PAD and FBG variability., Results: During a median follow-up of 19.5 years, 504 (6.5 %) lower-extremity PAD events were observed, 54.4% (n=274) were male, and 17.5% (n=88) were African-American. FBG variability was positively associated with incident lower-extremity PAD, with a linear relationship. HRs for CV and VIM were 1.015 (95% CI: 1.001 to 1.03; p = 0.023), and 1.032 (95% CI: 1.004 to 1.06; p = 0.022) for lower-extremity PAD, respectively. Participants in the lowest quartile of CV were at lower lower-extremity PAD risk compared with the highest ones (HR: 1.499, 95% CI: 1.16 to 1.938; p = 0.002)., Conclusions: Higher FBG variability was independently associated with increased prevalence of lower-extremity PAD in people without diabetes., Trial Registration Number: NCT00005131., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The purple soil sloping field is considered as the main source of sediment and non-point source pollution in the Three Gorges Reservoir area. To prevent and control the non-point source pollution, it is indispensable to explore the characteristics of nitrogen loss in the overland flow and interflow of purple soil sloping field in Three Gorges Reservoir area. The purple soil sloping runoff plots, located in the Shibaozhai Experimental Station of Chengdu Institute of Chinese Academy of Sciences in Zhongxian County, Chongqing, were studied. The experiment included no fertilization treatment (CK), traditional fertilization treatment (T 1 ), amended fertilization treatment (T 2 ), and reduced fertilizer with straw treatment (T 3 ). According to the data of volume of the interflow and runoff and the leach concentration and flux of nitrogen forms under rapeseed-maize rotation system, the response of nitrogen leaching flux to reduce fertilizer with straw application can be definite in purple soil sloping plots. The results show that the ratio of interflow to total runoff is 60.14%-88.56%, and the flux of nitrogen leaching in the interflow accounts for 72.88%-92.35% of total nitrogen loss flux. Ammonium was mainly leached by the overland flow. In addition, nitrate was mainly leached by the interflow and was the main form of nitrogen leaching. The fluxes of ammonium and nitrate under different treatments followed the order T 1 > T 2 > T 3 > CK. The total nitrogen flux of T 3 was 20.07 kg·(hm 2 ·a) -1 , which was 43.59% and 39.55% lower than that of T 1 and T 2 , respectively. The reduced fertilizer with straw application significantly decreased the leaching flux of ammonium, nitrate, and total nitrogen, and weakened the effect on runoff nitrogen leaching in the purple soil sloping plots.

Introduction: Restless legs syndrome (RLS) is a common neurological sensorimotor disorder among patients with end stage renal disease. This clinical trial aimed to provide evidence on the efficacy and safety of pramipexole in patients with uremic RLS receiving peritoneal dialysis (PD)., Methods and Analysis: This is a 12-week, multicentre, randomised, double-blind, placebo-controlled clinical trial. In total, 104 patients with uremic RLS receiving PD will be enrolled from four hospitals and randomly assigned in a 1:1 ratio to either placebo or pramipexole. We will determine the efficacy of pramipexole in the improvement of International RLS Study Group Rating Scale as the primary outcome, while responder rates for other RLS scales at week 12, change from baseline to week 12 for psychological status, sleep disorder and quality of life and blood pressure represent the secondary outcomes., Ethics and Dissemination: The study was approved by the ethics committees of Peking University First Hospital, Xinqiao hospital of Army Medical University, Cangzhou Center Hospital and Peking University Shenzhen Hospital. The results will be disseminated in peer-reviewed journals., Trial Registration Number: NCT03817554., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)