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Qian Li, Leipeng Ren, Weitong Wu, Dangze Sun, Lin Wei, Chao Ding, Peijia Luo Department of Thoracic Surgery, Xi’an Chest Hospital, Xi’an, Shaanxi, 710100, People’s Republic of ChinaCorrespondence: Peijia Luo, Department of Thoracic Surgery, Xi’an Chest Hospital, Xi’an, Shaanxi, 710100, People’s Republic of China, Email 1171185306@qq.comBackground: To establish and validate a nomogram for predicting the culture results of Mycobacterium tuberculosis in superficial lymph nodes.Methods: The clinical data of patients with superficial lymph node tuberculosis admitted to Xi’an City Chest Hospital from November 23, 2018, to May 30, 2024, were selected and divided into a training set and a validation set according to a ratio of 7:3. Influencing factors were identified through multivariate logistic regression analyses. Using R version 4.3.2, we developed a predictive model and generated a nomogram based on this model. The performance of the nomogram was evaluated using receiver operating characteristic (ROC) curves, calibration curve analysis (CCA), and decision curve analysis (DCA).Results: The positive rate of superficial lymph node tuberculosis culture was 23.0% (103/446). Multivariate Logistic regression analysis showed that anti-tuberculosis treatment duration (OR=0.98, 95% CI: 0.97 ~ 0.99), initial treatment or retreatment (OR=0.12, 95% CI: 0.05 ~ 0.28), and adenosine deaminase (OR=1.12, 95% CI: 1.03 ~ 1.22) were independent factors affecting the culture results of Mycobacterium tuberculosis in superficial lymph nodes. The areas under the ROC curves were 0.86 (95% CI: 0.82– 0.91) for the training set and 0.89 (95% CI: 0.84– 0.95) for the validation set. The P values of calibration curves were 1.000 and 0.961, respectively, and the predicted values were in good agreement with the actual values. The threshold probabilities of clinical decision curves were 3%~64% and 1%~68%, respectively.Conclusion: The positive rate of Mycobacterium tuberculosis culture in superficial lymph nodes is low. The increase in retreatment patients and anti-tuberculosis treatment time are obstacle factors for Mycobacterium tuberculosis culture positivity, while an increase in adenosine deaminase is a promoting factor for Mycobacterium tuberculosis culture positivity. The nomogram model established based on these factors can be used to predict the results of Mycobacterium tuberculosis culture in superficial lymph nodes.Keywords: superficial lymph node tuberculosis, mycobacterium culture, predictive model, nomogram

Linan Ren,1,2 Feng Ju,3 Siyuan Liu,1,2 Yunjia Cai,1,2 Xiaokun Gang,1 Guixia Wang1 1Department of Endocrinology and Metabolism, First Hospital of Jilin University, Changchun, Jilin, 130021, People’s Republic of China; 2Institute of Translational Medicine, First Hospital of Jilin University, Changchun, Jilin, 130021, People’s Republic of China; 3Department of Orthopedics, Yuci District People’s Hospital, Yuci, Shanxi, 030600, People’s Republic of ChinaCorrespondence: Xiaokun Gang; Guixia Wang, Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, Jilin Province, 130021, People’s Republic of China, Email gangxk@jlu.edu.cn; gwang168@jlu.edu.cnAbstract: Obesity represents a substantial risk factor for a multitude of metabolic disorders, which seriously threatens human life and health. As the global obesity epidemic intensifies, obesity-related nephropathy (ORN) has attracted great attention. ORN arises from both physical/mechanical and non-physical insults to the glomerular and tubular structures precipitated by obesity, culminating in structural impairments and functional aberrations within the kidneys. Physical injury factors include changes in renal hemodynamics, renal compression, and mechanical stretching of podocytes. Non-physical injury factors include overactivation of the RAAS system, insulin resistance, lipotoxicity, inflammation, and dysregulation of bile acid metabolism. Exploring molecules that target modulation of physical or nonphysical injury factors is a potential approach to ORN treatment. ORN is characterized clinically by microproteinuria and pathologically by glomerulomegaly, which is atypical and makes early diagnosis difficult. Investigating early diagnostic markers for ORN thus emerges as a critical direction for future research. Additionally, there is no specific drug for ORN in clinical treatment, which mainly focuses on weight reduction, mitigating proteinuria, and preserving renal function. In our review, we delineate a progressive therapeutic approach involving enhancements in lifestyle, pharmacotherapy, and bariatric surgery. Our emphasis underscores glucagon-like peptide-1 receptor agonists (GLP-1 RAs) as poised to emerge as pivotal therapeutic modalities for ORN in forthcoming clinical avenues. Keywords: Obesity-related nephropathy, pathophysiology, diagnostics, therapeutics

Lijie Ren,1 Ye Chen,2 Xianguo Han,3 Ziyi Chen,2 Zhi Wang,4 Wenxiao Li,2 Hongyuan Chen2 1Mental Health Center, Shanghai Customs University, Shanghai, People’s Republic of China; 2School of Customs and Public Administration, Shanghai Customs University, Shanghai, People’s Republic of China; 3School of Psychology, Shanghai Normal University, Shanghai, People’s Republic of China; 4School of Customs and Public Economics, Shanghai Customs University, Shanghai, People’s Republic of ChinaCorrespondence: Xianguo Han, School of Psychology, Shanghai Normal University, 100 Guilin Street, Xuhui District, Shanghai, 200234, People’s Republic of China, Email hanxg.psy@aliyun.comBackground: Suicide is a global public health issue. This study examined the role of COVID-19 burnout and reappraisal in suicidal ideation caused by depressive symptoms among Chinese college students.Methods: 587 students (261 boys, Mage = 19.53, SD = 1.42) were assessed using the Short Depression-Happiness Scale (SDHS), Positive and Negative Suicide Ideation (PANSI) inventory, and Emotion Regulation Scale (ERS).Results: Correlation analysis indicated depressive symptoms were negatively correlated with reappraisal and positively correlated with suicidal ideation and COVID-19 burnout. Reappraisal was negatively correlated with suicidal ideation and COVID-19 burnout. The moderated mediation model showed COVID-19 burnout enhanced the direct effect of depressive symptoms on suicidal ideation and indirectly enhanced this effect by weakening the protective role of reappraisal.Conclusion: These finding show that reappraisal acts as a protective factor against suicidal ideation in individuals with depressive symptoms, while COVID-19 burnout exacerbates this effect by weakening reappraisal’s protective role.Keywords: depressive symptoms, suicidal ideation, reappraisal, COVID-19 burnout, moderated mediation model

Lijing Huo,1 Xuexin Liu,2 Changmei Wei,1 Fang Yu,1 Luping Ren,3 Yanqing Tie1 1Department of Medical Laboratory, Hebei General Hospital, Shijiazhuang, Hebei Province, People’s Republic of China; 2Health Check-up Centers, Hebei General Hospital, Shijiazhuang, Hebei Province, People’s Republic of China; 3Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei Province, People’s Republic of ChinaCorrespondence: Lijing Huo, Department of Medical Laboratory, Hebei General Hospital, 348 Heping West Road, Xinhua District, Shijiazhuang, Hebei Province, People’s Republic of China, Email huolijing1979@126.comAim: This study was intended to establish the reference intervals of bone turnover markers (BTMs) for healthy populations.Methods: According to the Clinical Laboratory Standards Institute (CLSI) EP28-A3c, we recruited 774 healthy Chinese and investigated their clinical characteristics and relationships among gender, age, season and BTMs. The reference intervals of BTMs for healthy populations in Hebei of China were established through defining the central 95% range of all observations.Results: We found that gender were associated with 25(OH)D, OC, β-CTX, and P1NP (P < 0.05), but not PTH1-84 (P=0.138). All serum BTMs showed differences among different age groups (P < 0.01). The level of 25 (OH) D in winter showed statistical differences with spring, summer, and autumn (P< 0.05). The OC level showed statistical difference between summer and winter (P=0.000). The P1NP levels showed statistical difference between spring and winter (P=0.019), summer and winter (P=0.000), and summer and autumn (P=0.012), respectively. The PTH1-84 levels in winter showed statistical differences with spring, and summer (all P=0.000), while there was no statistically significant difference in β- CTX levels between seasons.Conclusion: We have established the reference intervals of several BTMs for healthy individuals in Hebei of China, which have statistical significance across different age groups and genders, and there are also significant differences between different seasons. Therefore, the Chinese medical laboratories in different locations should group individuals according to gender and age groups in different seasons, and establish corresponding biological reference intervals.Keywords: 25-hydroxyvitamin D, 25(OH)D, osteocalcin, OC, β-carboxy-terminal cross-linking telopeptide of type I collagen, β-CTX, N-terminal procollagen of type I collagen, P1NP, parathyroid hormone 1-84, PTH1-84

Liyuan Ren, Jinjin Yang, Yanshuang Li, Yanping Wang Department of Anesthesiology, Pain and Perioperative Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of ChinaCorrespondence: Yanping Wang, Department of Anesthesiology, Pain and Perioperative Medicine, the First Affiliated Hospital of Zhengzhou University, No. 1 East Jianshe Road, Zhengzhou, 450052, People’s Republic of China, Tel +86-371-13526857360, Email 282243756@qq.comPurpose: To investigate and quantify the effect of continuous esketamine infusion at different doses on the bispectral index (BIS) during sevoflurane anesthesia.Methods: A total of 120 patients scheduled for elective laparoscopic renal surgery were randomly divided into three groups. Under steady anesthesia and surgical situations, the patient was started on continuous infusion of the study drug: 0.125 mg/kg/h esketamine (group E1), 0.25 mg/kg/h esketamine (group E2), and the same volume of saline (group C). The primary outcome was changes in BIS value after 15 min (T15), 30 min (T30), 45 min (T45), and 60 min (T60) of drug infusion. The secondary outcomes were 95% spectral edge frequency (SEF95), electromyogram (EMG), heart rate (HR), and mean arterial pressure (MAP) from T0 to T60. Furthermore, postoperative pain, postoperative recovery, and perioperative adverse events were evaluated.Results: Compared with group C, group E1 exhibited significant BIS elevation at T30–T60 and group E2 at T15–T60 (P < 0.001). Compared with group E1, group E2 showed a more significant BIS elevation at T15–T60 (P < 0.001). The area under the curve (AUC) of BIS and SEF95 were significantly higher in group E2 than in groups C and E1 (P < 0.05). BIS value for any of the three groups was significantly correlated with SEF95 (P < 0.001). No significant differences were observed in the AUC of EMG, HR, and MAP among the three groups. Intraoperative remifentanil consumption and postoperative NRS of pain on movement were significantly reduced in group E2 compared with groups C and E1 (P < 0.05).Conclusion: Continuous infusion of both 0.125 and 0.25 mg/kg/h of esketamine increased the BIS value during sevoflurane anesthesia, and the BIS value gradually stabilized with the prolongation of the infusion time.Keywords: esketamine, bispectral index, 95% spectral edge frequency, sevoflurane

Li Ren, Zhaoling Li, Ji Wu, Lian Duan, Jialiang Gao Cardiovascular Department, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, People’s Republic of ChinaCorrespondence: Li Ren, Cardiovascular Department, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Address: No. 5, Beixiange, Xicheng District, Beijing, 100053, People’s Republic of China, Tel +86 18600697916, Email renlirl7961@hotmail.comObjective: This study aimed to assess the knowledge, attitudes and practices (KAP) among elderly coronary heart disease (CHD) patients toward self-perceived health abilities.Methods: This web-based study was carried out between April 2023 and September 2023 at Guang’anmen Hospital, China Academy of Chinese Medical Sciences. A self-developed questionnaire was utilized to collect demographic information from elderly CHD patients, and evaluate their KAP towards self-perceived health abilities.Results: A total of 568 valid questionnaires were collected. Among the participants, the average age was 65.97± 5.50 years, and 298 (52.46%) were female, and the mean scores for knowledge, attitudes, and practices were 6.34± 2.29 (possible range: 0– 9), 35.24± 4.99 (possible range: 9– 45), and 27.79± 10.09 (possible range: 9– 45), respectively. The structural equation model demonstrated that elderly CHD patients’ knowledge directly affects attitudes and practices, with path coefficient of 0.93 (P< 0.001) and 0.39 (P=0.033), respectively. Moreover, attitudes play an intermediary role between knowledge and practice with path coefficient of 0.75 (P< 0.001). Furthermore, residence directly affects knowledge with path coefficient of 0.67 (P< 0.001), cardiac function directly affects knowledge with path coefficient of − 0.97 (P< 0.001) and history of interventional therapy directly affects practice with path coefficient of 4.23 (P< 0.001).Conclusion: Elderly CHD patients demonstrated sufficient knowledge, positive attitudes, and proactive practices towards self-perceived health abilities. However, educational programs and behavior modification are recommended, particularly for elderly with lower age and education, living in rural areas, lacking interventional therapy, obese, or taking multiple CHD medications.Keywords: knowledge, attitudes, practices, cross-dimensional study, coronary heart disease, self-perceived health abilities

Qing Wang,1 Ke Liu,1 Tian Zhang,1 Ting Wang,2 Huan Li,1 Chang Wang,1 Jinhu Chen,1 Luping Ren1 1Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China; 2Department of Clinical laboratory, Nanjing Medical College, Nanjing, Jiangsu, People’s Republic of ChinaCorrespondence: Luping Ren, Email renluping1122@163.comBackground: The study estimated the association between NAFLD and SUA/Cr in Chinese non-obese patients with type 2 diabetes mellitus (T2DM) and also investigated mediating effect of TG.Methods: All patients were divided into NAFLD group (n = 420) and non-NAFLD group (n = 347). The differences of biochemical indicators between the two groups were compared. The link between SUA/Cr and other parameters was checked through Spearman correlation analysis. Differences in the incidence rate of NAFLD between SUA/Cr and TG 3 tertile subgroups were tested by chi-squared. To explore the independent influence of SUA/Cr and TG on NAFLD, logistic regression was performed. The predictive value of SUA/Cr and SUA/Cr combined with BMI for NAFLD was analyzed using ROC curves. In addition, to confirm whether TG has a mediating effect on the link of SUA/Cr and NAFLD, we conducted a mediating analysis.Results: NAFLD group had higher SUA/Cr values than individuals without NAFLD (P < 0.01). SUA/Cr was linked with TC and TG (r = 0.081, 0.215 respectively). NAFLD prevalence increased progressively from quartile 1 to quartile 3 of SUA/Cr (44% vs 57% vs 62%). Prevalence of NAFLD increased from quartile 1 to quartile 3 of TG (35.8% vs 58.7% vs 69.9%). Analysis of the logistic regression revealed that SUA/Cr and TG were statistically linked with NAFLD. The ROC curve pointed out that the area under the curve (AUC), sensitivity and specificity of SUA/Cr were 0.59, 0.629 and 0.522, respectively. The AUC, sensitivity and specificity for SUA/Cr combined with BMI were 0.719, 0.644 and 0.677, separately. The mediation analysis showed a statistically direct effect of SUA/Cr on NAFLD (β=0.148, 95% CI: 0.0393, 0.2585). The function of SUA/Cr on NAFLD partially mediated by TG (β=0.1571, 95% CI: 0.0704, 0.2869).Conclusion: SUA/Cr was significantly associated with NAFLD in non-obese T2DM patients, and TG partially mediated this association. SUA/Cr can be applied to predict for NAFLD.Keywords: nonalcoholic fatty liver disease, type 2 diabetes mellitus, serum uric acid to creatinine ratio

Li An,1,2,&ast; Xiaomei Ren,1,&ast; Ye Pan,2 Wei Gao,1 Liqun Ren,1 Jing Wang,3 Yao Wang2 1Department of Geriatrics, ZhongDa Hospital, Southeast University School of Medicine, Nanjing, 210009, People’s Republic of China; 2Department of Endocrine, ZhongDa Hospital, Southeast University School of Medicine, Nanjing, 210009, People’s Republic of China; 3Yizheng Hospital of Nanjing Drum Tower Hospital Group, Yizheng, 211400, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jing Wang; Yao Wang, Tel/Fax +86-25- 83272111, Email wang_yao100@163.com; yz3466599@hotmail.comBackground: The impact of inflammatory factors on the risk of diabetic nephropathy (DN) is inconsistent. Two-sample Mendelian randomization (MR) analyses were used to detect the causal role of inflammatory factors in DN risk.Methods: Inflammatory factor GWAS summary data were collected from a meta-analysis including 8,293 Finnish participants, and DN information was extracted from a GWAS of 213,746 individuals from FinnGen. The MR Pleiotropy Residual Sum and Outlier (MR-PRESSO) outlier test was used for the removal of horizontal pleiotropic outliers. Multivariable MR analysis was also used to adjust for pleiotropy.Results: IFN-γ [ORIVW: 1.33; 95% CI: 1.09– 1.63; p=0.005] and SCF [ORIVW: 1.25, 1.02– 1.52; p = 0.027] were associated with an increased risk of DN. MIP1b [ORIVW: 0.92; 95% CI: 0.85– 0.98; p = 0.022] and IL-16 [ORIVW: 0.89, 0.81– 0.99; p = 0.043] showed negative associations with the risk of DN. We validated our MR results with MR-PRESSO analyses. Significant horizontal pleiotropy was not found. Moreover, in the multivariable MR analysis, the associations between cytokines and DN risk remained.Conclusion: Our MR results based on genetic data contribute to a better understanding of the pathogenesis of DN and provide evidence for a causal effect of inflammatory factors on DN. These findings support targeting specific inflammatory factors to alleviate DN risk.Keywords: causal association, diabetic nephropathy, inflammatory factors, Mendelian randomization

Honghua Shen,1,2 Yiming Xu,2 Yin Zhang,2 Lei Ren,2 Rui Chen1 1Department of Respiratory Medicine, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, People’s Republic of China; 2Department of Respiratory Rehabilitation, the Fourth Rehabilitation Hospital of Shanghai, Shanghai, 200040, People’s Republic of ChinaCorrespondence: Rui Chen, Department of Respiratory Medicine, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, People’s Republic of China, Email chenruigood@126.comPurpose: We assess the predictive value of diaphragm excursion (DE) in enhancing exercise tolerance following pulmonary rehabilitation (PR) among patients with COPD-OSA overlap syndrome.Material and Methods: This prospective cohort study enrolled 63 patients diagnosed with COPD-OSA overlap syndrome who actively participated in a PR program from January 2021 to May 2023. Among these, 58 patients successfully completed the 20-week PR program, with exercise tolerance assessed through the measurement of six-minute walk distance (6MWD), and DE evaluated by ultrasonography. The responder to PR in terms of exercise ability was defined as a patient who showed an increase of > 30m in 6MWD. The cutoff value for predicting PR response based on DE was determined using receiver operating characteristic (ROC) curves.Results: Following the PR program, significant improvements were observed in mMRC, 6MWD, DE during deep breathing, and diaphragm thickness fraction (DTF). Of the participants, 33 patients (57%) were classified as responders, while 25 patients (43%) were considered non-responders. Baseline values of FEV1% predicted, 6MWD, DE during deep breathing, DTF, and PaO2 exhibited a significant elevation in responders as compared to non-responders. The changes of 6MWD were positively associated with the baseline values of DTF and DE during deep breathing, FEV1% predicted and PaO2, while negatively correlated with baseline value of mMRC. The predictive performance in terms of the area under the ROC curve for determining responder’s DTF was found to be 0.769, accompanied by a sensitivity of 85% and specificity of 68%, using a cutoff value at 17.26%. Moreover, it was observed that DE during deep breathing could predict the area under the ROC curve for responders to be 0.753, with a sensitivity of 91% and specificity of 56% at a cutoff value of 3.61cm.Conclusion: Diaphragm excursion serves as a valuable predictor for determining the enhancement of exercise tolerance following PR in patients with COPD-OSA overlap syndrome.Trial Registration: ChiCTR1800020257, www.chictr.org.cn/index.aspx.Keywords: pulmonary rehabilitation, COPD-OSA overlap syndrome, diaphragm excursion, diaphragm thickness fraction, six-minute walk distance

Linyuan Gui,1,&ast; Qingyuan Ye,2,&ast; Lu Yu,3 Geng Dou,1 Yang Zhou,1 Yang Liu,4 Yanqi Zhang,5 Xiaoshan Yang,1,6 Fang Jin,5 Shiyu Liu,1 Yan Jin,1 Lili Ren1 1State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China; 2State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China; 3Department of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, Shandong, 250012, People’s Republic of China; 4Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China; 5State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China; 6Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, 510280, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Lili Ren; Yan Jin, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China, Email lanyangddgy@qq.com; yanjin@fmmu.edu.cnBackground: Osteoporosis is a highly prevalent disease that causes fractures and loss of motor function. Current drugs targeted for osteoporosis often have inevitable side effects. Bone marrow mesenchymal stem cell (BMSCs)-derived apoptotic extracellular vesicles (ApoEVs) are nanoscale extracellular vesicles, which has been shown to promote bone regeneration with low immunogenicity and high biological compatibility. However, natural ApoEVs cannot inherently target bones, and are often eliminated by macrophages in the liver and spleen. Thus, our study aimed to reconstruct ApoEVs to enhance their bone-targeting capabilities and bone-promoting function and to provide a new method for osteoporosis treatment.Methods: We conjugated a bone-targeting peptide, (Asp-Ser-Ser)6 ((DSS)6), onto the surface of ApoEVs using standard carbodiimide chemistry with DSPE-PEG-COOH serving as the linker. The bone-targeting ability of (DSS)6-ApoEVs was determined using an in vivo imaging system and confocal laser scanning microscopy (CLSM). We then loaded ubiquitin ligase RING finger protein146 (RNF146) into BMSCs via adenovirus transduction to obtain functional ApoEVs. The bone-promoting abilities of (DSS)6-ApoEVs and (DSS)6-ApoEVsRNF146 were measured in vitro and in vivo.Results: Our study successfully synthesized bone-targeting and gained functional (DSS)6-ApoEVsRNF146 and found that engineered ApoEVs could promote osteogenesis in vitro and exert significant bone-targeting and osteogenesis-promoting effects to alleviate osteoporosis in a mouse model.Conclusion: To promote the bone-targeting ability of natural ApoEVs, we successfully synthesized engineered ApoEVs, (DSS)6-ApoEVsRNF146 and found that they could significantly promote osteogenesis and alleviate osteoporosis compared with natural ApoEVs, which holds great promise for the treatment of osteoporosis. Keywords: osteoporosis, mesenchymal stem cells, apoptotic extracellular vesicles, bone-targeting, bone regeneration

Mingxuan Zou,1,2,&ast; Bin Liu,2,&ast; Jing Ji,1 Lei Ren,3,4 Xiuchao Wang,2 Fengzhan Li2 1Public Health School, Shaanxi University of Chinese Medicine, Xianyang, 712046, People’s Republic of China; 2Department of Military Medical Psychology, Air Force Medical University, Xi’ an, 710032, People’s Republic of China; 3Military Psychology Section, Logistics University of PAP, Tianjin, 300309, People’s Republic of China; 4Military Mental Health Services & Research Center, Tianjin, 300309, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Fengzhan Li; Xiuchao Wang, Email psyfengzhan@126.com; Wangxiuchao1984@163.comBackground: Military personnel experience prolonged exposure to high-stress environments. Positive coping styles can assist in maintaining their mental and behavioral well-being, whereas negative coping styles cannot. Health behavior change theory specifies that an individual can transition from a negative to a positive coping style. The psychological resilience concept may prove vital in this transition.Methods: In a longitudinal study design, two questionnaires were administered to 233 military personnel twice, the first at T1 in April 2023 and the second at T2 in July 2023. The questionnaire measured individual negative coping style, positive coping style and psychological resilience.Results: The data showed that the negative coping style at T1 negatively predicted the level of psychological resilience at T2 (γ= - 0.26, p < 0.001) and the positive coping style at T2 (γ= - 0.16, p < 0.001). The level of psychological resilience at T1 positively predicted the positive coping style at T2 (γ= 0.22, p < 0.01). Psychological resilience played a mediating role between negative coping style and positive coping style. In addition, there was an interaction between psychological resilience and positive coping style in military personnel at the two time points.Conclusion: The negative coping styles that presently exist among military personnel have the potential to diminish their future positive coping styles by lowering their psychological resilience. This highlights the need to focus on the development and training of psychological resilience for military personnel, as it can effectively counteract negative coping styles and promote positive coping styles.Keywords: military personnel, coping style, resilience, cross-lagged analysis

A sodium lidar (light detection and range) network for the Earth's mesosphere and lower thermosphere (MLT) temperature, wind and sodium density measurements is designed and constructed in the second phase of the Chinese Meridional Project. Five narrowband sodium lidar systems are deployed across various regions in China, designed and developed based on similar principles and structures. They adhere to uniform data processing standards and operate under the same observational protocols. This allows them to form a network of lidar systems capable of detecting temperature and wind fields in the MLT. The preliminary observation results of the lidar near Tibetan plateau is demonstrated in this paper. This lidar network offers horizontal perspectives on large scale that a single‐station lidar system can't provide. Its future observations are expected to advance the understanding of atmospheric waves by studying wave propagation, chemical‐dynamical coupling processes and the horizonal structure of in the MLT region. Plain Language Summary: This paper describes a new lidar (light detection and range) network to observe the mesosphere and lower thermosphere (MLT) region, which is the coldest area in the earth. Five narrow band sodium lidars in this network measure the temperature, wind and sodium density. They adhere to uniform data processing standards and follow the same observational protocols, which define the temporal and range resolution of lidar data, as well as the world geodetic system. The preliminary results for wind, temperature and sodium density are obtained. The lidar network will provide effective means for MLT research. Key Points: Narrowband sodium lidar based on pulsed seeder laser is constructed to measure wind and temperature in the mesosphere and lower thermosphere regionFive lidars distributed in the region of China from 19.5°N to 53.5°N, and from 87.2°E to 122.4°E form a lidar networkPreliminary observation results are demonstrated the ability and potential of the lidar network to conduct more scientific research [ABSTRACT FROM AUTHOR]

Transition metal dichalcogenides (TMDs) like MoSe2 exhibit remarkable optical properties such as intense photoluminescence (PL) in the monolayer form. To date, narrow-linewidth PL is only achieved in micrometer-sized exfoliated TMD flakes encapsulated in hexagonal boron nitride (hBN). In this work, we develop a growth strategy to prepare monolayer MoSe2 on hBN flakes by molecular beam epitaxy in the van der Waals regime. It constitutes the first step toward the development of large area single crystalline TMDs encapsulated in hBN for potential integration in electronic or optoelectronic devices. For this purpose, we define a two-step growth strategy to achieve monolayer-thick MoSe2 grains on hBN flakes. The high quality of MoSe2 allows us to detect very narrow PL linewidth down to 5.5 meV at 13 K, comparable to the one of encapsulated exfoliated MoSe2 flakes. Moreover, sizeable PL can be detected at room temperature as well as clear reflectivity signatures of A, B, and charged excitons. [ABSTRACT FROM AUTHOR]

Migration of conventional petrochemical plasticizers can negatively affect the performance of plasticized products, human health and the environment and result in the reduction of petroleum resources. Thus, the development of bio-based plasticizers with migration resistance is very critical. In this study, two novel bio-based plasticizers with different structures derived from ricinoleic acid, i.e., epoxy acetylated benzyl ricinoleate (EABR) and epoxy acetyl terephthalate ricinoleate (EATPR), with good plasticizing effect and migration resistance were synthesized and characterized. The structure of EABR and EATPR was confirmed using FTIR and 1H NMR spectroscopies. The mechanical, thermal, and migration properties of the PVC samples plasticized with EABR and EATPR were extensively investigated, and the commercial plasticizer dioctyl terephthalate (DOTP) was used for comparison. The plasticized PVC samples with EABR and EATPR showed similar impact strength, elongation at break, and glass transition temperature (Tg) to DOTP-plasticized samples, indicating a good plasticizing effect on PVC. Furthermore, EABR and EATPR demonstrated superior performance in migration and volatility tests compared to DOTP. Besides, the plasticizing properties of the plasticized PVC were very sensitive to the structure of the plasticizer; EATPR, with a symmetric structure, showed better plasticization and plasticizing efficiency than EABR, with an asymmetric structure. In conclusion, the two bio-based plasticizers derived from ricinoleic acid showed attractive potential as alternatives to phthalate plasticizers, especially EATPR, with a larger symmetric molecular structure and higher aliphatic content. [ABSTRACT FROM AUTHOR]

Diabetes Mellitus is a metabolic disorder characterized primarily by chronic hyperglycemia. As the population ages, the prevalence of type 2 diabetes mellitus (T2DM) among the elderly is increasing, leading to a higher incidence of chronic complications, disability, and mortality associated with diabetes. This paper reviews the factors influencing chronic complications in elderly patients with T2DM and examines health behavior assessment tools for this demographic. The objective is to provide a reference for developing and implementing intervention plans and measures to address chronic complications in elderly T2DM patients, ultimately aiming to reduce the occurrence and progression of these complications.

Abstract Interpreting the degradation characteristics of waterlogged archaeological wood (WAW) is crucial for the conservation of wooden cultural heritage. Generally, multidisciplinary diagnostic methods, including physical, micromorphological, and chemical approaches, are employed to evaluate the preservation state of WAW. However, primarily focused on the sample level, this methodology limits the understanding of the variability in degradation from a detailed perspective. In this paper, we adopted the in-situ microscale attenuated total reflectance Fourier transform infrared (ATR-FTIR) method to investigate the degradation variability in waterlogged archaeological Masson pine (Pinus massoniana) wood excavated from the ancient Chinese shipwreck Nanhai No. 1. Specifically, spectra of earlywood (EW), latewood (LW), and compression wood (CW) were extracted and combined with chemometrics to achieve rapid classification of their degradation levels. The micromorphological features of wood cell walls in conjunction with the ratios of lignin (A1509) and carbohydrate (A1370) peak areas were used to estimate the degradation levels. Unlike recent wood, moderate degradation in CW and severe degradation in EW and LW were classified in archaeological samples. The degradation levels were effectively determined through principal component analysis (PCA) and sparse partial least squares discriminant analysis (sPLSDA). The results suggest that chemometric analysis is a promising method to discern the variable degradation levels of archaeological wood at the tissue level. The methodologies developed in this study provide detailed insights into the degradation characteristics in WAW and improve the accuracy of evaluating the preservation state.

Abstract Background The Chinese biosimilar industry has demonstrated rapid growth in recent years. Limited evidence is available about biosimilar uptake at the national level. This study aimed to assess biosimilar uptake in the case of trastuzumab and to explore potential factors influencing the biosimilar penetration at national and provincial levels. Methods This study employed an interrupted time series analysis to assess the level and trend changes of national trastuzumab originator consumption and the overall trastuzumab consumption after the price reduction of the originator and the introduction of the first biosimilar using the China Hospital Pharmacy Audit procurement data from March 2018 to February 2023. A latent class trajectory model (LCTM) was also adopted to estimate the biosimilar penetration across 30 provincial-level administrative divisions (PLADs). Based on the LCTM grouping results, provincial characteristics were analyzed. Results After rapid growth, the penetration of biosimilars demonstrated a moderate ascending trend at the national level, reaching 27% in February 2023. Following the introduction of the first biosimilar in July 2021, the consumption of the originator decreased by 0.5% per month (P = 0.008), and the growth rate of overall trastuzumab consumption decreased by 1.1% per month (P = 0.014). LCTM fit the best when the number of trajectory classes was two, dividing 30 PLADs into a group demonstrating a faster increase in biosimilar penetration and the other with a slower increase. The PLADs in the fast-increasing group had a higher proportion of the population covered by the national basic health insurance, a lower proportion of the urban population, a lower proportion of the population covered by the urban employee health insurance program, a lower gross domestic product per capita, a lower total health expenditure per capita, and a lower out-of-pocket expenditure. Conclusions The uptake of trastuzumab biosimilars in China was lower compared with major European countries. The introduction of trastuzumab biosimilars presented a substitutional effect. Perceptions of physicians and patients, the medicines procurement model, competition from other biologics, and health insurance payment methods may influence biosimilar uptake. Enhancing a comprehensive understanding of biosimilars among physicians and patients, including biologics with biosimilars in the national pooled procurement, and implementing provider payment reforms could foster biosimilar penetration.

Background Hepatic macrophages play a vital role in the defense mechanisms and maintaining the internal environment stability of body, and are also major cellular components involved in liver injury and repair. Macrophages derived from hematopoietic stem cells exhibit distinct gene regulation patterns compared to resident macrophages in the liver. More than 90% of primary liver cancer occurs on the basis of cirrhosis, and the dynamic changes of macrophages in the progression of cirrhosis to hepatocellular carcinoma are worth exploring. Objective To analyze the transcriptomic differences of hepatic macrophages originating from diverse sources, analyze the dynamic pattern of macrophage changes in liver cirrhosis and liver cancer progression, and explore potential strategies for preventing the progression of liver cancer. Methods In this study, single-cell transcriptomics data of healthy, cirrhotic and hepatocellular carcinoma (HCC) tissues were obtained from the Gene Expression Omnibus (GEO) database. The healthy and liver fibrosis data were obtained from the GSE136103 dataset of the GEO database, which included samples from five healthy liver tissues and five liver cirrhosis tissues. The HCC data were obtained from the GSE149614 dataset of the GEO database, which consisted of 21 samples from ten HCC patients. Utilizing the Seurat package, a clustering analysis was conducted on the transcriptomic data derived from liver fibrosis and HCC samples to identify distinct cell types. Notably, three distinctive clusters of macrophage subtypes were identified within the fibrosis samples, from which the top 200 marker genes were extracted. Metascape online analysis software was applied to functionally analyze each subcluster-specific expressed gene. Subgroup-specific expressed genes in liver fibrosis were extracted, and the function of macrophages in cirrhosis was explored by KEGG functional analysis. The CellChat software package was utilized to analyze intercellular interactions within liver fibrosis and HCC single-cell transcriptome data, differences in macrophage communication between cirrhosis and HCC samples were compared. Additionally, normal, fibrotic and cancerous macrophages were extracted, and batch effect correction was performed using the Harmony package. Subsequently, the Monocle package was employed for pseudo-time analysis to construct the developmental trajectory of macrophages spanning from a healthy state to fibrosis and eventually to the HCC microenvironment. The limma package was utilized to find genes that are continuously up-regulated and down-regulated during the evolution of macrophages from healthy state to cirrhotic state and finally to HCC, and functional enrichment analysis was performed. Results Unsupervised clustering was performed, and a total of three macrophage subclusters (designated as Mac1, Mac2, Mac3) were identified based on the expression patterns of marker genes. Mac1 originates from tissue-resident macrophages (Kupffer cells). Mac2 and Mac3 derived from blood monocytes and their numbers were significantly increased in cirrhotic tissue. Mac1 in cirrhotic tissue showed up-regulation of adaptive immune system-related functions. Mac2 and Mac3 subgroups show down-regulation of phagosome-related functions and antigen presentation functions. There were significant differences in communication between macrophages and other cell types in cirrhotic tissue and HCC tissue. Certain intercellular communication occurs only in cirrhotic macrophages, including cell communication of signaling pathways such as IFN-Ⅱ and CD40. After batch effect correction, pseudo-time series analysis was performed on macrophages from healthy liver, liver cirrhosis and HCC, the results suggest that there is a specific temporal relationship between the three groups of macrophages. This study identified 81 genes that were continuously down-regulated during the process, however, no genes were identified that were continuously up-regulated during the evolution of healthy-cirrhotic-HCC macrophage. Functional analysis suggested that the continuously down-regulated genes are functionally enriched for immune responses to bacteria. Conclusion Cirrhotic macrophages can be divided into three subgroups, of which Mac1 derived from liver-resident Kupffer cells and Mac2 and Mac3 derive from blood monocytes. Many immune-related cell communications in liver cirrhosis, such as IFN-Ⅱ and CD40 pathways, disappear in HCC. There is a continuous down-regulation of immune responses to bacteria in the evolution of healthy -cirrhotic-HCC macrophages, which may exacerbate the destructive effect of portal hypertension-induced gut microbiota displacement. For patients with liver cirrhosis, early treatment of portal hypertension-induced intestinal leakage (leaky gut) may be an important treatment strategy.

By using activated sludge from the anaerobic tank of a coking plant, a highly efficient phenol-degrading bacterial (PDB) community was successfully obtained through separation and domestication, and its effect on microbial degradation of phenol was investigated. The results showed that the degradation effect of PDB community on phenol was affected by the substrate concentration. The degradation rate reached 100% when the phenol concentration was lower than 700 mg/L. However, when the concentration of phenol increased to 1 300 mg/L, the degradation rate decreased to 41.6%. When the concentration of phenol exceeded 1 700 mg/L, the PDB community could basically unable to grow. High-throughput sequencing revealed that the species richness within the PDB community was high. Proteobacteria, Firmicutes, and Bacteroidota were dominant phyla, while Serratia sp., Bacillus sp., and Muribaculaceae sp. were core dominant genera of PDB. Metabolites analyzed by gas chromatography-mass spectrometry (GC-MS) revealed that the pathway for phenol degradation by PDB community was through ortho-cleavage, resulting in acidic intermediate products that subsequently decomposed into chain-like small molecular substances.

Abstract The activation of nuclear factor erythroid 2–related factor 2 (NRF2) has been observed in various cancers. Yet its exact contribution to the development of head and neck squamous cell carcinoma (HNSCC) remains undetermined. We previously found that NRF2 signaling is critical for the differentiation of squamous basal progenitor cells, while disruption of NRF2 causes basal cell hyperplasia. In this study, we revealed a correlation between elevated NRF2 activity and poor outcomes in HNSCC patients. We demonstrated that NRF2 facilitates tumor proliferation, migration, and invasion, as evidenced by both in vitro and in vivo studies. Significantly, NRF2 augments the expression of the antioxidant enzyme GPX2, thereby enhancing the proliferative, migratory, and invasive properties of HNSCC cells. Activation of GPX2 is critical for sustaining cancer stem cells (CSCs) by up-regulating NOTCH3, a key driver of cancer progression. These results elucidate that NRF2 regulates HNSCC progression through the NRF2-GPX2-NOTCH3 axis. Our findings proposed that pharmacological targeting of the NRF2-GPX2-NOTCH3 axis could be a potential therapeutic approach against HNSCC.