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ObjectiveAlthough guidelines support the efficacy of Modified Qing’ E Formula (MQEF) in treating postmenopausal osteoporosis (PMOP), its underlying mechanisms remain incompletely understood. This retrospective investigation aims to elucidate MQEF’s impact on serum exosomal miRNA expression in postmenopausal osteoporosis patients and to explore potential therapeutic mechanisms.MethodsFollowing ethical approval and registration, postmenopausal osteoporosis patients aged 50–85 years, meeting the diagnostic criteria were randomly selected and received MQEF decoction supplementary therapy. Serum samples were collected pre- and post-treatment, followed by isolation and sequencing of exosomal miRNAs. Differential miRNAs in serum exosomes were identified, and bioinformatics analysis was conducted to discern the principal exosomal miRNAs involved in MQEF’s effects on PMOP and the associated signaling pathways.ResultsEighteen clinical blood samples were collected. A total of 282,185 target genes were detected across the three groups. 306 miRNAs exhibited altered expression in serum exosomes of PMOP patients, while MQEF intervention resulted in changes in 328 miRNAs. GO enrichment analysis revealed the immune and endocrine systems was pertained. KEGG enrichment analysis indicated associations between PMOP occurrence and MQEF treatment with cytokine interactions, oxidative phosphorylation, and the renin-angiotensin system. Intersectional analysis identified 17 miRNAs, including 2 consistent trends. miR-3188 as a potentially pivotal miRNA implicated in both PMOP occurrence and MQEF treatment.ConclusionThis study constitutes the first randomized, retrospective clinical exploration confirming that MQEF demonstrates regulatory influence over exosomal miRNA expression in PMOP patients’ serum, its impact likely involves modulation of the immune and endocrine systems, as well as the renin-angiotensin system.

IntroductionSpecialized care is essential for the recovery of children with cerebral palsy (CP). This study investigates how different care modes impact the gut microbiota.MethodsFecal samples from 32 children were collected, among whom those cared for by family (n = 21) were selected as the observation group, and those cared for by children's welfare institutions (n = 11) were selected as the control group (registration number of LGFYYXLL-024). The gut microbiota profiles were analyzed.ResultsThere was no significant difference in the α-diversity of the gut microbiota and the abundance at the phylum level. However, at the genus level, the observation group showed a significant increase in the abundance of butyrate-producing bacteria Bacteroides and Lachnospiracea incertae sedis (P

BackgroundMale urethral stricture disease (USD) is predominantly characterized by scar formation. There are few effective therapeutic drugs, and comprehensive molecular characterizations of USD formation remain undefined.MethodsThe proteomic profiling of twelve scar tissues and five matched normal adjacent tissues (NATs). Proteomic analysis methods were applied to explore the molecular characterizations of USD formation, including uncovering mechanistic pathways and providing novel biomarkers for scar formation.ResultsComparative proteomic analysis showed that the extracellular matrix (ECM) and complement cascade signaling were predominant in scar tissues. COL11A1 and CD248 significantly contributed to the accumulation of ECM components. Our study presented diverse molecular mechanisms of scar formation across different ages and suggested the potential effects of PXK in Age 1 (

Solar photovoltaic (PV) is one of the most environmental-friendly and promising resources for achieving carbon peak and neutrality targets. Despite their ecological fragility, China’s vast desert regions have become the most promising areas for PV plant development due to their extensive land area and relatively low utilization value. Artificial ecological measures in the PV plants can reduce the environmental damage caused by the construction activity and promote the ecological condition of fragile desert ecosystems, therefore yield both ecological and economic benefits. However, the understanding of the current status and ecological benefits of this approach in existing desert PV plants is limited. Here we surveyed 40 PV plants in northern China’s deserts to identify the ecological construction modes and their influencing factors. We quantified the ecosystem service value (ESV) provided by these PV plants using remote sensing data and estimated the potential for ESV enhancement. Our results show that PV plant construction in desert regions can significantly improve the ecosystem, even with natural restoration measures (M1) alone, resulting in a 74% increase in average fractional vegetation cover (FVC) during the growing season, although the maximum average FVC of only about 10%. The integrated mode M4, which combined artificial vegetation planting M2 and sand control measures M3, further enhance the average growing season FVC to 14.53%. Currently, 22.5% of plants lack ecological measures, 40% employ only a single measure, but 92% of new plants since 2017 have adopted at least one ecological construction mode. The main influencing factors include surface type, policy support, water resources, ecological construction costs, and scientific management guidance. If artificial ecological construction were incorporated, a significant ESV could be achieved in these PV plants, reaching $8.9 million (a 7.7-fold increase) if assuming a targeted 50% vegetation coverage. This study provides evidence for evaluating the ecological benefit and planning of large-scale PV farms in deserts.

Macrophage polarization is closely associated with the pathogenesis of ulcerative colitis (UC). Quercetin, a flavonoid, has shown promise as a treatment for inflammatory diseases, but its specific mechanism of action remains unclear. This study investigates whether quercetin can regulate intestinal macrophage polarization and promote intestinal tissue repair via the cGAS-STING pathway for the treatment of UC. In vivo, mice with 3% DSS-induced UC were intraperitoneally injected with quercetin and RU.521 for 7 days, following which their general conditions and corresponding therapeutic effects were assessed. The impact of interferon-stimulated DNA (ISD) and quercetin on macrophage polarization and the cGAS-STING pathway was investigated using RAW264.7 cells and bone marrow-derived macrophages (BMDMs) in vitro. The results demonstrated that ISD induced M1 macrophage polarization and activated the cGAS-STING pathway in vitro, while quercetin reversed ISD’s inflammatory effects. In vivo, quercetin suppressed the cGAS-STING pathway in the intestinal macrophages of DSS-induced UC mice, which reduced M1 macrophage polarization, increased M2 polarization, and facilitated intestinal barrier repair in UC. Taken together, these findings provide new insights into the mechanisms via which quercetin could be used to treat UC.

BackgroundHyperglycemia in pregnancy (HGP) has generally been considered a risk factor associated with adverse outcomes in offspring, but its impact on the short-term outcomes of very preterm infants remains unclear.MethodsA secondary analysis was performed based on clinical data collected prospectively from 28 hospitals in seven regions of China from September 2019 to December 2020. According to maternal HGP, all infants were divided into the HGP group or the non-HGP group. A propensity score matching analysis was used to adjust for confounding factors, including gestational age, twin or multiple births, sex, antenatal steroid administration, delivery mode and hypertensive disorders of pregnancy. The main complications and the short-term growth status during hospitalization were evaluated in the HGP and non-HGP groups.ResultsA total of 2,514 infants were eligible for analysis. After matching, there were 437 infants in the HGP group and 874 infants in the non-HGP group. There was no significant difference between the two groups in main complications including respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, retinopathy of prematurity, patent ductus arteriosus, culture positive sepsis, intraventricular hemorrhage, periventricular leukomalacia, anemia, feeding intolerance, metabolic bone disease of prematurity, or parenteral nutrition-associated cholestasis. The incidences of extrauterine growth retardation and increased growth retardation for weight and head circumference in the non-HGP group were all higher than those in the HGP group after matching (P

Phytoplankton frequently blooms in estuaries and coastal seas. Numerous dynamic processes affect these regions, generating complex hydrodynamics that induce intense phytoplankton variability over multiple time scales. Especially, the variability over time scales of 100-101 days (event-scale) is a strong signal that is fundamental to coastal aquatic environments and ecosystems. Based on the historical monitoring of harmful algal bloom events and a fully coupled hydrodynamics-sediment-ecosystem numerical model, this study explored horizontal distribution patterns of the phytoplankton maximum off the Changjiang River Estuary over multiple time scales. Our results showed that the bloom events typically lasted less than a week and horizontal distribution of the horizontal chlorophyll maximum varied over the time scale of days. Tidal forcing was shown to dominate the periodic phytoplankton variability. The variations of river runoff and wind forcing also modulated this variability and added more disturbances. Increased runoff and enhanced summer monsoon wind caused the horizontal chlorophyll maximum to physically extend further offshore, while they also biologically stimulated phytoplankton blooms. The analysis of the time scale showed that the regulation of horizontal chlorophyll maximum responds faster to physical effects than in biological ones. At the same time, during neap tides, the adjustment of phytoplankton to the disturbances associated with the hydrodynamic processes was stably salient. Such adjustment was based on the adaptation to light availability and nutrient supply. This study contributes to the understanding of phytoplankton variability in estuaries affected by multiple physical-biological processes over the time scale of days and benefits to the management of environmental conservation.

The fruit fly Drosophila melanogaster has emerged as a valuable model for investigating human biology, including the role of the microbiome in health and disease. Historically, studies involving the infection of D. melanogaster with single microbial species have yielded critical insights into bacterial colonization and host innate immunity. However, recent evidence has underscored that multiple microbial species can interact in complex ways through physical connections, metabolic cross-feeding, or signaling exchanges, with significant implications for healthy homeostasis and the initiation, progression, and outcomes of disease. As a result, researchers have shifted their focus toward developing more robust and representative in vivo models of co-infection to probe the intricacies of polymicrobial synergy and dysbiosis. This review provides a comprehensive overview of the pioneering work and recent advances in the field, highlighting the utility of Drosophila as an alternative model for studying the multifaceted microbial interactions that occur within the oral cavity and other body sites. We will discuss the factors and mechanisms that drive microbial community dynamics, as well as their impacts on host physiology and immune responses. Furthermore, this review will delve into the emerging evidence that connects oral microbes to systemic conditions in both health and disease. As our understanding of the microbiome continues to evolve, Drosophila offers a powerful and tractable model for unraveling the complex interplay between host and microbes including oral microbes, which has far-reaching implications for human health and the development of targeted therapeutic interventions.

Necrotizing enterocolitis (NEC) is an inflammatory intestinal disease that profoundly affects preterm infants. Currently, the pathogenesis of NEC remains controversial, resulting in limited treatment strategies. The preterm infants are thought to be susceptible to gut inflammatory disorders because of their immature immune system. In early life, intestinal macrophages (IMφs), crucial components of innate immunity, demonstrate functional plasticity and diversity in intestinal development, resistance to pathogens, maintenance of the intestinal barrier, and regulation of gut microbiota. When the stimulations of environmental, dietary, and bacterial factors interrupt the homeostatic processes of IMφs, they will lead to intestinal disease, such as NEC. This review focuses on the IMφs related pathogenesis in NEC, discusses the multi-functional roles and relevant molecular mechanisms of IMφs in preterm infants, and explores promising therapeutic application for NEC.

Introduction: Improving energy efficiency is significant for achieving carbon emission reduction and promoting the transformation of green economic development. In the sustainable development framework set out in the 2030 Agenda for Sustainable Development, Goal 7.3 explicitly aims to double the global rate of energy efficiency improvement by 2030. The rapid development of digital technology, along with its universality and penetrative characteristics, has provide a feasible solution for improving energy efficiency and environmental conditions. However, the theoretical understanding of the impact and underlying logic of digital technology on energy efficiency remains unclear.Methods: Based on the panel data of 30 provinces in China from 2006 to 2021, this paper adopts econometric methods, including two-way fixed effect, instrumental variable method, and Driscoll-Kraay standard error. It investigates the influence of digital technology on energy efficiency and its internal mechanism from single factor and all factor levels.Result: The results show that Digital technology, represented by industrial robots, significantly improves energy efficiency, whether measured by the energy consumption intensity of GDP or the total-factor energy efficiency estimated using the SBM-GML model. The results still hold even after conducting endogeneity tests and robustness tests. Digital technology can improve energy efficiency by increasing virtual industrial agglomeration and promoting outward foreign direct investment.Discussion: In addition to promoting the theoretical understanding of the impact of digital technology on energy efficiency and exploring its mechanism, this paper also provides empirical evidence for policy makers and enterprises to formulate effective measures and strategies to improve energy efficiency under the background of digital economy.

BackgroundNoise exposure could lead to hearing loss and disorders of various organs. Recent studies have reported the close relations of environmental noise exposure to the metabolomics dysregulations and gut microbiota disturbance in the exposers. However, the associations between gut microbial homeostasis and the body metabolism during noise-induced hearing loss (NIHL) were unclear. To get a full understanding of their synergy in noise-associated diseases, it is essential to uncover their impacts and associations under exposure conditions.MethodsWith ten male rats with background noise exposure (≤ 40 dB) as controls (Ctr group), 20 age- and weight-matched male rats were exposed to 95 dB Sound pressure level (SPL) (LN group, n = 10) or 105 dB SPL noise (HN group, n = 10) for 30 days with 4 h/d. The auditory brainstem response (ABR) of the rats and their serum biochemical parameters were detected to investigate their hearing status and the potential effects of noise exposure on other organs. Metabolomics (UPLC/Q-TOF-MS) and microbiome (16S rDNA gene sequencing) analyses were performed on samples from the rats. Multivariate analyses and functional enrichments were applied to identify the dysregulated metabolites and gut microbes as well as their associated pathways. Pearson correlation analysis was performed to investigate the associations of the dysregulations of microbiota and the metabolites.ResultsNIHL rat models were constructed. Many biochemical parameters were altered by noise exposure. The gut microbiota constitution and serum metabolic profiles of the noise-exposed rats were also dysregulated. Through metabolomics analysis, 34 and 36 differential metabolites as well as their associated pathways were identified in LN and HN groups, respectively. Comparing with the control rats, six and 14 florae were shown to be significantly dysregulated in the LN group and HN group, respectively. Further association analysis showed significant correlations between differential metabolites and differential microbiota.ConclusionThere were cochlea injuries and abnormalities of biochemical parameters in the rats with NIHL. Noise exposure could also disrupt the metabolic profiles and the homeostatic balance of gut microbes of the host as well as their correlations. The dysregulated metabolites and microbiota might provide new clues for prevention of noise-related disorders.

Background and objectiveUterine leiomyoma is the most common benign tumor in females of reproductive age. However, its causes have never been fully understood. The objective of our study was to analyze the causal association between various factors and uterine leiomyoma using Mendelian randomization (MR).MethodsGenetic variables associated with risk factors were obtained from genome-wide association studies. Summary-level statistical data for uterine leiomyoma were obtained from FinnGen and the UK Biobank (UKB) consortium. We used inverse variance weighted, MR-Egger, and weighted median methods in univariate analysis. Multivariable MR analysis was used to identify independent risk factors. A fixed-effect model meta-analysis was used to combine the results of the FinnGen and UKB data.ResultsIn the FinnGen data, higher genetically predicted age at natural menopause, systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting insulin were associated with an increased risk of uterine leiomyoma, while higher age at menarche was associated with a reduced risk of uterine leiomyoma. Multivariable MR analysis of SBP and DBP showed that higher DBP might be an independent risk factor of uterine leiomyoma. In the UKB data, the results for age at natural menopause, SBP, DBP, and age at menarche were replicated. The result of the meta-analysis suggested that uterine leiomyoma could also be affected by polycystic ovary syndrome (PCOS), endometriosis, and 2-hour glucose level.ConclusionOur MR study confirmed that earlier menstrual age, hypertension, obesity, and elevated 2-hour glucose post-challenge were risk factors for uterine leiomyoma, and the causal relationship between smoking and uterine leiomyoma was ruled out. In addition, later age of menopause and endometriosis were found to increase the risk of uterine leiomyoma, while PCOS was found to decrease the risk.

Introduction: The effect of the conventional treatment methods of glioblastoma (GBM) is poor and the prognosis of patients is poor. The expression of MCL-1 in GBM is significantly increased, which shows a high application value in targeted therapy. In this study, we predicted the prognosis of glioblastoma patients, and therefore constructed MCL-1 related prognostic signature (MPS) and the development of MCL-1 small molecule inhibitors.Methods: In this study, RNA-seq and clinical data of 168 GBM samples were obtained from the TCGA website, and immunological analysis, differential gene expression analysis and functional enrichment analysis were performed. Subsequently, MCL-1-associated prognostic signature (MPS) was constructed and validated by LASSO Cox analysis, and a nomogram was constructed to predict the prognosis of patients. Finally, the 17931 small molecules downloaded from the ZINC15 database were screened by LibDock, ADME, TOPKAT and CDOCKER modules and molecular dynamics simulation in Discovery Studio2019 software, and two safer and more effective small molecule inhibitors were finally selected.Results: Immunological analysis showed immunosuppression in the MCL1_H group, and treatment with immune checkpoint inhibitors had a positive effect. Differential expression gene analysis identified 449 differentially expressed genes. Build and validate MPS using LASSO Cox analysis. Use the TSHR HIST3H2A, ARGE OSMR, ARHGEF25 build risk score, proved that low risk group of patients prognosis is better. Univariate and multivariate analysis proved that risk could be used as an independent predictor of patient prognosis. Construct a nomogram to predict the survival probability of patients at 1,2,3 years. Using a series of computer-aided techniques, two more reasonable lead compounds ZINC000013374322 and ZINC000001090002 were virtually selected. These compounds have potential inhibitory effects on MCL-1 and provide a basis for the design and further development of MCL-1 specific small molecule inhibitors.Discussion: This study analyzed the effect of MCL-1 on the prognosis of glioblastoma patients from the perspective of immunology, constructed a new prognostic model to evaluate the survival rate of patients, and further screened 2 MCL-1 small molecule inhibitors, which provides new ideas for the treatment and prognosis of glioblastoma.

Background: Hypertension, a major cardiovascular risk factor, severely impacts patients’ quality of life. Qiangli Dingxuan tablet (QDT) is a formally approved Chinese patent medicine, which has been widely used as an adjunctive treatment for hypertension. This study aimed to investigate the antihypertensive efficacy and safety of QDT combined with amlodipine besylate in patients with essential hypertension.Methods: In this randomized, double-blind, placebo-controlled, parallel-group, multicenter trial conducted in China, patients diagnosed with grade 1 to 2 essential hypertension were randomly assigned in a 1:1 to the treatment of QDT or placebo for 12 weeks, alongside their ongoing treatment with amlodipine besylate. The primary outcome was the change in office blood pressure (BP) from baseline to 12 weeks. In addition, safety analysis included the assessment of vital signs and laboratory values.Results: At baseline, 269 patients were randomly assigned to the QDT group (n = 133) or the placebo group (n = 136), and there were no significant differences in baseline characteristics between the two groups. The primary outcome based on the full analysis set from baseline to 12 weeks showed that the mean difference in the change of office systolic BP reduction between the two groups was 6.86 mmHg (95%CI, 4.84 to 8.88, p < 0.0001), for office diastolic BP, the mean difference in the change of office diastolic BP reduction between the two groups was 4.64 mmHg (95%CI, 3.10 to 6.18, p < 0.0001). In addition, traditional Chinese medicine symptom scores were significantly decreased in the QDT group compared with the placebo group. No severe adverse events attributable to QDT were reported.Conclusion: The combination of QDT and amlodipine besylate demonstrates superior efficacy compared to amlodipine besylate monotherapy in the management of essential hypertension. QDT shows potential as an adjunctive treatment for essential hypertension. However, further rigorous clinical trials are warranted to validate these findings.Clinical Trial Registration: [https://clinicaltrials.gov/study/NCT05521282?cond=NCT05521282&rank=1]; Identifier: [NCT05521282]

Background and aimsVitamin C, as an antioxidant, may play a role in the treatment of NAFLD. This research aimed to investigate the association of serum vitamin C levels with the risk of NAFLD and to further examine the causal relationship by Mendelian randomization (MR) method.MethodsThe cross-sectional study selected 5,578 participants of the National Health and Nutrition Examination Survey (NHANES), 2005–2006 and 2017–2018. The association of serum vitamin C levels with NAFLD risk was evaluated under a multivariable logistic regression model. A two-sample MR study, using genetic data from large-scale genome-wide association studies (GWAS) of serum vitamin C levels (52,014 individuals) and NAFLD (primary analysis: 1,483 cases /17,781 controls; secondary analysis: 1,908 cases/340,591 controls), was conducted to infer causality between them. The inverse-variance-weighted (IVW) was applied as the main method of MR analysis. A series of sensitivity analyzes were used to evaluate the pleiotropy.ResultsIn the cross-sectional study, results showed that Tertile 3 group (Tertile 3: ≥1.06 mg/dl) had a significantly lower risk (OR = 0.59, 95% CI: 0.48 ~ 0.74, p

Bamboo fiber/polypropylene composites (BPCs) have been widely used in buildings, interior decoration, and automobile components. However, pollutants and fungi can interact with the hydrophilic bamboo fibers on the surface of Bamboo fiber/polypropylene composites, degrading their appearance and mechanical properties. To improve their anti-fouling and anti-mildew properties, a superhydrophobic modified Bamboo fiber/polypropylene composite (BPC-TiO2-F) was fabricated by introducing titanium dioxide (TiO2) and poly(DOPAm-co-PFOEA) onto the surface of a Bamboo fiber/polypropylene composite. The morphology of BPC-TiO2-F was analyzed by XPS, FTIR, and SEM. The results showed that TiO2 particles covered on Bamboo fiber/polypropylene composite surface via complexation between phenolic hydroxyl groups and Ti atoms. Low-surface-energy fluorine-containing poly(DOPAm-co-PFOEA) was introduced onto the Bamboo fiber/polypropylene composite surface, forming a rough micro/nanostructure that endowed BPC-TiO2-F with superhydrophobicity (water contact angle = 151.0° ± 0.5°). The modified Bamboo fiber/polypropylene composite exhibited excellent self-cleaning properties, and a model contaminant, Fe3O4 powder, was rapidly removed from the surface by water drops. BPC-TiO2-F showed excellent anti-mold performance, and no mold was on its surface after 28 days. The superhydrophobic BPC-TiO2-F had good mechanical durability and could withstand sandpaper abrasion with a weight load of 50 g, finger wiping for 20 cycles, and tape adhesion abrasion for 40 cycles. BPC-TiO2-F showed good self-cleaning properties, mildew resistance, and mechanical resistance, giving it promising applications for automotive upholstery and building decoration.

Quiescence is a cellular state of reversible growth arrest required to maintain homeostasis and self-renewal. Entering quiescence allows the cells to remain in the non-dividing stage for an extended period of time and enact mechanisms to protect themselves from damage. Due to the extreme nutrient-deficient microenvironment in the intervertebral disc (IVD), the therapeutic effect of cell transplantation is limited. In this study, nucleus pulposus stem cells (NPSCs) were preconditioned into quiescence through serum starvation in vitro and transplanted to repair intervertebral disc degeneration (IDD). In vitro, we investigated apoptosis and survival of quiescent NPSCs in a glucose-free medium without fetal bovine serum. Non-preconditioned proliferating NPSCs served as controls. In vivo, the cells were transplanted into a rat model of IDD induced by acupuncture, and the intervertebral disc height, histological changes, and extracellular matrix synthesis were observed. Finally, to elucidate the mechanisms underlying the quiescent state of NPSCs, the metabolic patterns of the cells were investigated through metabolomics. The results revealed that quiescent NPSCs decreased apoptosis and increased cell survival when compared to proliferating NPSCs both in vitro and in vivo, as well as maintained the disc height and histological structure significantly better than that by proliferating NPSCs. Furthermore, quiescent NPSCs have generally downregulated metabolism and reduced energy requirements in response to a switch to a nutrient-deficient environment. These findings support that quiescence preconditioning maintains the proliferation and biological function potential of NPSCs, increases cell survival under the extreme environment of IVD, and further alleviates IDD via adaptive metabolic patterns.

IntroductionPostpartum depression (PPD) is a common neuropsychiatric disorder characterized by depression and comorbid anxiety during the postpartum period. PPD is difficult to treat because of its elusive mechanisms. Epigallocatechin-3-gallate (EGCG), a component of tea polyphenols, is reported to exert neuroprotective effects in emotional disorders by reducing inflammation and apoptosis. However, the effect of EGCG on PPD and the underlying mechanism are unknown.MethodsWe used a mouse model of PPD established by exposing pregnant mice to gestational stress. Open field, forced swimming and tail suspension tests were performed to investigate the anxiety and depression-like behaviors. Immunohistochemical staining was used to measure the c-fos positive cells. The transcriptional levels of hippocampal semaphorin3A(sema3A), (glycogen synthase kinase 3-beta)GSK3β and collapsin response mediator protein 2(CRMP2) were assessed by RT-PCR. Alterations in protein expression of Sema3A, GSK3β, p-GSK3β, CRMP2 and p-CRMP2 were quantified by western blotting. EGCG was administrated to analyze its effect on PPD mice.ResultsGestational stress induced anxiety and depression-like behaviors during the postpartum period, increasing Sema3A expression while decreasing that of phosphorylated GSK3β as well as c-Fos in the hippocampus. These effects were reversed by systemic administration of EGCG.ConclusionsThus, EGCG may alleviate anxiety and depression-like behaviors in mice by downregulating Sema3A and increasing GSK3β phosphorylation in the hippocampus, and has potential application in the treatment of PPD.

BackgroundCurrently, telomere length is known to reflect the replication potential and longevity of cells, and many studies have reported that telomere length is associated with age-related diseases and biological aging. Studies have also shown that vitamin C acts as an oxidant and free radical scavenger to protect cells from oxidative stress and telomere wear, thus achieving anti-aging effects. At present, there are few and incomplete studies on the relationship between vitamin C and telomere length, so this study aims to explore the relationship between vitamin C and telomere length.MethodsThis study used cross-sectional data from the National Health and Nutrition Examination Surveys (NHANES) database from 1999 to 2002, a total of 7,094 participants were selected from all races in the United States. Male participants accounted for 48.2% and female participants accounted for 51.8%. The correlation between vitamin C and telomere length was assessed using a multiple linear regression model, and the effect of dietary vitamin C on telomere length was obtained after adjusting for confounding factors such as age, gender, race, body mass index (BMI), and poverty income ratio (PIR).ResultsThis cross-sectional study showed that vitamin C was positively correlated with telomere length, with greater dietary vitamin C intake associated with longer telomeres (β = 0.03, 95% CI: 0.01–0.05, P = 0.003).ConclusionThis study shows that vitamin C intake is positively correlated with human telomere length, which is of guiding significance for our clinical guidance on people’s health care, but our study need to be confirmed by more in-depth and comprehensive other research results.

Glioma, is a representative type of intracranial tumor among adults, usually has a weak prognosis and limited treatment options. Traditional therapies, including surgery, chemotherapy, and radiotherapy, have had little impact on patient survival time. Immunotherapies designed to target the programmed cell death protein 1 (PD-1)/programmed death ligand 1 (PD-L1) signaling pathway have successfully treated various human cancers, informing the development of similar therapies for glioma. However, anti-PD-L1 response rates remain limited in glioma patients. Thus, exploring novel checkpoints targeting additional immunomodulatory pathways for activating durable antitumor immune responses and improving glioma outcomes is needed. Researchers have identified other B7 family checkpoint molecules, including PD-L2, B7-H2, B7-H3, B7-H4, and B7-H6. The current review article evaluates the expression of all 10 reported members of the B7 family in human glioma using The Cancer Genome Atlas (TCGA) and the Genotype-Tissue Expression (GTEx) data, as well as summarizes studies evaluating the clinical meanings and functions of B7 family molecules in gliomas. B7 family checkpoints may contribute to different immunotherapeutic management options for glioma patients.

TGF-β-activated kinase-1 (TAK1), tightly related to innate immunity, is phosphorylated and activated by X-linked protein kinase (PRKX) in humans and mammals, which belongs to the c-AMP-dependent protein kinase family. However, the relationship between PRKX and TAK1 remains unknown in teleost. It has been reported in vertebrates for the first time that TAK1 of black carp (bcTAK1) interacts with bcIRF7 and is capable to up-regulate bcIRF7-mediated IFN signaling in our previous study. In this study, the role of PRKX homologue of black carp (Mylopharyngodon piceus) (bcPRKX) in bcTAK1/IFN signaling has been explored. Overexpression of bcPRKX suppressed the transcription of interferon promoters but enhanced the transcription of NF-κB promoter. Mylopharyngodon piceus kidney (MPK) cells transfected with shRNA targeting bcPRKX gene presented enhanced antiviral activity against spring viremia of carp virus (SVCV), in which the mRNA levels of the antiviral proteins were increased, including MX1, Viperin and PKR. Overexpressed bcPRKX dampened bcTAK1/bcIRF7/IFN signaling in the luciferase reporter assay and plaque assay. The interaction between bcTAK1 and bcPRKX has been identified by the immunofluorescence (IF) staining and co-immunoprecipitation (co-IP) assay. In addition, we found that bcPRKX can trigger the degradation of bcTAK1. However, the lysosome inhibitor chloroquine, but not the proteasome inhibitor MG-132, prevented the bcTAK1 degradation mediated by bcPRKX. Thus, we conclude that bcPRKX inhibits bcTAK1/bcIRF7/IFN signaling during the innate immune activation by targeting bcTAK1 and triggers lysosome-dependent degradation of bcTAK1.

IntroductionAntenatal corticosteroids (ACS) administration is a standardized prenatal care for accelerating fetal maturation before anticipated preterm delivery, however, its effect on nutrition and growth is yet uncertain. This study aimed to examine if ACS application is associated with improvement in postnatal growth and nutrition in very preterm infants (VPIs).MethodsThis was a secondary analysis of a multicenter prospective survey included infants born before 32 weeks gestation and admitted to 28 tertiary neonatal intensive care units throughout China from September 2019 to December 2020. Infants were divided into no ACS, partial ACS and complete ACS groups according to the steroids exposure. For infants exposed to antenatal corticosteroids, complete ACS was defined as receiving all doses of steroids 24 h-7 days before delivery, otherwise it was referred to partial ACS. The primary outcomes of postnatal growth were compared among the 3 groups. The multivariable regression analyses were applied to evaluate the association of different steroids coverage with postnatal growth and nutritional outcomes while adjusting for potential confounders. For each outcome, no ACS coverage was defined as the reference group. Data were presented as unstandardized coefficients or adjusted odds ratios with 95% confidence intervals, P

BackgroundSeveral studies have investigated the combined use of sacubitril- valsartan after reperfusion in acute ST-segment elevation myocardial infarction (STEMI). However, the sample sizes of these studies were small and their results were somewhat heterogeneous. To determine the effect of sacubitril-valsartan on myocardial ischemia-reperfusion.MethodsSearch PubMed, EMbase, Web of Science and The Cochrane Library, CNKI database, VIP database and Wanfang digital journal full-text database for eligible articles from their date of inception up to April, 2022. All data were meta-analyzed using Review Manager 5.3 and STATA 16.0 software.ResultsA total of 23 studies including 2,326 patients with acute STEMI were included. These results of this meta-analysis indicated that left ventricular ejection fractions (LVEF) value within 6 months after surgery (OR, 4.29; 95% confidence interval, 3.78–4.80; P < 0.00001), left ventricular end-diastolic diameter (LVEDD) value within 6 months after surgery (OR, −3.11; 95% CI, −3.87 to −2.35; P < 0.00001) and left ventricular end-diastolic volume (LVEDV) value 6 months after operation (OR, −6.22; 95% CI, −7.10 to −5.35; P < 0.00001) are better than without sacubitril and valsartan.ConclusionTo sum up the above, the results of this study suggest that sacubitril- valsartan can reduce the reperfusion injury of ischemic myocardium by improving cardiac function within a follow-up period of 6 months.

ObjectiveThis study investigates the association between vestibular function and prognosis in patients with unilateral idiopathic sudden sensorineural hearing loss (UISSNHL).DesignA retrospective analysis of 64 patients with UISSNHL was performed. Pure tone audiometry and vestibular function tests for otoliths and semicircular canals were performed to assess the influence of vestibular functional status on the outcome of patients with UISSNHL.ResultsPatients with abnormal cervical vestibular evoked myogenic potential (cVEMP) or ocular vestibular evoked myogenic potential (oVEMP) responded less favorably to treatment. In the ineffective group, cVEMP was normal in four patients (6.3%) and oVEMPs in three (4.7%). Meanwhile, cVEMP was abnormal in 32 patients (50.0%) and oVEMP in 33 (51.6%). Better hearing recovery occurred in those with normal cVEMP (33.76 ± 15.07 dB HL improvement) or oVEMP (32.55 ± 19.56 dB HL improvement), but this was not the case in those with normal caloric tests. Patients with abnormalities in both cVEMP and oVEMP were less responsive to treatment and had worse hearing recovery than those with normal results in only one of the two tests.ConclusionAbnormal oVEMP and/or cVEMP results indicate poor auditory outcomes in patients with UISSNHL. Patients with impaired otolith organ function are likely to have a larger and more severe pathological change in their inner ear.

Coronary heart disease (CHD) is tightly associated with gut microbiota, but microbiota heterogeneity limits the application of microbial biomarkers and personalized interventions demand regional-specific features. The purpose of this study was to comprehensively characterize the regional pattern of gut microbiota in rural residents with CHD and assess the predictive value and clinical correlations of local microbial signatures. We profiled the gut microbiota by shotgun metagenomic sequencing from 19 CHD and 19 healthy residents in rural Xinxiang, China, and tested the physiological parameters. The results indicated that microbial diversity, as well as KEGG orthology (KO) and carbohydrate-active enzymes (CAZymes) functions, deserved no significant disparities between CHD and healthy residents. The relative abundance of Bacteroidetes phylum was significantly lower and unclassified Lachnospiraceae genus, and Eubacterium rectale species were markedly higher in CHD residents compared with the healthy control. Co-occurrence network revealed a more diverse and scattered ecology in CHD residents. LEfSe identified 39 potential biomarkers and butanoate metabolism and glycosyltransferases families were the enhanced KO and CAZymes in CHD residents, respectively. Twenty key signatures were determined by the random forest algorithm and most of them belonged to the Clostridium cluster. These key signatures harbored a superior accuracy of 83.9% to distinguish CHD and healthy residents and, fasting serum insulin, diastolic blood pressure, and body mass index were the top three clinical parameters influencing the gut bacterial community. Furthermore, we also found that low-density lipoprotein and waist circumference had significantly positive correlations with the members of the Clostridium cluster. These findings expand our knowledge in the regional-specific pattern of gut microbiota for rural CHD residents and highlight the non-invasive diagnostic value and clinical correlations of microbial signatures.

The developmental trajectory of speechreading skills is poorly understood, and existing research has revealed rather inconsistent results. In this study, 209 Chinese students with hearing impairment between 7 and 20 years old were asked to complete the Chinese Speechreading Test targeting three linguistics levels (i.e., words, phrases, and sentences). Both response time and accuracy data were collected and analyzed. Results revealed (i) no developmental change in speechreading accuracy between ages 7 and 14 after which the accuracy rate either stagnates or drops; (ii) no significant developmental pattern in speed of speechreading across all ages. Results also showed that across all age groups, speechreading accuracy was higher for phrases than words and sentences, and overall levels of speechreading speed fell for phrases, words, and sentences. These findings suggest that the development of speechreading in Chinese is not a continuous, linear process.

Background: With the development of fiberoptic bronchoscopy in the diagnosis and treatment of various pulmonary diseases, the anesthesia/sedation requirements are becoming more demanding, posing great challenges for patient safety while ensuring a smooth examination/surgery process. Remimazolam, a brand-new ultra-short-acting anesthetic, may compensate for the shortcomings of current anesthetic/sedation strategies in bronchoscopy.Methods: This study was a prospective, multicenter, randomized, double-blind, parallel positive controlled phase 3 clinical trial. Subjects were randomized to receive 0.2 mg/kg remimazolam besylate or 2 mg/kg propofol during bronchoscopy to evaluate the efficacy and safety of remimazolam.Results: A total of 154 subjects were successfully sedated in both the remimazolam group and the propofol group, with a success rate of 99.4% (95%CI of the adjusted difference −6.7 × 10%–6% to −5.1 × 10%–6%). The sedative effect of remimazolam was noninferior to that of propofol based on the prespecified noninferiority margin of −5%. Compared with the propofol group, the time of loss of consciousness in the remimazolam group (median 61 vs. 48s, p < 0.001), the time from the end of study drug administration to complete awakening (median 17.60 vs. 12.80 min, p < 0.001), the time from the end of bronchoscopy to complete awakening (median 11.00 vs. 7.00 min, p < 0.001), the time from the end of study drug administration to removal of monitoring (median 19.50 vs. 14.50 min, p < 0.001), and the time from the end of bronchoscopy to removal of monitoring (median 12.70 vs. 8.60 min, p < 0.001) were slightly longer. The incidence of Adverse Events in the remimazolam group and the propofol group (74.8% vs. 77.4%, p = 0.59) was not statistically significant, and none of them had Serious Adverse Events. The incidence of hypotension (13.5% vs. 29.7%, p < 0.001), hypotension requiring treatment (1.9% vs. 7.7%, p = 0.017), and injection pain (0.6% vs. 16.8%, p < 0.001) were significantly lower in the remimazolam group than in the propofol group.Conclusion: Moderate sedation with 0.2 mg/kg remimazolam besylate is effective and safe during bronchoscopy. The incidence of hypotension and injection pain was less than with propofol, but the time to loss of consciousness and recovery were slightly longer.Clinical Trial Registration:clinicaltrials.gov, ChiCTR2000039753

IntroductionThe Shenqisuxin granule (SQSX), a novel Chinese herbal formula, has the effect of preventing in-stent restenosis and improving angiogenesis. We intend to evaluate the efficacy and safety of SQSX to provide a possible therapeutic strategy for complex coronary artery disease (CCAD) after percutaneous coronary intervention (PCI).Methods/designThe study is a multi-center, randomized, double-blinded, parallel, placebo-controlled trial. A total of 120 participants will be randomized 1:1 into the intervention group and the control group. Based on standardized treatment, the intervention group and control group will receive SQSX and placebo for 2 months, respectively. The primary outcomes, metabolic equivalents (METS) and peak oxygen uptake (Peak VO2), and the secondary outcomes, including other indicators of cardiorespiratory fitness (CRF), the European Quality of Life Questionnaire (EQ-5D-5L), the Seattle Angina Scale (SAQ), etc., will be assessed at baseline and 2 months ± 3 days. In addition, the survey scales will also be tested at 1 month ± 3 days. Trimethylamine N-oxide (TMAO), high-sensitivity C-reactive protein (hs-CRP), and gut microbiota features will be assessed at baseline and 2 months ± 3 days to probe possible mechanism. The major adverse cardiac and cerebrovascular events (MACCE) and bleeding events will be monitored until the 12-month follow-up.DiscussionThis study is launched to assess the efficacy and safety of SQSX in CCAD after PCI and probe the possible mechanism.Clinical trial registrationChina Clinical Trial Registry, ChiCTR2200060979, Registered on June 14, 2022.

IntroductionAcute epidural abscess after percutaneous endoscopic lumbar discectomy is a rare but grievous complication. When faced with a long-segment epidural abscess, open surgery has traditionally been performed which can lead to huge surgical trauma and unpredictable complications. For this reason, surgeons around the world are constantly looking for more minimally invasive and effective surgical methods.Patient ConcernsOur patient was a 32-year-old woman who had been receiving percutaneous endoscopic interlaminar discectomy for L5/S1 lumbar disc herniation one week ago. She returned to our institution with a fever and lower back pain.DiagnosesMagnetic resonance imaging revealed a long segment epidural abscess accompanied by a paravertebral abscess, and staphylococcus aureus was detected in a bacterial culture of pyogenic fluids extracted from the paravertebral abscess.TreatmentsWe performed percutaneous endoscopic drainage (PED) for the epidural abscess. Long-term sensitive antibiotic treatment after surgery.OutcomesImmediate pain relief was achieved and the inflammatory reaction subsided after 4 weeks of antibiotic therapy. Re-examination of the lumbar spine MRI after 1 month showed that the epidural abscess disappeared completely.ConclusionPercutaneous endoscopy allowed us to approach the epidural abscess directly, enabling the immediate drainage of the abscess with minimal trauma to the patient. The good results obtained show that percutaneous endoscopic drainage is a reliable way to treat a long-segment epidural abscess.

AimThe study (PROSPERO: CRD42021240905) aims to reveal the relationships among red meat, serum lipids and inflammatory biomarkers.Methods and resultsPubMed, EMBASE and the Cochrane databases were explored through December 2021 to identify 574 studies about red meat and serum lipids markers including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), C-reactive protein (CRP) or hypersensitive-CRP (hs-CRP). Finally, 20 randomized controlled trials (RCTs) involving 1001 people were included, red meat and serum lipid markers and their relevant information was extracted. The pooled standard mean difference (SMD) was obtained by applying a random-effects model, and subgroup analyses and meta-regression were employed to explain the heterogeneity. Compared with white meat or grain diets, the gross results showed that the consumption of red meat increased serum lipid concentrations like TG (0.29 mmol/L, 95% CI 0.14, 0.44,P

ObjectiveTo investigate the incidence and related factors of extrauterine growth retardation (EUGR) and “true EUGR” in very preterm infants (VPI) from different regions of China.Materials and methodsClinical data of VPI were prospectively collected from 28 hospitals in seven different regions of China from September 2019 to December 2020. The infants were divided into a small for gestational age (SGA) group or non-SGA group at birth, with non-SGA infants at 36 weeks of gestation or at discharge being further divided into a EUGR group or a non-EUGR group. Infants in the EUGR and non-SGA group were defined as “true EUGR.” The general information of VPI, such as maternal complications during pregnancy, use of enteral nutrition and parenteral nutrition, and complications during hospitalization were compared between the groups.ResultsAmong the 2,514 VPI included in this study, 47.3, 41.5, and 33.3% of VPI were below the 10th percentile, and 22.6, 22.4, and 16.0% of VPI were below the 3rd percentile for weight, height, and head circumference at 36 weeks of gestation or at discharge, respectively, by the percentile on the 2013 Fenton curve. The incidences of EUGR and “true EUGR” evaluated by weight were 47.3 and 44.5%, respectively. Univariate analysis showed that there were statistically significant differences in the aspects of perinatal and nutritional characteristics, treatment, and complications between the groups. Multivariate analysis showed that in non-SGA infants, the cumulative caloric intake during the first week was a protective factor for “true EUGR,” while days to reach total enteral nutrition, late initiation of human milk fortifier, and moderate to severe bronchopulmonary dysplasia were independent risk factors for “true EUGR.”ConclusionMore attention should be paid to the nutritional management of VPI to prevent “true EUGR.” Cumulative caloric intake should be ensured and increased during the first week, total enteral nutrition should be achieved as early as possible, human milk fortifier should be added early, and moderate to severe bronchopulmonary dysplasia should be prevented. These strategies are very important for reducing the incidence of “true EUGR” in VPI.

Noise exposure can lead to various kinds of disorders. Noise-induced hearing loss (NIHL) is one of the leading disorders confusing the noise-exposed workers. It is essential to identify NIHL markers for its early diagnosis and new therapeutic targets for its treatment. In this study, a total of 90 plasma samples from 60 noise-exposed steel factory male workers (the noise group) with (NIHL group, n = 30) and without NIHL (non-NIHL group, n = 30) and 30 male controls without noise exposure (control group) were collected. Untargeted human plasma metabolomic profiles were determined with HPLC-MS/MS. The levels of the metabolites in the samples were normalized to total peak intensity, and the processed data were subjected to multivariate data analysis. The Wilcoxon test and orthogonal partial least square-discriminant analysis (OPLS-DA) were performed. With the threshold of p < 0.05 and the variable importance of projection (VIP) value >1, 469 differential plasma metabolites associated with noise exposure (DMs-NE) were identified, and their associated 58 KEGG pathways were indicated. In total, 33 differential metabolites associated with NIHL (DMs-NIHL) and their associated 12 KEGG pathways were identified. There were six common pathways associated with both noise exposure and NIHL. Through multiple comparisons, seven metabolites were shown to be dysregulated in the NIHL group compared with the other two groups. Through LASSO regression analysis, two risk models were constructed for NIHL status predication which could discriminate NIHL from non-NIHL workers with the area under the curve (AUC) values of 0.840 and 0.872, respectively, indicating their efficiency in NIHL diagnosis. To validate the results of the metabolomics, cochlear gene expression comparisons between susceptible and resistant mice in the GSE8342 dataset from Gene Expression Omnibus (GEO) were performed. The immune response and cell death-related processes were highlighted for their close relations with noise exposure, indicating their critical roles in noise-induced disorders. We concluded that there was a significant difference between the metabolite’s profiles between NIHL cases and non-NIHL individuals. Noise exposure could lead to dysregulations of a variety of biological pathways, especially immune response and cell death-related processes. Our results might provide new clues for noise exposure studies and NIHL diagnosis.

ObjectiveTo assess the predictive value of magnetic resonance imaging (MRI) radiomics for progression-free survival (PFS) in patients with prostate cancer (PCa).Methods191 patients with prostate cancer confirmed by puncture biopsy or surgical pathology were included in this retrospective study, including 133 in the training group and 58 in the validation group. All patients underwent T2WI and DWI serial scans. Three radiomics models were constructed using univariate logistic regression and Gradient Boosting Decision Tree(GBDT) for feature screening, followed by Cox risk regression to construct a mixed model combining radiomics features and clinicopathological risk factors and to draw a nomogram. The performance of the models was evaluated by receiver operating characteristic curve (ROC), calibration curve and decision curve analysis. The Kaplan-Meier method was applied for survival analysis.ResultsCompared with the radiomics model, the hybrid model consisting of a combination of radiomics features and clinical data performed the best in predicting PFS in PCa patients, with AUCs of 0.926 and 0.917 in the training and validation groups, respectively. Decision curve analysis showed that the radiomics nomogram had good clinical application and the calibration curve proved to have good stability. Survival curves showed that PFS was shorter in the high-risk group than in the low-risk group.ConclusionThe hybrid model constructed from radiomics and clinical data showed excellent performance in predicting PFS in prostate cancer patients. The nomogram provides a non-invasive diagnostic tool for risk stratification of clinical patients.

BackgroundAsthma is a common chronic disease among children, especially preschoolers. Some evidence suggests that diet may play a role in asthma, but the current findings are contradictory. The objective of our study was to determine the association between dietary intake and asthma in preschool children aged 2–5 years.MethodsWe selected preschool children aged 2–5 years with complete data on asthma diagnosis, diet, and body mass index (BMI) from the national health and nutrition examination survey (NHANES) database. In a selected population, children with self-reported asthma were included in the final sample. In children without self-reported asthma, we further used propensity score matching (PSM) to match age and sex for sampling, maintaining a ratio of 1:4 for cases. Lasso regression was used to identify dietary factors affecting asthma in preschoolers.ResultsA total of 269 children with self-reported asthma and 1,076 children without self-reported asthma were included in our study. Univariate analysis showed that there were significant differences in ethnicity and dietary zinc intake between asthmatic children and children without asthma. After adjusting for all dietary and demographic variables, the results of logistic Lasso regression analysis showed that non-Hispanic black (β = 0.65), vitamin B12 (β = 0.14), and sodium (β = 0.05) were positively associated with childhood asthma, while Vitamin K (β = −0.04) was negatively associated with childhood asthma.ConclusionIn conclusion, our study confirms that non-Hispanic black and dietary sodium intake are associated with a higher risk of asthma in preschoolers. In addition, our study found that dietary vitamin B12 was positively associated with childhood asthma, while vitamin K was negatively associated with childhood asthma.

ObjectivesThis study aims to investigate the relationship between preoperative sleep disturbance and postoperative pain in patients with a rotator cuff tear, and to provide a theoretical basis for taking corresponding interventions to alleviate postoperative pain in patients with rotator cuff tear.MethodsA total of 87 patients, who had undergone shoulder arthroscopy due to rotator cuff injury in Hunan Provincial People‘s Hospital from January to October 2021, were selected as the research subjects. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality of patients with rotator cuff tears. All patients were divided into the low sleep quality group (PSQI score >7 points, n = 61) and the high sleep quality group (PSQI score ≤7 points, n = 26). Postoperative pain was assessed by using the Numerical Rating Scale (NRS). General clinical data of the patients were collected 1 day, 2 days, and 1 month after surgery. Univariate and multivariate analyses of influencing factors were performed in patients with moderate or above pain at 1 month after surgery.ResultsThe score of postoperative pain of patients in the high sleep quality group was significantly lower than that of patients in the low sleep quality group (P < 0.05). A total of 35 patients (40.2%) had moderate or above pain 1 month after surgery, including 5 patients (19.2%) in the high sleep quality group and 30 patients (49.2%) in the low sleep quality group. The incidence rate of the low sleep quality group was significantly higher than that of the high sleep quality group (P = 0.009). After controlling confounding factors, preoperative sleep disturbance of patients was still independently associated with the occurrence of moderate or above pain 1 month after surgery (OR = 3.794, 95% CI: 1.261–11.409, P = 0.018).ConclusionPreoperative sleep disturbance can increase the risk of postoperatively moderate or above pain threshold in patients with rotator cuff tear. Paying more attention to and actively improving preoperative sleep disturbance can effectively promote postoperative pain management in patients with rotator cuff tears.

Small yellow croaker (Larimichthys polyactis), a benthic fish species widely distributed in the Northwest Pacific Ocean, plays an important role in the fishery catch of coastal countries. A large amount of dead small yellow croaker floated on the sea surface near 30.2°N, 125.3°E in the East China Sea on 19 February 2017, and more than 9,000 kilograms were caught by fishermen, which had never been recorded before. This study aims to investigate the dynamic causes of this sudden death event based on available in-situ, satellite and modelling data. The event occurred near the overwintering ground of small yellow croaker, where a majority of these fish assembled in winter. There were persistent ocean fronts at target site with average intensity of 0.05°C/km at sea surface and bottom in February 2017, which was the strongest in the past 5 years from 2015 to 2019. The fronts provided nutrients and food to fish, and the intense gradients prevented fish from crossing, thus forming “water barriers” to restrict the horizontal movement of fish. Due to enhanced convection, the water was well-mixed, enabling the demersal croaker to float to sea surface. The sea temperature was particularly warm in winter 2017, but then experienced a significant drop by more than 4.5°C in 40 days according to satellite and modelling datasets due to the northerly wind and the southeastward movement of cold eddy. The drop of temperature led to ‘cold shock’ of fish, affecting their physiological regulation and survival. Under the combined influence of these factors, a large number of small yellow croaker died and aggregated near the target site. This paper has a great reference value for further study on the living habits of small yellow croaker and their responses to marine dynamic changes.

With the increasing penetration of wind power into power systems and the random fluctuation of the wind farm (WF) output, system flexibility must be considered in the optimal generation dispatch. Based on the extreme scenarios of the WF output, we proposed a flexibility risk index to evaluate the system flexibility of each time interval. We established a five-objective security-constrained unit commitment (SCUC) model of a power system with WFs, thermal generation plants, battery energy storage stations, and pumped storage hydro stations. The objectives were to minimize the system flexibility risk, total network loss, operation cost, power purchase cost, and pollutant gas emissions. To obtain the Pareto optimal solutions of the model, based on the objective selection and ε-constraint methods, we proposed two methods to reduce the dimension of objectives and transformed the five-objective optimization model into a series of three-objective optimization models. Then, we used the normalized normal constraint method to solve the Pareto frontier surface of each three-objective optimization model. We used a color column to represent the value change of the two upper layer objectives and visualized the Pareto frontier of the five-objective SCUC model in the three-dimensional ordinate space. Case studies on the modified IEEE-9 bus system and an actual power grid demonstrated the effectiveness and high computational efficiency of the proposed method.

BackgroundUnlike chemical drugs with a single or a few kinds of active compounds, traditional Chinese medicines (TCMs)uses herbal formulas composed of numerous kinds of chemical constituents. Therefore, TCM clinical trials require unique and stricter standards for collecting, preserving, and transporting fecal samples than those used for chemical drugs. Unfortunately, there are no special standards for processing fecal samples in TCM clinical trials.MethodsWe invited interdisciplinary experts within TCM clinical trials and gut microbiome research to help formulate this standard. After more than a year’s in-depth discussion and amendments, we achieved a standard via expert interviews, literature research, questionnaire surveys, and public opinion solicitation. This standard has been reviewed and approved by the Standards Office of China of the Association of Chinese medicine.ResultsWe established a sample information processing method prior to TCM clinical sample collection, which is adapted to the unique features of TCM. The method formulates detailed processing requirements for TCM information in addition to the factors that may disturb the gut microbiome. We also constructed a set of methods for collecting, preserving, and transporting fecal samples that meet the characteristics of TCM. These methods formulate detailed operating specifications on the collection approaches, storage conditions, transportation requirements, and management of fecal samples.ConclusionsThis standard guides the information processing prior to sample collection and the standard operating procedures for the collection, preservation, and transportation of fecal samples in TCM clinical trials, which also can be used as a reference by clinicians and researchers in modern medicines.

Lung ultrasound is a technique that has rapidly developed in recent years. It is a low-cost, radiation-free, and easy-to-operate tool that can be repeatedly performed at the bedside. Compared to chest X-ray, lung ultrasound has high sensitivity and specificity in the diagnosis of neonatal respiratory distress syndrome, transient tachypnoea of newborns and pneumothorax. Lung ultrasound has been widely used in neonatal intensive care units. However, due to the physical barriers of air, where ultrasonic waves cannot pass and therefore reflection artifacts occur, it has limitations in some other lung diseases and cannot fully substitute for chest X-rays or CT/MRI scanning. This review describes these limitations in detail and highlights that if clinical symptoms are not effectively alleviated after medical treatment or the clinical presentation is not compatible with the ultrasound appearances, then chest X-rays or CT/MRI scanning should be performed to avoid misdiagnosis and mistreatment.

BackgroundStroke is a major health threat and the leading cause of mortality and disability in China. The aims of this study were to identify the possible influencing factors of health-related quality of life (HRQoL) and its domain-specific contents in stroke patients in rural areas in China.MethodsA total of 1,709 stroke patients aged 36–79 years from the baseline data of Henan Rural Cohort study (n = 39,259) were included in the cross-sectional study. The Chinese version of the European Quality of Life Five Dimension (including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) Five Level Scale (EQ-5D-5L) and visual analog scale (VAS) were used to evaluate HRQoL in stroke patients. Tobit regression models, generalized linear models and binary logistic regression models were constructed to determine potential influencing factors of the EQ-5D utility index, as well as influencing factors of each domain and VAS score.ResultsThe mean utility index and VAS scores of stroke patients were 0.885 (SD, 0.204), and 68.39 (SD, 17.31), respectively. Pain/discomfort (PD, 35.2%) and mobility (MO, 30.4%) were the most frequently reported issues. Regression models revealed that illiterate; a low monthly income; low physical activity intensity; and diabetes, anxiety, depression, or poor sleep quality were significantly associated with lower utility index and VAS scores among stroke patients. In addition, patients with stroke who were older, female, drinking, smoking, and consuming a high-fat diet, had a higher BMI, and lived with a stroke for a longer time, were also significantly associated with different dimensions of the EQ-5D.ConclusionPatients with stroke in rural areas in China had a low HRQoL. Factors associated with the EQ-5D utility index as well as each domain and VAS score, need to be considered by health providers in rural areas. Patients with stroke in rural areas need to be included in national basic public medical services and managed systematically by medical institutions.

In this work, a simple synthetic method was used to prepare a new type of magnetic dissolving pulp (MDP) @polydopamine (PDA) fibers. The hydroxyl groups of the fibers were converted into carboxyl groups after succinylation. Fe3O4 nanoparticles were grown in situ on the fibers. The prepared MDP@PDA fibers have catalytic reduction efficiency and adsorption performance for methylene blue organic dyes, and it has been thoroughly tested under various pH conditions. Fe3O4@PDA fibers have high reusability, are easy to separate, and regenerate quickly. The catalytic and adsorption efficiency barely decreases after repeated use. The surface of dissolving pulp fibers with a functionalized multifunctional PDA coating is used to create multifunctional catalysts and adsorbent materials. This study presents a very useful and convenient method for the synthesis and adjustment of MDP@PDA fibers, which have a wide range of potential applications in catalysis and wastewater treatment.

BackgroundColorectal cancer is a common malignant tumor appearing in the gastrointestinal tract. Surgical resection is recognized as the best means to improve patient survival. However, it is controversial whether early oral feeding (EOF) after elective colorectal resection demonstrates safety and efficacy in concerned clinical outcomes.MethodsWe searched PubMed, Embase, Cochrane Library, and CNKI from inception to September 2021. Two authors independently screened the retrieved records and extracted data. EOF was defined as feeding within 24 h after surgery, while traditional oral feeding (TOF) was defined as feeding that started after the gastrointestinal flatus or ileus was resolved. The primary outcome was nasogastric tube insertion, and the secondary outcomes were the length of hospital stay and total complications. Categorical data were combined using odds ratio (OR), and continuous data were combined using mean difference (MD).ResultsWe screened 10 studies from 34 records after full-text reading, with 1,199 patients included in the analysis. Nasogastric tube reinsertion (OR 1.69; 95% CI 1.08 to 2.64, p=0.02) was more frequent in the EOF group, and older ages (>60 years) were associated with higher risk of nasogastric tube reinsertion (OR 2.05; 95% CI 1.05 to 3.99, p = 0.04). Reduced length of hospital stay (MD −1.76; 95% CI −2.32 to −1.21; p < 0.01) and the rate of total complications (OR 0.49; 95% CI 0.37 to 0.65, p < 0.01) were observed in EOF compared with TOF.ConclusionsEOF was safe and effective for patients undergoing elective colorectal surgery, but the higher rate of nasogastric tube reinsertion compared with TOF should not be ignored.

The buoyant river plume front exhibits substantial variability in the sea surface under energetic external forcing. Although highly dynamic, the river plume is often “rooted” at specific locations through the bottom river plume front. In this study, we addressed this mechanism using the Pearl River plume as an example based on a well-validated numerical model. With this model, we described the spatiotemporal characteristics of the Pearl River salinity front. It was found that, although the surface Pearl River plume features bimodal extension in summer and winter seasons, owing to the reversal of the seasonal monsoon wind, there is a relatively stable bottom front extending from the river mouth to the downstream region (i.e., in the direction of propagation of Kelvin Wave). The occurrence probability of the bottom front showed that the front location varies only slightly and fixes at ∼8-m isobath. The Empirical Orthogonal Function (EOF) analysis demonstrated that runoff, wind, and tide are major regulating factors. These three factors jointly control the strength and position of the bottom front. In particular, the bottom front moves offshore during the spring tide but onshore during the neap tide, respectively, indicating a different mechanism from the classic frontal trapping theory. The sensitivity experiment without tide indicated that the bottom plume front shrinks significantly, and the river plume becomes more dynamic since it is no longer rooted on the seafloor.

AimTo investigate the use of human milk fortifier (HMF) for very preterm infants (VPIs) and complications and nutritional status of VPIs due to various breast milk enhancement strategies among the Chinese population.MethodsVPIs with birth weight < 1,800 g and wholly or predominantly breastfed were assigned to the following fortification groups: no HMF, early HMF (adding HMF at an enteral volume of ≤ 80 ml·kg−1·day−1), middle HMF (adding HMF at an enteral volume of 80–100 ml·kg−1·day−1), and late HMF (adding HMF at an enteral volume of ≥100 ml·kg−1·day−1). The growth status and complications for various groups were evaluated.ResultsWe enrolled 985 VPIs, of which 847 VPIs (86.0%) received HMF, whereas 138 VPIs (14.0%) did not. The number of VPIs in the early, middle, and late fortification groups were 89 (9.0%), 252 (25.6%), and 506 (51.4%), respectively. The complete fortification of the early, middle, and late fortification groups was achieved in 13.2 ± 11.0, 13.8 ± 11.7, and 12.3 ± 13.0 days, respectively, without significant differences (p > 0.05). The groups did not exhibit significant differences in the incidence of feeding intolerance, necrotizing enterocolitis (Bell stage ≥ 2), late-onset sepsis, and metabolic bone diseases (p > 0.05). The middle fortification groups exhibited the fastest growth velocity and the least dramatic decrease in the Z-score of weight and length, and the lowest incidence of EUGR (35.7%), whereas the “no HMF” groups exhibited the slowest growth velocity and the largest decline in the Z-score, and the highest incidence of EUGR (61.6%).ConclusionsThe usage rate of HMF was relatively low among Chinese VPIs, fortification often occurred in the late feeding stage, and the time to reach complete fortification was long. Adding HMF and different breast milk enhancement strategies did not increase the incidence of feeding intolerance and necrotizing enterocolitis. The enteral volume of 80–100 ml·kg−1·day−1 with HMF addition led to increased growth in the weight and length and lower EUGR incidence, indicating that the addition of HMF at the specific feeding volume might be the best practice for promoting growth.

BackgroundThe role of immune checkpoint inhibitors (ICIs) in NSCLC patients with EGFR mutations are controversial. In this study, we aim to investigate the therapeutic efficacy of ICIs alone or in combination in patients with EGFR mutated NSCLC in late-line settings, and explore the factors that may predict the efficacy of ICIs.Patients and MethodsWe retrospectively collected the clinical and pathological information of 75 patients with confirmed EGFR mutations. All patients have developed acquired resistance to EGFR-TKIs, and were treated with ICIs in late line settings from January 2019 to January 2021, at Shandong Caner Hospital and Institute. Therapeutic efficacy was evaluated by tumor response and survival.ResultsThe median follow-up period was 7.3months (range 1.8-31.8 months). The overall response rate (ORR) was 8.0%, and the disease control rate (DCR) was 78.7%. The median PFS for all patients was 3.9 months (95% CI, 2.7-5.0), while the median OS was 9.9 months (95% CI, 5.3-14.6). We found that patients with longer response duration to EGFR-TKIs (≥10 months) showed a longer PFS when treated with immunotherapy compared with patients with shorter PFS-TKI (

BackgroundD2 lymphadenectomy including No. 12a dissection has been accepted as a standard surgical management of advanced lower-third gastric cancer (GC). The necessity of extensive No. 12 nodes (No. 12a, 12b, and 12p) dissection remains controversial. This study aims to explore its impact on long-term survival for resectable GC.MethodsFrom 2009 to 2016, 353 advanced lower-third GC patients undergoing at least D2 lymphadenectomy during a radical surgery were included, with 179 patients receiving No. 12a, 12b, and 12p dissection as study group. A total of 174 patients with No. 12a dissection were employed as control group. Surgical and long-term outcomes including 90-day complications incidence, therapeutic value index (TVI), 3-year progression-free survival (PFS), and 5-year overall survival (OS) were compared between both groups.ResultsNo. 12 lymph node metastasis was observed in 20 (5.7%) patients, with 10 cases in each group (5.6% vs. 5.7%, p = 0.948). The metastatic rates at No. 12a, 12b, and 12p were 5.7%, 2.2%, and 1.7%, respectively. The incidence of 90-day complications was identical between both groups. Extensive No. 12 dissection was associated with increased TVI at No. 12 station (3.9 vs. 0.6), prolonged 3-year PFS rate (67.0% vs. 55.9%, p = 0.045) and 5-year OS rate (66.2% vs. 54.0%, p = 0.027). The further Cox-regression analysis showed that the 12abp dissection was an independent prognostic factor of improved survival (p = 0.026).ConclusionAdding No. 12b and 12p lymph nodes to D2 lymphadenectomy might be effective in surgical treatment of advanced lower-third GC and improve oncological outcomes compared with No. 12a-based D2 lymphadenectomy.