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Beili Shen, Bianling Liu, Yanhui Wang, Rui Wang, Dongfeng Gu The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People’s Hospital), Zhengzhou, Henan, 450003, People’s Republic of ChinaCorrespondence: Dongfeng Gu, Department of Nephrology, The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People’s Hospital), No. 33 Huanghe Road, Zhengzhou, Henan, 450003, People’s Republic of China, Tel +86-371-67077643, Email gudongfengzz@163.comPurpose: Deficiency in vitamin D is associated with adverse outcomes in several health conditions. However, the specific impact of vitamin D levels on mortality in acute kidney injury (AKI) patients remains inadequately explored. This study aims to investigate the association between serum vitamin D concentrations and mortality risk in critically ill patients diagnosed with AKI. We hypothesize that severe vitamin D deficiency is associated with an increased risk of 90-day all-cause mortality in these patients.Patients and Methods: This study retrospectively enrolled 259 adult AKI patients admitted to the intensive care unit (ICU) at The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People’s Hospital) between July 2021 and June 2023. Based on 25-hydroxyvitamin D (25-OHD) levels, they were categorized into 4 groups: severe deficiency (< 10 ng/mL), deficiency (10– 20 ng/mL), insufficiency (20– 30 ng/mL), and sufficiency (> 30 ng/mL). Multivariate survival analysis using Cox’s regression model was used to analyze the impact of vitamin D concentrations on the 90-day all-cause mortality risk after controlling for potential confounders.Results: The 90-day all-cause mortality rate was the highest in patients with severe deficiency (50.8%), followed by those with deficiency (35.0%), insufficiency (23.9%), and sufficiency (12.2%). Multivariate Cox regression showed that compared with sufficiency, severe deficiency (HR=3.34, 95% CI: 1.14– 9.77; P=0.03) was independently associated with a higher risk of 90-day all-cause mortality, but deficiency and insufficiency were not significantly associated with 90-day all-cause mortality risk.Conclusion: Severe vitamin D deficiency (< 10 ng/mL) significantly increases the risk of mortality in AKI patients, underlining the need for monitoring and potentially supplementing vitamin D in this population.Keywords: acute kidney injury, vitamin D deficiency, mortality, prognosis

Biao Tao,&ast; Dian Gu,&ast; Kai Wang,&ast; Yinan Li, Xianlin Xu, Jiexun Chen Department of Urology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, 211100, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jiexun Chen; Xianlin Xu, Department of Urology, Sir Run Run Hospital, Nanjing Medical University, 109 Longmian Road, Jiangning District, Nanjing, Jiangsu Province, 211100, People’s Republic of China, Email cjx128619@yeah.net; xianlinxu@njmu.edu.cnBackground and Aims: Metabolic syndrome (MetS) is associated with the development of several diseases. However, the correlation between MetS and size of renal cysts remains unclear. This research aims to explore the potential connection between them, offering theoretical guidance for clinical prevention and treatment of renal cysts.Methods: A total of 467 patients diagnosed with renal cysts and admitted to Sir Run Run Hospital, Nanjing Medical University from September 2019 to September 2020 were eventually included in this study. They were divided into the small cyst group (cyst volume≤ 1.5cm³) and the large cyst group (cyst volume> 1.5cm³) based on the median value of cyst volume. Multivariate logistic regression analysis was used to evaluate the association between MetS and size of renal cysts.Results: Our results indicated that MetS (OR 1.941, 95% CI 1.286– 2.927, P=0.002) was positively associated with the size of renal cysts. Additionally, multiple renal cysts (OR 2.259, 95% CI 1.402– 3.640, P=0.001) and serum globulin (OR 0.945, 95% CI 0.905– 0.987, P=0.011) were positively and negatively related to size of renal cysts, respectively.Conclusion: Our study reveals the association between MetS and the size of renal cysts. Patients with MetS are more likely to have larger renal cysts. The administration of MetS may help limit the development of renal cysts. Further prospective studies are needed to explore the causal relationship between MetS and renal cysts.Keywords: size of renal cysts, metabolic syndrome, metabolic disease, renal cyst

Jiawen Zhang,1,&ast; Duoduo Gu,2,&ast; Yang Yan,3,&ast; Ruoxin Pan,2 Hui Zhong,4,5 Chengfeng Zhang,1 Yang Xu2 1Department of Dermatology, Huashan Hospital of Fudan University, Shanghai, People’s Republic of China; 2Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 3Department of Cardiology, Ren Ji Hospital of Shanghai Jiao Tong University, Shanghai, People’s Republic of China; 4State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, People’s Republic of China; 5School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Chengfeng Zhang; Yang Xu, Email e3dangdang@hotmail.com; yangxu@njmu.edu.cnAbstract: Rosacea is a chronic inflammatory skin disease that affects a patient’s appearance and quality of life. It mainly affects the midface region and presents as erythema, flushing, telangiectasia, papules, pustules, and rhinophyma. Despite its prevalence, the precise pathophysiology of rosacea remains unknown, and novel pharmacological therapies are currently under investigation. Tranexamic acid (TA) is a synthetic, lysine-like compound that competitively inhibits fibrinogen production by synthesizing fibrinolytic enzymes. In addition to its popular application in hemorrhage treatment, TA has been used to manage a number of skin conditions, including melasma, chronic urticaria, and angioedema. TA is a better option for melasma treatment. However, the role of TA in treating rosacea has not yet been systematically elucidated. In this study, we reviewed all available literature on the use of TA for rosacea treatment. The included articles examined the therapeutic effects of TA in patients with rosacea, including traditional methods such as oral and topical administration and more novel approaches such as intradermal injections, microneedling, and laser-assisted delivery. Several recent clinical studies demonstrated that TA alleviates rosacea symptoms by restoring the permeability barrier, ameliorating the immune reaction, and inhibiting angiogenesis. In this review, we summarized the function and potential application of TA in rosacea treatment, aiming to facilitate the implementation of clinical applications.Keywords: rosacea, tranexamic acid, topical, oral, microinjection

Chunmei Yang,1,&ast; Xiaoling Che,1,&ast; Yu Zhang,2 Didi Gu,1 Guidong Dai,1 Jian Shu,1 Lu Yang1 1Department of Radiology, The Affiliated Hospital of Southwest Medical University, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, Sichuan Province, People’s Republic of China; 2Department of Radiology, The First People’s Hospital of Yibin, Yibin, 644000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jian Shu; Lu Yang, Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, People’s Republic of China, Tel +86 0830-18980253083 ; +86 0830-2504762, Email shujiannc@163.com; yanglu@swmu.edu.cnBackground: Development of versatile nanoplatform still remains a great challenge due to multistep synthesis and complicated compositions. Therefore, it is significant to develop a facile method to synthesize a nanocomposite to achieve multimodal imaging and even imaging-guided cancer therapeutics.Methods and Results: In our study, hyaluronic acid-functionalized iron (II) tungstate nanoparticles (HA-FeWO4 NPs) were successfully synthesized as a versatile nanoplatform by a facile one-pot hydrothermal procedure. The formed multifunctional HA-FeWO4 NPs were investigated via a series of characterization techniques, which demonstrated good biocompatibility, excellent dispersion, low cytotoxicity, active tumor-targeting ability and high photothermal efficiency. Furthermore, tumor was clearly visualized by HA-FeWO4 NPs with multimodal imaging of infrared thermal imaging, magnetic resonance imaging, computed tomography imaging in 4T1 tumor bearing mice. More importantly, HA-FeWO4 could achieve multimodal imaging-guided photothermal therapy of 4T1 tumors.Conclusion: The constructed HA-FeWO4 NPs have great potential as ideal nanotheranostic agents for multimodal imaging and even imaging-guided cancer theranostics in biological systems.Keywords: theranostics, multimodal imaging, photothermal therapy, diagnostic imaging, nanomedicine

Dongxing Gu,1,&ast; Yayun Lu,1,&ast; Baiqing Xu,1 Xuefeng Tang2 1Health Examination Center, Huadong Sanatorium, Wuxi, People’s Republic of China; 2Department of Health Nursing, Huadong Sanatorium, Wuxi, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Baiqing Xu; Xuefeng Tang, Huadong Sanatorium, No. 67 Jinyuan Road, Wuxi, 214065, People’s Republic of China, Email doctorxbq@163.com; 978665164@qq.comBackground and Objective: Evidence suggests that cardiometabolic index (CMI) has been identified as a novel obesity-related index associated with diabetes, hypertension, and cardiovascular disease. Current evidence suggests that the differences in sex hormones and regional fat distribution in both sexes are directly correlated with metabolic dysfunction-associated fatty liver disease (MAFLD) risk. This study aimed to investigate the diagnostic value of CMI in MAFLD in both sexes.Methods: This retrospective study included 6107 subjects who underwent annual health check-ups from March 2021 to January 2022. CMI was calculated by multiplying the ratio of triglycerides and high-density lipoprotein cholesterol (TG/HDL-C) by waist-to-height ratio (WHtR). Multivariable logistic regression analysis and restricted cubic spline were used to investigate the association of CMI and MAFLD risk. Receiver operating characteristic curve analysis was conducted for the exploration of the diagnostic accuracies of obesity-related indicators. Areas under the curves (AUCs) with 95% CIs were calculated.Results: Prevalence of MAFLD increased with elevated quartiles of CMI in both sexes. The median (IQR) age was 46.00 (18.00) years. Multivariate logistic regression analyses showed that higher CMI was independently associated with MAFLD, in which every additional standard deviation (SD) of CMI increased the risk of MAFLD (OR=2.72, 95% CI:2.35– 3.15 for males; OR=3.26, 95% CI:2.36– 4.51 for females). Subjects in the fourth quartile of CMI had the highest odds of MAFLD for males (OR=15.82, 95% CI:11.84– 21.14) and females (OR=22.60, 95% CI:9.52– 53.65)(all P for trend< 0.001). Besides, CMI had a non-linearity association with MAFLD (all P for non-linearity< 0.001). Furthermore, CMI exhibited the largest AUC compared to other obesity-related indexes in terms of discriminating MAFLD in males (AUC=0.796, 95% CI:0.782– 0.810) and females (AUC=0.853, 95% CI:0.834– 0.872).Conclusion: CMI was a convenient indicator for the screening of MAFLD among Chinese adults. Females with high CMI had a better diagnostic value for MAFLD than males.Keywords: metabolic dysfunction-associated fatty liver disease, cardiometabolic index, sex, general population, predicting value

Yue Zhang, Ruoxin Pan, Duoduo Gu, Xiaoqi Meng, Tingwei Liu, Yang Xu Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, 210029, People’s Republic of ChinaCorrespondence: Yang Xu, Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, Jiangsu Province, 210029, People’s Republic of China, Tel/Fax +86-13851856794, Email yangxu@njmu.edu.cnBackground and Aim: Clinical manifestations of rosacea include transient or persistent facial erythema, telangiectasia, papules, and pustules. The existing assessment tools primarily evaluate the facial area to assess the severity of rosacea. However, in addition to the face, telangiectasia, erythema, and flushing can occur in the ear. Here, we investigated the correlation between the dermoscopic characteristics of capillaries in the earlobe and auricle and the types and severity of rosacea.Materials and Methods: Experienced dermatologists evaluated the clinical type, medical history, severity, and distribution pattern of facial erythema. The clinical severity of rosacea was assessed using the standard grading system (SGS), clinician’s erythema assessment (CEA), and investigator’s global assessment (IGA). Relationships of the clinical types and severity with the dermoscopic characteristics of capillaries in the earlobe and auricle were further analyzed.Results: In total, 145 patients with rosacea were enrolled in this study. We found that SGS, CEA, and IGA correlated well with the dermoscopic features of capillaries in the earlobe (R = 0.357, 0.357, and 0.314, respectively) (p < 0.001) and auricle (R = 0.423, 0.443, and 0.374, respectively) (p < 0.001). However, there was no significant correlation between the features and types of rosacea.Conclusion: The dermoscopic characteristics of capillaries in the earlobe and auricle can be used as indicators of the clinical severity of rosacea, regardless of the clinical subtype.Keywords: skin conditions, ear, dermoscopy, blood vessels

Shuxin Liu,1,&ast; Siqi Liu,1,&ast; Dengfeng Gu,1 Xiaona Zhao,2 Hong Zhang,1 Chao Deng,1 Yajuan Gu2 1Department of Anesthesiology, First Affiliated Hospital, Shihezi University, Shihezi, People’s Republic of China; 2Department of Obstetrics, First Affiliated Hospital, Shihezi University, Shihezi, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Chao Deng, Department of Anesthesiology, First Affiliated Hospital, Shihezi University, Shihezi, People’s Republic of China, Email dcgyj1215@163.com Yajuan Gu, Department of Obstetrics, First Affiliated Hospital, Shihezi University, Shihezi, People’s Republic of China, Email 2584049853@qq.comObjective: This study investigates the effect of the Pain Sensitivity Questionnaire (PSQ) in guiding patient controlled intravenous analgesia (PCIA) on postoperative analgesia in women undergoing cesarean section.Methods: A total of 160 women who were to undergo a cesarean section under combined spinal and epidural anaesthesia were included in this study. Women with a preoperative PSQ < 4 were randomly divided into a low pain-sensitive control group (LC group), and a low pain-sensitive observation group (LO group), and women with preoperative PSQ > 6 were randomly divided into a high pain-sensitive control group (HC group) and a high pain-sensitive observation group (HO group). After the surgery, patients received the pump butorphanol concentration was 3.5 μg·kg− 1·h− 1 in the LC and HC groups, 3.0 μg·kg− 1·h− 1 in the LO group and 4.0 μg·kg− 1·h− 1 in the HO group.To compare the analgesic effects of postoperative PCIA and postoperative recovery in women.Results: Wound pain and uterine contraction pain VAS scores at rest and activity were significantly lower in the LC group than in the LO group at 4 and 8 h postoperatively (P< 0.05). Similarly, wound pain and uterine contraction pain VAS scores at rest and activity were significantly lower in the HO group than in the HC group at 8, 12, and 24 h postoperatively (P< 0.05). The Ramsay scores were significantly higher in the LC than in the LO groups at 4, 8, 12, 24, and 48 h postoperatively (P< 0.05), but there was no statistically significant difference between the Ramsay scores in the HC group and the HO group. There was no statistical difference in any of the post-operative recoveries (P> 0.05).Conclusion: Compared to the weight-based postoperative PCIA, the PSQ-based postoperative PCIA has better analgesic effects and can improve maternal satisfaction with postoperative analgesia.Keywords: pain sensitivity, butorphanol, cesarean section, operative analgesia

Dongming Gu, Bo Zhang, Jing Li, Yanpeng Li, Zhihua Wang, Jianjun Diao Department of Emergency, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, 201399, People’s Republic of ChinaCorrespondence: Jianjun Diao; Zhihua Wang, Department of Emergency, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, 2800 Gongwei Road, Pudong, Shanghai, 201399, People’s Republic of China, Tel +86-18918355085 ; +86-18918355561, Email 17317123631@189.cn; wzhys@163.comBackground: To investigate the early application of pulmonary ultrasonography and arterial blood gas analysis in critical patients with severe multiple injuries exacerbated by respiratory failure.Patients and Methods: The retrospective selection was performed on 81 patients admitted to our critical care unit between January 2020 and January 2021 with severe multiple injuries rendered worse by respiratory failure. Based on the different examination procedures, the patients were categorised into three groups (n=27): group A; diagnosed with pulmonary ultrasonography, group B; diagnosed with arterial blood gas; and group C; diagnosed with both pulmonary ultrasonography and arterial blood gas analyses. Patients were subsequently divided into a survival group (n = 65) and a death group (n = 16). On an annual basis, patients’ prognoses were examined in relation to the predictive value of pulmonary ultrasound.Results: Initial diagnosis, diagnosis, and initial correct treatment times were significantly shorter in groups B and C than group A (P< 0.05). In contrast, initial diagnosis time, diagnosis time, and initial correct treatment times were potentially shorter in group C than in group B (P< 0.05). Compared to groups B and C, group A had a considerably lower diagnosis rate for the examination methods (P< 0.05). The right diaphragm displacement and left diaphragm displacement in the survival group were potentially higher than the LUS score (P < 0.05). In contrast, the survival group’s lung ultrasound score (LUS) was considerably lower than the death group’s. Statistical analysis showed that the predictive values of right diaphragm displacement, left diaphragm displacement, and mean diaphragm displacement were significant compared with the LUS score. The findings of the receiver operating characteristic curve demonstrated that the right, left, and average diaphragm displacements had high predictive values.Conclusion: In the early evaluation of patients with severe multiple injuries complicated by respiratory failure, pulmonary ultrasonography combined with arterial blood gas analysis is crucial for the rapid diagnosis and prognosis prediction of patients.Keywords: pulmonary ultrasound, arterial blood gas analysis, severe multiple injuries, respiratory failure

Min Li, Meng Tao, Yue Zhang, Ruoxin Pan, Duoduo Gu, Yang Xu Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing, 210029, People’s Republic of ChinaCorrespondence: Yang Xu, Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), 300 Guangzhou Road, Nanjing, 210029, People’s Republic of China, Tel/Fax +86-13851856794, Email yangxu@njmu.edu.cnAbstract: Morbihan disease is a rare entity involving the upper two-thirds of the face and characterized by chronic erythematous edema, which is recalcitrant to the traditional therapy of rosacea. We report a case of Morbihan disease effectively treated with macro-focused high-intensity focus ultrasound (MF-HIFU). After MF-HIFU treatment, an obvious reduction in swelling was observed with decreased erythema and hyperalgesia. In addition, in-vitro experiments were conducted to measure the actual temperature of the skin tissue under the epidermis. The results of the in-vitro experiments showed that the temperature plateau in the skin sample was reached at approximately 42°C after 5-min treatment or longer. MF-HIFU might be a promising energy-based therapy for Morbihan disease.Keywords: erythema, edema, rosacea, energy-based treatment

Xincong Li,1,&ast; Shuangshuang Ren,1,&ast; Lutong Song,1 Deao Gu,2 Haoran Peng,1 Yue Zhao,1 Chao Liu,2 Jie Yang,3 Leiying Miao1 1Department of Cariology and Endodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210008, People’s Republic of China; 2Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210008, People’s Republic of China; 3Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210008, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Leiying Miao; Jie Yang, Email miaoleiying80@163.com; dorothy0314@sina.comIntroduction: Antibacterial photodynamic treatment (aPDT) has indispensable significance as a means of treating periodontal disorders because of its extraordinary potential for killing pathogenic bacteria by generating an overpowering amount of reactive oxygen species (ROS). The elevated ROS that may result from the antibacterial treatment procedure, however, could exert oxidative pressure inside periodontal pockets, causing irreparable damage to surrounding tissue, an issue that has severely restricted its medicinal applications. Accordingly, herein, we report the use of black phosphorus nanosheets (BPNSs) that can eliminate the side effects of ROS-based aPDT as well as scavenge ROS to produce an antibacterial effect.Methods: The antibacterial effect of ICG/aPDT was observed by direct microscopic colony counting. A microplate reader and confocal microscope enabled measurements of cell viability and the quantification of ROS fluorescence. BPNS administration regulated the oxidative environment. IL-1β, IL-6, TNF-α, IL-10, TGF-β, and Arg-1 mRNA expression levels were used to assess the inflammatory response after BPNS treatment. In vivo, the efficacy of the combination of BPNSs and ICG/aPDT was evaluated in rats with periodontal disease by histomorphometric and immunohistochemical analyses.Results: The CFU assay results verified the antibacterial effect of ICG/aPDT treatment, and ROS fluorescence quantification by CLSM indicated the antioxidative ability of the BPNSs. IL-1β, IL-6, TNF-α, IL-10, TGF-β, and Arg-1 mRNA expression levels were significantly decreased after BPNS treatment, confirming the in vitro anti-inflammatory effect of this nanomaterial. The histomorphometric and immunohistochemical analyses showed that the levels of proinflammatory factors decreased, suggesting that the BPNSs had anti-inflammatory effects in vivo.Conclusion: Treatment with antioxidative BPNSs gives new insights into future anti-inflammatory therapies for periodontal disease and other infection-related inflammatory illnesses and provides an approach to combat the flaws of aPDT.Graphical Abstract: Keywords: periodontitis, black phosphorus nanosheets, reactive oxygen species, antibacterial photodynamic therapy, macrophage polarization

Huiyu Wang,1,&ast; Dingyi Gu,1,&ast; Datian Chen,2,&ast; Jie Mei,1 Xuejing Yang,1 Junli Ding,1 Junying Xu,1 Meilin Wang,3 Chaoying Liu,1 Dong Hua1 1Comprehensive Cancer Center, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, 214023, People’s Republic of China; 2Department of Oncology, Haimen People’s Hospital Affiliated to Nantong University, Haimen, 226100, People’s Republic of China; 3The School of Public Health, Nanjing Medical University, Nanjing, 210000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Meilin Wang; Chaoying Liu, Email meilin_wang210@126.com; liuchaoying666@163.comPurpose: The aim of this study was to explore the clinical significance of deglycosylated PD-L1 level and its correlation with EGFR and ALK mutation in lung adenocarcinoma.Materials and Methods: We estimated the intensity of both native and deglycosylated PD-L1 signals using a 28– 8 antibody on lung adenocarcinoma tissue microarray sections. We analyzed the difference in the H-score between tumor and paratumor tissues, as well as that before and after deglycosylation. Correlations between EGFR or ALK status and PD-L1 expression were analyzed. We also evaluated the differences among survival curves.Results: The expression level of PD-L1 in lung adenocarcinoma tissues was significantly higher than that in paratumor tissues (P< 0.0001). Deglycosylation significantly enhanced the detection of PD-L1 in tumor tissues (P< 0.0001). There was no statistical significance between the signal intensity of deglycosylated PD-L1 and the survival of patients (P=0.9099). However, the response to deglycosylation of PD-L1 was significantly correlated with the survival of patients with stage N1-N3 (P=0.0435) and stage T3-T4 (P=0.0366) and male patients (P=0.0258). A statistical trend was found in the correlation between the response to deglycosylation of PD-L1 and the survival of patients with grade II–III plus grade III (P=0.0973). Correlation between EGFR or ALK status and the expression of PD-L1 was not found (P> 0.05).Conclusion: PD-L1 deglycosylation enhances the detection of PD-L1 when utilizing a 28– 8 antibody. Moreover, the response to deglycosylation of PD-L1 may predict the survival of certain patients with lung adenocarcinoma.Keywords: programmed death ligand 1, deglycosylation, lung adenocarcinoma, mutation, survival

Hui Yang,* Lan Liu,* Gai Li, Yinchen Chen, Dong Jiang, Wei Wang, Tianyuan Wang, Jinshan Sun, Jianfang Che, Dongmei Gu, Meng Lu, Aiping Wang Department of Endocrinology, The Air Force Hospital from Eastern Theater of PLA, Nanjing 210029, People’s Republic of China*These authors contributed equally to this workCorrespondence: Aiping Wang; Meng LuDepartment of Endocrinology, The Air Force Hospital from Eastern Theater of PLA, 1 Malujie Road, Nanjing 210029, People’s Republic of ChinaTel +86-25-80865162Email wap454hospital@163.com; lumeng365@hotmail.comAim: To explore the growth-promoting effect of vacuum sealing drainage (VSD) during the healing processes of diabetic foot ulcers (DFUs).Methods: From November 2018 to December 2019, 38 patients with unilateral DFUs were enrolled in this retrospective study. All patients were divided into two groups according to the use of VSD or not: the VSD group (n=20) and the control group (n=18). The following parameters were used to evaluate the healing process: changes in the mean areas of the ulcers; healing rate (HR); epithelial hyperplasia and angiogenesis as determined by hematoxylin-eosin staining (HE staining); and expression of CD34, CD68 and VEGF as assessed through immunohistochemistry. Perioperative side effects and complications were also recorded.Results: All patients received follow-up and eventually healed. The mean area of wounds was reduced in the VSD group compared to the control group (1.75± 0.64 cm2 vs 0.88± 0.54 cm2, P=0.031). The mean HR of the ulcers in the VSD group was significantly higher than that in the control group (35.23± 2.87% vs 28.78± 1.09%, P=0.017). HE staining showed that the amount of epithelial hyperplasia and angiogenesis increased significantly after VSD, and the immunohistochemistry results showed that the expression of CD34, CD68 and VEGF increased significantly in the VSD group.Conclusion: VSD could significantly accelerate the wound healing process, probably by enhancing the inflammatory response and promoting granulation and angiogenesis in DFUs.Keywords: vacuum sealing drainage, diabetic foot ulcers, wound healing, CD34, CD68, VEGF

Ziqing Wang,1,2 Weijie Liao,2,3 Fuhai Liu,2,4 Tingpeng Yang,2 Weidong Xie,2,3 Meijian Liao,3,4 Dayong Gu,5 Yaou Zhang2,3 1School of Chemistry, Tsinghua University, Beijing 100084, People’s Republic of China; 2State Key Laboratory of Chemical Oncogenomics, Tsinghua Shenzhen International Graduate School, Shenzhen 518055, People’s Republic of China; 3Key Laboratory in Healthy Science and Technology, Division of Life Science, Tsinghua Shenzhen International Graduate School, Shenzhen 518055, People’s Republic of China; 4Department of Pathology, Xuzhou Medical University, Xuzhou 221104, People’s Republic of China; 5Department of Laboratory Medicine, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, People’s Republic of ChinaCorrespondence: Yaou ZhangState Key Laboratory of Chemical Oncogenomics, Tsinghua Shenzhen International Graduate School, Shenzhen 518055, People’s Republic of ChinaTel +86-755-2603-6884Email zhangyo@sz.tsinghua.edu.cnDayong GuDepartment of Laboratory Medicine, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, People’s Republic of ChinaTel +86-13602601597Email wanhood@163.comPurpose: Long non-coding RNAs (lncRNAs) have been shown to be involved in many human diseases. In this study, we aimed to reveal the role and molecular mechanism of lncRNA EPB41L4A-AS1 in type 2 diabetic mellitus (T2DM)-related inflammation.Methods: To explore the relationships between the expression of EPB41L4A-AS1 and inflammatory factors in the blood of T2DM patients, we analyzed peripheral blood mononuclear cell (PBMC) expression microarrays of T2DM patients and expression microarrays of PBMC treated with lipopolysaccharide (LPS) from the GEO database. The relationship between EPB41L4A-AS1 and phospho-p65 was explored by Western blotting (WB) and immunofluorescence. The interactions between EPB41L4A-AS1 and myeloid differentiation factor 88 (MYD88) were also verified through quantitative real-time PCR, WB, and chromatin immunoprecipitation. Glycolysis and mitochondrial stress were detected by Seahorse.Results: EPB41L4A-AS1 showed very low expression, which was significantly negatively correlated with levels of inflammatory factors in PBMCs of T2DM patients and PBMCs treated with LPS. These results were verified by cell experiments on PBMC and THP-1 cells. Knockdown of EPB41L4A-AS1 led to the phosphorylation and nuclear translocation of p65 and thus activated the NF-κB signaling pathway; it also reduced the enrichment of H3K9me3 in the MYD88 promoter and increased expression of MYD88. Overall, EPB41L4A-AS1 knockdown promoted the level of glycolysis and ultimately enhanced the inflammatory response.Conclusion: EPB41L4A-AS1 knockdown activated the NF-κB signaling pathway through a MYD88-dependent regulatory mechanism, promoted glycolysis, and ultimately enhanced the inflammatory response. These results demonstrate that EPB41L4A-AS1 is closely associated with inflammation in T2DM, and that low expression of EPB41L4A-AS1 may be used as an indicator of chronic inflammation and possible diabetic vascular complications in T2DM patients.Keywords: inflammation, diabetes, EPB41L4A-AS1, NF-κB, MYD88

Yang Gong,1,* Wenjing Zhao,1,* Qiong Jia,1 Jiali Dai,1 Nan Chen,1 Yuetong Chen,1 Dongying Gu,1 Xinying Huo,1 Jinfei Chen1– 3 1Department of Oncology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 2Cancer Center, Taikang Xianlin Drum Tower Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, People’s Republic of China; 3Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jinfei ChenDepartment of Oncology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of ChinaTel/ Fax +86 258 535 8120Email jinfeichen@sohu.comBackground: IKBKB/IKKβ, as the core catalytic subunit of IκB kinase complex, participates in mediation of the classical NF-κB pathway, which has been linked to inflammation and tumorigenesis. Previous studies have shown that single nucleotide polymorphisms in IKBKB have been related to gastric cancer, but how they associate to the clinical outcome is not yet clear. In this study, we retrospectively investigated the associations between single nucleotide polymorphisms located in IKBKB and gastric cancer survival.Materials and Methods: IKBKB rs2272736 was genotyped in 1210 patients with primary gastric cancer in a Han Chinese population, and the relationships between rs2272736 and overall survival were evaluated. We conducted Cox proportional hazards regression, which was performed to estimate the effects of single nucleotide polymorphisms on the overall survival of patients, adjusted for potential confounding variables.Results: We found that patients with rs2272736 A allele in IKBKB had significantly prolonged overall survival time compared to those with the G allele (HR = 0.83, 95% CI = 0.68– 1.00, P = 0.050). In addition, AA genotype was demonstrated to have reduced risk of death for gastric cancer compared with that associated with the GG/GA genotypes, which was more common in patients with cardiac carcinoma, well-differentiated and moderately differentiated tumors, TNM Ⅰ/Ⅱ stages and intestinal type.Conclusion: Our findings have shown that single nucleotide polymorphism rs2272736 in IKBKB may be a promising prognostic biomarker which should promote personalized treatment.Keywords: gastric cancer, IKBKB, single nucleotide polymorphisms, survival

Fei Yang,* Rigao Chen,* Dangwei Gu, Qingqing Ye, Wei Liu, Jianhua Qi, Kai Xu, Xiaohong Fan Department of Spine Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiaohong Fan Email 173787798@qq.comPurpose: Although lumbar spinal stenosis (LSS) is the most common spinal disease in the elderly, there is still a confusion about the appropriate surgical treatment strategy. The aim of this study was to compare the safety and efficacy of full-endoscopic and microscopic unilateral laminotomy for bilateral decompression (ULBD) for LSS in elderly patients.Patients and Methods: A retrospective analysis of 61 consecutive elderly patients with LSS who underwent either full-endoscopic (FE group) or microscopic (Micro group) unilateral laminotomy for bilateral decompression was performed. Clinical data were assessed before 2 weeks, 3 months, 6 months and 12 months after surgery using the Visual Analog Scale (VAS), the Oswestry Disability Index (ODI) and the modified MacNab criteria.Results: There are no significant differences in VAS (back and leg) and ODI between the two groups. However, the VAS back pain in the FE group was significantly improved compared to the Micro group at 2 weeks. The rate of excellent or good outcomes was 87.88% and 85.71% in the FE and Micro group, respectively (P> 0.05). The hospital stay and early ambulation in FE group were shorter than those in Micro group, but the operation time was longer (P< 0.05). The complications between the FE group (18.18%) and the Micro group (17.86%) were minor (P> 0.05).Conclusion: Both full-endoscopic and microscopic decompression have achieved favorable clinical results in treating elderly lumbar spinal stenosis, and the complications are minor. Full-endoscopic decompression has the advantages of small incision and rapid recovery, which can be used as an alternative for the treatment of lumbar spinal stenosis, especially the elderly with comorbidities.Keywords: central stenosis, minimally invasive spinal surgery, MISS, comorbidity, complication

Ru-De Liu,1 Jia Wang,2 Dian Gu,3 Yi Ding,4 Tian Po Oei,5,6 Wei Hong,3 Rui Zhen,7 Yu-Meng Li3 1Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, People’s Republic of China; 2Teachers’ College, Beijing Union University, Beijing, People’s Republic of China; 3Faculty of Psychology, Beijing Normal University, Beijing, People’s Republic of China; 4Division of Psychological and Educational Services, Graduate School of Education, Fordham University, New York, NY, USA; 5School of Psychology, University of Queensland, St Lucia, QLD 4072, Australia; 6Department of Psychology, James Cook University, 387380, Singapore; 7Institute of Psychological Sciences, College of Education, Hangzhou Normal University, Hangzhou, People’s Republic of ChinaCorrespondence: Jia WangTeachers’ College, Beijing Union University, Beijing 100011, People’s Republic of ChinaEmail wangjia@mail.bnu.edu.cnPurpose: The aims of this study were to examine (a) the effects of parental phubbing on teenagers’ mobile phone dependency and (b) the mediating roles of subjective norm and dependent intention of underlying this relationship.Methods: We recruited 605 middle school students in Beijing, China and they completed the parental phubbing behaviors, subjective norm, dependency intention, and mobile phone dependency behavior questionnaires.Results: The results of the structure equation modeling revealed that parental phubbing behaviors significantly increased teenager’s mobile phone dependency behaviors in two indirect ways. First, parental phubbing reinforced teenagers’ mobile phone dependency intention, which in turn increased the likelihood of mobile phone dependency. Second, parental phubbing enhanced the tendency of parental mobile phone dependence norm perceived by teenagers, and thus reinforced their mobile phone dependency intention, ultimately increasing mobile phone dependency.Conclusion: We concluded that parental phubbing is a significant indicator of teenager mobile phone dependency and that mobile phone dependency intention plays a mediation role between them. In addition, the perceived parental mobile phone dependency norm played a mediation role between parental phubbing and mobile phone dependency intention and indirectly influenced the level of mobile phone dependency behaviors through the mediation effect of mobile phone dependency intention.Keywords: parental phubbing, mobile phone dependency, dependency intention, subjective norm

Lijuan Liu,* Lu Liu,* Yin Li, Xiaoxin Huang, Donglian Gu, Bo Wei, Danke Su, Guanqiao JinCentre of Imaging Diagnosis, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China*These authors contributed equally to this work Purpose: We developed a contrast agent for targeting E-selectin expression. We detected the agent using magnetic resonance imaging (MRI) in vivo in nude mice that had undergone nasopharyngeal carcinoma (NPC) metastasis.Methods: Sialyl Lewis X (sLeX) was conjugated with ultrasmall superparamagnetic iron oxide (USPIO) nanoparticles. Hydrodynamic size, polydispersity index, and ζ-potential of USPIO–polyethylene glycol (PEG) nanoparticles and USPIO-PEG-sLeX nanoparticles were measured. Component changes in nanoparticles of USPIO, USPIO-PEG, and USPIO-PEG-sLeX were analyzed by thermogravimetric analysis and Fourier-transform infrared spectroscopy. A model of NPC metastasis to inguinal lymph nodes in nude mice was used to investigate characteristics of the USPIO-PEG-sLeX nanoparticles in vivo. We investigated the ability of the T2* value, change in T2* value (ΔT2* value), and enhancement rate (ER) to assess accumulation of USPIO-PEG-sLeX nanoparticles quantitatively in mice of a metastasis group and control group. Four MRI scans were undertaken for each mouse. The first scan (t0) was done before administration of USPIO-PEG-sLeX nanoparticles (0.1 mL) via the tail vein. The other scans were carried out at 0 (t1), 1 (t2), and 2 hours (t3) postinjection. The mean optical density was used to reflect E-selectin expression.Results: sLeX was labeled onto USPIO successfully. In vivo, there were significant interactions between the groups and time for T2* values after administration of USPIO-PEG-sLeX nanoparticles. Six parameters (T2* at t2, ΔT2* at t1, ΔT2* at t2, ER at t1, ER at t2, and ER at t3) were correlated with the mean optical density.Conclusion: USPIO-PEG-sLeX nanoparticles can be used to assess E-selectin expression quantitatively. Use of such molecular probes could enable detection of early metastasis of NPC, more accurate staging, and treatment monitoring.Keywords: molecular MRI, contrast agent, E-selectin, Sialyl Lewis X, nasopharyngeal carcinoma, iron oxide

Nitryl chloride (ClNO2) is a radical reservoir species that releases chlorine radicals upon photolysis. An integrated analysis of the impact of ClNO2 on regional photochemistry in the Seoul metropolitan area (SMA) during the Korea-United States Air Quality Study (KORUS-AQ) 2016 field campaign is presented. Comprehensive multiplatform observations were conducted aboard the NASA DC-8 and at two ground sites (Olympic Park, OP; Taehwa Research Forest, TRF), representing an urbanized area and a forested suburban region, respectively. Positive correlations between daytime Cl2 and ClNO2 were observed at both sites, the slope of which was dependent on O3 levels. The possible mechanisms are explored through box model simulations constrained with observations. The overall diurnal variations in ClNO2 at both sites appeared similar but the nighttime variations were systematically different. For about half of the observation days at the OP site the level of ClNO2 increased at sunset but rapidly decreased at around midnight. On the other hand, high levels were observed throughout the night at the TRF site. Significant levels of ClNO2 were observed at both sites for 4-5 h after sunrise. Airborne observations, box model calculations, and back-trajectory analysis consistently show that these high levels of ClNO2 in the morning are likely from vertical or horizontal transport of air masses from the west. Box model results show that chlorine-radical-initiated chemistry can impact the regional photochemistry by elevating net chemical production rates of ozone by 25% in the morning.

Global warming amplifies the risk of wind‐induced building damage in coastal cities worldwide. Existing numerical methods for predicting building damage under winds have been limited to virtual environments, given the prohibitive costs associated with establishing city‐scale window inventories. Hence, this study introduces a cost‐effective workflow for wind damage prediction of real built environments, where the window inventory can be established with the multi‐view street view image (SVI) fusion and artificial intelligence large model. The feasibility of the method is demonstrated based on two real‐world urban areas. Notably, the proposed multi‐view method surpasses both the single‐view and aerial image‐based methods in terms of window recognition accuracy. The increasing availability of SVIs opens up opportunities for applying the proposed method not only in disaster prevention but also in environmental and energy topics, thereby enhancing the resilience of cities and communities from multiple perspectives. [ABSTRACT FROM AUTHOR]

Tropical rainforests are an important source of isoprenoid and other volatile organic compound (VOC) emissions to the atmosphere. The seasonal variation of these compounds is however still poorly understood. In this study, vertical profiles of mixing ratios of isoprene, total monoterpenes and total sesquiterpenes, were measured within and above the canopy, in a primary rainforest in central Amazonia, using a proton transfer reaction - mass spectrometer (PTR-MS). Fluxes of these compounds from the canopy into the atmosphere were estimated from PTR-MS measurements by using an inverse Lagrangian transport model. Measurements were carried out continuously from September 2010 to January 2011, encompassing the dry and wet seasons. Mixing ratios were higher during the dry (isoprene - 2.68 ± 0.9 ppbv, total monoterpenes - 0.67 ± 0.3 ppbv; total sesquiterpenes - 0.09 ± 0.07 ppbv) than the wet season (isoprene - 1.66 ± 0.9 ppbv, total monoterpenes - 0.47 ± 0.2 ppbv; total sesquiterpenes - 0.03 ± 0.02 ppbv) for all compounds. Ambient air temperature and photosynthetically active radiation (PAR) behaved similarly. Daytime isoprene and total monoterpene mixing ratios were highest within the canopy, rather than near the ground or above the canopy. By comparison, daytime total sesquiterpene mixing ratios were highest near the ground. Daytime fluxes varied significantly between seasons for all compounds. The maximums for isoprene (2.53 ± 0.5 μmol mg-2 hg-1) and total monoterpenes (1.77 ± 0.05μmol mg-2 hg-1) were observed in the late dry season, whereas the maximum for total sesquiterpenes was found during the dry-to-wet transition season (0.77 ± 0.1μmol mg-2 hg-1). These flux estimates suggest that the canopy is the main source of isoprenoids emitted into the atmosphere for all seasons. However, uncertainties in turbulence parameterization near the ground could affect estimates of fluxes that come from the ground. Leaf phenology seemed to be an important driver of seasonal variation of isoprenoid emissions. Although remote sensing observations of changes in leaf area index were used to estimate leaf phenology, MEGAN 2.1 did not fully capture the behavior of seasonal emissions observed in this study. This could be a result of very local effects on the observed emissions, but also suggest that other parameters need to be better determined in biogenic volatile organic compound (BVOC) models. Our results support established findings that seasonality of isoprenoids are driven by seasonal changes in light, temperature and leaf phenology. However, they suggest that leaf phenology and its role on isoprenoid production and emission from tropical plant species needs to be better understood in order to develop mechanistic explanations for seasonal variation in emissions. This also may reduce the uncertainties of model estimates associated with the responses to environmental factors. Therefore, this study strongly encourages long-term measurements of isoprenoid emissions, environmental factors and leaf phenology from leaf to ecosystem scale, with the purpose of improving BVOC model approaches that can characterize seasonality of isoprenoid emissions from tropical rainforests.

In this paper, the acoustic signal of the underwater explosion was taken as the main research object, and the mechanical and acoustic characteristics of the underwater explosion were studied by combining theoretical research with simulation, the propagation law of shock wave and the acoustic characteristics of explosion signal with different explosion depth and charge were obtained. The results show that the underwater explosion has strong acoustic power, high sound pressure level, wide frequency coverage of explosion acoustic signal. In low frequency band, the acoustic power level decays rapidly with the increase of frequency, and its acoustic energy is very high; in higher frequency band, the acoustic power level decays slowly, and its sound energy is relatively low; bubble pulsation has a great influence on the energy distribution of acoustic power level, and the more bubble pulsation times, the greater the proportion of low-frequency energy. The research results of this article can provide a theoretical basis for the research of fuze anti-interference. [ABSTRACT FROM AUTHOR]

Abnormal humoral responses toward motor end plate constituents in muscle induce myasthenia gravis (MG). To study the etiology of this disease, and whether it could be induced by host defense molecules, we examined the consequences of interferon (IFN) gamma production within the neuromuscular junction of transgenic mice. The transgenic mice exhibited gradually increasing muscular weakness, flaccid paralysis, and functional disruption of the neuromuscular junction that was reversed after administration of an inhibitor of acetylcholinesterase, features which are strikingly similar to human MG. Furthermore, histological examination revealed infiltration of mononuclear cells and autoantibody deposition at motor end plates. Immunoprecipitation analysis indicated that a previously unidentified 87-kD target antigen was recognized by sera from transgenic mice and also by sera from the majority of human MG patients studied. These results suggest that expression of IFN-gamma at motor end plates provokes an autoimmune humoral response, similar to human MG, thus linking the expression of this factor with development of this disease.