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The Chinese soft-shelled turtle (Pelodiscus sinensis), a type of warm-water reptile, is frequently chosen as the model animal to understand how organisms respond to environmental stressors. However, the responsive mechanism of P. sinensis to natural cold stress is unclear, especially in terms of metabolic pattern and molecular pathways. Herein, plasma biochemical, hepatic morphological, apoptotic, transcriptomic, and metabolomic detection methods were performed to investigate the response of P. sinensis to acute cold stress. A consistent increase in plasma AST and ALT activities with a decline in ALP activity was found following 14 °C and 7 °C cold stress compared with the control group. Plasma GLU, TG, CHO, and HDL contents, reflecting energy metabolism, were decreased to lower levels from 2 to 16 days post cold stress (dps). Histological and TUNEL detection in the liver demonstrated that the 14 °C and 7 °C cold stress caused severe morphological damage and cell apoptosis in a time-dependent manner. DEGs in the biosynthesis of fatty acids (Acsbg2, Acsl3, Acsl4, Acsl5, Mcat, and Acacb), as well as unsaturated fatty acids (Hsd17b12, Elovl7, Scd, and Baat), starch and sucrose metabolism (Pgm1, Pgm2, and Treh), and apoptosis (Ddit3, Gadd45a, Lmnb1, Tuba1c, Tnf, Tnfsf10, Fos, Itpr1, and Ctso) were discovered in the transcriptome under cold stress. The metabolomic data showed that metabolites, including chenodeoxycholic acid, oleoylethanolamide, uric acid, fructose 1,6-bisphosphate, CMP, and S-(Hydroxymethyl)-glutathione, were remarkably altered in the cold stress groups. Combined transcriptomic and metabolomic data revealed that pyrimidine metabolism, amino acid metabolism, and pyruvate metabolism were the most significant pathways regulated by the low-temperature exposure. Overall, this work suggests that 14 °C and 7 °C cold stress could induce obvious morphological damage and apoptosis in the liver at 4 dps. Moreover, energy metabolism and amino acid metabolism were the main signaling pathways in response to cold stress for P. sinensis.

The aim of this study is to evaluate the indoor temperature of a double-skin façades (DSF) high-rise building in Xi’an under different window opening arrangements, and to assess their impact on the operating time of the air-conditioning system. Compared to conventional buildings, double-skin façade (DSF) buildings can reduce energy consumption. While current research trends focus primarily on heat transfer and materials, there is limited exploration of window opening arrangements. To address this gap, VENT engineering software 2018 was used to simulate indoor temperatures at various window opening angles and determine the optimal arrangement. Additionally, the extreme random tree (ET) algorithm was employed to develop a model for indoor temperature prediction. Climate data were sourced from an online database and processed using the Spearman correlation coefficient method. Window opening arrangements were designed using orthogonal tests, and the performance of the DSF was evaluated with computational fluid dynamics (CFD) software (Fluent) 2023R1. An analysis of temperature variation in the double-skin façade (DSF) curtain wall revealed that the ET algorithm predicted indoor temperatures with 93% accuracy at a 50° window opening angle. Optimal window opening arrangement 2 resulted in a 2.7% reduction in the average interior temperature, a 3.6% reduction at a height of 1.2 m, and a decrease in air-conditioning runtime by 1.33 h. The extreme random tree (ET) algorithm was found to be more accurate than other methods in predicting DSF performance. These findings provide insights for optimizing the control and application of double-skin façades and suggest potential synergies with other systems.

It is a great challenge to prepare efficient and stable electrocatalysts for hydrogen evolution (HER) using non-precious metals. In this study, a series of PtCo/Ti3C2Tx-Y (Y: 16, 32, and 320, Y indicates the quality of Co(NO3)2) catalysts were synthesized by loading PtCo alloy on Ti3C2Tx. The PtCo/Ti3C2Tx-32 catalyst showed the best HER performance, reaching a current density of 10 mA cm−2 with low overpotential (36 and 101 mV) and small Tafel slopes (66.37 and 105.17 mV dec−1) in 0.5 mol L−1 H2SO4 and 1 mol L−1 KOH solution. The excellent HER activity of PtCo/Ti3C2Tx-32 can be attributed as follows: Ti3C2Tx has a unique two-dimensional structure, which can provide a large number of attachment sites for the PtCo alloy, hence exposing more active sites; on the other hand, it can also provide a fast and efficient conductive network for electron transport during electrocatalytic processes, thus enhancing the connectivity between electrolyte and catalyst. PtCo alloy makes the PtCo/Ti3C2Tx catalyst more hydrophilic, accelerating the release rate of bubbles. The DFT calculation results showed that the energy barrier of HER is reduced because the charge around Pt is redistributed by Co after alloying Pt and Co, so that the PtCo/Ti3C2Tx catalyst has a suitable ΔGH* value. This study can be expected to provide some references for the design and synthesis of Ti3C2Tx-supported alloy electrocatalysts with high activity and stability for HER.

Background/Aims: Necrotizing pancreatitis (NP) presents a more severe clinical trajectory and increased mortality compared to edematous pancreatitis. Prompt identification of NP is vital for patient prognosis. A risk prediction model for NP among Chinese patients has been developed and validated to aid in early detection. Methods: A retrospective analysis was performed on 218 patients with acute pancreatitis (AP) to examine the association of various clinical variables with NP. The least absolute shrinkage and selection operator (LASSO) regression was utilized to refine variables and select predictors. Subsequently, a multivariate logistic regression was employed to construct a predictive nomogram. The model's accuracy was validated using bootstrap resampling (n=500) and its calibration assessed via a calibration curve. The model's clinical utility was evaluated through decision curve analysis. Results: Of the 28 potential predictors analyzed in 218 AP patients, the incidence of NP was 25.2%. LASSO regression identified 14 variables, with procalcitonin, triglyceride, white blood cell count at 48 hours post-admission, calcium at 48 hours post-admission, and hematocrit at 48 hours post-admission emerging as independent risk factors for NP. The resulting nomogram accurately predicted NP risk with an area under the curve of 0.822, sensitivity of 82.8%, and specificity of 76.4%. The bootstrap-validated area under the curve remained at 0.822 (95% confidence interval, 0.737 to 0.892). This model exhibited excellent calibration and demonstrated greater predictive efficacy and clinical utility for NP than APACHE II, Ranson, and BISAP. Conclusions: We have developed a prediction nomogram of NP that is of great value in guiding clinical decision.

Psoriasis is a chronic inflammatory disease characterized by increased keratinocyte proliferation and local inflammation. Long noncoding RNAs (lncRNAs) play important regulatory roles in many immune-mediated diseases, including psoriasis. In this study, we aimed to investigate the role and mechanism of lnc-SPRR2G-2 (SPRR2G) in M5-treated psoriatic keratinocytes.Fluorescence in situ hybridization and quantitative real-time polymerase chain reaction (qRT-PCR) showed that lnc-SPRR2G-2 was significantly upregulated in psoriasis tissues and psoriatic keratinocytes. In psoriatic keratinocytes, functional and molecular experiment analyses demonstrated that SPRR2G regulated proliferation, cell cycle and apoptosis, and induced the expression of S100 calcium binding protein A7 (S100A7), interleukin (IL)-1β, IL-8 and C-X-C motif chemokine ligand 10 (CXCL10). The function of SPRR2G in psoriasis is related to the STAT3 signaling pathway and can be inhibited by a STAT3 inhibitor. Moreover, KH-type splicing regulatory protein (KHSRP) was proved to be regulated by lnc-SPRR2G-2 and to control the mRNA decay of psoriasis-related cytokines (p

In this paper, we select the China Carbon Market Price Index, which reflects the overall price changes in China’s carbon market (CCM), and employs the TVP-VAR-BK model to examine the risk spillover effects between the carbon market and high-carbon-emission industries in China from a frequency domain viewpoint. Employing the nonparametric quantile Granger causality test, it delves further into the effects of economic policy uncertainty (EPU) in China on the degree of risk spillovers between the carbon market and high-carbon-emission industries. There are significant risk spillover effects between the carbon market and high-carbon-emission industries. During the short term, the carbon market affects the cement industry more than the electric power and steel industries. However, the carbon market is affected by the volatility of the high-carbon-emission industries over the long term. In addition, the effect of EPU on the magnitude of risk spillovers between the carbon market and high-carbon-emission industries is nonsignificant at extreme quartiles and significant at the middle quartile level, which is typically asymmetric.

A rapid high-performance liquid chromatography (HPLC) protocol for the determination of amino acids with 6-aminoquinolyl-N-hydroxysuccinimidyl carbamate (AQC) derivatization was successfully developed for assessing amino acid levels in six species of representative commercial bee pollen. Based on a poroshell column, a favorable chromatographic separation of seventeen amino acids was achieved in approximately 10 min with satisfactory resolution. The LOD and LOQ of this method were less than 0.034 μg/mL and 0.232 μg/mL, and the intra- and inter-day RSDs ranged between 0.86–5.28 % and 3.21–6.50 %, respectively. The matrix effect (ME) ranged from −8 to 3, implying that the matrix effect was not significant. Under the optimum conditions, the established method was adopted to determine amino acids in six types of bee pollens. The results showed that the total amino acid content ranged from 151.94 mg/g (Rosa rugosa) to 214.52 mg/g (Leonurus artemisia) in the six bee pollen species. Notably, proline (Pro), valine (Val), leucine (Leu), and phenylalanine (Phe) were abundant in the majority of samples. To identify the suspicious samples, principal component analysis (PCA) was performed, and each type of bee pollen was differentiated. Results showed that, in the market, the qualification rate of RR was 100 %, but that of NN was merely 62.5 %, revealing that a few of them were counterfeit. This method offers advantages such as high speed, low cost, and outstanding performance.

BackgroundProtein Energy Wasting (PEW) has high incidence in adult hemodialysis patients and refers to a state of decreased protein and energy substance. It has been demonstrated that PEW highly affects the quality of survival and increases the risk of death. Nevertheless, its diagnostic criteria are complex in clinic. To simplify the diagnosis method of PEW in adult hemodialysis patients, we previously established a novel clinical prediction model that was well-validated internally using bootstrapping. In this multicenter cross-sectional study, we aimed to externally validate this nomogram in a new cohort of adult hemodialysis patients.MethodsThe novel prediction model was built by combining four independent variables with part of the International Society of Renal Nutrition and Metabolism (ISRNM) diagnostic criteria including albumin, total cholesterol, and body mass index (BMI). We evaluated the performance of the new model using discrimination (Concordance Index), calibration plots, and Clinical Impact Curve to assess its predictive utility.ResultsFrom September 1st, 2022 to August 31st, 2023, 1,158 patients were screened in five medical centers in Shanghai. 622 (53.7%) hemodialysis patients were included for analysis. The PEW predictive model was acceptable discrimination with the area under the curve of 0.777 (95% CI 0.741–0.814). Additionally, the model revealed well-fitted calibration curves. The McNemar test showed the novel model had similar diagnostic efficacy with the gold standard diagnostic method (p > 0.05).ConclusionOur results from this cross-sectional external validation study further demonstrate that the novel model is a valid tool to identify PEW in adult hemodialysis patients effectively.

BackgroundThe aim of this study was to investigate the relationship between triglyceride-glucose (TyG) index and cardiovascular disease (CVD) and all-cause mortality in adults with metabolic syndrome (MeS) and explore the mediating role of oxidative stress.MethodsThis study included 6131 adults with MeS from the National Health and Nutrition Examination Survey (NHANES). The relationships between TyG index and mortality were elucidated using multivariate Cox proportional hazards models, restricted cubic splines (RCS) Fine-Gray competing risk model. In addition, mediation analysis was used to test the indirect effect of oxidative stress indicators.ResultsOver a median 106-month follow-up, a total of 357 CVD and 1292 all-cause deaths were recorded. After multivariate adjustment, there was a J-type relationship between TyG index and CVD and all-cause mortality, with optimal inflection point of 9.13 and 8.92. After the threshold point, TyG index was positively associated with CVD (HR: 4.21, 95%CI: 1.82, 9.78) and all-cause mortality(HR: 2.93, 95%CI: 2.05, 4.18). Even using non-cardiovascular mortality as a competitive risk, the Fine-Gray model also illustrated that the cumulative CVD mortality incidence was higher in MeS with TyG index >9.13 (Fine-Gray P< 0.01). Mediation analysis revealed that biomarkers of oxidative stress, including gamma-glutamyl transferase and uric acid, collectively mediated 10.53% of the association between the TyG index and CVD mortality, and 8.44% of the association with all-cause mortality (P < 0.05).ConclusionIn the cohort study, TyG index was found to have a J-shaped association with CVD mortality and all-cause mortality in MeS population and oxidative stress may play a key mediating role in this relationship.

Purpose: Pathological fibrosis of the myodural bridge (MDB) affects cerebrospinal fluid circulation. However, no optimal drug treatments are available. We aimed to explore the antifibrotic effect of resveratrol on bleomycin-induced pathological fibrosis of the MDB and its underlying mechanisms. Methods: Genes common to the potential targets of resveratrol were determined using network pharmacology, genes related to muscle and tendon fibrosis were acquired from the GeneCards database, and genes related to MDB development were determined using Venny. These genes were considered potential resveratrol treatment targets in bleomycin-induced pathological fibrosis of the MDB and were annotated using bioinformatics methods. We validated the intersected genes using quantitative real-time polymerase chain reaction (qRT-PCR) and performed molecular docking analysis to calculate the binding activity between the target gene and resveratrol. Hematoxylin and eosin and Masson staining were used to detect the morphological changes in bleomycin-induced fibrosis of the MDB following resveratrol treatment. We used qRT-PCR and immunohistochemistry to evaluate the expression of the sirtuin 3 (SIRT3)/transforming growth factor-β1 (TGF-β1)/Smad pathway and the profibrotic markers α-smooth muscle actin (α-SMA) and Collagen Ⅰ. Results: Through network pharmacology and bioinformatics analyses, we identified four core intersected genes, and SIRT3 expression was validated using qRT-PCR. Molecular docking analysis revealed that resveratrol had good binding affinity for SIRT3. Resveratrol ameliorated morphological abnormalities in bleomycin-induced pathological fibrosis of the MDB by inhibiting fibroblast activation and excessive collagen fiber deposition. Resveratrol exerted its antifibrotic effect by regulating the SIRT3/TGF-β1/Smad pathway. Conclusion: Resveratrol has an antifibrotic effect in bleomycin-induced pathological fibrosis of the MDB in vivo and may be considered a novel therapeutic strategy.

ObjectiveOsteoarticular tuberculosis (OATB) is one of the most common forms of extrapulmonary tuberculosis; however, limited epidemiological data are available on this public health concern worldwide, especially in developing countries. This study aimed to analyze the clinical epidemiology and drug resistance characteristics of OATB cases in Hunan province which located in South-central China.MethodsWe retrospectively enrolled OATB patients with Mycobacterium tuberculosis culture positive at Hunan Chest Hospital from January 2013 through March 31, 2022. The multiple demographic, clinical variables and drug susceptibility data of the patients were collected from the hospital’s electronic patient records. Descriptive statistical methods, Chi-square test and logistic regression analysis were employed as statistical methods.ResultsOf the 269 OATB cases, 197 (73.23%) were males, 206 (76.85%) were farmers; patients’ ages ranged from 5 to 85 years, 57 (21.19%) aged at 20–29 years old and 52 (19.33%) aged at 60–69 years old. In terms of the disease, 177 (65.80%) had spinal TB with most occurrence in lumbar vertebrae (26.02%, 70/269), multiple spinal sites (18.96%, 51/269) and thoracic vertebrae (15.24%, 41/269). Outside of the spine, OATB mainly occurred in the lower limb (13.38%, 36/269). In terms of drug resistance, 40 (14.87%) and 72 (26.77%) were resistant to rifampicin (RFP) and isoniazid (INH) respectively; 38 (14.13%) were multi-drug resistant (MDR), and a total of 78 (29.00%) isolates were drug resistant. OATB patients aged 40–49 years old (compared to those aged ≥70 years) and from the west of Hunan province, China (compared to those from the center of Hunan) were at risk for developing RR/MDR (ORs were 5.057 and 4.942, respectively; 95% CIs were 1.009–25.342 and 1.458–16.750, respectively).ConclusionIn South-central China, OATB mainly affected males, farmers and those aged 20–29 and 60–69 years old. Spinal TB is prone to occur in the lumbar and multiple spinal sites. The resistance situation of OATB was serious, and people aged 40–49 years old and patients from the west of Hunan were risk factors of RR/MDR. All these findings will help to improve the prevention, diagnosis and treatment strategies of OATB.

Abstract BackgroundCardiovascular-kidney-metabolic (CKM) health is affected by social determinants of health, especially education. CKM syndrome has not been evaluated in Chinese population, and the association of education with CKM syndrome in different sexes and its intertwined relation with lifestyles have not been explored. ObjectiveWe aimed to explore the association between educational attainment and the prevalence of CKM syndrome stages in middle-aged and older Chinese men and women as well as the potential role of health behavior based on Life’s Essential 8 construct. MethodsThis study used data from the nationwide, community-based REACTION (Risk Evaluation of Cancers in Chinese diabetic individuals: a longitudinal study). A total of 132,085 participants with complete information to determine CKM syndrome stage and education level were included. Educational attainment was assessed by the self-reported highest educational level achieved by the participants and recategorized as low (elementary school or no formal education) or high (middle school, high school, technical school/college, or above). CKM syndrome was ascertained and classified into 5 stages according to the American Heart Association presidential advisory released in 2023. ResultsAmong 132,085 participants (mean age 56.95, SD 9.19 years; n=86,675, 65.62% women) included, most had moderate-risk CKM syndrome (stages 1 and 2), and a lower proportion were at higher risk of CKM (stages 3 and 4). Along the CKM continuum, low education was associated with 34% increased odds of moderate-risk CKM syndrome for women (odds ratio 1.36, 95% CI 1.23-1.49) with a significant sex disparity, but was positively correlated with high-risk CKM for both sexes. The association between low education and high-risk CKM was more evident in women with poor health behavior but not in men, which was also interactive with and partly mediated by behavior. ConclusionsLow education was associated with adverse CKM health for both sexes but was especially detrimental to women. Such sex-specific educational disparity was closely correlated with health behavior but could not be completely attenuated by behavior modification. These findings highlight the disadvantage faced by women in CKM health ascribed to low education, underscoring the need for public health support to address this inequality.

Icariin (ICA), a natural flavonoid glucoside from traditional Chinese medicine, possesses various pharmacological properties such as anti-inflammatory, anti-aging, and neuroprotective effects. Recent studies suggest its potential in treating Alzheimer’s disease (AD). However, the exact mechanisms of how ICA modulates neuroinflammation in AD remain unclear. In this study, oral ICA administration improved cognitive function in mice, decreasing escape latency in behavioral tests and altering protein levels related to AD pathology, including boosting acetylcholine and reducing p-tau/tau and acetylcholinesterase. Additionally, in 3 × Tg-AD mice, ICA therapy inhibited microglia and astrocyte activation and reduced inflammatory cytokines (IL-1β, TNF-α, IL-6) at the protein level. RNA-seq analysis revealed decreased expression of Nrxn3, Meg3, and Malat1 genes in 3 × Tg-AD animals treated with ICA. Furthermore, ICA activated the Akt/GSK-3β signaling pathway, known for its role in neuroinflammation, suggesting a potential mechanism by which ICA suppresses inflammation. This study proposes Meg3 and Malat1 lncRNA as therapeutic targets against AD, offering a novel approach for combating neuroinflammation in AD through the inhibition of the Akt/GSK-3β pathway.

Mesenchymal stem cells (MSCs) have promising potential for bone tissue engineering in bone healing and regeneration. They are regarded as such due to their capacity for self-renewal, multiple differentiation, and their ability to modulate the immune response. However, changes in the molecular pathways and transcription factors of MSCs in osteogenesis can lead to bone defects and metabolic bone diseases. DNA methylation is an epigenetic process that plays an important role in the osteogenic differentiation of MSCs by regulating gene expression. An increasing number of studies have demonstrated the significance of DNA methyltransferases (DNMTs), Ten-eleven translocation family proteins (TETs), and MSCs signaling pathways about osteogenic differentiation in MSCs. This review focuses on the progress of research in these areas.

Aims and objectives: During the new coronavirus disease 2019 (COVID-19) outbreak period, there was increasing presentation in the number of patients with acute primary angle closure (APAC). This study aimed to report the occurrence of APAC during the COVID-19 post-restriction period and investigate the related characteristics of these patients with APAC. Methods: This retrospective, multi-center study included consecutive patients seeking APAC treatment at two eye centers in China from December 7, 2022 to January 13, 2023 (post-restriction period) and from December 7, 2021 to January 13, 2022 (control period). Electronic medical records were reviewed, and ocular data of the affected eye(s) were analyzed for patients with unilateral or bilateral APAC. Information including COVID-19 related symptoms, medications used for COVID-19 infection, and living habits and emotions related to the COVID-19 outbreak during the post restriction period were collected using a questionnaire. Results: Overall, 189 (219 APAC eyes) and 51 (54 APAC eyes) patients with APAC were identified during the post-restriction and control periods, respectively. The patients identified during the post-restriction period were younger (P = 0.043) and had a longer duration from symptoms to treatment (P = 0.039), shorter axial length (P = 0.002), larger pupil diameter (P = 0.004), larger vertical cup disc ratio (P = 0.004), poorer mean deviation values (P = 0.003), and more glaucomatous optic neuropathy diagnoses (P = 0.032) compared with the patients with APAC identified during the control period. Among 151 included patients with APAC who completed the questionnaires, 130 patients with APAC were diagnosed with concurrent COVID-19 infection, of which 54 (41.5 %) had coughing and/or vomiting as the main symptoms. Of these, 89.2 % spent 0 h per day on outdoor activity; 44.6 % drank more water than usual, with 14.6 % drinking more than twice the amount of water than usual; 91.5 % used antipyretics; and 20.0 % had mood swings, including anxiety, depression, and tension, during the concurrent COVID-19 infection. Conclusion: In our study, a significant increase in the number of patients presenting with APAC with certain characteristics was observed during the COVID-19 post-restriction period. And whether COVID-19 symptoms, such as coughing and vomiting, and behavioral and psychological changes caused by COVID-19 infection contributing to the concurrence of APAC and COVID-19 recurrence require further investigation.

Water is an important constraint on alfalfa (Medicago sativa) production in arid and semiarid areas, and alternate irrigation in root areas has water-saving potential for alfalfa production. To investigate the impact of alternate partial root-zone irrigation (APRI) on the rhizosphere soil microorganisms of alfalfa, this study subjected alfalfa plants to different irrigation methods and irrigation levels. The growth status and rhizosphere soil microbial community diversity of alfalfa plants under alternate root-zone watering treatment were analyzed through laboratory experiments and high-throughput sequencing. The results showed that at soil moisture levels of 80% field moisture capacity (FMC) and 60% FMC, APRI had no significant impact on the biomass or nodule number of alfalfa. However, 40% FMC significantly reduced the individual plant dry weight, chlorophyll content, and nodule number of the alfalfa plants. APRI increased the relative abundance of Actinomycetes in the alfalfa rhizosphere soil. Moreover, at 60% FMC, the MBC and MBN of rhizosphere, relative abundance of Actinobacteria and unclassified K fungi and Chao 1 index of bacteria significantly increased under APRI treatment. While relative abundance of Ascomycetes and Proteobacteria in the alfalfa rhizosphere significantly reduced under 60% FMC + APRI treatment. In summary, under the same irrigation conditions, APRI did not significantly affect the growth of alfalfa in the short term. And 60%FMC + APRI treatment did significantly affect the groups, structure and diversity of the rhizosphere soil microbial communities.

BackgroundThis study examines whether clot patterns at large artery occlusion sites, as observed using digital subtraction angiography (DSA) and computed tomography angiography (CTA), can reliably indicate intracranial atherosclerotic stenosis (ICAS) in acute ischemic stroke (AIS) patients.MethodsWe conducted a retrospective analysis of patients treated with stent retriever thrombectomy for intracranial occlusions at our institute since 2017, with follow-up assessments conducted at 3 months. The patients were grouped based on the initial angiography clot topographies (i.e., cut-off or tapered signs). We assessed the potential of these topographies in predicting ICAS, including a clinical outcome analysis based on clot pattern, age, Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification, and onset-to-door time.ResultsAmong 131 patients (with a mean age of 66.6 years), the clot pattern emerged as a significant predictor of ICAS. The DSA-based model had a predictive area under the curve (AUC) of 0.745, with 55.1% sensitivity and 94.0% specificity. A multivariate model including age, onset-to-door time, TOAST classification as large artery atherosclerosis (LAA), and the presence of the tapered sign in clot patterns had an AUC of 0.916. In patients over 65 years of age with an onset-to-door time of >5 h and exhibiting a tapered sign in the clot pattern, the AUC reached 0.897. The predictive ability of the tapered sign was similar in DSA and CTA, showing 73.4% agreement between modalities.ConclusionThe clot pattern with the tapered sign as observed using DSA is significantly associated with ICAS. Incorporating this clot pattern with age, TOAST classification as LAA, and onset-to-door time enhances the prediction of ICAS. The clot pattern identified by CTA is also a reliable predictor, highlighting the importance of assessing clot patterns in ICAS identification.

BackgroundType 2 diabetes mellitus(T2DM) is characterized by hyperglycemia. Gut microbiome adjustment plays a positive part in glucose regulation, which has become a hotspot. Probiotics have been studied for their potential to control the gut flora and to treat T2DM. However, the conclusion of its glucose-lowering effect is inconsistent based on different probiotic intervention times.ObjectivesTo comprehensively evaluate how various probiotic intervention times affect glycemic control in people with T2DM.MethodsWe retrieved PubMed, Embase, Web of Science, and Cochrane Library on randomized controlled trials(RCTs)regarding the impact of probiotics on glycemic control in patients with T2DM from the inception to November 16, 2023. Separately, two researchers conducted a literature analysis, data extraction, and bias risk assessment of the involved studies. We followed the PRISMA guidelines, used RevMan 5.4 software for meta-analysis, and assessed the risk of bias by applying the Cochrane Handbook for Systematic Reviews 5.1.0.ResultsWe included eight RCTs with 507 patients. Meta-analysis revealed that the use of probiotics might considerably reduce levels of glycosylated hemoglobin (HbA1c) {mean deviation (MD) = -0.33, 95% confidence interval (CI) (-0.59, -0.07), p = 0.01}, Insulin {standard mean deviation (SMD) = -0.48, 95% CI (-0.74, -0.22), p = 0.0003} and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR){SMD = -1.36, 95% CI (-2.30, -0.41), p = 0.005} than placebo group. No statistically significant differences were found regarding fasting blood glucose (FBG) and body mass index (BMI) {SMD = -0.39, 95% CI (-0.83, 0.05), p = 0.08}, {SMD = -0.40, 95% CI (-1.07, 0.27), p = 0.25}, respectively. Subgroup analyses, grouped by intervention times, showed that six to eight weeks of intervention improved HbA1c compared to the control group (p < 0.05), both six to eight weeks and 12-24 weeks had a better intervention effect on Insulin, and HOMA-IR (p < 0.05).In contrast, there was no statistically significant variation in the length between FBG and BMI regarding duration.ConclusionThis meta-analysis found probiotics at different intervention times play a positive role in modulating glucose in T2DM, specifically for HbA1c in six to eight weeks, Insulin and HOMA-IR in six to eight weeks, and 12-24 weeks. To confirm our findings, further excellent large-sample research is still required.Systematic review registrationhttps://www.crd.york.ac.uk/prospero, identifier CRD42023483325.

At present, the global consensus on the concept of sustainable development continues to deepen, and China’s ecological civilization construction and rural revitalization strategy continue to advance. However, the rural environmental situation in China is becoming more and more complex. Therefore, a comprehensive review and summary of China’s rural environmental governance research are particularly important, which can not only provide theoretical support for future research but also offer vital guidance for governance practices. Based on the research literature of CNKI (1993–2023) and WOS (2001–2024), bibliometrics and CiteSpace software are adopted in this review to tease out the main characteristics, research hotspots and evolution trends of rural environmental governance research in China. The results indicate that: 1) Research interest shows an overall upward trend, with an expanding scale of interdisciplinary scholars and teams emerging. The collaboration network among authors and institutions in WOS appears tighter than that in CNKI. 2) In CNKI, Research hotspots revolve around environmental issues and pollution governance, social participation and governance mechanisms, ecological civilization and sustainable development, and rural revitalization and construction. In WOS, research hotspots pivot towards policy implementation and governance mechanisms, environmental issues and resource management, socio-economic impacts and equity, information disclosure and community participation, and technology and methods. 3) The research in CNKI has undergone three stages: “initiation”, “development”, and “deepening”. In contrast, the research in WOS started relatively late and is currently still in the “development” stage. Future research should focus on enhancing disciplinary integration and fostering collaboration among domestic and international scholars and institutions. Under the rural revitalization strategy, focus should be on achieving symbiosis between rural economic growth and ecological civilization construction. Simultaneously exploring diverse stakeholder governance models, focusing on rural living environment issues and striving to reduce rural carbon emissions to address climate change challenges.

BackgroundPoint-of-care Testing (POCT) glycosylated hemoglobin (HbA1c) is a convenient, cheap, effective and accessible screening method for type 2 diabetes in rural areas and community settings that is widely used in the European region and Japan, but not yet widespread in China. The study is the first to evaluate the cost-effectiveness of POCT HbA1c, fasting capillary glucose (FCG), and venous blood HbA1c to screen for type 2 diabetes in urban and rural areas of China, and to identify the best socio-economically beneficial screening strategy.MethodsBased on urban and rural areas in China, economic models for type 2 diabetes screening were constructed from a social perspective. The subjects of this study were adults aged 18–80 years with undiagnosed type 2 diabetes. Three screening strategies were established for venous blood HbA1c, FCG and POCT HbA1c, and cost-effectiveness analysis was performed by Markov models. One-way sensitivity analysis and probabilistic sensitivity analysis were performed on all parameters of the model to verify the stability of the results.ResultsCompared with FCG, POCT HbA1c was cost-effective with an incremental cost-utility ratio (ICUR) of $500.06/quality-adjusted life year (QALY) in urban areas and an ICUR of $185.10/QALY in rural areas, within the willingness-to-pay threshold (WTP = $37,653). POCT HbA1c was cost-effective with lower cost and higher utility compared with venous blood HbA1c in both urban and rural areas. In the comparison of venous blood HbA1c and FCG, venous blood HbA1c was cost-effective (ICUR = $20,833/QALY) in urban areas but not in rural areas (ICUR = $41,858/QALY). Sensitivity analyses showed that the results of the study were stable and credible.ConclusionsPOCT HbA1c was cost-effective for type 2 diabetes screening in both urban and rural areas of China, which could be considered for future clinical practice in China. Factors such as geographic location, local financial situation and resident compliance needed to be considered when making the choice of venous blood HbA1c or FCG.

Objective: Intrathecal drug delivery systems (IDDS) have been clinically applied to treat refractory cancer-related pain for years. In this study, we demonstrate the current clinical practice and outcomes of IDDS for cancer pain management over a 3-year period at a single tertiary medical center in China. Methods: Patients who received IDDS implantation for cancer-related pain from 2021 to 2023 were identified. The electronic medical records of all eligible patients were retrospectively reviewed for study data including baseline characteristics, IDDS variables and postoperative clinical outcomes. Results: A total of 96 consecutive individuals were identified for analysis and complete follow-up information was available in 72 patients with a follow-up rate of 75 %. Patients were 49.0 % female with a mean age of 62 ± 10 years. The top five cancer types in IDDS population were lung (34.4 %), colorectal (17.7 %), pancreatic (11.5 %), breast (5.2 %) and liver (4.2 %) cancer. The median duration from cancer diagnosis to IDDS implantation was 24 months (interquartile range [IQR] 12–48 months) and from pain onset to IDDS implantation was 6 months (IQR 2–12 months). In addition, the median oral morphine equivalents (OME) daily dose was 290 mg (IQR 100–632 mg). Mean NRS was 7.5 ± 0.8 before implantation and decreased to an average of 3.0 ± 1.1 after IDDS (p

Summary: Background: Endovascular therapy (EVT) was demonstrated effective in acute large vessel occlusion (LVO) with large infarction. Revealing subgroups of patients who would or would not benefit from EVT will further inform patient selection for EVT. Methods: This post-hoc analysis of the ANGEL-ASPECT trial, a randomised controlled trial of 456 adult patients with acute anterior-circulation LVO and large infarction, defined by ASPECTS 3–5 or infarct core volume 70–100 mL, enrolled from 46 centres across China, between October 2, 2020 and May 18, 2022. Patients were randomly assigned (1:1) to receiving EVT and medical management or medical management alone. One patient withdrew consent, 455 patients were included in this post-hoc analysis and categorised into 4 subgroups by lower or higher NIHSS (< or ≥16) and smaller or larger infarct core (< or ≥70 mL). Those with lower NIHSS & smaller core, and higher NIHSS & larger core were considered clinical-radiological matched subgroups; otherwise clinical-radiological mismatched subgroups. Primary outcome was 90-day modified Rankin Scale (mRS). ANGEL-ASPECT is registered with ClinicalTrials.gov, NCT04551664. Findings: Overall, 139 (30.5%) patients had lower NIHSS & smaller core, 106 (23.3%) higher NIHSS & larger core, 130 (28.6%) higher NIHSS & smaller core, and 80 (17.6%) lower NIHSS & larger core. There was significant ordinal shift in the 90-day mRS toward a better outcome with EVT in clinical-radiological matched subgroups: lower NIHSS & smaller core (generalised OR, 1.76; 95% CI, 1.18–2.62; p = 0.01) and higher NIHSS & larger core (1.64; 1.06–2.54; 0.01); but not in the two clinical-radiological mismatched subgroups. Interpretation: Our findings suggested that in patients with anterior-circulation LVO and large infarction, EVT was associated with improved 90-day functional outcomes in those with matched clinical and radiological severities, but not in those with mismatched clinical and radiological severities. Simultaneous consideration of stroke severity and infarct core volume may inform patient selection for EVT. Funding: Unrestricted grants from industry [Covidien Healthcare International Trading (Shanghai), Johnson & Johnson MedTech, Genesis MedTech (Shanghai), and Shanghai HeartCare Medical Technology].

Sakuranetin, a flavonoid phytoalexin in rice, plays a crucial role in defense against pathogen infection. While MYB-type transcription factors are well-known to regulate plant growth, development, secondary metabolism, and adaptation to environmental stresses, the function of rice MYB-related transcription factors in sakuranetin biosynthesis and sakuranetin-mediated defense remains unclear. In this study, we identified and characterized OsMYB1R, a novel single repeat MYB transcription factor that acts as a transcriptional activator in sakuranetin biosynthesis. Protein-DNA binding and activation assays revealed that OsMYB1R directly regulates the gene promoter of OsNOMT, a key enzyme in sakuranetin synthesis. Molecular analyses and infection studies using OsMYB1R-overexpressing (OsMYB1R-OE) and OsMYB1R-knockout (Osmyb1r, generated using CRISPR/Cas9) plants demonstrated that OsMYB1R increases sakuranetin production and decreases Magnaporthe oryzae infection by transcriptionally regulating OsNOMT expression. This finding indicates a positive regulation of sakuranetin biosynthesis and antifungal resistance by the OsMYB1R-OsNOMT crosstalk. Interestingly, the alteration of OsMYB1R expression did not affect yield-related agronomic traits. Our results reveal a novel and positive role of 1R-MYB in secondary metabolite biosynthesis and pathogen defense, suggesting that OsMYB1R is a potential gene for effectively enhancing rice resistance without compromising yield.

BackgroundThe triglyceride glucose (TyG) index has been associated with an increased risk in breast cancer. However, this association remains unclear among the Chinese population. This study aimed to investigate whether the TyG index is associated with the risk of prevalent breast cancer in Chinese women.MethodsThis cross-sectional study included 142,184 women from the REACTION (Risk Evaluation of Cancers in Chinese Diabetic Individuals: A Longitudinal) Study, which recruited adults aged 40 years or older from 25 centers across mainland China between 2011 and 2012. The TyG index was calculated according to the formula: Ln (fasting triglycerides [mg/dL] × fasting glucose [mg/dL]/2). Multivariable-adjusted logistic regression models were used to evaluate odds ratios (ORs) and 95% confidence intervals (CIs) regarding the associations between the TyG index and breast cancer.ResultsMultivariable-adjusted logistic regression analysis showed that compared with the lowest quartile of the TyG index, the highest quartile of the TyG index was significantly associated with an increased risk of prevalent breast cancer, with an OR (95% CI) of 1.61 (1.19–2.17). In the stratified analysis, the association of each 1 SD increase in the TyG index with risk of prevalent breast cancer was more dominant in individuals with menarche at age 13–17, those who were postmenopausal, those with a history of breastfeeding, and those who had two to four children, with the ORs (95% CIs) of 1.35 (1.09–1.68), 1.27 (1.05–1.54), 1.26 (1.05–1.52), and 1.32 (1.08–1.62), respectively. Moreover, among those without discernible insulin resistance (homeostatic model assessment-insulin resistance [HOMA-IR] ≥2.5), hyperglycemia and dyslipidemia, each 1 SD increase in the TyG index was associated with a 1.36-fold increase in breast cancer risk, with an OR (95% CI) of 2.36 (1.44–3.87).ConclusionThe TyG index is significantly associated with the prevalent breast cancer risk among middle-aged and elderly Chinese women.

Abstract Hexagonal MAB phases （h‐MAB） have attracted attention due to their potential to exfoliate into MBenes, similar to MXenes, which are predicted to be promising for Li‐ion battery applications. However, the high cost of synthesizing MBenes poses challenges for their use in batteries. This study presents a novel approach where a simple ball‐milling treatment is employed to enhance the purity of the h‐MAB phase Ti2InB2 and introduce significant indium defects, resulting in improved conductivity and the creation of abundant active sites. The synthesized Ti2InB2 with indium defects (VIn‐Ti2InB2) exhibits excellent electrochemical properties, particularly exceptional long‐cycle stability at current densities of 5 A g−1 (5000 cycles, average capacity decay of 0.0018%) and 10 A g−1 (15 000 cycles, average capacity decay of 0.093%). The charge storage mechanism of VIn‐Ti2InB2, involving a dual redox reaction, is proposed, where defects promote the In‐Li alloy reaction and a redox reaction with Li in the TiB layer. Finally, a Li‐ion full cell demonstrates cycling stability at 0.5 A g−1 after 350 cycles. This work presents the first accessible and scalable application of VIn‐Ti2InB2 as a Li‐ion anode, unlocking a wealth of possibilities for sustainable electrochemical applications of h‐MAB phases.

BackgroundThis study examines the association between Hemoglobin Glycation Index (HGI) and the risk of mortality among individuals with hypertension and to explore gender-specific effects.MethodsData from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018 were analyzed. Three models were constructed to assess the relationship between HGI and mortality risks, controlling for various covariates. Nonlinear relationships were explored using restricted cubic splines (RCS) and threshold effect analysis.ResultsThe findings reveal a U-shaped relationship between HGI and the cardiovascular disease (CVD) and all-cause mortality after adjusting for multiple covariates. Gender- specific analysis indicated a U-shaped relationship in men, with threshold points of -0.271, and 0.115, respectively. Before the threshold point, HGI was negatively associated with CVD mortality (HR: 0.64, 95%CI: 0.44, 0.93, P=0.02) and all-cause mortality (HR: 0.84, 95%CI: 0.71, 0.99), and after the threshold point, HGI was positively associated with CVD mortality (HR: 1.48, 95%CI: 1.23, 1.79, P

Mercury (Hg) contamination poses a global threat to the environment, given its elevated ecotoxicity. Herein, we employed the lepidopteran model insect, silkworm (Bombyx mori), to systematically investigate the toxic effects of Hg-stress across its growth and development, histomorphology, antioxidant enzyme activities, and transcriptome responses. High doses of Hg exposure induced evident poisoning symptoms, markedly impeding the growth of silkworm larvae and escalating mortality in a dose-dependent manner. Under Hg exposure, the histomorphology of both the midgut and fat body exhibited impairments. Carboxylesterase (CarE) activity was increased in both midgut and fat body tissues responding to Hg treatment. Conversely, glutathione S-transferase (GST) levels increased in the fat body but decreased in the midgut. The transcriptomic analysis revealed that the response induced by Hg stress involved multiple metabolism processes. Significantly differently expressed genes (DEGs) exhibited strong associations with oxidative phosphorylation, nutrient metabolisms, insect hormone biosynthesis, lysosome, ribosome biogenesis in eukaryotes, and ribosome pathways in the midgut or the fat body. The findings implied that exposure to Hg might induce the oxidative stress response, attempting to compensate for impaired metabolism. Concurrently, disruptions in nutrient metabolism and insect hormone activity might hinder growth and development, leading to immune dysfunction in silkworms. These insights significantly advance our theoretical understanding of the potential mechanisms underlying Hg toxicity in invertebrate organisms.

Heat stroke (HS) is a critical condition with extremely high mortality. Heat acclimation (HA) is widely recognized as the best measure to prevent and protect against HS. Preventive administration of oral rehydration salts III (ORSIII) and probiotics have been reported to sustain intestinal function in cases of HS. This study established a rat model of HA that was treated with probiotics-based ORS (ORSP) during consecutive 21-day HA training. The results showed that HA with ORSP could attenuate HS-induced hyperthermia by regulating thermoregulatory response. We also found that HA with ORSP could significantly alleviate HS-induced multiple organ injuries. The expression levels of a series of heat-shock proteins (HSPs), including HSP90, HSP70, HSP60, and HSP40, were significantly up-regulated from the HA training. The increases in intestinal fatty acid binding protein (I-FABP) and D-Lactate typically seen during HS were decreased through HA. The representative TJ proteins including ZO-1, E-cadherin, and JAM-1 were found to be significantly down-regulated by HS, but sustained following HA. The ultrastructure of TJ was examined by TEM, which confirmed its protective effect on the intestinal barrier protection following HA. We also demonstrated that HA raised the intestinal levels of beneficial bacteria Lactobacillus and lowered those of the harmful bacteria Streptococcus through 16S rRNA gene sequencing. These findings suggest that HA with ORSP was proven to improve intestinal thermotolerance and the levels of protective gut microbiota against HS.

Penthorum chinense Pursh (P. chinense), a functional food, has been applied to protect the liver against alcohol-related fatty liver disease (ALD) for a long history in China. This study was designed to evaluate the ameliorative activity of the polyphenolic fraction in P. chinense (PGF) depending on the relief of ALD. The ALD mouse model was established by exposing the mice to a Lieber-DeCarli alcohol liquid diet. We found that PGF administration significantly ameliorated alcohol-induced liver injury, steatosis, oxidative stress, and inflammation in mice. Furthermore, alcohol-increased levels of the critical hepatic lipid synthesis proteins sterol regulatory element binding transcription factor (SREBP-1) and diacylglycerol o-acyltransferase 2 (DGAT2) were attenuated by PGF. Similarly, PGF inhibited the expression of the lipid transport protein very low-density lipoprotein receptor (VLDLR). Interestingly, PGF restored alcohol-inhibited expression of carnitine palmitoyltransferase 1 (CPT1) and peroxisome proliferator-activated receptor alpha (PPARα), essential fatty acid β-oxidation proteins. Mechanistic studies revealed that PGF protects against alcohol-induced hepatocyte injury and lipid deposition via the SIRT1/AMPK signaling pathway. In sum, this research clearly demonstrated the protective effects of PGF against ALD, which was mediated by activating SIRT1/AMPK pathways in hepatocytes. We provide a new theoretical basis for using P. chinense as a functional food in ALD.

As a medicine-food homology herb, Dendrobium spp. has versatile applications in modern medicine and food industry. Herein, an ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) based method was established for simultaneous quantification of six active components, including gigantol, erianin, naringenin, quercetin, rutin, and p-coumaric acid in Dendrobium spp., on the basis of optimized sample preparation, mass spectrometry conditions, and chromatography conditions. Sample extraction was carried out using methanol at a temperature of 60 °C, followed by separation on a T3 C18 column utilizing a gradient eluting program. The results demonstrated excellent linearity (r > 0.999) for the six active components within a specified concentration range. The average recovery rates ranged from 84.7 % to 106.9 %, and the precision (RSD) was within 7.4 %. The detection and quantification limits of this method ranged from 0.34 to 4.17 ng mL−1 and 1.12–13.91 ng mL−1, respectively. The established method demonstrates high accuracy and reliability and is applicable in practical sample detection. Different Dendrobium spp. exhibit specific variations in compound composition, with D. fimbriatum Hook. having a higher content of benzyl compounds and D. crystallinum. Rchb. f. having a higher content of flavonoids. This study provides experimental evidence for the quality and safety regulation of Dendrobium spp.

Summary: Deciphering how different behaviors and ultrasonic vocalizations (USVs) of rats interact can yield insights into the neural basis of social interaction. However, the behavior-vocalization interplay of rats remains elusive because of the challenges of relating the two communication media in complex social contexts. Here, we propose a machine learning-based analysis system (ARBUR) that can cluster without bias both non-step (continuous) and step USVs, hierarchically detect eight types of behavior of two freely behaving rats with high accuracy, and locate the vocal rat in 3-D space. ARBUR reveals that rats communicate via distinct USVs during different behaviors. Moreover, we show that ARBUR can indicate findings that are long neglected by former manual analysis, especially regarding the non-continuous USVs during easy-to-confuse social behaviors. This work could help mechanistically understand the behavior-vocalization interplay of rats and highlights the potential of machine learning algorithms in automatic animal behavioral and acoustic analysis.

Abstract Background Systemic immune‐inflammation index (SII) provides convincing evaluation of systemic immune and inflammatory condition in human body. Its correlation with prostate cancer (PCa) risk remains uncharted. The principal objective of this investigation was to elucidate the association between SII and the risk for PCa in middle‐aged and elderly males. Materials and Methods Analysis entailed multivariate linear and logistic regression, generalized additive model, and smoothing curve fitting using resource from 2007 to 2010 National Health and Nutrition Examination Survey (NHANES). To ascertain robustness and consistency of this association across different demographic strata, we conducted rigorous subgroup analyses and interaction tests. Results Among 3359 participants, those with elevated SII displayed higher total prostate‐specific antigen (tPSA) levels, higher risk for PCa, and lower free/total PSA (f/t PSA) ratio. Specifically, each unit increase of log2 (SII) was associated with a 0.22 ng/mL increase in tPSA (β: 0.22, 95% confidence intervals [CI] 0.05–0.38), a 2.22% decline in f/t PSA ratio (β: −2.22, 95% CI −3.20 to −1.23), and a 52% increased odds of being at high risk for PCa (odds ratio [OR]: 1.52, 95% CI 1.13–2.04). People in the top quartile of log2 (SII) exhibited 0.55 ng/mL increased tPSA (β: 0.55, 95% CI 0.19–0.90), 4.39% reduced f/t PSA ratio (β: −4.39, 95% CI −6.50 to −2.27), and 168% increased odds of being at high risk for PCa (OR: 2.68, 95% CI 1.32–5.46) compared to those in the bottom quartile. Conclusion Systemic immune and inflammatory condition, as represented by SII, is independently and positively associated with tPSA levels and the risk for PCa, as well as independently and negatively associated with f/t PSA ratio among middle‐aged and older US males. These findings may enhance the effectiveness of PCa screening in predicting positive biopsy results.

Abstract. Background:. The effect of bariatric surgery on type 2 diabetes mellitus (T2DM) control can be assessed based on predictive models of T2DM remission. Various models have been externally verified internationally. However, long-term validated results after laparoscopic sleeve gastrectomy (LSG) surgery are lacking. The best model for the Chinese population is also unknown. Methods:. We retrospectively analyzed Chinese population data 5 years after LSG at Beijing Shijitan Hospital in China between March 2009 and December 2016. The independent t-test, Mann-Whitney U test, and chi-squared test were used to compare characteristics between T2DM remission and non-remission groups. We evaluated the predictive efficacy of each model for long-term T2DM remission after LSG by calculating the area under the curve (AUC), sensitivity, specificity, Youden index, positive predictive value (PPV), negative predictive value (NPV), and predicted-to-observed ratio, and performed calibration using Hosmer-Lemeshow test for 11 prediction models. Results:. We enrolled 108 patients, including 44 (40.7%) men, with a mean age of 35.5 years. The mean body mass index was 40.3 ± 9.1 kg/m2, the percentage of excess weight loss (%EWL) was (75.9 ± 30.4)%, and the percentage of total weight loss (%TWL) was (29.1± 10.6)%. The mean glycated hemoglobin A1c (HbA1c) level was (7.3 ± 1.8)% preoperatively and decreased to (5.9 ± 1.0)% 5 years after LSG. The 5-year postoperative complete and partial remission rates of T2DM were 50.9% [55/108] and 27.8% [30/108], respectively. Six models, i.e., "ABCD", individualized metabolic surgery (IMS), advanced-DiaRem, DiaBetter, Dixon et al's regression model, and Panunzi et al's regression model, showed a good discrimination ability (all AUC >0.8). The "ABCD" (sensitivity, 74%; specificity, 80%; AUC, 0.82 [95% confidence interval [CI]: 0.74-0.89]), IMS (sensitivity, 78%; specificity, 84%; AUC, 0.82 [95% CI: 0.73-0.89]), and Panunzi et al's regression models (sensitivity, 78%; specificity, 91%; AUC, 0.86 [95% CI: 0.78-0.92]) showed good discernibility. In the Hosmer-Lemeshow goodness-of-fit test, except for DiaRem (P 0.05). The P values of calibration results of the "ABCD" and IMS were 0.07 and 0.14, respectively. The predicted-to-observed ratios of the "ABCD" and IMS were 0.87 and 0.89, respectively. Conclusion:. The prediction model IMS was recommended for clinical use because of excellent predictive performance, good statistical test results, and simple and practical design features.

Abstract Anxiety/stress-related disorders have been associated with multiple diseases, whereas a comprehensive assessment of the structure and interplay of subsequent associated diseases and their genetic underpinnings is lacking. Here, we first identify 136, out of 454 tested, medical conditions associated with incident anxiety/stress-related disorders attended in specialized care using a population-based cohort from the nationwide Swedish Patient Register, comprising 70,026 patients with anxiety/stress-related disorders and 1:10 birth year- and sex-matched unaffected individuals. By combining findings from the comorbidity network and disease trajectory analyses, we identify five robust disease clusters to be associated with a prior diagnosis of anxiety/stress-related disorders, featured by predominance of psychiatric disorders, eye diseases, ear diseases, cardiovascular diseases, and skin and genitourinary diseases. These five clusters and their featured diseases are largely validated in the UK Biobank. GWAS analyses based on the UK Biobank identify 3, 33, 40, 4, and 16 significantly independent single nucleotide polymorphisms for the link to the five disease clusters, respectively, which are mapped to several distinct risk genes and biological pathways. These findings motivate further mechanistic explorations and aid early risk assessment for cluster-based disease prevention among patients with newly diagnosed anxiety/stress-related disorders in specialized care.

We report two cases of tufted angioma with atypical clinical presentations in adults. Patient 1 was a 41-year-old male with painful red plaques on his neck for 2 years. Cutaneous examination showed dark red papules distributed in clusters on the red plaques (7 cm×3.5 cm in size) of the neck, tough texture and some pseudo-vesicular lesions. Laboratory tests revealed a platelet (PLT) count of 83×109/L and abnormal coagulation. Histopathology revealed nodular endothelial cell hyperplasia arranged in tufts and looked like "cannonball" appearance in the dermis and subcutaneous tissue. Immunohistochemical stainings of CD31 and CD34 were positive, and D2-40 was focally positive.Diagnosis: Tufted angioma. The patient refused the treatment with oral propranolol, but was still under follow-up. Patient 2 was a 30-year-old female with a brown nodule on the left dorsal foot, accompanied by pruritus and pain for over two months. Dermatological examination showed a brown nodule in a diameter of about 0.8 cm, with a hard and rough surface. Laboratory tests were normal in routine blood test, liver, kidney and coagulation functions, except elevations in IgG (23.70 g/L) and C3 (0.888 g/L), and ANA 1∶640(+). Histopathological analysis revealed compact arrangement of endothelial cells with tuft proliferation in the dermis. Immunohistochemical stainings of CD31 and CD34 were positive, and D2-40 was focally positive. Diagnosis was tufted angioma. Surgical resection was given.

Abstract Background Extrachromosomal circular DNAs (eccDNAs) exist in human blood and somatic cells, and are essential for oncogene plasticity and drug resistance. However, the presence and impact of eccDNAs in type 2 diabetes mellitus (T2DM) remains inadequately understood. Methods We purified and sequenced the serum eccDNAs obtained from newly diagnosed T2DM patients and normal control (NC) subjects using Circle-sequencing. We validated the level of a novel circulating eccDNA named sorbin and SH3‐domain‐ containing‐1circle97206791–97208025 (SORBS1circle) in 106 newly diagnosed T2DM patients. The relationship between eccDNA SORBS1circle and clinical data was analyzed. Furthermore, we explored the source and expression level of eccDNA SORBS1circle in the high glucose and palmitate (HG/PA)-induced hepatocyte (HepG2 cell) insulin resistance model. Results A total of 22,543 and 19,195 eccDNAs were found in serum samples obtained from newly diagnosed T2DM patients and NC subjects, respectively. The T2DM patients had a greater distribution of eccDNA on chromosomes 1, 14, 16, 17, 18, 19, 20 and X. Additionally, 598 serum eccDNAs were found to be upregulated, while 856 eccDNAs were downregulated in T2DM patients compared with NC subjects. KEGG analysis demonstrated that the genes carried by eccDNAs were mainly associated with insulin resistance. Moreover, it was validated that the eccDNA SORBS1circle was significantly increased in serum of newly diagnosed T2DM patients (106 T2DM patients vs. 40 NC subjects). The serum eccDNA SORBS1circle content was positively correlated with the levels of glycosylated hemoglobin A1C (HbA1C) and homeostasis model assessment of insulin resistance (HOMA-IR) in T2DM patients. Intracellular eccDNA SORBS1circle expression was significantly enhanced in the high glucose and palmitate (HG/PA)-induced hepatocyte (HepG2 cell) insulin resistance model. Moreover, the upregulation of eccDNA SORBS1circle in the HG/PA-treated HepG2 cells was dependent on generation of apoptotic DNA fragmentation. Conclusions These results provide a preliminary understanding of the circulating eccDNA patterns at the early stage of T2DM and suggest that eccDNA SORBS1circle may be involved in the development of insulin resistance.

Abstract Background Although EGFR-TKI resistance mechanisms in non-small cell lung cancer (NSCLC) have been extensively studied, certain patient subgroups remain with unclear mechanisms. This retrospective study analysed mutation data of NSCLC patients with EGFR-sensitive mutations and high programmed death-ligand 1 (PD-L1) expression or high TMB to identify primary resistance mechanisms. Methods Hybrid capture-based next-generation sequencing (NGS) was used to analyse mutations in 639 genes in tumor tissues and blood samples from 339 NSCLC patients. PD-L1 immunohistochemical staining was also performed on the same cell blocks. Molecular and pathway profiles were compared among patient subgroups. Results TMB was significantly higher in lung cancer patients with EGFR-sensitive mutations and high PD-L1 expression. Compared with the high-expression PD-L1 or high TMB and low-expression or TMB groups, the top 10 genes exhibited differences in both gene types and mutation rates. Pathway analysis revealed a significant mutations of the PI3K signaling pathway in the EGFR-sensitive mutation group with high PD-L1 expression (38% versus 12%, p

Detecting small slow targets on sea surface has always been a hot topic in radar target detection. Classical target detection methods based on single input mode are particularly prone to losing the phase information of the radar echo signal, which affects the detection performance of the radar. To solve the problem of phase information loss, a False alarm Control method of Multi-input Convolutional Neural Network (FC-MCNN) is proposed in this article. First, several classic Convolutional Neural Network (CNN) models are compared and analyzed. Then, a Multi-input Convolutional Neural Network (MCNN) is designed to extract more useful information from radar echo signal. Simultaneously, in order to improve the generalization performance of the model and control the false alarm probability, a controllable false alarm Support Vector Machine (SVM) is used to modify the final output module. In addition, the datasets are also preprocessed before being input into the proposed model. Finally, the performance of the proposed method is verified by the IPIX measured data sets. The results show that the proposed method has a higher detection probability and better computational performance than the traditional CNN detection methods.