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ObjectiveTo explore the clinical and prognostic characteristics of chronic kidney disease （CKD） patients with Pneumocystis jirovecii pneumonia （PJP）， thus facilitating the diagnosis and treatment of Pneumocystis jirovecii infections.MethodsWe retrospectively analyzed the clinical date of 22 CKD patients with PJP who were hospitalized in the First Affiliated Hospital with Nanjing Medical University and diagnosed by metagenomic next-generation sequencing （mNGS） from October 1， 2019 to October 31， 2023. Based on the prognosis， CKD patients with PJP were divided into the cured group （n=14） and death group （n=8）. The clinical characteristics， laboratory examination indicators， and disease treatment situations of the two groups of patients were compared.ResultsA total of 22 CKD patients were diagnosed with PJP， including 6 males （27.3%） and 16 females （72.7%）. The mean age was （57.1 ± 16.3） years. The primary underlying diseases were membranous nephropathy， immunoglobulin A nephropathy （IgAN）， lupus nephritis，antineutrophil cytoplasmic antibody （ANCA）-associated glomerulonephritis. The median time of PJP was 3 （2， 108） months after the diagnosis of nephropathy. Totally 16 （72.7%） patients developed type Ⅰ respiratory failure. All patients had a history of glucocorticoids or immunosuppressants use 3 months prior to PJP. CT findings included mixed ground-glass opacities type and nodular type （81.8%）. Lactate dehydrogenase （LDH） was elevated in all patients. The 1，3-β-glucan test was positive in 18 patients （81.8%）. Lymphocyte count was low in 16 patients （72.7%）. The cluster of differentiation 4 receptors （CD4） cell count averaged at 292.3 cells/μL， and 60.0% of the patients had CD4 cell count

Abstract Despite being increasingly adopted in various regions, the model of Hospital‐at‐home can still appear to be confusing to many healthcare workers. The authors examined and summarized the existing concepts and implementations of Hospital‐at‐home. How Hospital‐at‐home contrasts to traditional inpatient models were outlined.

The genome tagging project (GTP) plays a pivotal role in addressing a critical gap in the understanding of protein functions. Within this framework, we successfully generated a human influenza hemagglutinin-tagged sperm-specific protein 411 (HA-tagged Ssp411) mouse model. This model is instrumental in probing the expression and function of Ssp411. Our research revealed that Ssp411 is expressed in the round spermatids, elongating spermatids, elongated spermatids, and epididymal spermatozoa. The comprehensive examination of the distribution of Ssp411 in these germ cells offers new perspectives on its involvement in spermiogenesis. Nevertheless, rigorous further inquiry is imperative to elucidate the precise mechanistic underpinnings of these functions. Ssp411 is not detectable in metaphase II (MII) oocytes, zygotes, or 2-cell stage embryos, highlighting its intricate role in early embryonic development. These findings not only advance our understanding of the role of Ssp411 in reproductive physiology but also significantly contribute to the overarching goals of the GTP, fostering groundbreaking advancements in the fields of spermiogenesis and reproductive biology.

The newt genus Tylototriton is widely distributed in east, southeast, and south Asia. Previous studies have shown that basic surveys of this genus are far from comprehensive, and unknown species still exist within the group. In this study, we described a new species of this genus, Tylototriton gaowangjienensis sp. nov., from Gaowangjie National Nature Reserve in Hunan Province, China, based on evidence from molecular identification and morphological comparisons. Additionally, we conducted phylogenetic analysis of the genus to elucidate the taxonomic status of the new species. Based on combined mitochondrial 16S rRNA and ND2 gene sequences, the phylogenetic tree supported the new species as a member of the T. wenxianensis species subclade in the subgenus Yaotriton. It can be distinguished from its congeners by the combination of the following characteristics: (1) medium-sized body; (2) finger tips extending beyond the snout while forelimbs stretched forward; (3) tips of forelimbs and hindlimbs reaching and overlapping when folded towards the body; (4) snout edge round; (5) absence of small papillae in the male cloacal fissure; (6) dorsal ridges narrow, with width smaller than the eye diameter; (7) head length (HDL) greater than head width (HDW) (HDL/HDW = 1.04~1.22); (8) orange markings absence on the parotoid; (9) nodule-like warts on body sides continuous; (10) vomerine teeth not connected at the tip, extending to the occipital bone at the posterior end.

Objectives To assess the therapeutic effects and safety of Tongxie Yaofang (TXYF) granules vs placebo as an alternative treatment for diarrhoea-predominant irritable bowel syndrome (IBS-D). We hypothesised that TXYF would improve clinical responses among patients with IBS-D.Design A randomised, double-blind, placebo-controlled, phase II, superiority trial.Setting Outpatients attending the Fangshan Hospital, Beijing University of Chinese Medicine, Beijing, China.Participants 96 eligible participants included men and women ranging from late adolescence to middle adulthood (18–65 years), diagnosed with IBS-D according to the Rome IV criteria. In addition, they were required to have an irritable bowel syndrome symptom severity score (IBS-SSS) of at least 75.Interventions TXYF granules (3.7 g) twice daily (taken orally before meals) or placebo for 8 weeks.Primary and secondary outcomes The primary outcome was the response rate measured by the change in IBS-SSS compared with baseline at week 8. Secondary outcomes included stool frequency; stool consistency at weeks 4, 8 and 20; and quality of life, anxiety and depression at week 8; and safety was monitored throughout the trial.Results The TXYF and placebo groups each comprised 48 participants. The response rate was not significantly different at week 8 between the two groups (the unadjusted treatment effect estimate (intention-to-treat analysis) was 1.12 (95% CI (0.89, 1.41)), p=0.348). Both groups had a high and similar rate of symptom reduction (79.2% (38/48) vs 70.8% (34/48)). There were no statistically significant differences between the two groups on secondary outcomes, although both groups showed substantial improvements. Adverse events in the TXYF and placebo groups were one (sinus arrhythmia) and two (elevated transaminases, weakly positive faecal occult blood), respectively. No serious adverse events occurred.Conclusions Despite showing clinically meaningful improvements in IBS-D symptoms and a reasonable safety profile after 8 weeks, no significant differences were observed between the TXYF and placebo groups. This suggests that the severity of IBS-D symptoms in both treatment arms might have decreased over time, regardless of the treatment, and highlights the need to investigate the relationship between IBS-D and patient psychology. Future large-scale, rigorously designed trials with longer treatment and follow-up periods are essential to evaluate the therapeutic effects and safety of TXYF, and to explore the psychological factors.Trial registration number ISRCTN12453166.

Geographical accessibility is important for promoting health equity, and calculating it requires the locations of all existing healthcare facilities in a region. Authoritative location data collected by governments is accurate but mostly not publicly available, while point-of-interest (POI) data from online sources, such as Baidu Maps and AutoNavi Maps are easily accessible. However, the accuracy of the latter has not been thoroughly analyzed. Taking Baotou, a medium-sized city in China, as aneample, we assessed the suitability of using POI data for measuring geographic accessibility to healthcare facilities.We computedthe difference of geographic accessibility calculated based on POI data and that on authoritative data.Logistic regression and a multiple linear regression model was applied to identify factors related to the consistency between the two data sources. Compared to authoritative data, POI data exhibited discrepancies, with completeness of 54.9% and accuracy of 63.7%. Geographic accessibility calculated based on both data showed similar patterns, with good consistency for hospitals and in urban areas. However, large differences (>30 minutes) were shown in rural areas for primary healthcare facilities. The differences were small regarding to population- weighted average accessibility (with slight underestimation of 3.07 minutes) and population coverage across various levels of accessibility (with differences less than 1% of the population) for the entire area. In conclusion, POI data can be considered foruse in both urban areas and at the level of entire city; however, awareness should be raised in rural areas.

Background: Altered cerebral cortex’s structural organization has been found in individuals with betel quid dependence (BQD). However, the neurological underpinnings of the BQD-related abnormalities in cortical thickness and brain circuitry deficit are largely unknown. Objective: This study aimed to investigate potential abnormalities of brain circuitry in the cortical thickness of BQD individuals by applying the surface-based morphometry (SBM) method. Design: Cross-sectional study. Methods: High spatial resolution, three-dimensional T1-weighted structural imaging data were collected from 53 individuals with BQD and 37 healthy controls (HCs) who were similar to the BQD group in terms of age, sex, and educational level. The SBM method was applied to analyze the cortical thickness alterations in BQD-related areas. Independent-samples t -test was used to assess the cortical thickness difference between the two groups. Pearson correlation analysis was used to investigate the correlation between cortical thickness changes and clinical characteristics, including BQD scale scores and duration of BQD. Results: The BQD group had a higher cortical thickness than the HC group at the lateral orbitofrontal ( t = 4.703, p = 0.0028) and pars opercularis ( t = 3.602, p = 0.0403) clusters in the right cerebral hemisphere, with age, sex, and education duration as covariates ( p < 0.05, Monte Carlo). There were no significant differences in age, sex, or education duration-adjusted cortical thickness of the left cerebral hemisphere between BQD chewers and HCs ( p > 0.05, Monte Carlo). Correlation analysis revealed that the cortical thickness of the right pars opercularis was negatively correlated with the BQD duration ( r = −0.274, p = 0.047). The cortical thickness of the right lateral orbitofrontal cluster was not significantly correlated with Betel Quid Dependence Scale (BQDS) or BQD duration ( p > 0.05). Conclusion: This study demonstrated that BQD might be associated with changes in the orbitofrontal and pars opercularis cortical thickness, which may be related to the neurobiological basis of BQD.

The aim of this study was to explore the impacts of incorporating α-lipoic acid (LA) in a high-fat diet (HFD) on growth, lipid metabolism and mitochondrial function in Lateolabrax maculatus. A normal-fat diet (NFD, 10 % lipid), a high-fat diet (HFD, 16 % lipid) and three LA-added HFD (200, 400, or 600 mg kg−1 LA) were prepared and fed to five group of L. maculatus for 57 days. Supplementation of 400 mg kg−1 LA to the HFD improved growth performance and feed utilization. LA treatment reduced the lipids concentration in serum and liver. Moreover, application of 400 mg kg−1 LA in HFD notably decreased the activity of transaminases in serum. Liver oil red O staining results revealed the larger area of red lipid droplets in HFD group compared to the NFD group. Also, abdominal fat HE staining results showed larger adipocytes in the HFD group. Interestingly, LA application led to a reduction in the area of red lipid droplets and a decrease in the size of adipocytes. Furthermore, LA addition alleviated the HFD-induced oxidative stress as identified by enhanced mitochondrial citrate synthase, isocitrate dehydrogenase, α-ketoglutarate dehydrogenase, and succinate dehydrogenase activities. Meanwhile, LA administration induced the activation of mitochondrial biogenesis, and up-regulated the expression of autophagy-related genes. In conclusion, LA incorporation into HFD for L. maculatus promoted growth performance, enhanced liver mitochondrial function, and mitigated excessive fat accumulation in the liver.

Dragon’s blood (Resina Draconis) is the red resin of Dracaena spp, which has a variety of biological activities and pharmacological effects, including anti-thrombotic, anti-inflammatory, anti-bacterial, analgesic, anti-oxidant, anti-tumor, and immunosuppressive. In China, the main source of dragon’s blood is Dranaena Cochinchinensis (Lour.) S.C.Chen. A wide array of studies have speculated that the dragon’s blood derived from Dranaena Cochinchinensis (Lour.) S.C.Chen possesses cardiovascular protective effects. It has been reported that Chinese dragon’s blood can potentially alleviate and treat conditions such as coronary heart disease, myocardial infarction, and myocardial ischemia–reperfusion through its anti-inflammatory and antioxidant properties, which have not been systematically stated in previous reviews. Moreover, the precise underlying pharmacological mechanisms through which the Chinese dragon’s blood exhibits cardioprotective effects are not fully understood. Therefore, this article discusses the pharmacological action and biomolecular mechanism of dragon’s blood from Dranaena Cochinchinensis (Lour.) S.C.Chen and how it prevents and protects against cardiovascular diseases. The review article concludes with prospects for further application of dragon’s blood in respect to cardiovascular diseases.

Rhododendron Linnaeus, 1753, the largest genus of woody plants in the Northern Hemisphere, includes some of the most significant species in horticulture. Rhododendron ambiguum Hemsl, 1911, a member of subsection Triflora Sleumer 1947, exemplifies typical alpine Rhododendron species. The analysis of the complete chloroplast genome of R. ambiguum offers new insights into the evolution of Rhododendron species and enhances the resolution of phylogenetic relationships. This genome is composed of 207,478 base pairs, including a pair of inverted repeats (IRs) of 47,249 bp each, separated by a large single-copy (LSC) region of 110,367 bp and a small single-copy (SSC) region of 2,613 bp. It contains 110 genes: 77 protein-coding genes, 29 tRNAs, four unique rRNAs (4.5S, 5S, 16S, and 23S), with 16 genes duplicated in the IRs. Comparative analyses reveal substantial diversity in the Rhododendron chloroplast genome structures, identifying a fourth variant pattern. Specifically, four highly divergent regions (trnI-rpoB, ndhE-psaC, rpl32-ndhF, rrn16S-trnI) were noted in the intergenic spacers. Additionally, 76 simple sequence repeats were identified. Positive selection signals were detected in four genes (cemA, rps4, rpl16, and rpl14), evidenced by high Ka/Ks ratios. Phylogenetic reconstruction based on two datasets (shared protein-coding genes and complete chloroplast genomes) suggests that R. ambiguum is closely related to R. concinnum Hemsley, 1889. However, the phylogenetic positions of subsection Triflora Pojarkova, 1952 species remain unresolved, indicating that the use of complete chloroplast genomes for phylogenetic research in Rhododendron requires careful consideration. Overall, our findings provide valuable genetic information that will enhance understanding of the evolution, molecular biology, and genetic improvement of Rhododendron spieces.

Objective: This study aims to explore the relationship between different endometrial preparations and pregnancy outcomes among patients with regular ovulatory cycles in order to find the best endometrial preparation methods in the freeze–thaw embryo transfer (FET) cycle. Materials and Methods: This is a retrospective study to investigate FET pregnancy outcomes in women who had a regular menstrual cycle, were younger than 35 years old, and underwent a modified natural cycle (mNC), ovulation induction (OI), or a hormone replacement treatment (HRT) cycle. A total of 1071 frozen cycles were included for analysis. Results: The implantation rate and live birth rate (LBR) in the OI group show a significant difference when compared to the mNC and HRT groups (P < 0.01). After adjusting for confounding factors, the logistic regression analysis revealed that the number of embryos transferred, the embryo stage, and quality were significantly associated with clinical pregnancy rate and LBR. The LBR was additionally affected by the mode of the endometrial preparation; the OI cycle could increase LBR. Conclusions: Endometrial preparation methods affect the LBR in women with a regular menstrual cycle. The OI cycle had an advantage in the LBR of FET.

Background: With the outbreak of COVID-19 in China, a large number of COVID-19 patients are at risk of long COVID after recovery. The purpose of our research is to systematically review the existing clinical studies to understand the current prevalence and related risk factors of long COVID in COVID-19 patients in China. Methods: The protocol of this systematic review was registered on PROSPERO (CRD42024519375). We searched six electronic databases from 1st January 2020–1st March 2024. Literature screening, data extraction, and risk bias assessment were independently carried out by two reviewers. Quality of the included studies was evaluated by AHRQ and NOS. The meta-analysis was performed by R software 4.2.3 to derive the prevalence of long COVID and risk factors. Results: Overall, 50 studies with 65880 participants were included. The results showed that the prevalence of long COVID (with at least one symptom) among the COVID-19 patients was approximately 50 % (95 %Confidence Interval (CI) 42–58 %) in China. Although we conducted meta-regression and subgroup analysis, the heterogeneity of the study was high. But the Omicron BA.2 variant had a statistically significant effect on the prevalence of long COVID (P = 0.0004). The three most common symptoms of long COVID were fatigue (0.33, 95 %CI 0.28–0.39), cognitive decline (0.30, 95 %CI 0.14–0.46) and shortness of breath (0.29, 95 %CI 0.15–0.43). Patients with severe acute phase of COVID-19 (Odds Ratio (OR) 1.57, 95 % CI 1.39–1.77), combined 2 comorbidities (OR 1.80, 95 % CI 1.40–2.32), combined 3 comorbidities (OR 2.13, 95 % CI 1.64–2.77), advanced age (OR 1.02, 95 % CI 1.01–1.04), female (OR 1.58, 95 % CI 1.44–1.73) were the risk factors for long COVID prevalence. Conclusion: Current systematic review found that nearly half of COVID-19 patients may suffering from long COVID in China. Establishing a long COVID recovery-support platform and regular follow-up would help to long-term monitor and manage the patients, especially those high-risk population.