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Haoran Chu,&ast; Houming Zhu,&ast; Jiashu Ma, Yijia Jiang, Cuicui Cui, Xianxia Yan, Qin Li, Xinyan Zhang, Diancai Chen, Xianwei Li, Ranran Li Department of Psychiatry, Shandong Mental Health Center, Shandong University, Jinan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ranran Li, Department of Psychiatry, Shandong Mental Health Center, Shandong University, Jinan, Shandong, 250014, People’s Republic of China, Tel +86 18678777190, Email dtlrr113@126.comObjective: This paper aims to explore the expression characteristics of mitochondrial function-related genes in patients with first-episode schizophrenia (SCZ)and the correlation between differentially expressed genes and clinical metabolic indicators.Methods: Twenty patients with first-episode SCZ who had not taken antipsychotic drugs (patient group) and twenty healthy controls (control group) were included. Quantitative real-time PCR technology was used to detect the expression levels of genes related to mitochondrial quality control and oxidative phosphorylation in peripheral blood leukocytes, and metabolic indicators such as blood biochemistry and blood glucose were collected.Results: The gene expression levels of key genes related to mitochondrial function, PGC-1a, PARK2, and LC3B, in the patient group were significantly lower than those in the control group (P < 0.05). Correlation analysis showed that the expression level of PGC-1a gene in the patient group was negatively correlated with very low-density lipoprotein levels (r =− 0.451), and the expression level of PARK2 gene in the patient group was negatively correlated with uric acid levels (r =− 0.447).Conclusion: The expression levels of multiple key genes in the mitochondrial quality control and oxidative phosphorylation processes in patients with first-episode SCZ display a downward trend. The differentially expressed genes are correlated with the metabolic abnormalities of the patients, suggesting that mitochondrial dysfunction may be related to the high incidence of metabolic diseases in patients with SCZ.Keywords: first-episode, schizophrenia, drug naive, mitochondria dysfunction, metabolic indicators, metabolic indicators

Zhilang Qiu,1,2,&ast; Jun Ran,1,2,&ast; Yifan Yang,1,2,&ast; Yue Wang,1,2 Yang Zeng,1,2 Yinhui Jiang,1 Zuquan Hu,1 Zhu Zeng,1 Jian Peng1,2 1Key Laboratory of Infectious Immune and Antibody Engineering of Guizhou Province, Cellular Immunotherapy Engineering Research Center of Guizhou Province, School of Biology and Engineering/School of Basic Medical Sciences, Guizhou Medical University, Guiyang, Guizhou, 550025, People’s Republic of China; 2The Engineering Research Center of Health Medicine Biotechnology of Institution of Higher Education of Guizhou Province, Guizhou Medical University, Guiyang, Guizhou, 550025, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jian Peng; Zhu Zeng, Email jianpeng@gmc.edu.cn; zengzhu@gmc.edu.cnPurpose: The emergence of carbapenem-resistant Acinetobacter baumannii (CRAB) poses great difficulties in clinical treatment, and has been listed by the World Health Organization as a class of pathogens in urgent need of new antibiotic development. In our previous report, the novel antimicrobial peptide Cec4 showed great potential in decreasing the clinical CRAB biofilm, but its mechanism of action is still illusive. Therefore, in order to evaluate the clinical therapeutic potential of Cec4, it is necessary to explore the mechanism of how Cec4 decreases mature biofilms.Methods: Key genes involved in the removal of CRAB biofilms by Cec4 were analyzed using transcriptomics. Based on the results of the bioinformatics analysis, the CRISPR-Cas9 method was used to construct the deletion strain of the key gene. The pYMAb2 plasmid was used for the complementation strain construction. Finally, the roles of key genes in biofilm removal by Cec4 were determined by crystal violet staining, podocyte staining, laser confocal imaging, and MBC and MBEC50.Results: Combined with transcriptome analysis, we hypothesized that OmpH is a key gene involved in the removal of CRAB biofilms by Cec4. Deletion of the OmpH gene did not affect A. baumannii growth, but decreased A. baumannii capsule thickness, increasing biofilm production, and made biofilm-state A. baumannii more sensitive to Cec4.Conclusion: Cec4 decreases biofilms formed by CRAB targeting OmpH. Deletion of the OmpH gene results in an increase in biofilms and greater sensitivity to Cec4, which enhances the removal of A. baumannii biofilms by Cec4.Keywords: Acinetobacter baumannii, antibiofilm mechanism, antimicrobial peptide, OmpH

Hui Yin,&ast; Xiao Lin,&ast; Chun Gan, Han Xiao, Yaru Jiang, Xindi Zhou, Qing Yang, Wei Jiang, Mo Wang, Haiping Yang, Gaofu Zhang, Han Chan, Qiu Li Department of Nephrology, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Chongqing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Han Chan; Qiu Li, Chongqing Medical University, Chongqing, People’s Republic of China, Email chenhancq@126.com; liqiu809@hospital.cqmu.edu.cnPurpose: This study identified factors that identification of progression-predicting utility from steroid-sensitive nephrotic syndrome(SSNS) to steroid-dependent or frequently relapsing nephrotic syndrome (SDNS/FRNS) in patients and developed a corresponding predictive model.Patients and Methods: This retrospective study analyzed clinical data from 756 patients aged 1 to 18 years, diagnosed with SSNS, who received treatment at the Department of Nephrology, Children’s Hospital of Chongqing Medical University, between November 2007 and May 2023. We developed a shrinkage and selection operator (LASSO) - logistic regression model, which was visualized using a nomogram. The model’s performance, validity, and clinical utility were evaluated through receiver operating characteristic curve analysis, confusion matrix, calibration plot, and decision curve analysis.Results: The platelet-to-lymphocyte ratio (PLR) was identified as an independent risk factor for progression, with an odds ratio (OR) of 1.01 (95% confidence interval (CI) = 1.01– 1.01, p = 0.009). Additionally, other significant factors included the time for urinary protein turned negative (OR = 1.17, 95% CI = 1.12– 1.23, p < 0.001), estimated glomerular filtration rate(eGFR) (OR = 0.99, 95% CI = 0.98– 0.99, p < 0.001), low-density lipoprotein (OR = 0.90, 95% CI = 0.83– 0.97, p = 0.006), thrombin time (OR = 1.22, 95% CI = 1.07– 1.39, p = 0.003), and neutrophil absolute counts (OR = 1.10, 95% CI = 1.02– 1.18, p = 0.009). The model’s performance was assessed through internal validation, yielding an area under the curve of 0.78 (0.73– 0.82) for the training set and 0.81 (0.75– 0.87) for the validation set.Conclusion: PLR, eGFR, the time for urinary protein turned negative, low-density lipoprotein, thrombin time, and neutrophil absolute counts may be effective predictors for identifying SSNS patients at risk of progressing to SDNS/FRNS. These findings offer valuable insights for early detection and support the use of precision medicine strategies in managing SDNS/FRNS.Keywords: PLR, LASSO, SSNS, SDNS/FRNS, nomogram, prediction

Liuyi Huang,&ast; Xiaoxia Huang,&ast; Wei Zhou, Yanting Jiang, Haiqing Zhu, Yuehong Lao, Zhenjia Deng, Yuting Tang, Jian Wang, Xi Li Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Nanning, Guangxi, 530021, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xi Li; Jian Wang, Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, No. 6 Shuangyong Road, Nanning, Guangxi, 530021, People’s Republic of China, Email cicicats@126.com; wangjian616161@163.comObjective: Idiopathic inflammatory myopathies (IIM) are classified into four subgroups: dermatomyositis (DM), anti-synthetase syndrome (ASS), immune-mediated necrotizing myopathy (IMNM), and sporadic inclusion body myositis (sIBM); however, the role of LGALS3BP in IIM remains unclear. Our study aimed to explore the ability of LGALS3BP to discriminate between the IIM subtypes. The correlation between serum LGALS3BP levels, clinical features, and inflammatory markers in patients with IIM was also assessed.Methods: Based on the Gene Expression Omnibus (GEO) database, we used bioinformatics analysis to screen for overlapping extracellular protein-differentially expressed genes between any two groups of DM, ASS, IMNM, and healthy controls (HCs). This study enrolled 84 patients with IIM and 36 HCs, and participant baseline data and laboratory parameters were recorded. Serum LGALS3BP levels were measured using an enzyme-linked immunosorbent assay (ELISA).Results: Through bioinformatics analysis, LGALS3BP was selected as a potential biomarker for the identification of DM, ASS, IMNM, and HC. LGALS3BP expression decreased sequentially in the DM, ASS, IMNM, and HC groups, with significant differences among the two groups. The ELISA results were similar to those of the bioinformatics analysis; however, the difference in serum LGALS3BP expression between DM and ASS was not statistically significant. According to the receiver operating characteristic (ROC) curve analysis, using HC as the control group, the area under the curve (AUC) values of serum LGALS3BP levels for the diagnosis of IIM, DM, and ASS were > 0.8. In addition, patients with elevated serum LGALS3BP levels had a higher prevalence of interstitial lung disease (ILD). Serum LGALS3BP levels correlated with inflammatory markers.Conclusion: LGALS3BP is differentially expressed in DM, ASS, IMNM, and HC and may assist in assessing the severity of IIM-ILD.Keywords: LGALS3BP, idiopathic inflammatory myopathies, dermatomyositis, anti-synthetase syndrome, immune-mediated necrotizing myopathy, interstitial lung disease

Haimiti Abudouaini,1 Junsong Yang,1 Meng Li,2 Pingzheng Zhang,2 Kaiyuan Lin,1 Yonghong Jiang,3 Kongjiang Tao,3 Hong Zhang2 1Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi, 710054, People’s Republic of China; 2Department of Ultrasound Medical Center, Honghui Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi, 710054, People’s Republic of China; 3Department of Computed Tomography, Honghui Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi, 710054, People’s Republic of ChinaCorrespondence: Hong Zhang, Department of Ultrasound Medical Center, Honghui Hospital, Xi’an Jiaotong University, No. 76, Nanguo Road, Beilin District, Xi’an, Shaanxi, 710054, People’s Republic of China, Email 254972342@qq.comObjective: To explore the preliminary application value of real-time ultrasound-guided combined with CT monitoring in percutaneous cervical disc puncture injection for diagnostic trials.Methods: Sixty patients with suspected cervical discogenic dizziness undergoing percutaneous cervical disc puncture between January 2023 and February 2024 were randomly divided into two groups: real-time ultrasound-guided combined with CT monitoring and CT-guided alone. The groups were compared for pre-puncture positioning time, total puncture process time, number of CT exposures, and complications. Subsequent treatment and medications were consistent between the two groups.Results: Sixty patients were divided into the the real-time US-guided combined with CT monitoring group (n=30) and the CT-guided group (n=30). Pre-puncture positioning time in the real-time US-guided combined with CT monitoring group was shorter than that in the CT-guided group, but there was no statistical difference between the two groups (P> 0.05). The total puncture process time and the number of CT exposures in the real-time US-guided combined with CT monitoring group were smaller than those in the CT-guided group, and there was a statistical difference between the two groups (P< 0.05). Two cases of hematoma appeared in CT guidance alone, and no hematoma appeared in the real-time US-guided combined with CT monitoring group.Conclusion: Real-time ultrasound-guided combined with computed tomography monitoring in percutaneous cervical disc puncture is a rapid, visible, safe, and effective method.Keywords: real-time ultrasound guidance, CT guidance, cervical disc puncture diagnostic trial, cervical discogenic dizziness, cervical spine disease

Andie MacNeil,1,2 Aneisha Taunque,2 Sarah N Leo,1 Grace Li,3 Margaret de Groh,4 Ying Jiang,4 Esme Fuller-Thomson1,2 1Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada; 2Institute for Life Course and Aging, University of Toronto, Toronto, Ontario, Canada; 3Department of Sociology, University of Victoria, Victoria, British Columbia, Canada; 4Applied Research Division, Center for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, CanadaCorrespondence: Esme Fuller-Thomson, Institute for Life Course & Aging, Factor-Inwentash Faculty of Social Work Cross-Appointed to Faculties of Medicine & Nursing, University of Toronto, 246 Bloor St. West, Toronto, ON, M5S 1V4, Canada, Tel +1 (416) 978-3269, Fax +1 (416) 978-7072, Email esme.fuller.Thomson@utoronto.caBackground: Individuals with migraine are recognized to have a heightened risk of depression compared to the general population. The COVID-19 pandemic and associated public health restrictions exacerbated several known risk factors for depression, but limited longitudinal research has examined the impact of the pandemic on the mental health of people with migraine.Aim: To examine the cumulative incidence of depression and recurrent depression among older adults with migraine, and to identify factors associated with depression among older adults with migraine during the pandemic.Methods: Data came from four waves of the Canadian Longitudinal Study on Aging’s comprehensive cohort (n=2181 with migraine). The outcome of interest was a positive screen for depression based on the CES-D-10 during the autumn of 2020. Bivariate and multivariate logistic regression analyses were conducted.Results: Older adults with migraine, both with and without a history of depression, experienced increases in depression when compared to pre-pandemic levels, and when compared to older adults without migraine. The risk of incident and recurrent depression was higher among those who felt lonely and those who experienced an increase in family conflict during the pandemic. The risk of incident depression only was higher among those who experienced difficulty accessing healthcare and those who experienced other family challenges, such as increased caregiving responsibilities. The risk of recurrent depression only was higher among those who felt left out socially, those with functional limitations, and those whose income did not satisfy their basic needs.Conclusion: Targeted interventions are needed to support the mental health of older adults with migraine.Keywords: migraine, depression, COVID-19, older adults, CLSA

Haiming Yan,1– 3,&ast; Suling Chen,1,2,&ast; Xinrui Gao,1,2,&ast; Yuanhui Jiang,1,2 Guangyu Liang,1,2 Jie Peng,1,2 Shaohang Cai1,2 1Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China; 2State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China, Ministry of Education; Guangdong Provincial Key Laboratory of Viral Hepatitis Research; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology, Guangzhou, People’s Republic of China; 3Department of Infectious Diseases, The First People’s Hospital of Foshan, Foshan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jie Peng; Shaohang Cai, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, People’s Republic of China, Email pjie138@163.com; shaohangcai@foxmail.comBackground: Metabolic disorders and immunosenescence increase the risk of complications in people living with HIV (PLWH), affecting mortality and quality of life. However, their relationship remains unclear.Methods: Participants were grouped by median TyG index, and logistic regression identified baseline independent factors of a high TyG index at Week 24. The association of the TyG index for hepatic steatosis was determined using ROC curves. We also explored correlations between the TyG index and aging markers, including CD4/CD8 ratio and CD8+ T cells and evaluated health-related quality of life (HRQoL).Results: A total of 203 PLWH were included in the study. We observed that PLWH in high TyG group tended to be older (P< 0.001), have greater body weight (P< 0.001), higher ALT levels (P=0.021), and increased low-density lipoprotein levels (P=0.001). ROC analysis revealed that TyG index was closely associated with hepatic steatosis at Week 52 (AUC=0.743) and Week 104 (AUC=0.728). Moreover, a higher TyG index was positively correlated with CD8+ T cell counts, while patients in the high TyG group had lower CD4/CD8 ratios at Week 52 and Week 104. Poorer mental health was observed in patients with CD8+ T cell counts ≥ 1000 and a high TyG index. Multivariate analysis further identified baseline older age (OR=1.108, P=0.002), elevated cholesterol (OR=3.407, P< 0.001), and low HDL (OR=0.003, P< 0.001) as factors associated with a high TyG index at Week 24.Conclusion: The TyG index is closely linked to metabolic disorders and immunosenescence in PLWH. It offers a basis for personalized treatment strategies, improving physical and mental health and reducing complication risks.Keywords: HIV/AIDS, triglyceride-glucose index, metabolic disorders, immunosenescence, hepatic steatosis

Yunqing Jiang,1,&ast; Haowen Qi,2,&ast; Mingjuan Wang,1 Kai Chen,3 Chen Chen,1 Haifeng Xie2 1Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases, Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, People’s Republic of China; 2Department of Prosthodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases, Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, People’s Republic of China; 3Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, School of Environmental Science and Engineering, Nanjing University of Information Science and Technology, Nanjing, 210044, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Chen Chen, Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases, Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, People’s Republic of China, Tel +8625 69 593 031, Fax +8625 86 516 414, Email ccchicy@njmu.edu.cn Haifeng Xie Department of Prosthodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases (Nanjing Medical University), Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, People’s Republic of China, Tel +8625 69 593 081, Fax +8625 86 516 414, Email hfxie@njmu.edu.cn; xhf-1980@126.comPurpose: Based on nanomedicine strategies, this study employed cucurbit[7]uril (Q[7]) as the macromolecular carrier to synthesize nanocomplex drug delivery system for chlorogenic acid (CGA). The nanocomplex drug delivery system is intended to overcome the unsatisfactory biocompatibility and bioavailability of CGA and realizing its potential role in long-term osteoporosis (OP) medication.Methods: The nanocomplex was synthesized by the reflux stirring method. The chemical structure of the nanocomplex was characterized by Fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), X-ray diffraction analysis (XRD), UV-visible spectrophotometry (UV-vis), zeta potential analysis and transmission electronic microscope (TEM). The Cell Counting Kit-8 (CCK-8) assay, Live/Dead staining assay, and cytoskeleton staining were conducted to testify the biocompatibility of the nanocomplex. The release assay, Ferric Reducing Ability of Plasma (Frap) assay and Reactive oxygen species (ROS) staining were implemented to evaluate the release profile of CGA as well as its remaining antioxidative levels.Results: CGA and Q[7] formed hydrogen bonding through an exclusion interaction, with the binding ratio more than 1:1. The nanocomplex had a crystalline and spherical-like structure and improved thermal stability. The nanocomplex demonstrated better biocompatibility than free CGA. The release profile of CGA from the nanocomplex was much steadier, and 70% of CGA was released in 5 days. The CGA released from the nanocomplex maintained its antioxidative properties at high levels and effectively eliminated the accumulated ROS in MC3T3-E1 cells under oxidative stress.Conclusion: Q[7] has been demonstrated to be an ideal nanocarrier for CGA and the nanocomplex delivery system holds the potential for the long-term medication strategy of OP. Keywords: Osteoporosis medication, Chlorogenic acid, Cucurbit[n]uril, Nano drug delivery system, Chemical analysis

Yizi Jiang,1 Min Jia2 1First Clinical Medical College, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, People’s Republic of China; 2Department of Dermatology, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, People’s Republic of ChinaCorrespondence: Min Jia, Department of Dermatology, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, People’s Republic of China, Tel +86 13985033118, Email 15685156561@163.comBackground: Because of its possible significance in metabolic diseases, the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) has garnered attention as a novel and trustworthy lipid biomarker. Psoriasis may be linked to metabolic problems and obesity, according earlier research. Uncertainty surrounds the relationship between NHHR and the onset of psoriasis, though. The primary aim of this investigation was to examine the relationship between NHHR and psoriasis.Patients and methods: This cross-sectional analysis used data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2009 and 2014. The association between psoriasis and NHHR was examined using multivariate logistic regression, and smoothed curve fitting was done to explore the non-linear relationship. Furthermore, Subgroup and sensitivity studies were performed in order to confirm the robustness of the findings.Results: Psoriasis and NHHR were shown to be positively correlated in 15,951 adult individuals who were at least 20 years old. Psoriasis risk rose by 7% for each unit increase in NHHR [1.07 (1.01, 1.14)]. Individuals in the highest NHHR tertile were 39% more likely compared to those in the bottom tertile to have psoriasis [1.39 (1.09, 1.78)]. Across subgroups, this favorable connection remained consistent.Conclusion: Elevated NHHR levels are positively correlated with an upsurge chance of psoriasis in the adult population in the United States. The significance of NHHR as an indication for early psoriasis risk assessment is shown by this study.Keywords: non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio, psoriasis, lipids, NHANES, cross-sectional study

Letao Zhu,1 Yanfeng Li,1 Qingshi Zhao,1 Changyu Li,1 Zongbi Wu,2 Youli Jiang1 1Department of Neurology, People’s Hospital of Longhua, Shenzhen, 518109, People’s Republic of China; 2Nursing Department, Shenzhen Traditional Chinese Medicine Hospital, The Fourth Clinical Medical School of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, 518033, People’s Republic of ChinaCorrespondence: Youli Jiang, Department of Neurology, People’s Hospital of Longhua, No. 38, Jinglong Jianshe Road, Longhua District, Shenzhen, Tel +8618545403739, Fax +86 27741585-8500, Email h2362120381@163.com Zongbi Wu, Nursing Department, Shenzhen Traditional Chinese Medicine Hospital, The Fourth Clinical Medical School of Guangzhou University of Chinese Medicine, No. 1, Fuhua Road, Futian District, Shenzhen, People’s Republic of China, Tel +8615384435576, Fax +86 0755-88359899, Email wuzongbi2016@126.comBackground: Acute ischemic stroke (AIS) is increasingly affecting younger populations, necessitating prompt thrombolytic therapy within a narrow therapeutic window. Pre-hospital delays are prevalent, particularly in China, yet targeted research on the youth population remains scarce.Methods: In this retrospective cohort study, data from AIS patients aged 18– 50 admitted to Longhua District People’s Hospital, Shenzhen from December 2021 to December 2023 were analyzed using XGBoost and Random Forest machine learning algorithms, coupled with SHAP visualization, to identify factors contributing to pre-hospital delays.Results: Among 1954 AIS patients, 528 young patients were analyzed. The median time to hospital arrival was 8.34 hours, with 82.0% experiencing delays. Analysis of different age subgroups showed that young patients aged 36– 50 years old had a higher delay rate than patients under 36 years old. Machine learning algorithms identified stroke awareness, age, TOAST classification, ambulance arrival, dysarthria, mRS on admission, dizziness, wake-up stroke, etc. as important determinants of delay.Conclusion: This study highlights the necessity of machine learning in identifying delay risk factors in young stroke patients. Enhanced public education, particularly regarding stroke symptoms and the use of emergency services, is crucial for reducing pre-hospital delays and improving patient outcomes.Keywords: acute ischemic stroke, onset-to-door time, young adults, machine learning, emergency medical services

Yingli Wang,1,2,&ast; Yalin Jiang,2,&ast; Meiling Xie,1,2,&ast; Bin Qi,2 Kunpeng Pu,2 Wenjie Du,2 Qingqing Zhang,2 Mengmeng Ma,2 Ziyong Chen,2 Yongxia Guo,2 Hui Qian,2 Kaiqin Wang,2 Tulei Tian,2 Lin Fu,3 Xiaofei Zhang2 1Bengbu Medical University Graduate School, Bengbu, Anhui, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, The Affiliated Bozhou Hospital of Anhui Medical University, Bozhou, Anhui, People’s Republic of China; 3Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Lin Fu, Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, People’s Republic of China, Tel +86 551 6516 7923, Email fulindev@126.com Xiaofei Zhang, Department of Respiratory and Critical Care Medicine, The Affiliated Bozhou Hospital of Anhui Medical University, Bozhou, Anhui, 236800, People’s Republic of China, Email zhangxiaofeibz@163.comBackground: Leucine-rich α-2 glycoprotein 1 (LRG1) is associated with various inflammatory lung diseases. Nevertheless, the connection between LRG1 and adult community-acquired pneumonia (CAP) individuals was still not well understood. Through a prospective cohort study, the correlations of serum LRG1 with severity and prognosis were evaluated in CAP patients.Methods: The study encompassed 327 patients who received the diagnosis of CAP. We collected fasting venous blood and clinical features. Serum LRG1 was detected by ELISA. CAP severity was assessed using various scoring systems. The prognostic outcomes were observed through follow-up visits.Results: The level of serum LRG1 at admission was gradually increased with CAP severity scores. Serum LRG1 level shown positive associations with inflammatory indices, including C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6). Linear and logistic regression analyses suggested that serum LRG1 at admission was positively associated with severity scores and the risk of death in CAP patients. Serum LRG1 in combination with CAP severity scores significantly increased the predictive powers for severity and death compared with single serum LRG1 or severity scores.Conclusion: The study revealed positive connections of serum LRG1 levels with severity and poor prognosis in CAP patients, suggesting LRG1 partakes into the physiological processes of CAP. Serum LRG1 may be regarded as a potential biomarker in predicting the severity and death among CAP patients.Keywords: community-acquired pneumonia, LRG1, severity, outcomes, cohort study

Yanyan Jiang,1 Zhengzheng Chen,1 Huoyang Lv,2 Lihua Jiang,1 Zhiyuan Fan3 1Medical Laboratory Center, Tongxiang First People’s Hospital, Jiaxing, Zhejiang, People’s Republic of China; 2Medical Laboratory Center, Zhejiang Provincial People’s Hospital, Hangzhou, Zhejiang, People’s Republic of China; 3Department of Emergency Medicine, Tongxiang First People’s Hospital, Jiaxing, Zhejiang, People’s Republic of ChinaCorrespondence: Zhiyuan Fan, Department of Emergency Medicine, Tongxiang First People’s Hospital, Jiaxing, Zhejiang, People’s Republic of China, Email fanzhiyuan19880916@126.comBackground: Magnusiomyces capitatus (M. capitatus) is a dimorphic opportunistic fungus that is a rare yeast and rarely reported in Asia. Owing to the absence of established clinical breakpoints, the treatment of this fungus poses challenges.Case Presentation: We report a rare case of a young, non-immunocompromised man with cerebral palsy, spinal deformity, and pulmonary M. capitatus infection. The patient’s condition improved after treatment with voriconazole and became stable.Conclusion: M. capitatus infection is commonly associated with hematologic tumors and compromised immunity. Reports of M. capitatus infection in patients with non-immunocompromised host are uncommon. Insufficient understanding of these fungi may lead to underdiagnosis of fungal infection and clinical misdiagnosis, potentially resulting in delayed treatment and increased mortality.Keywords: invasive fungal infection, Magnusiomyces capitatus, MALDI-TOF MS, ITS, cerebral palsy, spinal deformity

Bin Liu,&ast; Bingtian Zhao,&ast; Yan Yin, Yan Jiang, Xue Feng, Lei Wang, Liang Zhai, Guangxin Liu, Dongsheng Shi, Jianwen Qin Department of Respiratory and Critical Medicine, Tianjin Chest Hospital, Tianjin, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Dongsheng Shi; Jianwen Qin, Tianjin Chest Hospital, No. 261, Taierzhuang South Road, Jinnan District, Tianjin, 300051, People’s Republic of China, Email shi_ds@126.com; qinjianwen2005@aliyun.com; 5020200603@nankai.edu.cnPurpose: DNA methylation plays a regulatory role in the oncogenesis and tumor progression and is valuable in the diagnosis and prognosis of cancer. While circulating tumor DNA (ctDNA) is widely used in the detection of oncogenic mutations and the guidance of treatment in advanced non-small cell lung cancer (NSCLC), studies of ctDNA methylation remains insufficient. We aim to investigate the methylation profiles of ctDNA in patients with advanced NSCLC undergoing EGFR-tyrosine kinase inhibitor (EGFR-TKI) therapy and to discover novel biomarkers with predictive or prognostic value.Patients and Methods: We recruited 49 patients with EGFR-mutated advanced NSCLC undergoing EGFR-TKI as first-line treatment. Utilizing next-generation sequencing, we examined the somatic mutations and methylation signatures within the tumor-associated genomic regions of ctDNA from pre-treatment blood. Subsequently, we explored the association of these molecular features with the patients’ response to therapy and their progression-free survival (PFS).Results: Genomic mutation profiling revealed no significant association of PFS or best overall response (BOR) and ctDNA status. Evaluation of ctDNA methylation showed a negative correlation between the methylation of small nucleolar RNA (snoRNA) genes and PFS (R=− 0.31, P=0.043). Furthermore, high-level methylation of SNORD3F was associated with poorer PFS (mPFS 346d vs 243d, HR 0.49, 95% CI 0.24– 0.93, P=0.029).Conclusion: Our study explored the prognostic value of ctDNA methylation in patients with advanced NSCLC undergoing targeted therapies and first revealed the predictive role of SNORD3F.Keywords: ctDNA, EGFR, DNA methylation, lung cancer, snoRNA, SNORD3F

Shuqi Gao,1,2,&ast; Zhe Sui,3,&ast; Qian Jiang,1,2 Yueyao Jiang1 1Department of Pharmacy, China–Japan Union Hospital of Jilin University, Changchun, Jilin Province, 130033, People’s Republic of China; 2School of Pharmacy, Jilin University, Changchun, Jilin Province, 130021, People’s Republic of China; 3Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, 130033, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yueyao Jiang, Department of Pharmacy, China–Japan Union Hospital of Jilin University, Changchun, Jilin Province, 130033, People’s Republic of China, Tel +86 13844817007, Email jyy0705@jlu.edu.cnAbstract: Niosomes are key nanocarriers composed of bilayer vesicles formed by non-ionic surfactants and cholesterol, offering advantages such as high physicochemical stability, biodegradability, cost-effectiveness, and low toxicity. This review discusses their significant role in drug delivery, including applications in anticancer therapy and vaccine delivery. It also highlights the impact of non-ionic surfactants on niosome formation, drug delivery pathways, and protein corona formation—a relatively underexplored topic. Furthermore, the application of artificial intelligence in optimizing niosome design and functionality is examined. Future research directions include enhancing formulation techniques, expanding application scopes, and integrating advanced technologies. This review provides comprehensive insights and practical guidance for advancing niosome-based drug delivery systems. Keywords: niosomes, non-ionic surfactant, drug delivery systems, niosome functionalization

Yueyao Jiang,1,* Chengran Wang,2,* Chuancheng Zu,3,* Xin’ao Rong,2 Qian Yu,1 Jinlan Jiang2 1Department of Pharmacy, China–Japan Union Hospital of Jilin University, Changchun, Jilin Province, 130033, People’s Republic of China; 2Department of Scientific Research Center, China–Japan Union Hospital of Jilin University, Changchun, Jilin Province, 130033, People’s Republic of China; 3China–Japan Union Hospital of Jilin University, Changchun, Jilin Province, 130033, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qian Yu, Department of Pharmacy, China–Japan Union Hospital of Jilin University, No. 126, Xiantai Street, Changchun, Jilin Province, 130033, People’s Republic of China, Email yuqian@jlu.edu.cn Jinlan Jiang, Department of Scientific Research Center, China–Japan Union Hospital of Jilin University, No. 126, Xiantai Street, Changchun, Jilin Province, 130033, People’s Republic of China, Email jiangjinlan@jlu.edu.cnAbstract: Given the global prevalence of prostate cancer in men, it is crucial to explore more effective treatment strategies. Recently, immunotherapy has emerged as a promising cancer treatment due to its unique mechanism of action and potential long-term effectiveness. However, its limited efficacy in prostate cancer has prompted renewed interest in developing strategies to improve immunotherapy outcomes. Nanomedicine offers a novel perspective on cancer treatment with its unique size effects and surface properties. By employing targeted delivery, controlled release, and enhanced immunogenicity, nanoparticles can be synergized with nanomedicine platforms to amplify the effectiveness of immunotherapy in treating prostate cancer. Simultaneously, nanotechnology can address the limitations of immunotherapy and the challenges of immune escape and tumor microenvironment regulation. Additionally, the synergistic effects of combining nanomedicine with other therapies offer promising clinical outcomes. Innovative applications of nanomedicine include smart nanocarriers, stimulus-responsive systems, and precision medicine approaches to overcome translational obstacles in prostate cancer immunotherapy. This review highlights the transformative potential of nanomedicine in enhancing prostate cancer immunotherapy and emphasizes the need for interdisciplinary collaboration to drive research and clinical applications forward. Keywords: prostate cancer, nanomedicine, immunotherapy, TME

Yan Jiang,1,&ast; Baolin Luo,2,&ast; Wen Lu,1 Yaqin Chen,1 Yanchun Peng,2 Liangwan Chen,3,4 Yanjuan Lin2,3 1School of Nursing, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China; 2Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, Fujian, People’s Republic of China; 3Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, People’s Republic of China; 4Fujian Provincial Special Reserve Talents Laboratory, Fuzhou, Fujian, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Liangwan Chen, Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, People’s Republic of China, Email fjxhlwc@163.com Yanjuan Lin, Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, Fujian, People’s Republic of China, Email fjxhyjl@163.comPurpose: The Aggregate Index of Systemic Inflammation (AISI) has emerged as a novel marker for inflammation and prognosis, but its role in patients with acute myocardial infarction has not been studied. Therefore, this study aimed to investigate the impact of different AISI levels on the clinical outcomes of patients with acute myocardial infarction.Patients and Methods: This study was a retrospective study, including 1044 patients with acute myocardial infarction (AMI) who were treated at the Fujian Medical University Affiliated Union Hospital, China from May 2017 to December 2022. The patients were divided into high and low AISI groups based on the median value (Q1 Group, ≤ 416.15, n=522; Q2 Group, ≥ 416.16, n=522), and the differences in baseline characteristics and clinical outcomes between the two groups were analyzed. The primary outcome included major adverse cardiovascular and cerebrovascular events (MACCEs), while the secondary outcomes included contrast-induced nephropathy (CIN) risk and all-cause rehospitalization rate.Results: The findings of the single-factor analysis suggest that a significant association between high AISI levels and the occurrence of MACCEs in AMI patients. After adjusting for confounding factors, the results indicated that compared to Q1, patients in the Q2 group had a higher risk of all-cause mortality [adjusted odds ratio (aOR) 4.64; 95% CI 1.37– 15.72; p=0.032], new-onset atrial fibrillation (aOR 1.75; 95% CI 1.02– 3.00; p=0.047), and CIN (aOR 1.75; 95% CI 1.02– 3.01; p=0.043), with all differences being statistically significant.Conclusion: In the population of AMI patients, an elevated AISI level is significantly associated with an increased risk of cardiovascular death and can serve as an early marker for adverse prognosis.Keywords: acute myocardial infarction, inflammation index, clinical outcomes, MACCEs

Jia Zhang,1 Zhijian Wang,1 Yushan Jiang,1 Dan Zhang,2 Wanyan Den,3 Danni Wang,1 Jiayi Peng,1 Jiajun Li,4,&ast; Wenxiang Huang1,&ast; 1Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 2Department of Emergency and Critical Care, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 3Department of Pathogenic Biology, College of Basic Medicine, Chongqing Medical University, Chongqing, 400016, People’s Republic of China; 4Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wenxiang Huang, Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China, Email wenxiang_huang@163.comAbstract: Streptococcus pyogenes, also known as Group A Streptococcus (GAS), can cause severe invasive diseases with high fatality rates. We report a case of necrotizing fasciitis and myositis complicated by Streptococcal Toxic Shock-Like Syndrome (STSS) caused by the invasive emm 22/ST46 strain of Streptococcus pyogenes in China. A previously healthy 57-year-old Chinese Canadian man presented with right calf pain and ulceration following a hike in the Gobi Desert, which progressed to unconsciousness and severe infection. Despite initial treatment, his condition deteriorated, leading to his transfer to our intensive care unit. Metagenomic Next-Generation Sequencing identified Streptococcus pyogenes, and antimicrobial susceptibility testing revealed resistance to erythromycin, tetracycline, and clindamycin. Despite broad-spectrum antimicrobial therapy, debridement, and supportive measures, the patient’s condition necessitated amputation of the right lower limb. He recovered and was discharged from the hospital on Day 43. Whole-genome sequencing of the isolate identified 15 multiple virulence factors. Phylogenetic analysis revealed that the closest relative of the isolate was a strain identified in China. This case underscores the importance of early recognition and treatment of invasive GAS infections to prevent severe outcomes, and we should pay attention to invasive emm 22/ST46 GAS infections in China.Keywords: group A Streptococcus, streptococcal toxic shock-like syndrome, amputation, superantigens, metagenomic next-generation sequencing

Xiaoyi Liu,1,&ast; Zhiwei Lin,2,&ast; Yiwen Li,3 Zhiwei Zhong,1 Aiwu Wu,1 Yueting Jiang3 1KingMed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, People’s Republic of China; 2Department of Clinical Laboratory of the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, People’s Republic of China; 3Department of Clinical Laboratory, the Key Laboratory of Advanced Interdisciplinary Studies Center, the First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, Guangzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Aiwu Wu; Yueting Jiang, Email aiwwu66@163.com; jyting8899@126.comPurpose: The clinical distribution characteristics of nontuberculous mycobacteria (NTM) in general hospital were explored to guide the clinical diagnosis and treatment of NTM infection.Methods: Samples with positive mycobacterium culture in the First Affiliated Hospital of Guangzhou Medical University were collected and identified through PCR. Phenotypic drug sensitivity experiments were conducted on 44 Mycobacteroides abscessus isolated from clinical departments with broth microdilution method, and rrl, rrs and erm (41) genes associated with drug resistance were detected.Results: From September 2020 to July 2023, 314 mycobacterium-positive isolates were separated from patients in the First Affiliated Hospital of Guangzhou Medical University, with 147 (46.8%) NTM isolates were included in our study. The samples were respiratory tract specimens mainly, with 64% bronchoalveolar lavage fluid. Of 144 cases identified, samples were from 133 patients (60 males and 73 females; gender ratio of 0.82:1). NTM was mainly isolated from the people aged 40 and above, especially females (χ2 = 10.688, P = 0.014). M. abscessus (61, 42.36%), M. intracellulare (35, 24.31%) were the two most NTMs in this hospital. Clinical strains of M. abscessus exhibited high resistance to antibiotics, except for cefoxitin (31.8%), linezolid (25.0%), amikacin (0%), and clarithromycin (18.2%). Among 8 strains of M. abscessus with clarithromycin acquired resistance, just 4 strains (50.0%) showed mutations (A2270G, A2271G) in rrl gene, but a new mutation (C2750T) was detected in 1 strain. Among 14 strains of M. abscessus with clarithromycin-induced resistance, 13 (93.0%) strains had T28 erm (41) gene and 1 (7.0%) strain had C28 erm (41) gene.Conclusion: M. avium–intracellulare complex was gradually becoming predominant strain in Guangzhou area. The resistant situation of M. abscessus in general hospital had shown severe. Potential mutation in rrl gene associated with clarithromycin acquired resistance of M. abscessus were found, but drug-resistant mechanism remained unclear.Keywords: nontuberculous mycobacterium, drug resistance, clarithromycin, Mycobacteroides abscessus

Huifang Cai,1,&ast; Zongbi Wu,2,&ast; Jieling Xu,1 Taifen Wang,2 Yanfeng Li,3 Youli Jiang,3 Mingming Xu2 1Guangzhou University of Chinese Medicine Fourth Clinical Medical College, Shenzhen, People’s Republic of China; 2Nursing Department, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, People’s Republic of China; 3Department of Neurology, People’s Hospital of Longhua, Shenzhen, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Youli Jiang; Mingming Xu, Email h2362120381@163.com; szszyyhlb@163.comObjective: This study investigates the prevalence and determinants of social isolation in peritoneal dialysis (PD) patients, focusing on the influence of environmental systems and individual behaviors on their social well-being.Methods: We conducted a cross-sectional study from December 2023 to February 2024 at Shenzhen Traditional Chinese Medicine Hospital. A total of 259 PD patients were enrolled using a consecutive sampling method. Data were collected via validated tools including the Pittsburgh Sleep Quality Index (PSQI), Lubben Social Network Scale-6 (LSNS-6), Family APGAR Questionnaire, and Social Anxiety Subscale of Self-Consciousness Scale (SASS-CS). Statistical analyses utilized Spearman correlation and multiple linear regression to identify factors associated with social isolation.Results: The average score for social isolation was 11 (range 7– 15). Significant predictors of social isolation included education level, physical inactivity, and normal hemoglobin concentrations. Social isolation was negatively correlated with family functionality and positively correlated with social anxiety. Regression analysis confirmed education, family functionality, and social anxiety as significant independent predictors of social isolation.Conclusion: Social isolation is common among PD patients, driven by factors such as education level, physical inactivity, and unexpectedly, normal hemoglobin levels linked to greater family isolation. Targeted interventions like education, physical activity promotion, and innovative therapies such as animal-assisted activities and social gardening can help reduce isolation and improve patient well-being.Plain Language Summary: 1. Why is this study needed? Peritoneal dialysis is a common treatment for severe kidney disease. This study is crucial because it examines how being isolated affects patients undergoing this treatment, as social isolation can worsen their health outcomes. 2. What is the key problem/issue/question this manuscript addresses? The main issue addressed is understanding the factors that contribute to social isolation in peritoneal dialysis patients and how this isolation impacts their health and quality of life. 3. What is the main point of your study? The study explores how various factors such as education levels, physical activity, and family support influence social isolation among these patients. It also looks at the broader environmental and social settings that affect their interactions and mental health. 4. What are your main results and what do they mean? Our findings show that patients with higher education, better family support, and more physical activity are less socially isolated. Addressing these factors can greatly enhance the well-being and social interactions of peritoneal dialysis patients, suggesting the need for targeted support and community integration initiatives.Keywords: peritoneal dialysis, social isolation, social support systems, physical inactivity, educational disparities, mental health

Ben Wang,1,2 Peilin Cheng,2 Bingjie Jin,2 Ying Jiang,2 Qingcai Wang,1 Hongwei Xu2 1Department of Gastroenterology, The Affiliated Taian City Central Hospital of Qingdao University, Taian, People’s Republic of China; 2Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of ChinaCorrespondence: Hongwei Xu, Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China, Email xuhongwei@sdfmu.edu.cnBackground & Aims: The metabolic pathways of tryptophan (TRP) have been implicated in the pathophysiology of irritable bowel syndrome (IBS), positing that the strategic modulation of TRP consumption may exert regulatory effects on serotonin levels, consequently altering the clinical manifestation of IBS. This systematic review was meticulously orchestrated to evaluate the effect of TRP restriction on IBS.Methods: A comprehensive search of the MEDLINE/PubMed, Cochrane Library, and Embase databases was conducted. Controlled trials that compared the efficacy of TRP restriction in IBS patients were scrutinized. The primary outcomes were gastrointestinal symptoms, quality of life, and pain, whereas the secondary outcomes included anxiety, mood, and safety. The risk of bias was meticulously assessed according to the guidelines recommended by the Cochrane Collaboration.Results: A total of five trials, enrolling 135 participants, were incorporated into the qualitative synthesis. Low-TRP intake attenuated gastrointestinal discomfort and enhanced psychological well-being in IBS patients, while the effects of acute TRP depletion were controversial. Safety data from one randomized controlled trial reported no occurrence of adverse events.Conclusion: This systematic review suggests that moderating, rather than depleting, TRP intake may potentially be a feasible and safe adjunctive treatment for patients with IBS. Future research incorporating a high-quality study design and consensus on clinical outcome measurements for IBS is warranted.Keywords: irritable bowel syndrome, reduced tryptophan diet, acute tryptophan depletion, systematic review

You Jiang,1,2 Wenbo Li,1,2 Jun Zhang,1 Kun Liu,1 Yuee Wu,3 Zhengguang Wang1 1Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230011, People’s Republic of China; 2Department of General Surgery, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, People’s Republic of China; 3Department of Electrocardiogram Diagnosis, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230060, People’s Republic of ChinaCorrespondence: Zhengguang Wang, Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230011, People’s Republic of China, Email wangzhengguang@ahmu.edu.cnBackground: Cysteine desulfurase (NFS1) is closely associated with the occurrence and development of human tumors, but its relationship with the prognosis and immunity of gastric cancer (GC) patients remains unclear.Methods: To study the relationship between NFS1 and GC, GC-related data of TCGA were downloaded and analyzed. At the same time, Tumor Immune Estimation Resource (TIMER) and Kaplan‒Meier Plotter were used for relevant online analysis. Clinical samples were collected for immunohistochemical testing to validate the results.Results: The mRNA and protein levels of NFS1 in GC tissues were significantly higher than those in normal tissues. In terms of the operating characteristic curve (ROC), the area under the curve (AUC) was 0.793, indicating that NFS1 had a high diagnostic value for GC. Further analysis showed that NFS1 expression was highly correlated with the depth of tumor invasion, lymph node metastasis, and tumor stage. Survival analysis showed that patients with high expression of NFS1 had a poorer prognosis, and NFS1 was an independent risk factor. Enrichment analysis by GO, KEGG, and GSEA showed that NFS1 was enriched in immune-related pathways. The expression of NFS1 was significantly positively correlated with the proportion of macrophages M0 and plasma cells but negatively correlated with the proportion of B cells memory, monocytes, and mast cells resting. In addition, NFS1 expression was significantly correlated with TMB levels and responses to immunotherapy.Conclusion: Our results suggest that NFS1 may be a potential biomarker for the diagnosis and prediction of prognosis and immunotherapy efficacy in GC.Keywords: NFS1, gastric cancer, prognostic biomarker, immune infiltration

Rong Liu,1,&ast; Tingfen Ji,1,2,&ast; Yixia Jiang,1 Hequan Li1 1Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, Lishui People’s Hospital, Lishui, Zhejiang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Hequan Li, Email lihequan@zju.edu.cnPurpose: Recurrent inflammatory fevers with multisystem involvement occur clinically and may indicate an autoimmune disease.Case: We present a young male diagnosed with pulmonary embolism who experienced recurrent fever during hospitalization and was unresponsive to antibiotics and antipyretics. A follow-up history revealed chronic oral and genital ulcers, leading to a final diagnosis of Behçet’s disease.Conclusion: The patient’s temperature normalized rapidly after corticosteroid therapy, and infection markers returned to normal. Complete remission was achieved with immunosuppression and glucocorticoid therapy. Reporting characteristics, treatment experience, and outcomes of such cases are essential to inform future diagnosis and management strategies.Keywords: fever, Behçet’s disease, pulmonary embolism, atrial mass

Yi Fang,1 Yuqi Jiang,2 Linlin Ma,1 Huixian Chen,1 Zhi Li,1 Fen Luo,1 Wen Jiang,1 Shuya Cai,1 Qiaoqiao Guo,3 Zhiqin Yin1,4 1School of Nursing, Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China; 2The First Hospital of Jiaxing City, Jiaxing City, Zhejiang Province, People’s Republic of China; 3College of Renji, Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China; 4Wenzhou Health Promotion Research Center, Wenzhou City, Zhejiang Province, People’s Republic of ChinaCorrespondence: Zhiqin Yin; Qiaoqiao Guo, Email yzq@wmu.edu.cn; 1574612325@qq.comPurpose: While previous studies have extensively examined the impact of receiving positive social support during social support interactions on depressive symptoms among older adults, adverse effects experienced, such as being rejected or ignored, are often overlooked. Moreover, there has been limited discussion on the effects of giving social support to others. Thus, this study investigates the impacts of social support given by disabled older adults to others on their own depressive symptoms, as well as the mediating role of receiving social support (both positive and negative aspects) and the moderating effect of the activity of daily living (ADL).Patients and Methods: This cross-sectional, community-based study was conducted in Wenzhou and Jiaxing City, China, from September 2021 to September 2022, with a total of 255 disabled older adults meeting the inclusion and exclusion criteria. The data were collected face-to-face using a structured questionnaire. The participants were asked to complete the Barthel Index Scale, the Chinese version of the Positive and Negative Social Exchange Scale, the Giving Social Support questionnaire, and the Short Form Chinese Geriatric Depression Scale to measure disability, receiving positive and negative social support, giving social support, and depressive symptoms, respectively. Descriptive statistical analysis, correlation analysis, mediation effect tests, and moderation effect tests were used to analyse the questionnaire data.Results: The social support provided by disabled older adults to others primarily involved companionship and care. The positive aspect of social support received was largely emotional support, while the negative aspect was mainly characterised by failure to obtain help and unsympathetic behaviour. Providing social support was found to be associated with a potential beneficial effect on depressive symptoms, linked to lower severity, with this effect fully mediated by receiving social support. Specifically, receiving emotional support accounted for 56.63% of the effect size, while failure to obtain help and unsympathetic behaviour contributed 21.55%, and rejection and neglect collectively accounted for 21.83%. Additionally, the effect was partially moderated by ADL, with older adults exhibiting lower ADL scores showing a greater benefit from both giving and receiving social support compared to those with higher ADL scores.Conclusion: It is imperative to recognise and encourage disabled older adults to provide social support to others, especially emotional support, while reducing negative feedback, such as neglect and unnecessary blame. This could alleviate their depressive symptoms and promote psycho-social well-being.Keywords: disabled older adults, social support, social exchange, depressive symptoms, ADL

Yingying Jiang,1,&ast; Siqi Ge,2,&ast; Chunyang Wang,1 Chen Jin,1 Yumei Zhao,1 Qingying Liu3 1Department of Neuropharmacology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People’s Republic of China; 2Department of Neuroepidemiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People’s Republic of China; 3Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Henan, 450052, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Qingying Liu, Email liuqy1679@163.comBackground: Sleep played an important part in human health, and COVID-19 led to a continuous deterioration of sleep. However, the causal relationship between micronutrient and sleep disorder was not yet fully understood.Methods: In this research, the genetic causal relationship between micronutrient and sleep disorder was analyzed utilizing a two-sample Mendelian randomization (MR). Single nucleotide polymorphisms (SNPs) were used as instrumental variables. The analyses were conducted using the MR-Egger, inverse variance weighted, weighted mode, weighted median, simple mode, Cochran’s Q test and leave-one-out.Results: Our results suggested that 8 genetically predicted micronutrients participated in sleep disorders, including liver iron (L-iron) and iron in sleeping too much, spleen iron (S-iron) in sleeplessness/insomnia, trouble falling or staying asleep, sleep duration (undersleepers) and nonorganic sleeping disorders, iron metabolism disorder (IMD) and vitamin B12 deficiency anaemia (VB12DA) in narcolepsy, urine sodium (uNa) in narcolepsy, sleep apnea syndrome and sleep disorder, vitamin D (VD) in sleep duration (oversleepers), 25-Hydroxyvitamin D (25(OH)D) in trouble falling or staying asleep.Conclusion: Our study used Mendelian randomization methods at the SNP level to explore the potential causal relationship among L-iron, iron, S-iron, IMD, uNa, 25(OH)D, VD, VB12DA with certain sleep disorder subtypes. Our results uncovered a micronutrient-based strategy for alleviating sleep disorder symptoms.Keywords: Mendelian randomization, micronutrient, sleep disorder, causality, vitamin

Jun Zheng,1 Xiaohong Pan,2 Yiyun Jiang3 1Department of Rehabilitation, Nanxing Health Service Center, Shangcheng, Hangzhou, Zhejiang, 310000, People’s Republic of China; 2Tuberculosis Care Unit, Hospital of Integrated Traditional Chinese and Western Medicine, Zhejiang, 310003, People’s Republic of China; 3Department of Comprehensive Surgery, Hangzhou Geriatric Hospital, Zhejiang, 310022, People’s Republic of ChinaCorrespondence: Yiyun Jiang, Department of Comprehensive Surgery, Hangzhou Geriatric Hospital, No. 50, Jingxin Road, Hangzhou, Zhejiang, 310022, People’s Republic of China, Tel +8615088664025, Email 458247254@qq.comAbstract: Thrombotic thrombocytopenic purpura is a rare but life-threatening emergency. Tuberculosis can have hematologic complications. However, concurrent tuberculosis and thrombotic thrombocytopenic purpura are extremely rare. In this study, we report a 53-year-old man who was initially treated for pulmonary tuberculosis but later developed weakness and an altered mental status. Laboratory tests revealed evidence of thrombocytopenia, acute renal insufficiency, and microangiopathic hemolytic anemia. Brain imaging identified intracranial hemorrhage. Further testing revealed low ADAMTS13 activity (1.8%) and positive anti-ADAMTS13 antibody, confirming the diagnosis of thrombotic thrombocytopenic purpura. The patient had a full recovery after anti-tuberculosis treatment, plasma exchange, and supportive care. We present this rare case and review previous relevant studies to remind clinicians about the potential connections between tuberculosis and thrombotic thrombocytopenic purpura. In patients with signs of severe thrombocytopenia and microangiopathic hemolysis, necessary diagnostic tests should be performed to eliminate the possibility of thrombotic thrombocytopenic purpura occurring concurrently with tuberculosis.Keywords: Thrombotic thrombocytopenic purpura, tuberculosis, case report, literature review

Liming Qin,1,2,&ast; Moqin Qiu,3,&ast; Jingmei Tang,2 Shuyan Liu,4 Qiuling Lin,5 Qiongguang Huang,2 Xiaoxia Wei,5 Qiuping Wen,1 Peiqin Chen,6 Zihan Zhou,7 Ji Cao,7 Xiumei Liang,8 Qian Guo,9 Cunli Nong,9 Yizhen Gong,5 Yuying Wei,1 Yanji Jiang,10 Hongping Yu,1,2,11– 13 Yingchun Liu1 1Department of Experimental Research, Guangxi Medical University Cancer Hospital, Nanning, People’s Republic of China; 2School of Public Health, Guangxi Medical University, Nanning, People’s Republic of China; 3Department of Respiratory Oncology, Guangxi Medical University Cancer Hospital, Nanning, People’s Republic of China; 4Key Laboratory of Biological Molecular Medicine Research, Education Department of Guangxi Zhuang Autonomous Region, Guangxi Medical University, Nanning, People’s Republic of China; 5Department of Clinical Research, Guangxi Medical University Cancer Hospital, Nanning, People’s Republic of China; 6Editorial Department of Chinese Journal of Oncology Prevention and Treatment, Guangxi Medical University Cancer Hospital, Nanning, People’s Republic of China; 7Department of Cancer Prevention and Control, Guangxi Medical University Cancer Hospital, Nanning, People’s Republic of China; 8Department of Disease Process Management, Guangxi Medical University Cancer Hospital, Nanning, People’s Republic of China; 9Liuzhou Worker’s Hospital, Liuzhou, People’s Republic of China; 10Department of Scientific Research, Guangxi Medical University Cancer Hospital, Nanning, People’s Republic of China; 11Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Ministry of Education, Guangxi Medical University, Nanning, People’s Republic of China; 12Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Nanning, People’s Republic of China; 13Key Cultivated Laboratory of Cancer Molecular Medicine of Guangxi Health Commission, Guangxi Medical University Cancer Hospital, Nanning, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yingchun Liu; Hongping Yu, Department of Experimental Research, Guangxi Medical University Cancer Hospital, 71&num; Hedi Road, Qingxiu District, Nanning, People’s Republic of China, Tel +86-15877191237 ; +86-771-5330850, Fax +86-771-5312000, Email liuyingchun@stu.gxmu.edu.cn; yuhongping@stu.gxmu.edu.cnPurpose: P53 is a suppressor gene closely related to carcinogenesis. However, the associations between genetic variants in the p53 signaling pathway and prognosis in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) remain unknown. The current study aims to analyze associations between the single nucleotide polymorphisms (SNPs) in p53 pathway-related genes and survival of patients with HBV-HCC.Methods: We evaluated the associations between 4698 SNPs in 70 genes of the p53 pathway and overall survival (OS) of 866 patients in additive genetic models by using Cox proportional hazards regression analysis. Stepwise multivariable Cox regression analysis was conducted to determine the independent effects of identified SNPs in single-locus analyses. The expression of quantitative trait loci (eQTL) was also analyzed using data from GTEx and 1000 Genomes Project, and functional prediction of SNPs was performed by using RegulomeDB v2.2, 3DSNP v2.0, HaploReg v4.2 and VannoPortal.Results: We found that two novel SNPs of CD82 rs7925603 A > G and PMAIP1 rs4396625 A > T, were significantly and independently associated with OS [adjusted hazards ratios (HRs) and 95% confidence intervals (CI) were 1.27 (1.10– 1.48) and 0.77 (0.66– 0.91), respectively; P = 0.001 and = 0.002, respectively] and that the combined risk genotypes of these SNPs showed a significant association with OS in patients with HBV-HCC (Ptrend < 0.001). Further eQTL analysis in the GTEx dataset showed that the rs7925603 G allele was associated with lower CD82 mRNA expression levels, while the rs4396625 T allele was associated with higher PMAIP1 mRNA expression levels in whole blood cells.Conclusion: We identified two observed survival-associated SNPs in CD82 and PMAIP1 in the p53 pathway, which influenced HBV-HCC survival possibly through a mechanism of altering mRNA expression. Large studies are warranted to validate our findings.Keywords: hepatocellular carcinoma, hepatitis B virus, p53 signaling pathway, genetic variants, survival

Yizi Jiang,1 Min Jia2 1First Clinical Medical College, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, People’s Republic of China; 2Department of Dermatology, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, People’s Republic of ChinaCorrespondence: Min Jia, Department of Dermatology, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, People’s Republic of China, Tel +8613985033118, Email 15685156561@163.comPurpose: The weight-adjusted-waist index (WWI) is a new indicator that may be used to assess obesity. However, there has never been any prior research indicating a link between psoriasis and WWI. Hence, the aim of this investigation is to search for the correlation between the two.Patients and Methods: Cross-sectional analyses used National Health and Nutrition Examination Survey (NHANES) data from 2003 to 2006 and 2019 to 2014. Through multivariate logistic regression, the connection between Psoriasis and WWI was explored, while subgroup analyses aimed to identify possible causes. Furthermore, Smoothed curve fitting was also performed to further understand the association. The non-linear connection was examined through the use of threshold effects.Results: There were 21,916 participants over the age of 20 in the research. Psoriasis and WWI were revealed to be positively correlated [1.25 (1.14, 1.38)] using multivariate logistic regression analysis. This association was observed in both men [1.50(1.29,1.78)] and hypertensive patients [1.37(1.16,1.62)] in subgroup analysis. Furthermore, we noticed a curvilinear association between WWI and psoriasis, wherein the inflection point was identified as 10.15. To the left of the inflection point, there existed a negative correlation [0.12(0.02,0.91)] while to the right, a positive one [1.68(1.03,2.72)].Conclusion: According to our findings, psoriasis and WWI are related, although more extensive prospective research is still required to support this conclusion.Keywords: WWI, obesity, NHANES, cross-sectional study

Yun Shi,1,2 Chan Wang,2 Mary Ann Sevick,1– 3 Han Bao,4 Xinyi Xu,1,2 Yulin Jiang,1,2 Ziqiang Zhu,5 Ashley Wei,1,2 Naumi M Feldman,6 Lu Hu1,2 1Center for Healthful Behavior Change, Institute for Excellence in Health Equity, NYU Langone Health, New York, NY, USA; 2Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA; 3Department of Medicine, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA; 4Jacobi Medical Center, New York, NY, USA; 5Wellsure Medical Practice, New York, NY, USA; 6Charles B. Wang Community Health Center, New York, NY, USACorrespondence: Lu Hu, Center for Healthful Behavior Change, Institute for Excellence in Health Equity, NYU Langone Health, 180 Madison Ave, New York, NY, 10016, USA, Tel +1 646-501-3438, Email lu.hu@nyulangone.orgPurpose: The purpose of this study is to describe diabetes distress and related factors among Chinese Americans with type 2 diabetes in New York City (NYC).Methods: We conducted a secondary data analysis of the baseline data from three research studies conducted among community-dwelling Chinese American adults with type 2 diabetes. Diabetes Distress Scale (DDS) was used to measure sources of diabetes distress including emotional-, regimen-, interpersonal-, and physician-related distress. A score of 2 or greater indicates moderate diabetes distress or higher. Patient Health Questionnaire-2 (PHQ-2) was used to measure depressive symptoms. Participants’ sociodemographic information was also collected. Descriptive statistics were used to describe diabetes distress, and logistic least absolute shrinkage and selection operator (LASSO) regression was used to examine factors associated with diabetes distress level.Results: Data from 178 participants (mean age 63.55± 13.56 years) were analyzed. Most participants were married (76.40%), had a high school degree or less (65.73%), had a household annual income < &dollar;25,000 (70.25%), and reported limited English proficiency (93.22%). About 25.84% reported moderate or higher overall distress. The most common sources of distress were emotional burden (29.78%), followed by regimen- (28.65%), interpersonal- (18.54%), and physician-related distress (14.04%). Participants who were younger, female, limited English proficient, and had elevated depressive symptoms were more likely to have higher diabetes distress.Conclusion: Diabetes distress is prevalent among Chinese immigrants with type 2 diabetes, especially emotional- and regimen-related distress. Given the known link between diabetes distress and poor glycemic control, it is critical to screen for diabetes distress at primary care clinics and incorporate psychological counseling in diabetes care in this underserved population.Keywords: Chinese Americans, immigrant health, ethnic minority, diabetes distress, psychological burden, mental health, stress, emotional distress

Jingfang Chen,1,2 Linlin Liu,3 Junxiong Huang,1 Youli Jiang,4 Chengliang Yin,1 Lukun Zhang,5 Zhihuan Li,1 Hongzhou Lu1,5 1Faculty of Medicine, Macau University of Science and Technology, Macau, 999078, People’s Republic of China; 2Department of Research and Teaching, The Third People’s Hospital of Shenzhen, Shenzhen, 518112, People’s Republic of China; 3Hengyang Medical School, School of Nursing, University of South China, Hengyang, 421001, People’s Republic of China; 4Department of Neurology, The People’s Hospital of Longhua, Shenzhen, 518109, People’s Republic of China; 5Department of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The Third People’s Hospital of Shenzhen, Shenzhen, 518112, People’s Republic of ChinaCorrespondence: : Zhihuan Li; Hongzhou Lu, Faculty of Medicine, Macau University of Science and Technology, Macau, 999078, People’s Republic of China, Email baopullon@163.com; luhongzhou@szsy.sustech.edu.cnBackground: Both HIV and TB are chronic infectious diseases requiring long-term treatment and follow-up, resulting in extensive electronic medical records. With the exponential growth of health and medical big data, effectively extracting and analyzing these data has become the research hotspot. As a fundamental aspect of artificial intelligence, machine learning has been extensively applied in medical research, encompassing diagnosis, treatment, patient monitoring, drug development, and epidemiological investigations. This significantly enhances medical information systems and facilitates the interoperability of medical data.Methods: In our study, we analyzed longitudinal data from the electronic health records of 4540 patients, gathered from the National Clinical Research Center for Infectious Diseases in Shenzhen, China, spanning from 2017 to 2021. Initially, we employed the fine-tuned ChatGLM to structure the electronic medical records. Subsequently, we utilized a multi-layer perceptron to classify each patient and determined the presence of tuberculosis in HIV patients. Using machine learning-based natural language processing, we structured these records to build a specialized database for HIV and TB co-infection. We studied the epidemiological characteristics, focusing on incidence patterns, patient characteristics, and influencing factors, to uncover the transmission characteristics of these diseases in Shenzhen. Additionally, we used Long Short-Term Memory to create a predictive model for TB co-infection among HIV patients, based on their medical records. This model predicted the risk of TB co-infection, providing scientific evidence for clinical decision-making and enabling early detection and precise intervention.Results: Based on the refined ChatGLM model tailored for structured electronic health records, the accuracy of symptom extraction consistently surpassed 0.95 precision. Key symptoms such as diarrhea and normal showed precision rates exceeding 0.90. High scores were also achieved in recall and F1 scores. Among 4540 HIV patients, 758 were diagnosed with concurrent tuberculosis, indicating a 16.7% co-infection rate, while syphilis co-infection affected 25.1%, underscoring the prevalence of concurrent infections among HIV patients. Utilizing electronic health records, a Multilayer Perceptron classifier was developed as a benchmark against Long Short-Term Memory to predict high-risk groups for HIV and tuberculosis co-infections. The Multilayer Perceptron classifier demonstrated predictive ability with AUROC values ranging from 0.616 to 0.682 on the test set, suggesting opportunities for further optimization and generalization despite its accuracy in identifying HIV-TB co-infections. In tuberculosis intelligent diagnosis based on laboratory results, the Long Short-Term Memory showed consistent performance across 5-fold cross-validation, with AUROC values ranging from 0.827 to 0.850, indicating reliability and consistency in tuberculosis prediction. Furthermore, by optimizing classification thresholds, the model achieved an overall accuracy of 81.18% in distinguishing HIV co-infected tuberculosis from simple HIV infection.Conclusion: Combining the Multilayer Perceptron classifier with Long Short-Term Memory represented an advanced approach for effectively extracting electronic health records and utilizing it for disease prediction. This underscored the superior performance of deep learning techniques in managing both structured and unstructured medical data. Models leveraging laboratory time-series data demonstrated notably better performance compared to those relying solely on electronic health records for predicting tuberculosis incidence. This emphasized the benefits of deep learning in handling intricate medical data and provided valuable insights for healthcare providers exploring the use of deep learning in disease prediction and management.Keywords: Prediction models, HIV, Tuberculosis, Machine Learning, Artificial Intelligence

Wei Zhang, Haiqing Liu, Tuantuan Li, Ying Jiang, Xiaoyu Cao, Li Chen, Lili Zhou The Second People’s Hospital of Fuyang City, Fuyang, Anhui, People’s Republic of ChinaCorrespondence: Lili Zhou, The Second People’s Hospital of Fuyang City, No. 1088, West Yinghe Road, Fuyang, Anhui, People’s Republic of China, Email zw2314160@163.comObjective: Investigate the differences in clinical manifestations, imaging features, and associated inflammatory markers between Nontuberculous Mycobacterial Pulmonary Disease (NTM-PD) and Pulmonary Tuberculosis (PTB), identify potential risk factors for NTM-PD, and establish a logistic regression model to evaluate its diagnostic value.Methods: Baseline data were collected from 145 patients with NTM-PD and 206 patients with PTB. Propensity score matching (PSM) was utilized to achieve a 1:1 match between the two groups, resulting in 103 matched pairs. The differences in comorbidities, imaging features, and inflammatory markers were compared between the two groups. Multivariate binary logistic regression analysis was conducted to identify independent influencing factors, and the diagnostic value of the established model was evaluated.Results: After matching, significant differences were observed between the NTM-PD group and the PTB group in terms of diabetes, bronchiectasis, chronic obstructive pulmonary disease(COPD), cystic and columnar changes, lung cavity presentation, and monocyte percentage (MONO%), lymphocyte count (LYMPH&num;), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) (P

Yan Jiang,1 Yuanyuan Peng,1 Yingyi Wu,1 Qing Sun,1 Tebo Hua2 1Department of Ultrasound, Ningbo Medical Centre Lihuili Hospital, Ningbo, Zhejiang, People’s Republic of China; 2Department of Thyroid Breast Surgery, Ningbo Medical Centre Lihuili Hospital, Ningbo, Zhejiang, People’s Republic of ChinaCorrespondence: Tebo Hua, Department of Thyroid Breast Surgery, Ningbo Medical Centre Lihuili Hospital, Ningbo, Zhejiang, 315040, People’s Republic of China, Email huatebo@163.comObjective: To develop a clinical-radiomics model using a multimodal machine learning method for distinguishing ductal carcinoma in situ (DCIS) from breast fibromatosis.Methods: The clinical factors, ultrasound features, and related ultrasound images of 306 patients (198 DCIS patients) were retrospectively collected. Patients in the development and validation cohort were 184 and 122, respectively. The independent clinical and ultrasound factors identified by the multivariable logistic regression analysis were used for the clinical-ultrasound model construction. Then, the region of interest of breast lesions was delineated and radiomics features were extracted. Six machine learning algorithms were trained to develop a radiomics model. The algorithm with higher and more stable prediction ability was chosen to convert the output of the results into the Radscore. Further, the independent clinical predictors and Radscore were enrolled into the logistic regression analysis to generate a combined clinical-radiomics model. The receiver operating characteristic curve analysis, DeLong test, and decision curve analysis were adopted to compare the prediction ability and clinical efficacy of three different models.Results: Among the six classifiers, logistic regression model was selected as the final radiomics model. Besides, the combined clinical-radiomics model exhibited a superior ability in distinguishing DCIS from breast fibromatosis to the clinical-ultrasound model and the radiomics model.Conclusion: The combined model by integrating clinical-ultrasound factors and radiomics features performed well in predicting DCIS, which might promote prompt interventions to improve the early diagnosis and prognosis of the patients.Keywords: multimodal machine learning, clinical-ultrasound features, radiomics, ductal carcinoma in situ

Zhenghuan Song,1,&ast; Jiaqin Cai,2,&ast; Yihu Zhou,3 Yueyi Jiang,3 Shiyi Huang,2 Lianbing Gu,1,2 Jing Tan1,2 1Department of Anesthesiology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 21009, People’s Republic of China; 2Xuzhou Medical University, Xuzhou, 21009, People’s Republic of China; 3Nanjing Medical University, Nanjing, 21009, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jing Tan; Lianbing Gu, Department of Anesthesiology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 21009, People’s Republic of China, Tel +86-13813967939; +86-13951947684, Email tanjing@njmu.edu.cn; 13951947684@163.comPurpose: Artificial intelligence (AI) is increasingly influencing various medical fields, including anesthesiology. The Introduction of artificial intelligent patient-controlled analgesia (Ai-PCA) has been seen as a significant advancement in pain management. However, the adoption and practical application of Ai-PCA by medical staff, particularly in anesthesia and thoracic surgery, have not been extensively studied. This study aimed to investigate the knowledge, attitudes and practices (KAP) among anesthesia and thoracic surgery medical staff toward artificial intelligent patient-controlled analgesia (Ai-PCA).Participants and Methods: This web-based cross-sectional study was conducted between November 1, 2023 and November 15, 2023 at Jiangsu Cancer Hospital. A self-designed questionnaire was developed to collect demographic information of anesthesia and thoracic surgery medical staff, and to assess their knowledge, attitudes and practices toward Ai-PCA.Results: A total of 519 valid questionnaires were collected. Among the participants, 278 (53.56%) were female, 497 (95.76%) were employed in the field of anesthesiology, and 188 (36.22%) had participated in Ai-PCA training. The mean knowledge, attitude, and practice scores were 7.8± 1.75 (possible range: 0– 10), 37.43± 4.16 (possible range: 9– 45), and 28.38± 9.27 (possible range: 9– 45), respectively.Conclusion: The findings revealed that anesthesia and thoracic surgery medical staff have sufficient knowledge, active attitudes, but poor practices toward the Ai-PCA. Comprehensive training programs are needed to improve anesthesia and thoracic surgery medical staff’s practices in this area.Keywords: knowledge, attitudes, practices, Ai-PCA, cross-sectional study

Weixin Bei,1,2,&ast; Shuhui Dong,1,2,&ast; Guoying Liu,1,3,4,&ast; Lanfeng Lin,2,5,&ast; Yaofei Jiang,1,2 Nian Lu,1,2 Wangzhong Li,1,2 Hu Liang,1,2 Yanqun Xiang,1,2 Weixiong Xia1,2 1Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China; 2State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China; 3Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China; 4Department of Radiation Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China; 5Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yanqun Xiang; Weixiong Xia, Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People’s Republic of China, Tel +86-20-87343643, Fax +86-20-87343392, Email xiangyq@sysucc.org.cn; xiawx@sysucc.org.cnBackground: We aim to evaluate the efficacy and safety of anti-PD1 rechallenge in combination with chemotherapy in patients with metastatic nasopharyngeal carcinoma (mNPC) who have progressed on prior anti-PD1 therapy.Patients and Methods: We enrolled patients with mNPC who received chemotherapy combined with PD-1 immune-checkpoint inhibitors (ICIs) or chemotherapy alone after prior progression of anti-PD1 therapy. The primary endpoint was progress-free survival (PFS), and the secondary endpoints included overall survival (OS), disease control rate (DCR) and objective response rate (ORR).Results: A total of 96 patients were eligible between January 2015 and December 2020. Thirty-seven (38.5%) were in the PD-1 ICIs re-challenge group, while the remaining 59 patients (61.5%) were in the chemotherapy group. The ORR and DCR of PD-1 ICIs group and chemotherapy group were 37.8% vs 23.7% and 86.5% vs.74.5%, respectively. After a median follow-up period of 21.1 months (IQR 16.1– 28.7), the log-rank analysis demonstrated a significantly improved PFS in the PD-1 ICIs re-challenge group compared to the chemotherapy group (8.4 months [95% CI 4.3– 14.0] vs 5.0 months [95% CI 2.8– 7.2], P = 0.03). However, no significant difference in OS was observed between the two groups (28.3 vs 24.1 months, P = 0.09). The two groups had similar adverse reactions, but the incidence of grade 3 or 4 thrombocytopenia was significantly higher in the PD-1 ICIs re-challenge group (18.9% vs 3.4%, P = 0.025).Conclusion: mNPC patients who progressed from prior anti-PD1 therapy could benefit from the anti-PD1 rechallenge in combination with chemotherapy. However, further validation is needed.Keywords: metastatic nasopharyngeal carcinoma, chemotherapy, PD-1 immune checkpoint inhibitors, second-line treatment strategies

Yuwei Jiang,1,2,&ast; Wenjun Dang,3,&ast; Lirong Sui,1 Tianci Gao,1 Xiangying Kong,1 Jin Guo,1 Shuang Liu,1 Hong Nie,3 Zhimei Jiang1,2 1College of Rehabilitation Medicine, Jiamusi University, Jiamusi City, Hei longJiang Province, People’s Republic of China; 2Pediatric Cerebral Palsy Prevention and Treatment Center of Heilongjiang Province, Jiamusi City, Hei longJiang Province, People’s Republic of China; 3College of Jiamusi, HeiLongJiang University of Chinese Medicine, Jiamusi City, Hei longJiang Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhimei Jiang; Shuang Liu, Email 15704601990@163.com; 307692456@qq.comAbstract: We conducted an umbrella evaluation to quantitatively synthesize previous systematic reviews and meta-analyses, thereby collating evidence on the association between vitamin D and core symptoms in people with autism in anticipation of informing clinical vitamin D supplementation. Based on the pre-established protocol, we ended up with 9 studies. Based on rigorous analysis, we found that vitamin D deficiency early in life is a risk factor for the development of ASD and that vitamin D supplementation improves the core symptoms of ASD. Our study concludes that vitamin D supplementation is beneficial for individuals with autism, that vitamin D deficiency early in embryonic life increases the risk of ASD, and that our study supports the idea that prevention begins with vitamin D supplementation early in life. At the same time, we must recognize that our current conclusions support the benefits of vitamin D supplementation for children with ASD, but we are unable to determine the causal relationship, ie, how vitamin D works in ASD, and we need more basic research to explore the mechanisms involved.Keywords: autism spectrum disorders, vitamin D, core symptoms, 25(OH)D, umbrella review

Haijie Tan,1,&ast; Yi Chen,2,&ast; Yan Jiang,1 Xiaojing Sun,1 Wei Ye,1 Xuefang Zhu,1 Xiangsheng Xiong1 1Department of Anesthesiology, The Fifth People’s Hospital of Huaian, Huaian, People’s Republic of China; 2Department of Anesthesiology and Perioperative Medicine, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiangsheng Xiong, Department of Anesthesiology, The Fifth People’s Hospital of Huaian, Huaian, People’s Republic of China, Email 158193942@qq.comBackground: Vasopressors remain an important strategy for managing spinal anesthesia-induced hypotension in women with preeclampsia. The aim of this study was to investigate the ED90s and efficacy ratio of phenylephrine and norepinephrine in managing spinal anesthesia-induced hypotension in women with preeclampsia during cesarean delivery.Methods: 60 women with preeclampsia, who underwent cesarean delivery, were randomly assigned to receive either a continuous intravenous infusion of phenylephrine or norepinephrine following spinal anesthesia. The initial dosage of phenylephrine or norepinephrine for the first women was 0.5 or 0.05 μg/kg/min, respectively, and subsequent infusion dosages were adjusted based on their efficacy in preventing spinal anesthesia-induced hypotension (defined as a systolic blood pressure less than 80% of the baseline level). The incremental or decremental doses of phenylephrine or norepinephrine were set at 0.1 or 0.01 μg/kg/min. The primary outcomes were the ED90s and efficacy ratio of phenylephrine and norepinephrine infusions for preventing spinal anesthesia-induced hypotension prior to delivery.Results: The results obtained from isotonic regression analysis revealed that the ED90 values of the phenylephrine and norepinephrine group for preventing spinal anesthesia-induced hypotension were 0.597 (95% CI: 0.582– 0.628) and 0.054 (95% CI: 0.053– 0.056) μg/kg/min, respectively, with an efficacy ratio of 11.1:1. The results of Probit regression analysis revealed that the ED90 values were determined to be 0.665 (95% CI: 0.576– 1.226) and 0.055 (95% CI: 0.047– 0.109) μg/kg/min, respectively, with an efficacy ratio of 12.1:1.Conclusion: The administration of 0.6 μg/kg/min phenylephrine and 0.05 μg/kg/min norepinephrine has been found to effectively manage a 90% incidence of spinal anesthesia-induced hypotension in women with preeclampsia.Keywords: ED90, phenylephrine, norepinephrine, spinal anesthesia-induced hypotension, preeclampsia, cesarean delivery

Xiaoyu Wu,1,2 Chun Liu,2 Yuqing Jiang,2 Ting Dai,1,2 Linxiang Zhang,1,2 Jiafeng Wang,1,2 Hongbin Zhao1,2 1Gansu Provincial Maternity and Child-Care Hospital, Gansu Provincial Central Hospital, Gansu, People’s Republic of China; 2Changzhou Medical Center, The Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou, People’s Republic of ChinaCorrespondence: Hongbin Zhao, Gansu Provincial Maternity and Child-care Hospital, Gansu Provincial Central Hospital, Gansu, 730070, People’s Republic of China, Email zhao761032@163.comBackground: Salidroside (SAL) is the most effective component of Rhodiola rosea, a traditional Chinese medicine. Cryptotanshinone (CT) is the main fat-soluble extract of Salvia miltiorrhiza, exhibiting considerable potential for application in osteogenesis. Herein, a polycaprolactone/gelatin nanofiber membrane loaded with CT and SAL (PSGC membrane) was successfully fabricated via coaxial electrospinning and characterized.Methods and Results: This membrane capable of sustained and controlled drug release was employed in this study. Co-culturing the membrane with bone marrow mesenchymal stem cells and human umbilical vein endothelial cells revealed excellent biocompatibility and demonstrated osteogenic and angiogenic capabilities. Furthermore, drug release from the PSGC membrane activated the Wnt/β-catenin signaling pathway and promoted osteogenic differentiation and vascularization. Evaluation of the membrane’s vascularization and osteogenic capacities involved transplantation onto a rat’s subcutaneous area and assessing rat cranium defects for bone regeneration, respectively. Microcomputed tomography, histological tests, immunohistochemistry, and immunofluorescence staining confirmed the membrane’s outstanding angiogenic capacity two weeks post-operation, with a higher incidence of osteogenesis observed in rat cranial defects eight weeks post-surgery.Conclusion: Overall, the SAL- and CT-loaded coaxial electrospun nanofiber membrane synergistically enhances bone repair and regeneration.Keywords: gelatin, coaxial electrospinning, vascularization and bone regeneration

Yue Han,&ast; Jingyi Wang,&ast; Jin Zhang,&ast; Xi Zheng, Yijia Jiang, Wei Liu, Wenxiong Li Department of Surgical Intensive Care Unit, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wenxiong Li, Department of Surgical Intensive Care Unit, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, People’s Republic of China, Tel +86 136 0109 7813, Email liwx1126@163.comPurpose: Sepsis-associated acute kidney injury (S-AKI) contributes to high mortality, but it is lack of specific treatments. We aimed to investigate the underlying mechanism of S-AKI and to identify target drugs to alleviate AKI.Methods: We establish a stable mouse model of S-AKI by Pseudomonas aeruginosa incision infection. Based on high-throughput sequencing and bioinformatics analysis, we investigated the underlying mechanism and selected the target drug (VX-702) for S-AKI. An in vitro model established by co-cultured of kidney tubular epithelial cell line (TCMK-1) cells with lipopolysaccharide (LPS)-induced leukemic monocyte/macrophage cells (RAW264.7), we explored the effect of VX-702 on S-AKI.Results: The data showed interleukin (IL)-6 and IL-1β were the hub genes, and the mitogen-activated protein kinase (MAPK) signaling pathway was the main pathway involved in S-AKI. Administration of VX-702 by oral gavage decreased the elevated concentrations of IL-6, IL-1β, serum creatinine, and blood urea nitrogen in mice with S-AKI. Moreover, VX-702 reduced the number of apoptotic cells in damaged kidney tissues. Cell viability was decreased, and the number of apoptotic cells was increased in TCMK-1 cells co-cultured with LPS-induced RAW264.7 cells compared to LPS-induced TCMK-1 cells. VX-702 treatment reversed this effect. VX-702 treatment reduced the levels of phosphorylated p38 MAPK and proinflammatory cytokines in RAW264.7 cells and the supernatant. VX-702 could bind IL-6, IL-1β and MAPK, and affect the binding of IL-1β and its receptor, as demonstrated by molecular docking.Conclusion: VX-702 ameliorated S-AKI by inhibiting the release of proinflammatory cytokines from macrophages, indicating its potential as a novel therapeutic for S-AKI treatment.Keywords: sepsis-associated acute kidney injury, VX-702, macrophages, inflammatory factor, MAPK

Shi-Yuan Fan,1,&ast; Zi-Chi Zhao,1,&ast; Xing-Lv Liu,1 Ying-Gang Peng,1 Hui-Min Zhu,1 Shi-Fan Yan,2 Yan-Juan Liu,2 Qin Xie,2 Yu Jiang,2 Sai-Zhen Zeng1 1The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People’s Hospital), Changsha, Hunan, 410005, People’s Republic of China; 2Department of Emergency, Institute of Emergency Medicine, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, 410005, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Sai-Zhen Zeng, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People’s Hospital), 61 Jie-Fang West Road, Fu-Rong District, Changsha, Hunan, 410005, People’s Republic of China, Email 55445321@qq.com Yu Jiang, Department of Emergency, Institute of Emergency Medicine, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), 61 Jie-Fang West Road, Fu-Rong District, Changsha, 410005, People’s Republic of China, Email jiangyu@hunnu.edu.cnBackground: Globally, the subsequent complications that accompany sepsis result in remarkable morbidity and mortality rates. The lung is among the vulnerable organs that incur the sepsis-linked inflammatory storm and frequently culminates into ARDS/ALI. The metformin-prescribed anti-diabetic drug has been revealed with anti-inflammatory effects in sepsis, but the underlying mechanisms remain unclear. This study aimed to ascertain metformin’s effects and functions in a young mouse model of sepsis-induced ALI.Methods: Mice were randomly divided into 4 groups: sham, sham+ Met, CLP, and CLP+ Met. CLP was established as the sepsis-induced ALI model accompanied by intraperitoneal metformin treatment. At day 7, the survival state of mice was noted, including survival rate, weight, and M-CASS. Lung histological pathology and injury scores were determined by hematoxylin–eosin staining. The pulmonary coefficient was used to evaluate pulmonary edema. Furthermore, IL-1β, CCL3, CXCL11, S100A8, S100A9 and NLRP3 expression in tissues collected from lungs were determined by qPCR, IL-1β, IL-18, TNF-α by ELISA, caspase-1, ASC, NLRP3, P65, p-P65, GSDMD-F, GSDMD-N, IL-1β and S100A8/A9 by Western blot.Results: The data affirmed that metformin enhanced the survival rate, lessened lung tissue injury, and diminished the expression of inflammatory factors in young mice with sepsis induced by CLP. In contrast to sham mice, the CLP mice were affirmed to manifest ALI-linked pathologies following CLP-induced sepsis. The expressions of pro-inflammatory factors, for instance, IL-1β, IL-18, TNF-α, CXCL11, S100A8, and S100A9 are markedly enhanced by CLP, while metformin abolished this adverse effect. Western blot analyses indicated that metformin inhibited the sepsis-induced activation of GSDMD and the upregulation of S100A8/A9, NLRP3, and ASC.Conclusion: Metformin could improve the survival rate, lessen lung tissue injury, and minimize the expression of inflammatory factors in young mice with sepsis induced by CLP. Metformin reduced sepsis-induced ALI via inhibiting the NF-κB signaling pathway and inhibiting pyroptosis by the S100A8/A9-NLRP3-IL-1β pathway.Keywords: sepsis, pediatric, inflammation, pyroptosis, ALI

Ying Jiang,1,&ast; Chuankai Lin,1,&ast; Min Xu,2,&ast; Taiwen Zhu,1 Xuhong Li,1 Wei Wang1 1Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, People’s Republic of China; 2Medical and Nursing School, Wuhan Railway Vocational College of Technology, Wuhan, 430205, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wei Wang, Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, People’s Republic of China, Tel +86 15071128246, Email wangwei1069@163.comIntroduction: Obstructive sleep apnea (OSA) is a respiratory disorder characterized by chronic intermittent hypoxia and fragmented sleep, leading to inflammatory response and oxidative stress. However, the differences in immune inflammatory response in OSA patients with different severity remain unclear.Purpose: This study aims to examine the differences in peripheral blood immune cells and their risk factors in OSA patients.Patients and Methods: A total of 277 snoring patients from the Sleep Respiratory Disorder Monitoring Center of Zhongnan Hospital of Wuhan University were recruited in this study. According to the diagnosis and severity criteria of OSA, the included patients were further divided into simple snoring, mild, moderate, and severe groups. Peripheral blood immune cell counts including white blood cells, neutrophils, lymphocytes, monocytes, eosinophils, basophils, red blood cells, platelets, and polysomnography indicators were collected from the patients.Results: Compared with simple snoring patients, the OSA patients had increased circular monocyte and basophil count levels. In addition, correlation analysis results indicated that monocyte count was positively associated with chronic obstructive pulmonary disease (COPD), smoking, apnea-hypopnea index (AHI), the longest apnea duration, and Oxygen desaturation index (ODI), and negatively correlated with average SpO2 in snoring patients. Finally, multiple linear regression analysis revealed that AHI, COPD, smoking, and maximum heart rate were independent predictors of monocyte count.Conclusion: OSA patients had a significant increase in their peripheral blood monocyte count. AHI, COPD, smoking, and maximum heart rate were risk factors for increased peripheral blood monocyte count in OSA patients. These findings suggest that peripheral blood monocytes can be considered an inflammatory biomarker of OSA.Keywords: obstructive sleep apnea, peripheral blood cell count, monocytes, polysomnography, inflammatory biomarker

Zhida Bian,1– 3,&ast; Bo Wang,2,4,&ast; Xingqi Wu,3,5,6,&ast; Kai Wang,3,5– 7 Yi Jiang1,8 1Anhui Medical University School of Basic Medicine, Hefei, 230032, People’s Republic of China; 2Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230088, People’s Republic of China; 3Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, People’s Republic of China; 4State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, People’s Republic of China; 5Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China; 6Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, 230022, People’s Republic of China; 7The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230032, People’s Republic of China; 8State Key Laboratory of Brain and Cognitive Science, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Psychology, Chinese Academy of Sciences, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Kai Wang, Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China, Email wangkai1964@126.com Yi Jiang, Anhui Medical University School of Basic Medicine, Hefei, 230032, People’s Republic of China, Tel +86 10 64879639, Fax +86 10 64856521, Email yijiang@psych.ac.cnIntroduction: Conventional methods like patient history, neuropsychological testing, cerebrospinal fluid examination, and magnetic resonance imaging are widely used to diagnose cases in the current clinical setting but are limited in classifying Alzheimer’s disease (AD) stages. Patients with AD exhibit visual perception deficits, which may be a potential target to assess the severity of the disease according to visual paradigms. However, owing to the inconsistent forms of perceived objects, the defects of current visual processing paradigms often lead to inconsistent results and a lack of sensitivity and specificity.Methods: We develop two paradigms based on global-first topological approach of visual perception, which avoids inconsistent results and lack of sensitivity and specificity owing to the inconsistent forms of perceived objects in traditional paradigms, delineate a unique detection strategy from perception organization (Experiment 1) and visual working memory (VWM) (Experiment 2).Results: Except for the significant differences of the reaction times (RTs) between groups, significant differences were found when AD subjects recognize small figures due to the consistency of global and local figures in similarity test. The difference of RTs between recognizing global and local figures can be recognized in AD and mild cognitive impairment (MCI) group compared to healthy elderly (HE) in similarity test (Experiment 1). The memory capacity of AD patients was significantly lower than MCI group. Topological interference effect was observed in MCI and HE group, whereas MCI patients may have a greater difference trend in non-topological and topological changes than HE (Experiment 2).Conclusion: Our paradigms provide a new strategy, which can assist clinical severity staging and linking topological approach of visual perception with pathophysiological processes in AD.Keywords: Alzheimer’s disease, visual perception deficits, paradigm, working memory, perceptual organization

Liyun Zou,1,&ast; Qiufeng Wei,1,&ast; Sining Pan,1,&ast; Fei Xiao,1,2 Yage Jiang,1 Yu Zhong,1 Yubo Xie1,3 1Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China; 2Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, People’s Republic of China; 3Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yubo Xie; Yu Zhong, Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China, Tel +86 13977121557 ; +86 15177929679, Email xybdoctor@163.com; zzlugl@163.comBackground: Perioperative anesthetic management of patients with diabetic foot undergoing surgical treatment is challenging due to their poor cardiovascular health status. According to previous literature, general anesthesia and peripheral nerve block have their own advantages and disadvantages for such patients. We reported the effect of these two anesthesia techniques on perioperative hemodynamics and prognosis in these patients.Methods: This study employed a prospective randomized controlled design, where patients meeting the inclusion criteria were assigned to two groups: the general anesthesia group (GA group) and the peripheral nerve block group (PNB group). The primary outcomes were the differences in intraoperative hemodynamic stability and the incidence of postoperative complications between the two groups. The second outcomes were postoperative numerical rating scale scores, analgesic drug remedies, postoperative sleep conditions monitored by sleep bracelets and health status assessed by EQ-5D-5 L scores.Results: One hundred and nine subjects were enrolled in this study, including 54 in the GA group and 55 in the PNB group. The baseline parameters of the two groups were comparable. The GA group exhibited a significantly higher incidence of hypotension, and Colloid intake and total fluid intake were significantly higher in the GA group than in the PNB group. Additionally, a larger proportion of patients in the GA group. The scores of postoperative pain during the 48 hours after surgery were significantly higher, and more patients needed tramadol for postoperative analgesia during the 24 h after surgery in the GA group than in the PNB group. Patients in the PNB group slept better, first feeding time, earlier out-of-bed activity and earlier discharge from the hospital, compared to the GA group. However, there was no obvious difference in postoperative complications between the two groups except pharyngeal pain.Conclusion: Peripheral nerve block is a better option in patients with diabetes undergoing elective below-knee surgery than general anesthesia.Keywords: diabetic foot, general anesthesia, peripheral nerve block, hemodynamic, postoperative pain, postoperative complication

Jingnan Zhao,1 Chengyu Qian,2 Youqiao Jiang,1,3 Wangrui He,1 Wenhua Wu1 1Tuberculosis Control Department, Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, 330029, People’s Republic of China; 2Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, Beijing, 101149, People’s Republic of China; 3Young Scientific Research and Innovation Team, Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, Jiangxi, 330029, People’s Republic of ChinaCorrespondence: Wangrui He, Tuberculosis Control Department, Jiangxi Provincial Center for Disease Control and Prevention, No. 555, Beijing East Road, Nanchang, Jiangxi, 330029, People’s Republic of China, Email jxcdccbs@126.comPurpose: In this study, we aimed to determine the transmission pattern of multidrug-resistant tuberculosis (MDR-TB) isolates circulating in Jiangxi Province with whole-genome sequencing (WGS). In addition, we also sought to describe mutational resistome of MDR-TB isolates.Patients and Methods: A total of 115 MDR-TB isolates determined by the phenotypic proportion method of drug susceptibility testing between January 2018 and December 2022 from provincial drug surveillance (DRS) in Jiangxi were included in our analysis. The demographic data and treatment history were extracted from the National TB Registry System. WGS was used to analyze the genotypic characteristics of drug resistance and transmissions.Results: About 62.6% of MDR-TB strains were isolated from cases that received previous anti-tuberculosis treatment. According to the WGS results, 96.5% were genotypic MDR-TB, and more than half of MDR-TB isolates tested were also resistant to streptomycin (59.1%), ethambutol (56.5%), and fluroquinolones (53.0%), while resistance to cycloserine and linezolid was lowest, only in two (1.7%) and one (0.9%) isolate, respectively. Ser450Leu in rpoB (57.9%), Ser315Thr in katG (74.1%), Met306Val in embB (40.0%), Lys43Arg in rpsL (75.0%), Ala90Val in gyrA (32.8%) were predominant mutant types among the rifampin-, isoniazid-, ethambutol-, streptomycin-, fluoroquinolones-resistant isolates, respectively. Lineage 2 (East Asian genotype) occurred at the highest frequency with 97 cases (84.3%), followed by lineage 4 (Euro-American genotype) with 18 cases (15.7%). Additionally, 5 clusters consisting of 10 isolates were identified in the present study, demonstrating a clustering rate of 8.7%.Conclusion: MDR/Rifampicin-Resistant (RR)-TB epidemic in this region is driven by lineage 2 clade that also show higher resistance to other anti-tuberculosis drugs. Lower cluster rates compared with a relatively higher proportion of new MDR-TB cases indicate that a considerable number of MDR-TB cases remain undiagnosed.Keywords: Mycobacterium tuberculosis, drug resistant, whole-genome sequencing, genetic diversity, transmission dynamics

Ning Li,&ast; Jia-Min Shao,&ast; Ye Jiang, Chu-Han Wang, Si-Bo Li, De-Chao Wang, Wei-Ying Di Department of Neurology, Affiliated Hospital of Hebei University, Baoding, Hebei Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wei-Ying Di, Email diweiying@126.comBackground: This study addresses the predictive modeling of Enlarged Perivascular Spaces (EPVS) in neuroradiology and neurology, focusing on their impact on Cerebral Small Vessel Disease (CSVD) and neurodegenerative disorders.Methods: A retrospective analysis was conducted on 587 neurology inpatients, utilizing LASSO regression for variable selection and logistic regression for model development. The study included comprehensive demographic, medical history, and laboratory data analyses.Results: The model identified key predictors of EPVS, including Age, Hypertension, Stroke, Lipoprotein a, Platelet Large Cell Ratio, Uric Acid, and Albumin to Globulin Ratio. The predictive nomogram demonstrated strong efficacy in EPVS risk assessment, validated through ROC curve analysis, calibration plots, and Decision Curve Analysis.Conclusion: The study presents a novel, robust EPVS predictive model, providing deeper insights into EPVS mechanisms and risk factors. It underscores the potential for early diagnosis and improved management strategies in neuro-radiology and neurology, highlighting the need for future research in diverse populations and longitudinal settings.Keywords: Enlarged Perivascular Spaces, cerebral small vessel disease, predictive model, risk factors, neuro-radiology, LASSO regression

Aleksandr Kakinen,1,2 Yuhao Jiang,2 Thomas Paul Davis,2 Tambet Teesalu,3,4 Mart Saarma1 1Institute of Biotechnology, HiLIFE, University of Helsinki, Helsinki, Finland; 2Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane, QLD, Australia; 3Institute of Biomedicine and Translational Medicine, Faculty of Medicine, University of Tartu, Tartu, Estonia; 4Materials Research Laboratory, University of California Santa Barbara, Santa Barbara, CA, USACorrespondence: Mart Saarma, Institute of Biotechnology, HiLIFE, University of Helsinki, Viikinkaari 5D, Helsinki, 00790, Finland, Tel +358505002726 ; +358294159378, Email mart.saarma@helsinki.fi Aleksandr Kakinen, Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Building 75, Cnr College Road& Cooper Road, St Lucia, QLD, 4067, Australia, Tel +61 7 344 63152, Email a.kakinen@uq.edu.auAbstract: Brain diseases are the most devastating problem among the world’s increasingly aging population, and the number of patients with neurological diseases is expected to increase in the future. Although methods for delivering drugs to the brain have advanced significantly, none of these approaches provide satisfactory results for the treatment of brain diseases. This remains a challenge due to the unique anatomy and physiology of the brain, including tight regulation and limited access of substances across the blood-brain barrier. Nanoparticles are considered an ideal drug delivery system to hard-to-reach organs such as the brain. The development of new drugs and new nanomaterial-based brain treatments has opened various opportunities for scientists to develop brain-specific delivery systems that could improve treatment outcomes for patients with brain disorders such as Alzheimer’s disease, Parkinson’s disease, stroke and brain tumors. In this review, we discuss noteworthy literature that examines recent developments in brain-targeted nanomedicines used in the treatment of neurological diseases.Keywords: brain delivery, blood-brain barrier, targeted delivery, nanoparticle, neurodegenerative diseases, stroke, cancer

Rong Zhou,1,2,&ast; Chen Suo,1,3,&ast; Yong Jiang,4,&ast; Liyun Yuan,5 Tiejun Zhang,1,3 Xingdong Chen,3,6 Guoqing Zhang5,7 1Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200433, People’s Republic of China; 2Shanghai Southgene Technology Co., Ltd., Shanghai, 201203, People’s Republic of China; 3Taizhou Institute of Health Sciences, Fudan University, Taizhou, 225300, People’s Republic of China; 4China National Clinical Research Center for Neurological Diseases, Beijing, 100070, People’s Republic of China; 5Bio-Med Big Data Center, CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Science, Shanghai, 200031, People’s Republic of China; 6State Key Laboratory of Genetic Engineering, Human Phenome Institute, School of Life Sciences, Fudan University, Shanghai, 200433, People’s Republic of China; 7Shanghai Sixth People’s Hospital, Shanghai, 200233, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Guoqing Zhang, Bio-Med Big Data Center, CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Science, Shanghai, 200031, People’s Republic of China, Email gqzhang@sinh.ac.cn Xingdong Chen, Taizhou Institute of Health Sciences, Fudan University, Taizhou, 225300, People’s Republic of China, Email xingdongchen@fudan.edu.cnPurpose: The prevalence of obstructive sleep apnea (OSA) is high worldwide. This study aimed to quantify the relationship between the incidence of OSA and sleep patterns and genetic susceptibility.Methods: A total of 355,133 white British participants enrolled in the UK Biobank between 2006 and 2010 with follow-up data until September 2021 were recruited. We evaluated sleep patterns using a customized sleep scoring method based on the low-risk sleep phenotype, defined as follows: morning chronotype, 7– 8 hours of sleep per day, never/rarely experience insomnia, no snoring, no frequent daytime sleepiness, never/rarely nap, and easily getting up early. The polygenic risk score was calculated to assess genetic susceptibility to OSA. Cox proportional hazard models were used to evaluate the associations between OSA and sleep patterns and genetic susceptibility.Results: During a mean follow-up of 12.57 years, 4618 participants were diagnosed with OSA (age: 56.83 ± 7.69 years, women: 31.3%). Compared with those with a poor sleep pattern, participants with a normal (HR: 0.42, 95% CI: 0.38– 0.46), ideal (HR: 0.21, 95% CI: 0.19– 0.24), or optimal (HR: 0.15, 95% CI: 0.12– 0.18) sleep pattern were significantly more likely to have OSA. The genetic susceptibility of 173,239 participants was calculated, and the results showed that poor (HR: 3.67, 95% CI: 2.95– 4.57) and normal (HR: 1.89, 95% CI: 1.66– 2.16) sleep patterns with high genetic susceptibility can increase the risk for OSA.Conclusion: This large-scale prospective study provides evidence suggesting that sleep patterns across seven low-risk sleep phenotypes may protect against OSA in individuals with varying degrees of genetic susceptibility.Keywords: obstructive sleep apnea, sleep phenotype, sleep pattern, healthy sleep score, genetic susceptibility, polygenic risk score

Tingting Shao,1 Chengwei Zhu,2 Hanning Lei,2 Yiru Jiang,3 Haitao Wang,4 Cai Zhang2 1Institute of Early Childhood Education, Faculty of Education, Beijing Normal University, Beijing, People’s Republic of China; 2Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, People’s Republic of China; 3School of Education Science, Shangrao Normal University, Shangrao, People’s Republic of China; 4Department of education, Ocean University of China, Qingdao, People’s Republic of ChinaCorrespondence: Cai Zhang, Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing, 100875, People’s Republic of China, Email caizhangbj@163.comPurpose: With the increasing ubiquity of smartphones in our daily lives, technoference has emerged as a novel threat to family relationships and child development. This study explored the impact of parent-child technoference on child problematic smartphone use and its underlying mechanism and potential gender difference among children.Participants and Methods: The participants were 3032 fourth-grade students (42.6% female; 80.6% one-child families; 32.9% lower income level families, 33.3% middle income level families; Mage = 10.59 years, SD=0.32) from 535 primary schools. Students in the target classes were invited to participate anonymously in the questionnaire survey in classrooms. Then, SPSS, AMOS and other software were used to analyze the data.Results: 1) Parent-child technoference, negative parenting styles and child problematic smartphone use were positively correlated with each other, while they were negatively correlated with parent-child relationship; 2) Parent-child technoference can not only directly and positively predict child problematic smartphone use, but also indirectly and positively predict child problematic smartphone use through parent-child relationship and negative parenting styles respectively; 3) Parent-child relationship and negative parenting styles play a chain mediating role between parent-child technoference and child problematic smartphone use; 4) There are significant gender differences in the chain mediation model.Conclusion: The results showed that parent-child technoference significantly affected child problematic smartphone use through a chain mediation of parent-child relationship and negative parenting styles. Gender differences were observed, with girls experiencing a more pronounced disruption in the parent-child relationship, while boys were more likely to develop problematic smartphone use. In cases of strained parent-child relationships due to technoference, girls also tended to perceive more negative parenting styles. These findings promote parents’ understanding of the influencing factors and mechanisms of child problematic smartphone use, especially helpful for follow-up measures to prevent and intervene child problematic smartphone use from the perspective of families and parents.Keywords: parent-child technoference, parent-child relationship, negative parenting styles, child problematic smartphone use, gender difference

Shenglan Zhu,1 Junlin Ren,2 Ling Feng,1 Yi Jiang1 1Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People’s Republic of China; 2Department of Computer Science, Huazhong University of Science and Technology, Wuhan, 430074, People’s Republic of ChinaCorrespondence: Yi Jiang; Ling Feng, Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, Hubei, 430030, People’s Republic of China, Email einsmeer@foxmail.com; fltj007@163.comIntroduction: Previous studies have shown that pregnant women with systemic lupus erythematosus (SLE) tend to have a higher risk of adverse pregnancy outcomes, but the potential causal role remained unclear. In this study, we aimed to investigate the causal relationship between SLE and some common pregnancy complications and outcomes using two-sample Mendelian randomization (MR).Methods: The genetic tools were derived from genome-wide association studies of SLE and pregnancy complications and outcomes. MR analysis was performed using inverse variance weighting as primary method. Sensitivity analyses were performed to evaluate the robustness of the results. A retrospective analysis was conducted on 200 pregnant women with SLE and a control group of pregnant women delivering at Tongji Hospital.Results: In the results, we found that genetic susceptibility to SLE was associated with a higher risk of gestational diabetes mellitus (OR = 1.028, 95% CI: 1.006– 1.050), premature delivery (OR = 1.039, 95% CI: 1.013– 1.066), polyhydramnios (OR = 1.075, 95% CI: 1.004– 1.151) and premature rupture of membranes (OR = 1.030, 95% CI: 1.001– 1.060). Some of the retrospective analysis results align with the findings from the MR analysis, indicating that pregnant women with SLE have a higher risk of developing gestational diabetes mellitus and preterm birth. Additionally, although MR analysis did not reveal a causal relationship between SLE and preeclampsia/eclampsia, retrospective analysis discovered that SLE pregnant women are more susceptible to developing preeclampsia/eclampsia (OR = 2.935, 95% CI: 1.118– 7.620).Conclusion: Our study findings suggest a potential causal relationship between SLE and increased risks of gestational diabetes and preterm delivery. Clinical data indicate that pregnant women with SLE are more prone to developing preeclampsia/eclampsia. Clinicians need to be vigilant about the occurrence of these conditions when managing pregnant women with SLE.Keywords: systemic lupus erythematosus, pregnancy complications, Mendelian randomization, gestational diabetes mellitus, preeclampsia, retrospective analysis

Yaping Jiang,1,&ast; Yuying Cai,1,&ast; Xin Zhang,1 Li Chen,1 Xingtao Zhou,2 Yihui Chen1 1Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China; 2Eye Institute and Department of Ophthalmology, Institute for Medical and Engineering Innovation, Eye & ENT Hospital, Fudan University; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xingtao Zhou, Eye Institute and Department of Ophthalmology, Institute for Medical and Engineering Innovation, Eye & ENT Hospital, Fudan University; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, No. 19 Baoqing Road, Xuhui District, Shanghai, 200031, People’s Republic of China, Email doctzhouxingtao@163.com Yihui Chen, Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Shanghai, 200090, People’s Republic of China, Email 1300089@tongji.edu.cnBackground: Laser therapy has been proven as an effective technique for managing ophthalmological disorders. To guide future research, we conducted a bibliometric analysis of laser applications in eye diseases from 1990 to 2022, aiming to identify key themes and trends.Methods: We retrieved 3027 publications from the Web of Science Core Collection (WoSCC). Bibliometrix was used for science mapping of the literature, while VOSviewer and CiteSpace were applied to visualize co-authorship, co-citation, co-occurrence, and bibliographic coupling networks.Results: From a co-citation reference network, we identified 52 distinct clusters. Our analysis uncovered three main research trends. The first trend revolves around the potential evolution of corneal laser surgery techniques, shifting from the treatment of refractive errors to broader applications in biomedical optics. The second trend illustrates the advancement of laser applications in treating a range of disorders, from retinal and ocular surface diseases to glaucoma. The third trend focuses on the innovative uses of established technologies.Conclusion: This study offers significant insights into the evolution of laser applications in ophthalmology over the past 30 years, which will undoubtedly assist scientists in directing further research in this promising field.Keywords: laser, bibliometric, research trend, systematic review, CiteSpace

Suling Chen,1,&ast; Yuanhui Jiang,1,&ast; Xiaoli Lin,1,&ast; Hongjie Chen,1 Xiaoxuan Wu,2 Zhe Qian,3 Xuwen Xu,1 Huiqun Zhong,1 Jie Peng,1 Shaohang Cai1 1Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China; 2Department of Communicable and Endemic Disease Control and Prevention, Haizhu District Center for Disease Control and Prevention, Guangzhou, People’s Republic of China; 3Second Department of Elderly Respiratory, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Huiqun Zhong; Jie Peng, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, People’s Republic of China, Email lovely870821@163.com; pjie138@163.comPurpose: This study aims to investigate the relationship between estimated pulse wave velocity (ePWV) and metabolic syndrome (MetS) in people living with HIV (PLWH), proposing a novel and convenient predictor for early detection of MetS in PLWH.Patients and Methods: A total of 485 PLWH were enrolled. These participants were categorized into two groups based on the estimated pulse wave velocity (ePWV) level. Demographic and clinical data were collected to investigate the correlation between ePWV and MetS.Results: The cohort of 485 PLWH was categorized into high-ePWV and low-ePWV groups based on ePWV cutoff value of 10 m/s. We observed significant differences in components of MetS including triglycerides (TG, P < 0.05), HDL cholesterol (HDL-C, P < 0.01), systolic blood pressure (SBP, P < 0.001), diastolic blood pressure (DBP, P < 0.05), and fasting plasma glucose (FPG, P < 0.001) between the two groups. Furthermore, we employed receiver operating characteristic (ROC) curves to demonstrate the effectiveness of ePWV as a predictive indicator for MetS in PLWH (AUC = 0.739, P

Yiyang Gong,1,2,&ast; Minqin Zhou,2,&ast; Yanting Zhu,2,&ast; Jingying Pan,2 Xuanrui Zhou,2 Yike Jiang,2 Hong Zeng,2 Hao Zheng,2 Xitong Geng,2 Da Huang1 1Department of Thyroid Surgery; Second Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China; 2Second College of Clinical Medicine, Nanchang University, Nanchang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Da Huang, Department of Thyroid Surgery, Second Affiliated Hospital of Nanchang University, 1 Minde Road, Nanchang, Jiangxi Province, 330000, People’s Republic of China, Tel +13576113993, Email danmo0904@163.comPurpose: Hepatocellular carcinoma is the most common primary liver cancer, with poor prognosis. Complex immune microenvironment of the liver is linked to the development of HCC. PVALB is a calcium-binding protein which has been described as a cancer suppressor gene in thyroid cancer and glioma. Nevertheless, the role of PVALB in HCC is unknown.Materials and Methods: We obtained data from TCGA and GSE54236 datasets. MCP-counter, WGCNA and LASSO model were applied to identify PVALB. With UALCAN, MethSurv, and other websites, we probed the expression, methylation and survival of PVALB. LinkedOmics and GSEA were adopted for functional analysis, while TIMER, TISIDB, Kaplan-Meier plotter, TIDE databases were utilized to evaluate the relevance of PVALB to the tumor immune microenvironment and predict immunotherapy efficacy. TargetScan, DIANA, LncRNASNP2 databases and relevant experiments were employed to construct ceRNA network. Finally, molecular docking and drug sensitivity of PVALB were characterized by GeneMANIA, CTD, and so on.Results: PVALB was recognized as a gene associated with HCC and NK cell. Its expression was down-regulated in HCC tissue, which lead to adverse prognosis. Besides, the hypomethylation of PVALB was related to its reduced expression. Notably, PVALB was tightly linked to immune, and its reduced expression attenuated the anticancer effect of NK cells via the Fas/FasL pathway, leading to a adverse outcome. The lnc-YY1AP1-3/hsa-miR-6735-5p/PVALB axis may regulate the PVALB expression. Finally, we found immunotherapy might be a viable treatment option.Conclusion: In a word, PVALB is a prognostic indicator, whose low expression facilitates HCC progression by impacting NK cell infiltration.Keywords: PVALB, hepatocellular carcinoma, immune, ceRNA, bioinformatics, prognostic factor