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Maoye Shen,1 Wenxue Jiang,1 Ping Qian,1 Gaorui Cai,1 Xiaona Wu,1 Jinghua Wang,2 Xianjia Ning,2 Lixia Song1 1Department of Orthopedics, Shenzhen Third People’s Hospital and the Second Hospital Affiliated with the Southern University of Science and Technology, Shenzhen, Guangdong, People’s Republic of China; 2Center of Clinical Epidemiology, Shenzhen Third People’s Hospital and the Second Hospital Affiliated with the Southern University of Science and Technology, Shenzhen, Guangdong, People’s Republic of ChinaCorrespondence: Lixia Song, Department of Orthopedics, Shenzhen Third People’s Hospital and the Second Hospital Affiliated with the Southern University of Science and Technology, 29 Bulan Road, Longgang District, Shenzhen, Guangdong Province, 518112, People’s Republic of China, Tel + 86-755-61222333, Fax + 86-755-61238928, Email songlixia525529@163.com Xianjia Ning, Center of Clinical Epidemiology, Shenzhen Third People’s Hospital and the Second Hospital Affiliated with the Southern University of Science and Technology, 29 Bulan Road, Longgang District, Shenzhen, Guangdong Province, 518112, People’s Republic of China, Tel +86-755-61222333, Fax +86-755-61238928, Email xjn0906@163.comBackground: Bilateral hip arthroplasty is a common surgical intervention for patients with bilateral hip disease. The decision between simultaneous versus staged procedures remains debated, primarily due to concerns over cost, postoperative recovery, and complication rates. This study aimed to evaluate the economic burden and clinical outcomes of simultaneous versus staged bilateral hip arthroplasty.Methods: In this single-center, prospective study, patients who underwent bilateral hip replacement at XXX between 2021 and 2022 were included. Participants were divided into groups based on the surgical approach: simultaneous bilateral hip arthroplasty or staged bilateral hip arthroplasty. Data on costs, operation times, hospital stay lengths, and postoperative outcomes were collected and analyzed.Results: A total of 57 patients were studied, with 45 undergoing simultaneous and 12 staged surgeries. The total cost for staged procedures was significantly higher, with a mean difference of 63,967.54 yuan compared to simultaneous procedures. No significant difference was found in prosthesis costs between the groups. Operation times and hospital stays did not significantly differ, with averages closely aligned between the simultaneous (operation time: 3.2 hours, hospital stay: 5 days) and staged groups (operation time: 3.4 hours, hospital stay: 5.2 days). The obesity rate was higher in the simultaneous group (P < 0.05).Conclusion: Simultaneous bilateral hip arthroplasty appears to be an economically favorable option, with comparable perioperative and immediate postoperative outcomes to staged procedures. These insights have significant implications for clinical practice and policy-making, suggesting that simultaneous procedures can be safely implemented for appropriate patients, potentially optimizing healthcare resources.Keywords: Bilateral Hip Arthroplasty, Simultaneous, Staged, Economic Burden, Clinical Outcomes

Bowen Wei,1,2,&ast; Qingyun Yue,1,2,&ast; Yuxiu Ka,1,2,&ast; Chenyang Sun,1,2 Yuxing Zhao,1,2 Xiaomei Ning,1,2 Yue Jin,1,2 Jingyue Gao,1,2 Yuanhao Wu,1,2 Wei Liu1,2 1Department of Rheumatism and Immunity, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China; 2National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wei Liu, Email fengshiliuwei@163.comBackground: Primary Sjögren’s syndrome (pSS) is an autoimmune condition marked by lymphocyte infiltration in the exocrine glands. Our study aimed to identify a novel biomarker for pSS to improve its diagnosis and treatment.Methods: The gene expression profiles of pSS were obtained from the Gene Expression Omnibus (GEO) database. The specific differentially expressed genes (DEGs) were screened by the Least Absolute Shrinkage and Selection Operator (LASSO), Random Forest (RF), and Recursive Feature Elimination with Support Vector Machines (SVM-RFE). A biomarker was picked out based on correlation and diagnostic performance, the connection between the biomarker and clinical traits and immune infiltrating cells was explored, and the biomarker’s protein expression level in the serum of pSS patients was detected by enzyme-linked immunosorbent assay (ELISA). The competitive endogenous RNA (ceRNA) network regulated by the biomarker was predicted to verify the reliability of the biomarker in diagnosing pSS.Results: IFI44, XAF1, GBP1, EIF2AK2, IFI27, and IFI6 showed prominent diagnostic ability, with the high accuracy (AUC = 0.859) and significance (R ≥ 0.8) of IFI44 within the training dataset. IFI44 strongly exhibited a negative correlation with resting NK cells, macrophages M0, and eosinophils, and a positive correlation with activated dendritic cells, naive B cells, and activated CD4 memory T cells. Furthermore, IFI44 was significantly positively correlated with clinical traits such as IgG, SSA, SSB, ANA, and ESSDAI, with its protein expression level in the serum of pSS patients being notably elevated compared to controls (p < 0.001). Finally, the ceRNA regulatory network showed that hsa-miR-944, hsa-miR-9-5p, hsa-miR-126-5p, and hsa-miR-335-3p were significantly targeted IFI44, suggesting that IFI44 may serve as a dependable biomarker for pSS.Conclusion: In this study, we dug out IFI44 as a biomarker for pSS, systematically studied the potential regulatory mechanism of IFI44, and verified its reliability as a biomarker for pSS.Keywords: primary Sjögren’s syndrome, machine learning, immune cell infiltration, biomarker, IFI44

Guiqing Liu,1 Yuanyuan Yi,1 Yanni Wang,1 Yuru Feng,1 Minyi Lin,1 Xu Yan,1 Jinghua Wang,2 Xianjia Ning,2 Nan Ma1 1Department of Liver Surgery (Liver Transplantation), Shenzhen Third People’s Hospital and the Second Hospital Affiliated with the Southern University of Science and Technology, Shenzhen, Guangdong, People’s Republic of China; 2Center of Clinical Epidemiology, Shenzhen Third People’s Hospital and the Second Hospital Affiliated with the Southern University of Science and Technology, Shenzhen, Guangdong, People’s Republic of ChinaCorrespondence: Nan Ma, Department of Liver Surgery (Liver Transplantation), Shenzhen Third People’s Hospital and the Second Hospital Affiliated with the Southern University of Science and Technology, 29 Bulan Road, Longgang District, Shenzhen, Guangdong Province, 518112, People’s Republic of China, Tel +86-755-61222333, Fax +86-755-61238928, Email manan133@163.comObjective: We aimed to explore the status of nutritional and frailty in patients undergoing liver transplantation and the associated influencing factors.Methods: We conducted a follow-up analysis of 44 patients who underwent liver transplantation between 2021 and 2022. We followed up and recorded the nutritional status and risk of weakness at different time-points (days 1, 2, 3, 6, 9, and 12) postoperatively. Patient information regarding demographics, physical examination, medical history, and perioperative blood tests were collected. Binary logistic regression was applied to identify risk factors for weakness after liver transplantation.Results: The cohort comprised 44 liver transplant recipients, with a mean age of 47.66 years (standard deviation=9.49 years). Initial analysis revealed that, compared to the group without nutritional risks, the group with nutritional risks displayed elevated age and preoperative blood ammonia levels one week post-surgery. Moreover, this group had reduced levels of albumin and total bile acid preoperatively. Patients with preoperative nutritional risks were also prone to similar risks 2 weeks postoperatively. Further, a correlation was observed between preoperative pulmonary infections and increased frailty risk 6 days postoperatively. At both 9 and 12 days postoperatively, patients with frailty risk exhibited higher preoperative white blood cell counts and ammonia levels than those without. Multivariable analysis, controlling for confounding factors, indicated a significant association between preoperative nutritional status and nutritional risk 2 weeks postoperatively, as well as a link between preoperative white blood cell count and frailty risk at 12 days postoperatively.Conclusion: There was a significant correlation between preoperative nutritional status and nutritional risk 2 weeks after liver transplantation, and preoperative white blood cell count was an independent risk factor for weakness 12 days postoperatively. Preoperative nutritional management for patients could potentially mitigate the likelihood of adverse clinical outcomes.Keywords: malnutrition, frailty, liver transplantation, risk factors, epidemiology

Jianlin Wang,&ast; Zhaoyang Wen,&ast; Yumei Xu, Xin Ning, Deping Wang, Jimin Cao, Yanlin Feng Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, and the Department of Physiology, Shanxi Medical University, Taiyuan, 030001, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yanlin Feng; Jimin Cao, Email feng@sxmu.edu.cn; caojimin@sxmu.edu.cnBackground: Wound healing is a continuous and complex process that comprises multiple phases including hemostasis, inflammation, multiplication (proliferation) and remodeling. Although a variety of nanomaterials have been developed to control infection and accelerate wound healing, most of them can only promote one phase but not multiple phases, resulting in lower efficient healing. Although various formulations such as nitric oxide releasing wound dressings were developed for dual action, the nanostructure synthesis and the encapsulation process were complex.Materials and Methods: Here, we report on the design of graphene-barium titanate nanosystem to procedural promote the wound healing process. The antibacterial effect was assessed in Gram-negative Escherichia coli bacteria (E. coli) and Gram-positive Staphylococcus aureus bacteria (S. aureus), the cell proliferation and migration experiment was investigated in mouse embryonic fibroblast (NIH-3T3) cells, and the wound healing effect was analyzed in female BALB/c mice with infected skin wound on the back.Results: Results showed that graphene-barium titanate nanosystem could generate abundant ROS to kill both E. coli and S. aureus. The growth curves, bacterial viability, colony number formation and scanning electron microscopy (SEM) images of E. coli and S. aureus all confirmed the antibacterial effect. Cell Counting Kit-8 (CCK-8) assay displayed that GBT possesses great biocompatibility. EdU assay showed that GBT plus white light irradiation significantly promoted the proliferation and migration of NIH-3T3 cells. Scratch assay found that GBT could achieve a fast scratch closure compared to the control. In vivo wound healing effect indicates that GBT can accelerate wound repair procedure.Conclusion: GBT nanocomposite is capable of programmatically accelerating wound healing through multiple stages, including production of a large amount of ROS after white light exposure to effectively kill E. coli and S. aureus to prevent wound infection and as a scaffold to accelerate fibroblast proliferation and migration to the wound to accelerate wound healing.Keywords: graphene-barium titanate nanosystem, wound healing, reactive oxygen species, antibacterial, proliferation

Kazumasa Saigoh,1 Takao Takeshima,2 Masami Nakai,3 Yoshiyuki Shibasaki,4 Miki Ishida,5 Xiaoping Ning,6 Steve Barash,6 Yuki Isogai,4 Nobuyuki Koga7 1Department of Neurology, Kindai University School of Medicine, Osaka, Japan; 2Headache Center, Department of Neurology, Tominaga Hospital, Osaka, Japan; 3Medical Affairs, Otsuka Pharmaceutical Co, Ltd, Osaka, Japan; 4Medical Affairs, Otsuka Pharmaceutical Co, Ltd, Tokyo, Japan; 5Headquarters of Clinical Development, Otsuka Pharmaceutical Co, Ltd, Osaka, Japan; 6Teva Branded Pharmaceutical Products R&D, Inc, West Chester, PA, USA; 7Medical Affairs, Otsuka Pharmaceutical Co, Ltd, Tokushima, JapanCorrespondence: Masami Nakai, Medical Affairs, Otsuka Pharmaceutical Co., Ltd, 3-2-27 Otedori, Chuo-ku, Osaka, 540-0021, Japan, Tel +81-80-9026-3806, Email nakai.masami@otsuka.jpPurpose: The monoclonal antibody fremanezumab has been shown effective and well tolerated in numerous Phase 2 and Phase 3 trials. This subgroup analysis of the international HALO episodic migraine (EM; [NCT02629861]) trial and a similarly designed phase 2b/3 trial in Japanese and Korean patients (NCT03303092) sought to evaluate the efficacy and safety of fremanezumab in Japanese patients with EM.Patients and Methods: In both trials, eligible patients were randomly assigned at baseline to receive subcutaneous monthly fremanezumab, quarterly fremanezumab, or placebo in a 1:1:1 ratio. The primary endpoint was the mean change from baseline in the monthly (28-day) average number of migraine days during the 12-week period after the first dose of fremanezumab or placebo. Secondary endpoints assessed other aspects of efficacy, including disability and medication use.Results: A total of 301 patients in the Japanese and Korean phase 2b/3 trial and 75 patients in the HALO EM trial were Japanese with baseline and treatment characteristics similar between treatment groups. According to ANCOVA analysis of the primary endpoint, both fremanezumab quarterly and monthly led to greater reductions in the monthly (28-day) average number of migraine days than placebo. This was supported by MMRM analysis of the primary endpoint over the initial 4 weeks, highlighting the rapid onset of action of fremanezumab. Results of secondary endpoint analysis supported the primary endpoint analyses. Fremanezumab was well tolerated with no new safety signals seen in this population of Japanese patients.Conclusion: Fremanezumab appears to be an effective and well-tolerated preventive medication for Japanese patients with EM.Keywords: calcitonin gene-related peptide, episodic migraine, fremanezumab, Japanese

Kazumasa Saigoh,1 Takao Takeshima,2 Masami Nakai,3 Yoshiyuki Shibasaki,4 Miki Ishida,5 Xiaoping Ning,6 Steve Barash,6 Yuki Isogai,4 Nobuyuki Koga7 1Department of Neurology, Kindai University School of Medicine, Osaka, Japan; 2Headache Center, Department of Neurology, Tominaga Hospital, Osaka, Japan; 3Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Osaka, Japan; 4Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Tokyo, Japan; 5Headquarters of Clinical Development, Otsuka Pharmaceutical Co., Ltd., Osaka, Japan; 6Teva Branded Pharmaceutical Products R&D, Inc., West Chester, PA, USA; 7Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Tokushima, JapanCorrespondence: Masami Nakai, Medical Affairs, Otsuka Pharmaceutical Co., Ltd., 3-2-27 Otedori, Chuo-ku, Osaka, 540-0021, Japan, Tel +81-80-9026-3806, Email nakai.masami@otsuka.jpPurpose: Fremanezumab monoclonal antibody therapy has demonstrated efficacy for chronic migraine (CM) with rapid onset and good tolerability. This subgroup analysis of two clinical trials (Japanese and Korean CM Phase 2b/3 [NCT03303079] and HALO CM Phase 3 [NCT02621931]) aimed to evaluate the efficacy and safety of fremanezumab in Japanese patients.Patients and Methods: Both trials randomly assigned eligible patients at baseline (1:1:1 ratio) to subcutaneous monthly fremanezumab, quarterly fremanezumab, or placebo at 4-week intervals. The primary endpoint was the mean change from baseline in the monthly (28-day) average number of headache days of at least moderate severity during the 12-week period after the first dose of study medication (analyzed by ANCOVA over 12 weeks and MMRM over initial 4 weeks). Secondary endpoints examined other aspects of efficacy, including medication use and disability.Results: A total of 479 and 109 patients were Japanese in the Japanese and Korean CM Phase 2b/3 and HALO CM trials, respectively. Baseline and treatment characteristics were generally similar between treatment groups for both trials. Results of subgroup analyses for the primary endpoint according to ANCOVA demonstrated the superiority of fremanezumab over placebo in Japanese patients (quarterly fremanezumab, p=0.0005; monthly fremanezumab, p=0.0002 in both trials). Results using the MMRM analysis confirmed the rapid onset of action in this population. Results of the secondary endpoints further supported the efficacy of fremanezumab in Japanese patients. Fremanezumab was well tolerated with nasopharyngitis and injection-site reactions representing the most common adverse events in all treatment groups.Conclusion: Despite the limitations of subgroup analyses, these consistent results confirm the efficacy and tolerability of fremanezumab in Japanese patients with CM.Keywords: calcitonin gene-related peptide, chronic migraine, fremanezumab, Japanese

Yu Yu,&ast; Ligang Ding,&ast; Yu Deng,&ast; Hao Huang, Sijing Cheng, Chi Cai, Min Gu, Xuhua Chen, Xiaohui Ning, Hongxia Niu, Wei Hua Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wei Hua, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People’s Republic of China, Email drhuaweifw@sina.comBackground: The joint association of atrial fibrillation (AF) and statin therapy with adverse outcomes in heart failure (HF) patients with cardiac resynchronization therapy (CRT) has not been fully investigated so far. The purpose of this study was to explore the independent and joint association of AF and statin therapy with adverse outcomes.Methods: Study patients were divided into four groups according to AF status and statin use: Non-AF/Statin, Non-AF/Non-Statin, AF/Statin, and AF/Non-Statin. Multivariate Cox proportional hazards regression models were used to evaluate the independent and joint association of AF and statin therapy with poor prognosis.Results: Among 685 CRT patients, there were 180 deaths (26.5%) and 198 HF hospitalization (29.6%) during the 14 years of follow-up. AF was associated with a 46% increased risk of all-cause mortality (HR, 1.46; 95% CI, 1.03– 2.07) and a 59% increased risk of HF hospitalization (HR, 1.59; 95% CI, 1.16– 2.20) than those without AF. However, statin therapy failed to improve the prognosis. In the joint analysis, compared with the Non-AF/Statin group, the AF/Non-Statin group suffered a higher risk of all-cause mortality (HR, 1.75; 95% CI, 1.04– 2.93) and HF hospitalization (HR, 1.76; 95% CI, 1.08– 2.86). Furthermore, adding AF to the traditional risk factor model significantly improved the predictive value for death (C-statistic from 0.654 to 0.691) and HF (C-statistic from 0.613 to 0.675).Conclusion: AF was associated with poor prognosis, and statin use failed to improve the prognosis. Further analysis showed that statin therapy is ineffective in improving prognosis and fails to attenuate the adverse effects of AF.Graphical Abstract: Keywords: atrial fibrillation, cardiac resynchronization therapy, joint association, prognosis, statin therapy

Shanshan Hou,1 Chao Li,2 Yihua Wang,3 Jiayin Sun,2 Yutong Guo,4 Xiaofan Ning,1 Kai Ma,1 Xinyue Li,1 Hua Shao,2 Guanqun Cui,5 Minghua Jin,1 Zhongjun Du2 1School of Public Health Jilin University, Changchun, Jilin Province, 130021, the People’s Republic of China; 2Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong Province, 250062, the People’s Republic of China; 3Chemical Institute of Chemical Industry, Xinjiang University of Science and Technology, Korla, Bayinguoleng Mongolian Autonomous Prefecture, Xinjiang Uygur Autonomous Region, 841000, the People’s Republic of China; 4Navel Medical University, Shanghai, 200433, the People’s Republic of China; 5Department of Respiratory Medicine, Children’s Hospital Affiliated to Shandong University, Ji’nan, Shandong Province, 250022, the People’s Republic of ChinaCorrespondence: Minghua Jin, School of Public Health, Jilin University, Changchun, Jilin Province, 130021, the People’s Republic of China, Email jinmh@jlu.edu.cn Zhongjun Du, Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong Province, 250062, the People’s Republic of China, Email duzj1981@163.comIntroduction: Silica nanoparticles (SiNPs) have been widely used in food, cosmetics, medicine and other fields; however, there have been growing concerns regarding their potential adverse effects on health. A large number of studies have confirmed that SiNPs with small particle diameters can pass through the blood brain barrier, causing irreversible damage to the nervous system. This study aims to further explore the molecular mechanism of neurotoxicity of SiNPs and provide a toxicological basis for the medical application of SiNPs.Methods: We conducted an in vitro study using neuroimmune cells (mouse microglial cells, BV2) of the central nervous system to study inflammation and ferroptosis after exposure to SiNPs. We detected cell viability, morphology and ultrastructure, antioxidant function, inflammation, and ferroptosis-related proteins to explore the role of pyroptosis and ferroptosis in the damage of BV2 cells induced by SiNPs. We further explored the relationship between the inflammatory response and ferroptosis induced by SiNPs by silencing the NOD-like receptor thermal protein domain associated protein 3 (NLRP3) gene and inhibiting ferroptosis.Results: The results showed that SiNPs could invade the cytoplasm, change the ultrastructure, activate NLRP3 inflammasomes, release a large number of inflammatory factors, and trigger inflammatory reaction. We also found that SiNPs could disrupt cellular antioxidant function, increase intracellular ferrous ion level and induce ferroptosis. In addition, both inflammation and ferroptosis are alleviated in NLRP3 gene-silenced cells.Conclusion: SiNPs could induce BV2 cytotoxicity through inflammatory response and ferroptosis, which may be mediated by the activation of the NLRP3 inflammasomes.Keywords: SiNPs, microglia, inflammation, ferroptosis, molecular mechanism

Kaifang Wang,1,2 Xin Ning,1 Chuanyue Qin,1 Jianlin Wang,1 Wenjie Yan,1 Xin Zhou,1 Deping Wang,1 Jimin Cao,1 Yanlin Feng1 1Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, and the Department of Physiology, Shanxi Medical University, Taiyuan, People’s Republic of China; 2Department of Cardiology, First Clinical Medical College, Shanxi Medical University, Taiyuan, People’s Republic of ChinaCorrespondence: Jimin Cao; Yanlin Feng, Email caojimin@sxmu.edu.cn; feng@sxmu.edu.cnIntroduction: The wide application of copper oxide nanoparticles (CuO NPs) in industry, agriculture, environmental remediation, and biomedicine has increased the risk of human exposure to CuO NPs. Recent studies suggested that CuO NPs have genotoxic and cytotoxic effects on various cells. However, little is known about the toxicity of CuO NPs on major peripheral organs after respiratory exposure.Materials and Methods: We investigated the toxicities of CuO NPs on human bronchial epithelial (BEAS-2B) and human cardiomyocytes (AC16) cells in vitro, and on the lungs, liver, kidneys, and heart of spontaneously hypertensive rats (SHRs) at 24 and 72 h after intrabronchial instillation in vivo.Results: CuO NPs induced concentration-dependent toxicities in both BEAS-2B and AC16 cells mainly through hierarchical oxidative stress mechanisms, involving generation of reactive oxygen species (ROS), upregulation of heme oxygenase-1 (HO-1), mitochondrial dysfunction, and secretion of proinflammatory and profibrogenic cytokines. Respiratory exposure to CuO NPs induced acute multiple organ injuries in SHRs manifesting through inflammation and fibrosis. However, cardiac injury was relatively less severe than injuries in the lungs, liver, and kidneys. Upregulation of serum C-reaction protein (CRP), tumor necrosis factor α (TNF-α), intercellular adhesion molecule 1 (ICAM-1), endothelin-1 (ET-1), angiotensin converting enzyme (ACE), and von Willebrand factor (vWF) after exposure to CuO NPs indicated systematic inflammation, endothelial injury, and potential prothrombosis.Conclusion: Respiratory exposure to CuO NPs induced acute injuries in main peripheral organs, including the lungs, liver, kidneys, and heart. Individuals with existing cardiovascular diseases were susceptible to exposure to CuO NPs. This study provides a warning about the extensive toxic effects of CuO NPs, especially in the susceptible population.Keywords: CuO nanoparticle, nanotoxicology, hierarchical oxidative stress response, intratracheal instillation, spontaneously hypertensive rat

Jie Bao,1,&ast; Lifeng Wang,2,&ast; Peng Hu,3,&ast; Jie Liu,2,4– 6 Jun Tu,2,4– 6 Jinghua Wang,2,4– 6 Jidong Li,2,7 Xianjia Ning2,4– 6 1Department of Rehabilitation Medicine, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China; 2Center of Clinical Epidemiology & Evidence-Based Medicine, Tianjin Jizhou People’s Hospital, Tianjin, 301900, People’s Republic of China; 3Department of Acupuncture Encephalopathy, Binhai New Area Hospital of TCM, Tianjin, 300451, People’s Republic of China; 4Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China; 5Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China; 6Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of China; 7Department of Neurosurgery, Tianjin Jizhou People’s Hospital, Tianjin, 301900, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xianjia Ning, Laboratory of Epidemiology, Tianjin Neurological Institute & Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of China, Tel +86-22-60817505, Fax +86-22-60817448, Email xning@tmu.edu.cn Jidong Li, Department of Neurosurgery, Tianjin Jizhou People’s Hospital, Center of Clinical Epidemiology & Evidence-Based Medicine, Tianjin Jizhou People’s Hospital, 18 Nanhuan Road, Jizhou District, Tianjin, 301900, People’s Republic of China, Tel/Fax +86-22- 60733586, Email jd_li_doctor@163.comIntroduction: Metabolic syndrome (MetS) is a chronic and complex disease associated with all-cause mortality, cardiovascular disease, and type 2 diabetes. The present study aimed to evaluate the prevalence of MetS and its risk factors among middle-aged and older adults in low-income, low-education rural areas with a high incidence of stroke.Methods: This cross-sectional study of the general population was performed from April 2019 to June 2019 in rural areas of Tianjin, China. All eligible residents aged ≥ 45 years and without active malignant tumors, hepatic failure, and severe renal disease underwent routine medical examinations, which included a questionnaire, physical examination, and routine blood and biochemical tests. The modified International Diabetes Federation criteria for the Asian population was used to identify patients with MetS.Results: A total of 3175 individuals (44.8% men, 55.2% women) were included in the final analysis. The prevalence of MetS was 52.8%, with higher prevalence in women than in men (62.4%and 40.9%, respectively). Of the five MetS components, high blood pressure and abdominal obesity were the two most prevalent in both women and men, accounting for 89.3% and 62.0%, respectively, followed by elevated fasting plasma glucose, low high-density lipoprotein cholesterol, and elevated triglycerides. Multivariate logistic regression analysis revealed the following traits to be risk factors for MetS: female sex, self-reported smoking, self-reported snoring, high body mass index, high waist-to-hip ratio, and high serum urate level.Conclusion: The prevalence of MetS was quite high in rural areas with a low-income, low-education population. Implementing preventive and therapeutic interventions based on these risk factors is essential to prevent metabolic abnormalities.Keywords: metabolic syndrome, epidemiology, risk factors, population-based, cross-sectional study

Xiaoying Ning, Yanfei Zhang, Wei Wang, Huling Yan, Yumin Xia Department of Dermatology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of ChinaCorrespondence: Yanfei Zhang, Department of Dermatology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China, Email zhangyanfei723@163.comBackground: Vitiligo is a common, acquired depigmenting disorder. The pathogenesis is not clear, neuropsychological factors may be involved. Vitiligo will affect the individual’s physical and psychological health, leading to different levels of psychological behavior problems. However, there are few research on psychological symptoms in patients with vitiligo in China.Methods: Adult patients with vitiligo were selected in convenient sampling method from March 2019 to November 2019 from the dermatology clinic. They were evaluated by the DLQI (Dermatology Life Quality Index), SCL-90 (Symptom Checklist-90), SADS (Social Avoidance and Distress Scale) and MCMQ (Medical Coping Modes Questionnaire).Results: The DLQI score was 7.56 ± 6.11, which was in the third level. The SCL-90 score of patients with vitiligo was 136.44 ± 39.19, significantly higher than the Chinese norms (P < 0.05), and it mainly manifested as interpersonal sensitivity, depression, anxiety and phobia, which may be affected by the patient’s gender, marital status, severity of disease, stage and location of skin lesions. The total score of SADS in patients was 10.30 ± 6.38. The total score and scores in all dimensions of SADS were significantly higher than the Chinese norms (all P < 0.05), which were related with the patient’s gender, educational attainment, severity, type and stage of skin lesions. For MCMQ, the facing score was significantly lower than the Chinese norms (P < 0.05), and the avoiding and yielding scores were significantly higher than the Chinese norms (all P < 0.05).Conclusion: In China, vitiligo affects the patient’s quality of life to varying degrees, resulting in a series of psychological and behavioral problems. We should actively concern and improve the psychological health status and behavior of patients, and multidisciplinary treatment strategies and education about vitiligo should be given to the patients.Keywords: vitiligo, quality of life, psychological health status, behavioral and psychological symptoms

Xiufen Wang,1– 3 Li Luo,1– 3 Dandan Zhang,1– 3 Jinghua Wang,4,5 Xianjia Ning,4,5 Yi Lin,2,3,6 Xue Ke,1– 3 Guobao Li1– 3 1Department of the Third Pulmonary Disease, The Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China; 2The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, People’s Republic of China; 3National Clinical Research Center for Infectious Diseases, Shenzhen, Guangdong, People’s Republic of China; 4Center of Clinical Epidemiology, The Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China; 5Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China; 6Department of the Second Pulmonary Disease, The Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of ChinaCorrespondence: Guobao Li; Xue Ke, Department of the Third Pulmonary Disease, The Third People’s Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology & National Clinical Research Center for Infectious Diseases, 29 Bulan Road, Shenzhen, Guangdong Province, 518112, People’s Republic of China, Tel +86-755-61238942, Fax +86-755-61238928, Email Lgb062112@163.com; blueske_520@163.comObjective: Patients with tuberculosis have a high nutritional risk, and patients with tuberculosis and structural lung disease have a poor quality of life. However, few studies have investigated the nutritional risk of patients with tuberculosis and structural lung disease. This study aimed to evaluate nutritional risk in patients with pulmonary tuberculosis and structural lung disease and to identify factors associated with nutritional risk in this population.Methods: We performed a cross-sectional study of patients diagnosed with pulmonary tuberculosis and structural lung disease admitted to The Third People’s Hospital of Shenzhen, China between January 1, 2019 and December 31, 2021. We assessed participants’ nutritional risk using the Nutritional Risk Screening 2002 tool, and analyzed the relationship between nutritional risk and sociodemographic factors, disease status, and laboratory test results.Results: Of the 415 participants, 53.5% were at nutritional risk on admission to the hospital. Nutritional risk was significantly associated with being unmarried, destroyed lung, and red blood cell (RBC) and lymphocyte counts.Conclusion: Patients with tuberculosis and structural lung disease had a high prevalence of nutritional risk. The main factors associated with nutritional risk were being unmarried, lung cavitation, and low RBC and lymphocyte counts. Patients hospitalized with pulmonary TB should be evaluated for nutritional risk. Moreover, unmarried patients and patients with lung cavitation or low RBC or lymphocyte counts should be closely monitored.Keywords: structural lung disease, nutritional risk, risk factors, pulmonary tuberculosis, destroyed lung

Yumei Wu,1 Hui Zeng,2 Meiping Zhang,1 Chunyan Li,2 Yuanlin Tang,2 Xiufen Li,1 Shanyou Yuan,3 Qifeng Wei,3 Jinghua Wang,4 Xianjia Ning,4 Xiaoyin Zhang1 1Department of Gastroenterology, the Third People’s Hospital of Shenzhen, Shenzhen, Guangdong Province, People’s Republic of China; 2Department of Health Management, the Third People’s Hospital of Shenzhen, Shenzhen, Guangdong Province, People’s Republic of China; 3Department of Orthopedics, the Third People’s Hospital of Shenzhen, Shenzhen, Guangdong Province, People’s Republic of China; 4Centre of Clinical Epidemiology, the Third People’s Hospital of Shenzhen, Shenzhen, Guangdong Province, People’s Republic of ChinaCorrespondence: Xiaoyin Zhang, Department of Gastroenterology, the Third People’s Hospital of Shenzhen, 29 Bulan Road, Longgang District, Shenzhen, Guangdong Province, 518112, People’s Republic of China, Tel +86-755-61222333, Fax +86-755-61238928, Email xhnk_01@163.com Xianjia Ning, Center of Clinical Epidemiology, the Third People’s Hospital of Shenzhen, 29 Bulan Road, Longgang District, Shenzhen, Guangdong Province, 518112, People’s Republic of China, Tel +86-755-61222333, Fax +86-755-61238928, Email xning@tmu.edu.cnPurpose: Helicobacter pylori is one of the most common causes of peptic ulcers, gastritis, and gastric cancers. This study investigated sex-specific differences in the prevalence of H. pylori infection and its associated factors among individuals undergoing hospital-based health examinations in southern China.Methods: This study enrolled consecutive healthy individuals who underwent regular health examinations at a hospital physical examination center between September 2020 and September 2021. Anthropometric characteristics and biochemical profiles were measured. All individuals underwent carbon-13 urea breath tests. Univariate and multivariate analyses were used to evaluate the factors associated with H. pylori infection.Results: A total of 5035 individuals (men, 59.1%; women, 40.9%) were included in the analyses. The total rate of H. pylori infection was 35.0% (men, 35.5%; women, 34.3%). In the multivariate analysis, the risk factors identified for H. pylori infections were high fasting blood glucose levels and blood pressure ≥ 160 mmHg in men and older age, high body mass index, and low albumin levels in women.Conclusion: These findings suggest that physicians must be aware of the metabolic factors associated with H. pylori infections in the Chinese population. Early detection of these factors and timely intervention are expected to reduce H. pylori infections and provide a theoretical basis for the primary prevention of several gastrointestinal diseases.Keywords: Helicobacter pylori infection, gastrointestinal disease, sex differences, prevalence, metabolic factors

Jiapeng Fu,1– 3,&ast; Jian Li,1– 3,&ast; Zhi Liu,1– 3 Shasha Zheng,1– 3 Xue Li,1– 3 Xianjia Ning,4,5 Jinghua Wang,4,5 Wenying Gao,1– 3 Guobao Li1– 3 1Department of the Third Pulmonary Disease, The Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China; 2The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, People’s Republic of China; 3National Clinical Research Center for Infectious Diseases, Shenzhen, Guangdong, People’s Republic of China; 4Center of Clinical Epidemiology, The Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China; 5Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Guobao Li; Wenying Gao, Department of the Third Pulmonary Disease, The Third People’s Hospital of Shenzhen, 29 Bulan Road, Longgang District, Shenzhen, Guangdong Province, 518112, People’s Republic of China, Tel +86-755-61238942, Fax +86-755-61238928, Email Lgb062112@163.com; jmjtgwy@126.comPurpose: Tracheobronchial tuberculosis (TBTB) has been proposed to occur more commonly in female patients. However, to date, studies that systematically delineate differences between female and male patients with TB infection are lacking. We aimed to comprehensively assess the sex-specific differences in clinical manifestation, bronchoscopy performance, bacteriological examination, and imaging of TBTB in Shenzhen, China.Methods: All patients with diagnosed TBTB from August 1, 2018 to July 31, 2021 at The Third People’s Hospital of Shenzhen were enrolled in the present study. Demographic information, clinical manifestations, blood tests, chest computed tomography, and bronchoscopic findings were collected, and assessed their sex-specific differences.Results: Of these 331 patients, 238 patients (71.9%) were female, and 93 patients (28.1%) were male, with an overall average age of 37.3 years. The average age of male patients with TBTB was more than 5 years older than that of female patients. The prevalence of lymph fistula and diabetes mellitus was significantly higher in male patients than female patients (8.6% vs 1.7%, P = 0.005; 17.2% vs 2.1%, P < 0.001). The positive proportion of sputum smear was higher in male patients (27.9%) than in female patients (16.7%, P = 0.026). Moreover, the mean monocyte-to-lymphocyte ratio, serum CRP, and IL-6 levels were significantly higher in male patients than in female patients (P < 0.05).Conclusion: In summary, in patients with TBTB diagnosis, male sex was associated with a high prevalence of diabetes mellitus, lymph fistula, and smear-positive ratio, as well as high inflammation levels. The management of young female and male patients with diabetes mellitus and high inflammation levels should be strengthened. Furthermore, to reduce the burden of TBTB, we must pay attention to the risk of TBTB in past tuberculosis patients, especially male patients under 45 years old and female patients over 45 years old.Keywords: sex difference, tracheobronchial tuberculosis, inflammation

Yunpeng Lin,1,&ast; Yan Li,2,3,&ast; Zhiying Li,4,&ast; Zhen Zhang,5 Jie Liu,3,6– 8 Jiayi Sun,5 Jun Tu,3,6– 8 Jinghua Wang,3,6– 8 Wenjuan Zhang,5 Jidong Li,2,9 Xianjia Ning3,6– 8 1Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China; 2Department of Anesthesiology, Tianjin Jizhou People’s Hospital, Tianjin, 301900, People’s Republic of China; 3Center of Clinical Epidemiology & Evidence-Based Medicine, Tianjin Jizhou People’s Hospital, Tianjin, 301900, People’s Republic of China; 4Department of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine & National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300193, People’s Republic of China; 5Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China; 6Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China; 7Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China; 8Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of China; 9Department of Neurosurgery, Tianjin Jizhou People’s Hospital, Tianjin, 301900, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xianjia Ning, Department of Neurology, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin, 300052, People’s Republic of China, Tel +86-22-60817505, Fax +86-22-60817448, Email xning@tmu.edu.cn Jidong Li, Department of Neurosurgery, Tianjin Jizhou People’s Hospital, 18 Nanhuan Road, Jizhou District, Tianjin, 301900, People’s Republic of China, Tel/Fax +86-22- 60733586, Email jd_li_doctor@163.comPurpose: More than 150 million people are estimated to have been examined for the presence of carotid plaques (CPs) in China; a sex-related imbalance in the prevalence exists. However, the relationship between sex and the incidence of CP development is unclear, especially in low-income areas of China. Hence, this study aimed to identify the sex differences in CP development and CP burden in both sexes in this population.Methods: The study population included individuals aged ≥ 45 years in a rural area of Tianjin, China. Carotid ultrasonography was performed in the 2014 and 2019 cohorts, and information on carotid ultrasonography, including the formation and number of CPs, was collected twice. Logistic analyses were used to investigate the predictors of CP formation and numbers of plaques.Results: A total of 1479 participants were analyzed. The incidence of CP was 20.3% and 29.0% in women and men, respectively. In women, high low-density lipoprotein cholesterol (LDL-C) levels was independent predictors of CP formation (RR: 1.217, 95%CI: 1.010, 1.461; P=0.039). For men, the corresponding predictors were hypertension, alcohol consumption, and low high-density lipoprotein cholesterol (HDL-C) levels (all P< 0.05); none of the examined factors were associated with plaque numbers.Conclusion: In the study population, men had a higher incidence of plaque than women. Predictors of CP are different in men and women. LDL-C control is critical for moderating atherosclerosis in women; in men, managing blood pressure, stopping alcohol consumption, and controlling HDL-C levels are important.Keywords: atherosclerosis, carotid plaque, sex differences, predictors, prospective study

Jianwen Ren, Xiaoying Ning, Dingwei Zhang, Yanfei Zhang Department of Dermatology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xian, Shaanxi Province, People’s Republic of ChinaCorrespondence: Yanfei ZhangDepartment of Dermatology, The Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xi Wu Road, Xi’an, 710004, Shaanxi Province, People’s Republic of ChinaTel/Fax +86-29-87679301Email zhangyanfei723@163.comPurpose: Cutaneous lichen planus (CLP) is an autoinflammatory skin disorder, and it is associated with metabolic syndrome. Wingless-type mouse mammary tumor virus integration site family member 5a (Wnt5a) is a potential factor in metabolic complications and it was shown to be upregulated in CLP lesions. Whether Wnt5a is altered in the circulation of patients with CLP is unclear. This study aimed to measure serum Wnt5a level in patients with CLP and to assess its relationship with body mass index (BMI).Methods: We included 46 adult patients with CLP and 38 healthy adults as control. Serum Wnt5a was measured using enzyme-linked immunosorbent assay.Results: The mean serum Wnt5a was significantly higher in patients than controls (all P-value < 0.001). The mean serum Wnt5a levels in obese (BMI between 30 and 40) patients were significantly higher than lean (BMI between 20 and 25) patients (P-value < 0.001). Compared to lean patients with CLP, the concentration of serum Wnt5a levels was increased gradually with BMI score (all P-value < 0.05).Conclusion: Serum Wnt5a might be a potential biomarker for CLP and it was associated with BMI. An increase in serum Wnt5a may contribute to the development of metabolic comorbidity in CLP patients.Keywords: wingless-type mouse mammary tumor virus integration site family member 5a, cutaneous lichen planus, metabolic comorbidity, obesity

Xuchao Ning,1 Renzhi Li,2 Bin Zhang,3 Yue Wang,4 Ziyi Zhou,1 Zanzan Ji,5 Xiajie Lyu,6 Zhenyu Chen1 1Department of Cosmetic and Plastic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266072, People’s Republic of China; 2Dalian Medical University, Dalian, Liaoning, 116000, People’s Republic of China; 3Office of Family Planning, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266072, People’s Republic of China; 4Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266072, People’s Republic of China; 5The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266072, People’s Republic of China; 6Weifang Medical University, Weifang, Shandong, 261000, People’s Republic of ChinaCorrespondence: Zhenyu ChenDepartment of Cosmetic and Plastic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266072, People’s Republic of ChinaEmail qdfy_plastic2017@163.comBackground: Tumor microenvironment (TME) refers to the cellular environment where tumors exist, including immune cells, fibroblasts, stromal cells, chemokines, etc. TME is closely related to the prognosis of various tumors; nevertheless, limited studies have established predictive prognosis models based on TME. This work aims to construct a survival prediction model for melanoma patients based on TME.Methods: Data of 482 melanoma patients were extracted from The Cancer Genome Atlas (TCGA) database. Based on the infiltration of immune cells (Immune score), stromal cells (Stromal score), and tumor purity (Estimate score), the “Estimate” algorithm was used to construct 3 scores for each patient. To identify the differentially expressed genes (DEGs), Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were conducted using DAVID database and visualized using the R software. The STRING database was used to construct the protein-protein interaction (PPI) network and functional modules. FGD2 expression was confirmed via Western Blotting and quantitative reverse transcription PCR (RT-qPCR) analyses.Results: Patients with higher immune scores estimate scores showed better OS than those with lower scores. All three scores were related to age and primary tumor stage. Further, DEGs between patients with high immune/stromal scores and low immune/stromal scores were screened. Eventually, 10 down-regulated DEGs and 201 up-regulated DEGs were identified as TME associated genes. Out of these, the FGD2 gene demonstrated close association with survival and was confirmed in the included melanoma patients.Conclusion: In summary, TME is closely associated with the prognosis of melanoma patients. Besides, genes including FGD2 promote the TME-mediated regulation of melanoma.Keywords: tumor microenvironment, the cancer genome atlas, melanoma, FGD2

Xiaoying Ning, Dingwei Zhang, Yuan Wang, Jia Huo, Ying Huang, Ying Guo, Zhengxiao Li, Yanfei Zhang Department of Dermatology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xian, Shaanxi Province, People’s Republic of ChinaCorrespondence: Zhengxiao Li; Yanfei ZhangDepartment of Dermatology, The Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xi Wu Road, Xian, Shaanxi Province, 710004, People’s Republic of ChinaTel/Fax +86-29-87679301Email lizhengxiao1979@163.com; zhangyanfei723@163.comPurpose: Psoriasis is a systemic, chronic and inflammatory condition. The exact pathogenesis is unclear. The abnormal expression of Wnt5a pathway in psoriasis vulgaris has been confirmed. Whether it is related to the severity of psoriasis is unclear.Methods: Thirty-eight skin lesions from psoriasis vulgaris patients and 22 healthy adult skin tissues were taken. The semi-quantitative immunohistochemistry score of Wnt5a, Frizzled5 and Frizzled2 was evaluated under a microscope by two independent dermatologists. Psoriasis area and severity index (PASI) score system was used to evaluate the disease severity.Results: The average PASI score of the patients was 16.25 ± 7.8, and the average duration of disease was 19.6 ± 10.4 months. Wnt5a, Frizzled5 and Frizzled2 were highly expressed in psoriasis lesions. The semi-quantitative immunohistochemistry scores of Wnt5a, Frizzled5 and Frizzled2 were positively correlated with PASI scores (r = 0.71, r = 0.46, r = 0.65, respectively, all P-value < 0.01), but not correlated with duration of disease (r = 0.11, r = 0.17, r = 0.29, respectively, all P-value > 0.05). There were significant positive correlations between Wnt5a and Frizzled5 (r = 0.57, P-value < 0.01), as well as Wnt5a and Frizzled2 (r = 0.59, P-value < 0.01).Conclusion: Wnt5a and its receptors play an important role in pathogenesis of psoriasis vulgaris and are positively correlated with the severity of psoriasis, and may be one of the immunohistochemical predictors of the severity of the disease.Keywords: psoriasis vulgaris, Wnt5a, PASI, Frizzled5, Frizzled2

Jing Han,1,&ast; Jie Liu,1– 4,&ast; Yakun Wu,1,5,&ast; Qiuxing Lin,1– 3,5 Dandan Guo,1 Xin Zhang,1 Jun Tu,1– 3,5 Xianjia Ning,1– 3,5 Jinghua Wang1– 3,5 1Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China; 2Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China; 3Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of China; 4Center of Clinical Epidemiology & Evidence-Based Medicine, The Jizhou People’s Hospital, Tianjin, 301999, People’s Republic of China; 5Department of Neurology, Tangshan Gongren Hospital, Tangshan, 063000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jinghua Wang; Xianjia Ning Email jwang3@tmu.edu.cn; xning@tmu.edu.cnObjective: Although stroke mortality has remained stable over the past decade, the long-term trends of stroke burden are scarce in China, especially in low-income populations. Thus, we aimed to explore the secular trends in the prognosis of stroke in a low-income population in China.Methods: This was a population-based stroke surveillance study that included all of the participants in the Tianjin Brain Study. Stroke management and outcomes were evaluated for all stroke patients. Trends in the burden of stroke were assessed as annual percentage changes.Results: Overall, 1462 stroke cases occurred from 1992 to 2018, and 58.7% of patients were male. The rates of diagnosis by neuroimaging and of hospitalization increased noticeably across sexes and ages for all stroke types, and the greatest increases were observed among elderly women; diagnosis by neuroimaging increased by 4.7% and the rate of hospitalization increased by 12.4% (all P< 0.001). Stroke fatality decreased by 3.7% annually among those aged < 65 years and by 3.1% among patients aged ≥ 65 years; the corresponding rates were 7.4% and 3.5%, respectively, for women. The recurrence rate of ischemic stroke significantly decreased among all men, by 9.6% for those aged < 65 years and by 3.1% for those aged ≥ 65 years; however, for women, this rate only significantly decreased for those aged ≥ 65 years.Conclusion: Our findings suggest that the allocation of medical resources has improved over the past decades. However, it is crucial to enhance secondary stroke prevention for women aged < 65 years by controlling risk factors in low-income populations.Keywords: stroke burden, case fatality, recurrence, trends, low-income population

Xiaobing Tian,1,&ast; Yan Li,2,3,&ast; Jie Liu,1,2,4,5,&ast; Qiuxing Lin,1,2,4,5 Qiaoxia Yang,6 Jun Tu,1,2,4,5 Jinghua Wang,1,2,4,5 Jidong Li,2,7 Xianjia Ning1,2,4,5 1Department of Neurology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China; 2Center of Clinical Epidemiology & Evidence-Based Medicine, The Jizhou People’s Hospital, Tianjin, People’s Republic of China; 3Department of Anesthesiology, The Jizhou People’s Hospital, Tianjin, People’s Republic of China; 4Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, People’s Republic of China; 5Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, People’s Republic of China; 6Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China; 7Department of Neurosurgery, The Jizhou People’s Hospital, Tianjin, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xianjia Ning; Jidong Li Email xning@tmu.edu.cn; jd_li_doctor@163.comIntroduction: Isolated impaired glucose tolerance (i–IGT) is a subtype of prediabetes in which an individual demonstrates elevated 2-h post-glucose load glucose levels but normal fasting plasma glucose levels. However, few studies have explored the prevalence and risk factors of i–IGT among adults in rural China. Thus, we aimed to explore the prevalence and risk factors of i–IGT among adults ≥ 50 years old in a low-income, rural population in China.Materials and Methods: Individuals aged ≥ 50 years with normal fasting plasma glucose levels were included in the final analysis. Fasting and 2-h venous blood samples were collected to assess the selected parameter measurements.Results: A total of 2175 individuals were included in this study. The i–IGT prevalence was 22.9% and significantly higher among females than among males (P< 0.05). Older age [odds ratio (OR), 1.606; 95% confidence interval (CI), 1.101– 2.342; P=0.014), hypertension (OR, 1.554; 95% CI, 1.152– 2.019; P=0.004), and central obesity (OR, 1.395; 95% CI, 1.099– 1.771; P=0.006) were associated with i–IGT. Moreover, white blood cell (OR, 1.089; 95% CI, 1.009– 1.175; P=0.029), high-sensitivity C-reactive protein (OR, 1.049; 95% CI, 1.020– 1.078; P=0.001), serum uric acid (OR, 1.0003; 95% CI, 1.001– 1.004; P=0.001), triglyceride (OR, 1.540; 95% CI, 1.105– 2.147; P=0.011), and alanine aminotransferase (OR, 1.012; 95% CI, 1.004– 1.021; P=0.004) levels were also linked to i–IGT in the analyzed population.Conclusion: Health promotion education and a standardized approach to managing body weight, BP, and lipid and uric acid levels would benefit this low-income population in rural China for reducing the risk of cardiovascular disease.Keywords: impaired glucose tolerance, prevalence, risk factors, normal fasting plasma glucose, epidemiology

Liming Fan,1,&ast; Qiaoxia Yang,2,&ast; Xin Zhang,3,&ast; Qiuxing Lin,3– 5 Dandan Guo,3 Jie Liu,2– 4 Jun Tu,3– 5 Jinghua Wang,3– 5 Yan Li,6 Xianjia Ning3– 5 1Department of Medical Clinical Laboratory, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China; 2Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China; 3Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China; 4Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China; 5Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of China; 6Department of Anesthesiology, Tianjin Jizhou People’s Hospital, Tianjin, 301900, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xianjia NingDepartment of Neurology, Tianjin Medical University General Hospital, Laboratory of Epidemiology, Tianjin Neurological Institute & Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, 154 Anshan Road, Heping District, Tianjin, 300052, People’s Republic of ChinaTel +86-22-60817505Fax +86-22-60817448Email xning@tmu.edu.cnYan LiDepartment of Anesthesiology, Tianjin Jizhou People’s Hospital, 18 Nanhuan Road, Jizhou District, Tianjin, 301900, People’s Republic of ChinaTel/Fax +86-22- 60733586Email drliyan@163.comIntroduction: Carotid atherosclerosis is a well-established biomarker associated with future cardiovascular disease and stroke. We explored the influence of sex on the relationship between metabolic syndrome (MetS) and its components with carotid intima-media thickness (CIMT) among a low-income population in China, which has a high incidence of stroke.Methods: This population-based study recruited participants aged ≥ 45 years from rural areas of Tianjin, China between April 2014 and January 2015. Anthropometric characteristics and biochemical profiles were measured. CIMT was assessed using ultrasonography. Diagnosis of MetS and its components was made using the modified International Diabetes Federation criteria for the Asian population. A multivariate linear regression model was used to evaluate the effects of sex on the relationship between the presence of MetS and its components and CIMT.Results: A total of 3583 individuals (men, 41.4%; women, 58.6%) were included in the analyses. MetS was prevalent in 54.5% (men, 42.3%; women, 63.2%) of the participants. Mean CIMT was 0.57 ± 0.09 mm. In the multivariate analysis, for both sexes, CIMT increased significantly when MetS was present compared with when it was not (both P < 0.001). A common trend was observed in both sexes, in that CIMT increased as the number of MetS components increased, with β (95% confidence interval [CI]) = 0.021 (0.000, 0.042) for men and 0.014 (0.002, 0.026) for women (both P < 0.05). Of the five MetS components, elevated blood pressure was an independent risk factor for increased CIMT in both sexes (men: β = 0.013; 95% CI: 0.003, 0.023; P = 0.008; women: β = 0.024; 95% CI: 0.016, 0.033; P < 0.001). Moreover, abdominal obesity was also an independent risk factor for increased CIMT in men (β = 0.013; 95% CI: 0.003, 0.023; P = 0.008) but not in women.Conclusion: The presence and number of components of MetS were associated with CIMT in both men and women. Sex differences were found in the impact of individual components of MetS on CIMT. Early identification and management of MetS according to sex-specific risk of MetS should be considered to reduce the prevalence and burden of carotid atherosclerosis in rural China, which has a high incidence of stroke, a known consequence of carotid atherosclerosis.Keywords: atherosclerosis, carotid intima-media thickness, metabolic syndrome, components, sex differences

Changqing Zhan,1 Qiao Wang,2 Jie Liu,3– 5 Lei Wang,1 Zongsheng Chen,1 Hongbo Pang,1 Jun Tu,3– 5 Xianjia Ning,3– 5 Jinghua Wang,3– 5 Shizao Fei1 1Department of Neurology, The Second People’s Hospital of Wuhu, Wuhu, Anhui, People’s Republic of China; 2Department of Pathology, The Second People’s Hospital of Wuhu, Wuhu, Anhui, People’s Republic of China; 3Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China; 4Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China; 5Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of ChinaCorrespondence: Shizao FeiDepartment of Neurology, The Second People’s Hospital of Wuhu, 259 Jiuhuazhong Road, Wuhu, 241000, Anhui Province, People’s Republic of ChinaTel +86-553-3909017Fax +86-553-3832545Email feishizao@163.comJinghua WangLaboratory of Epidemiology, Tianjin Neurological Institute, Department of Neurology, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin, 300052, People’s Republic of ChinaTel +86-22-60817504Fax +86-22-60817448Email jwang3@tmu.edu.cnIntroduction: To explore the relationship between metabolic syndrome (MetS) and cognitive impairment in a low-income and low-education population.Methods: All residents aged ≥ 45 years in a low-income population in Tianjin, China, were eligible to participate in this study. The Mini-Mental State Examination (MMSE) scale was used to conduct a preliminary screening and assessment of the participants’ cognitive statuses. The MMSE components are orientation, registration, attention and calculation, recall, and language.Results: In this population, the prevalences of MetS and cognitive impairment were 54.1% and 44.5%, respectively. In the overall population, the registration score was 0.105 points lower in the elevated triglycerides (TG) group than in the normal TG group (β, − 0.105; 95% confidence interval [CI]: − 0.201, − 0.010; P=0.030). In men, high TG was associated with registration scores that were 0.152 points lower than those in the normal TG group (95% CI: − 0.281, − 0.022; P=0.022), while larger WC and lower HDL-C had positive effects on cognitive scores (all P< 0.05). However, in women, there were no significant differences between cognitive scores and MetS or its components.Conclusion: In this population, first, TG had a great impact on cognition, even greater than the impact of MetS on cognition. Second, the impact of MetS components on cognition was more obvious in men, and not all of the effects were negative. Therefore, the effect of MetS on cognition may need to be analyzed separately for different populations, and it may be that the effect of a single component is greater than the overall effect. When formulating prevention strategies for cognitive impairments, population differences must also be taken into consideration.Keywords: cognitive impairment, MMSE, metabolic syndrome, aging, population-based study

Hongli Zhao,1,* Ying Zhang,2,* Jianhong Ye,3 Hongjiang Wei,4 Zhengping Huang,5 Xiaoyan Ning,6 Xiaoying Fu1 1Department of Endocrinology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, 510317, People’s Republic of China; 2Department of Endocrinology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, People’s Republic of China; 3Department of Endocrinology, Foshan Hospital of Traditional Chinese Medicine, Foshan, 528000, People’s Republic of China; 4Outpatient Department, Guangdong Second Provincial General Hospital, Guangzhou, 510317, People’s Republic of China; 5Department of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, Guangzhou, 510317, People’s Republic of China; 6Department of Gastroenterology, Guangdong Second Provincial General Hospital, Guangzhou, 510317, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jianhong YeDepartment of Endocrinology, Foshan Hospital of Traditional Chinese Medicine, No. 6, Qinren Road, Chancheng District, Foshan, Guangdong Province, 528000, People’s Republic of ChinaTel/Fax +86 0757-83066101Email jhy_ye@outlook.comObjective: The incidence of Hashimoto’s thyroiditis (HT) in patients with polycystic ovary syndrome (PCOS) is significantly higher than in normal controls, and there is a risk of more severe metabolic symptoms when the two diseases occur together. This study compares insulin secretion, insulin resistance (IR) and thyroid function in patients with PCOS with and without HT.Methods: A total of 164 patients (52 patients with HT (HT+) and 112 patients without HT diagnosed PCOS at our hospital were enrolled for testing of oral glucose tolerance, insulin release, thyroid function, the presence of thyroglobulin and thyroid peroxidase antibodies, and blood lipid levels.Results: Patients with PCOS and HT had higher insulin secretion and IR levels than those without HT, while free thyroxine and thyrotropin levels were significantly lower. The ratio of free thyroxine to thyrotropin was higher in patients with HT.Conclusion: HT may related with IR and relatively low thyroid function in patients with PCOS. Thus, thyroid function and autoimmune status in patients with PCOS should be evaluated in clinical practice.Keywords: polycystic ovary syndrome, Hashimoto’s thyroiditis, insulin resistance, oral glucose tolerance test

Xiaoyi Ning,1,* Yun Kuang,1,* Shuwei Zhao,2 Wenjing Hou,2 Guoping Yang,1,3,4 Xuerui Zhu,5 Ruiling Liu,6 Jie Huang1 1Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 2Center of Clinical Medical Trial, Medical University General Hospital, Tianjin, People’s Republic of China; 3Research Center for Drug Clinical Evaluation of Central South University, Changsha, Hunan, People’s Republic of China; 4Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 5Department of clinical research and development, Zhejiang Wolwo Biopharmaceuticals, Deqing, Zhejiang, People’s Republic of China; 6Department of Allergy, Medical University General Hospital, Tianjin, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ruiling LiuDepartment of Allergy, Medical University General Hospital, Tianjin 300052, People’s Republic of ChinaTel/Fax +8618622930966Email lrly05@163.comJie HuangCenter for Clinical Pharmacology, The Third Xiangya Hospital, Central South University, 138 TongZiPo Road, Changsha, Hunan 410013, People’s Republic of ChinaTel/Fax +8615116469024Email cellahuang1988@163.comBackground: Eight extracts from common native allergens, Artemisia annua pollen, Platanus pollen, Humulus pollen, Betula platyphylla pollen, Ambrosia artemisiifolia pollen, Blattella germanica, cat dander and dog dander were developed for skin prick test (SPT). Since standardization and composition alone cannot guarantee that the allergen extracts are within the concentration range that give the best chance of a true diagnosis, it is necessary to explore the optimal diagnostic concentration (ODC) of allergens in SPT.Objective: To identify the optimal diagnostic concentration of eight allergen extracts in SPT and assess the safety of simultaneous administration.Patients and Methods: Patients with a history of allergic disease were enrolled in this two-part open-label, parallel study. In Study 1, 92 patients were enrolled into eight groups according to their disease-causing allergens and were given three increasing concentrations of the corresponding allergen. In Study 2, 20 patients were divided into two concentration groups and were given all of the eight allergens. Safety and sensitivity were evaluated to determine the optimal diagnostic concentration.Results: In Study 1, the sensitivity of seven allergen extracts was > 80% at middle and high concentrations, except for Ambrosia artemisiifolia pollen. The optimal diagnostic concentration (in DU/mL) for eight allergens was 33,333, 12,000, 8667, 50,000, 40,000, 3333, 7000, and 5000. In Study 2, the prevalence of adverse events in the two groups was 70% and 80%, respectively. A total of 10 wheals of 8 patients did not subside < 24 h after SPTs.Conclusion: The eight allergens showed high sensitivity and safety at a certain concentration, which was defined as optimal diagnostic concentration. The results support further clinical research of investigated allergens and our study offers a scheme to determine the ODC of allergens in SPT.Keywords: skin prick test, allergen, optimal diagnostic concentration

Abstract Herein, 2-(2-methoxyphenoxy)-1-phenylethanol (β-O-4), 2-methoxyphenyl anisole (α-O-4) and 4-phenoxyphenol (4-O-5) were selected as typical lignin model compounds. Given the effectiveness of traditional acid–base catalysts for lignin depolymerisation, a novel Ni/CaO–H-ZSM-5(60) catalyst was prepared to investigate the difficulty level of C–O bond of three model compounds cleavage in ethanol. It was observed that Ni/CaO–H-ZSM-5(60) had prominent performance on the C–O bond cleavage at very mild conditions (140 °C, 1 MPa H2). Among them, the C–O bond of α-O-4 and β-O-4 could be completely cleaved within 60 min. Although the C–O bond of 4-O-5 had high bond energy, 41.2% of conversion was occurred in 60 min. The introduction of CaO could regulate the acidity of H-ZSM-5 to enhance the ability to break C–O bonds. Moreover, the possible pathways of C–O ether bonds in three lignin model compounds cleavage were proposed in order to selectively obtain target products from the raw lignin degradation.

Yutaka Takagi,1 Xuanhe Ning,1 Akihiko Takahashi,1 Chiaki Ishizaki,2 Takahiro Nishizaka,1 Kazuhiro Kaizu,1 Masahiro Miyaki,1 Hotaka Yamamuro,1 Makoto Kawashima3 1Skin Care Product Research, Kao Corporation, Tokyo, Japan; 2Ebisu Skin Research Center, Inforward, Inc., Tokyo, Japan; 3Department of Dermatology, Tokyo Women’s Medical University, Tokyo, Japan Objective: Dry and scaly conditions on the scalp are often observed in patients with atopic dermatitis, seborrheic dermatitis and/or pityriasis capitis. Those scalp lesions often exhibit low barrier function and reduced ceramide levels. Therefore, a clinical study was conducted to evaluate the efficacy of topical application of a pseudo-ceramide and eucalyptus extract-containing lotion on the scalps of patients with skin diseases.Methods: Thirty-four subjects participated in this study (atopic dermatitis: 19 subjects; seborrheic dermatitis: 6 subjects; pityriasis capitis: 9 subjects). After 4 weeks of daily treatment with a pseudo-ceramide and eucalyptus extract-containing lotion, the skin symptoms had significantly improved in all patients with those skin diseases.Results: Skin dryness, scaling, and erythema were significantly improved by treatment with the lotion. The moisture-retention ability of the scalp was significantly increased and itchiness, evaluated using a visual analog scale, decreased significantly. Accompanying those improvements was a significant improvement in the quality of life of the subjects, evaluated by the Skindex-16®.Conclusion: From these results, we conclude that this pseudo-ceramide and eucalyptus extract-containing lotion effectively improved the dry and scaly conditions of the scalp as well as the quality of life of subjects with atopic dermatitis, seborrheic dermatitis, or pityriasis capitis. Keywords: formulation, skin care, moisturization, scalp lotion, sensitive skin, inflammation

Complex biological tissues consist of numerous cells in a highly coordinated manner and carry out various biological functions. Therefore, segmenting a tissue into spatial and functional domains is critically important for understanding and controlling the biological functions. The emerging spatial transcriptomics technologies allow simultaneous measurements of thousands of genes with precise spatial information, providing an unprecedented opportunity for dissecting biological tissues. However, how to utilize such noisy, sparse, and high dimensional data for tissue segmentation remains a major challenge. Here, we develop a deep learning-based method, named SCAN-IT by transforming the spatial domain identification problem into an image segmentation problem, with cells mimicking pixels and expression values of genes within a cell representing the color channels. Specifically, SCAN-IT relies on geometric modeling, graph neural networks, and an informatics approach, DeepGraphInfomax. We demonstrate that SCAN-IT can handle datasets from a wide range of spatial transcriptomics techniques, including the ones with high spatial resolution but low gene coverage as well as those with low spatial resolution but high gene coverage. We show that SCAN-IT outperforms state-of-the-art methods using a benchmark dataset with ground truth domain annotations.

This study sequentially extracted five cell wall polysaccharides from passion fruit peels using water, cyclohexane-trans-1,2-diamine tetra-acetate (CDTA), Na2CO3, and NaOH at varying concentrations. The composition, structure, and physical properties of these polysaccharides were investigated. The results demonstrated that water-extracted polysaccharides yielded the highest content, accounting for 9.04% of the dry weight of the peel's alcohol-insoluble residue. This was followed by polysaccharides extracted with 4 mol/L NaOH (8.15%), 0.05 mol/L CDTA (7.38%), 0.05 mol/L Na2CO3 (5.36%), and 1 mol/L NaOH (3.89%). Water-extracted and 0.05 mol/L CDTA-extracted polysaccharides were dominated by homogalacturonan, with molecular weights of 198.46 kDa and 73.67 kDa, respectively. The 0.05 mol/L Na2CO3-extracted polysaccharides had a high percentage of rhamnogalacturonan (53.47%) and the most negligible molecular weight (30.29 kDa). The polysaccharides extracted with 1 mol/L NaOH and 4 mol/L NaOH were hemicellulosic in nature, primarily composed of xylose, glucose, mannose, and galactose. All polysaccharides exhibited shear-thinning flow behaviors in aqueous solutions. The 0.05 mol/L Na2CO3-extracted polysaccharides showed the highest apparent viscosity and demonstrated elastic behavior, with the elastic modulus G′ exceeding the viscous modulus G″. The water-extracted polysaccharides and the 0.05 mol/L CDTA-extracted polysaccharides exhibited a gel-to-sol transition at angular frequencies near 1.10 and 0.43 rad/s, respectively. The 0.05 mol/L Na2CO3-extracted polysaccharides displayed relatively excellent emulsifying ability and emulsion stability. Hemicellulosic polysaccharides exhibited lower viscosity and higher thermal stability. Thus, passion fruit peels contained abundant cell wall polysaccharides, with different polysaccharides showing varied potential for emulsification and food texture improvement. This study provides valuable insights for the in-depth development of the extraction and use of peel polysaccharide fractions.

Abstract Background Disulfidptosis refers to cell death caused by the accumulation and bonding of disulfide in the cytoskeleton protein of SLC7A11-high level cells under glucose deprivation. However, the role of disulfidptosis-related genes (DRGs) in prostate cancer (PCa) classification and regulation of the tumor microenvironment remains unclear. Methods Firstly, we analyzed the expression and mutation landscape of DRGs in PCa. We observed the expression levels of SLC7A11 in PCa cells through in vitro experiments and assessed the inhibitory effect of the glucose transporter inhibitor BAY-876 on SLC7A11-high cells using CCK-8 assay. Subsequently, we performed unsupervised clustering of the PCa population and analyzed the differentially expressed genes (DEGs) between clusters. Using machine learning techniques to select a minimal gene set and developed disulfidoptosis-related risk signatures for PCa. We analyzed the tumor immune microenvironment and the sensitivity to immunotherapy in different risk groups. Finally, we validated the accuracy of the prognostic signatures genes using single-cell sequencing, qPCR, and western blot. Results Although SLC7A11 can increase the migration ability of tumor cells, BAY-876 effectively suppressed the viability of prostate cancer cells, particularly those with high SLC7A11 expression. Based on the DRGs, PCa patients were categorized into two clusters (A and B). The risk label, consisting of a minimal gene set derived from DEGs, included four genes. The expression levels of these genes in PCa were initially validated through in vitro experiments, and the accuracy of the risk label was confirmed in an external dataset. Cluster-B exhibited higher expression levels of DRG, representing lower risk, better prognosis, higher immune cell infiltration, and greater sensitivity to immune checkpoint blockade, whereas Cluster A showed the opposite results. These findings suggest that DRGs may serve as targets for PCa classification and treatment. Additionally, we constructed a nomogram that incorporates DRGs and clinical pathological features, providing clinicians with a quantitative method to assess the prognosis of PCa patients. Conclusion This study analyzed the potential connection between disulfidptosis and PCa, and established a prognostic model related to disulfidptosis, which holds promise as a valuable tool for the management and treatment of PCa patients.

Abstract Background The multidimensional health poverty afflicting rural women of reproductive age bears profound implications for the sustainable development of families, societies, and healthy villages. Elucidating vulnerable groups at risk of multidimensional health poverty and delineating its determinants can inform refinements and implementation of health-poverty alleviation policies. Methods Based on the 2022 "Health Status and Health Service Utilization" survey data in rural Ningxia, China, this study analyzes the dimension of health status, capacity for health service utilization, health expenditure and security using the A-F dual-threshold method, logit model, and probit model. It comprehensively evaluates multidimensional health poverty and analyzes its determining factors among rural women of childbearing age. Results With k set at 0.3, the health multidimensional poverty index, incidence, and intensity among rural women of reproductive age were 0.021, 0.053, and 0.392, respectively. Chronic illness, capacity for free gynecological examination utilization, health examination utilization, and borrowing due to illness contributed significantly to multidimensional health poverty. Risk factors for multidimensional health poverty among rural women of childbearing age include age, unemployment, family size, and lack of sanitary toilets. Protective factors include being married, educational level, non-farm or student occupation, receiving government support, separate housing and kitchen, owning a television and computer. Conclusions Even with the elimination of absolute poverty, the multidimensional health poverty situation among rural women remains important from a gender perspective. It is recommended to strengthen economic assistance and health service support for these groups, improve the level of rural health services from a gender perspective, and enhance housing structure and sanitation toilet usage in rural areas. Efforts should be made to narrow the digital divide in rural areas and promote digital health education. Pre-interventions on multidimensional health poverty can provide new pathways for the development, empowerment, and well-being of rural women of childbearing age.