Search

"Wide-awakeness"is the core proposition in Maxine Green's philosophy.The proposal of"wide-awakeness"is based on the reflection of the harm of technical rationality, the correction of excessive pursuit of the value of educational tools, and the vigilance of the numbness of "given" and the neglect of self-existence in teachers'work and life.This concept, borrowed from the field of sociology, aims to describe the ideal state of consciousness of teachers who maintain a high degree of consciousness tension and pay full attention to educational life, taking into account the dual demands of teachers'self-consciousness and identity consciousness.For teachers, the realization of "wide-awakeness"has the dual value of boosting personal growth and role growth: it can not only help teachers consciously change the status quo and pursue a better life, but also encourages teachers to transcend their own knowledge and thinking limitations, innovate teaching content and methods, and help students develop their personality and play their potential.

Copper-chromium-zirconium alloy is a common alloy enhanced by precipitation， and it is extensively used in high-speed railway contact wires， lead frames， and heat exchange. The high-performance， complex-structured CuCrZr alloy produced by selective laser melting（LSM） has vast application potential in electronic components and heat exchangers. CuCrZr alloy powders were used as basic materials and manufactured by selective laser melting. Additionally， the effect of laser energy density on the microstructure and characteristics of SLM CuCrZr alloy was investigated. The results show that with the increase of laser energy density， the relative density of the alloy increases. At low energy density （119 J/mm3）， there are irregular holes on the surface of alloy sample， because the molten metal exhibits poor fluidity in the region surrounding the edge of the defect-prone molten pool. However， when the energy density increases to 267 J/mm3， the number of irregular holes decreases. Moreover， the relative density reaches the maximum value of 98.34% with the increasing energy density. Additionally， the electrical conductivity of the CuCrZr alloys with different process parameters is between 15.57%IACS and 18.68%IACS. Relative density is one of the variables that influence electrical conductivity， and the samples with great relative density have higher electrical conductivity than those with low relative density. Furthermore， there are significant differences in the strength and elongation properties of the samples with different process parameters. When the laser power is kept constant and the scanning speed and spacing are decreased， the strength of the alloy gradually increases. However， when the laser power increases and the scanning speed and spacing remain constant， the strength of the alloy increases accordingly. It can be concluded that the SLM process parameters have a great influence on the mechanical properties of the produced alloy. Density is intimately retated to the tensile characteristics of materials. Particularly， the greater the relative density is， the smaller the porosity of the material is， and the greater its strength is. With the increase in the bulk energy density， the degree of densification of the samples increases， and their tensile characteristics are enhanced. The SLM-5# sample， manufactured with the parameters P=400 W， V=500 mm/s， and h=0.1 mm， shows the largest relative density and the highest ultimate tensile strength （330.63 MPa）， also has excellent plasticity， with the elongation of 30.81%. In addition， the sample exhibits ductile fracture properties， and the fracture surface has varying degrees of porosity and inclusion flaws. These are formed by the solidification of splash and unmelted particles generated during the SLM process， the pore size is between 3 μm and 100 μm， and tensile deformation traces in the form of wrinkles are dispersed around the inner walls of the holes， indicating that the samples generate significant amounts of plastic deformation during the tensile process. The presence of varying degrees of porosity and inclusion flaws on the fracture surface may disrupt the consistency of the internal structure of the molded components. The XRD spectrum indicates that the phase composition of the SLM CuCrZr alloy sample is α-Cu， and the Bragg peak of the sample significantly differs from that of the CuCrZr alloy powder. During the SLM process， the XY plane of the sample produces a strong ｛110｝ texture.The elongation at break of SLM CuCrZr alloy reaches 40.95%， and the tensile fracture morphology shows that defects such as unfused particles and holes are the key factors reducing the strength of the alloy.

The defects on TB6 titanium alloy were repaired using pulsed TIG（tungsten inert gas） additive manufacturing technology， and the effects of process parameters （pulse current and pulse time） and heat treatment on the microstructure and mechanical properties of the repaired TB6 titanium alloy were studied to determine the optimal heat treatment process parameters. The results show that the mechanical properties are relatively better in the as-repaired state when the pulse current is 50 A and the pulse time is 40 ms， with a tensile strength of 1113 MPa and an elongation of 5.26%. These samples are sequentially subjected to solid solution and aging heat treatment. When the samples are solid solution treated for 2 h under different temperatures （740， 760， 780 ℃）， the primary α phase is increasingly dissolved， while the β phase gradually grows and evenly distributes in the matrix. After water quenching， the growth of the β phase is inhibited， and acicular rhombic martensite α'' phase is precipitated in β grains， resulting in a decrease in tensile strength and a remarkable increase in elongation. Under different aging temperatures （500， 520， 540 ℃） for 8 h， the α'' phase continuously grows and gradually transforms to equiaxial grain， and the mechanical properties are greatly improved. The optimal microstructure and mechanical properties are achieved under the conditions of 780 ℃/2 h WC+520 ℃/8 h AC， with a tensile strength of 1119 MPa and an elongation of 7.36%.

Fiber reinforced polymer composites are widely used in aerospace， automotive， shipbuilding， rail transportation， and other fields. With the development of lightweight high-speed aerospace and precision instrument automation， vibration problems are increasingly prominent， and it is necessary to develop new structural-damping composites with high mechanical properties and high vibration damping performance. Based on the research of fiber reinforced polymer damping composites in the past decade， the damping mechanism of the material was described， and the influence of polymer matrix， reinforced fiber， interface and other factors on the damping performance of fiber reinforced polymer composites was summarized， providing a reference for further developing fiber reinforced polymer composites with the required damping performance. Finally， the existing problems and development directions of fiber reinforced polymer damping composites are discussed， such as the development of new materials， new methods，new mechanisms， the co-optimization of damping properties of composite materials and mechanical/technological properties， and the corresponding relationship between the damping properties of components， materials and structures.

In order to expand the application of silver carp protein hydrolysate in frozen dough, this paper investigated the effects of silver carp protein hydrolysates on the freezable water content, water distribution and migration, microstructure, rheological properties, fermentation properties of frozen dough during frozen storage, and analyzed specific volume, textural properties and sensory score of bread. The DSC and LF-NMR results showed that the addition of silver carp protein hydrolysate inhibited the increase of freezable water content and water fluidity of dough during the frozen storage. The SEM, rheological and fermentation properties results showed that the addition of silver carp protein hydrolysate reduced the mechanical damage of gluten network structure, and increased the proportion of elastic properties and fermentation volume of dough during frozen storage. The results of specific volume and texture showed that the addition of silver carp protein hydrolysate improved the specific volume and elasticity of bread, and reduced its hardness and chewability. Silver carp protein hydrolysate also improved sensory score of bread. In conclusion, it can be seen that silver carp protein hydrolysate can effectively improve the quality of frozen dough and bread.

In order to broaden the use of taro paste resources and improve its nutritional value, taro paste was used as a fermentation substrate and fermented by Lactobacillus plantarum type TR22, followed by adding it to the dough to make bread. Based on the changes in the nutrient composition of the substrate during the fermentation process, the effects of different additions (0%, 5%, 10% and 15%, w/w) of taro paste on the flour properties, rheological properties and bread quality were investigated. The results showed that taro paste fermented by Lactobacillus fermentation had up to 8.39×106 CFU/mL of Lactobacillus colonies, 5.21 mg/g of lactic acid and 4.96 mg/g of acetic acid, respectively, and extracellular polysaccharides increased from 1.43 to 2.38 g/kg, with varying degrees of increase in amino acid content. The addition of fermented taro paste enhanced the water absorption, elasticity and softness of the dough, and to some extent increased the specific volume and air holding capacity of the bread, resulting in a softer state of organization and a reduction in the number of air holes in the core capsule. In conclusion, the addition of Lactobacillus fermented taro paste can improve the quality of bread, providing a theoretical basis for the use of fermented taro paste in bread products.

Ningkang Li,1,2,&ast; Xia Qi,2,&ast; Jiamin Bao,2 Yang Gu,1,2 Xiaohong Zhou,1,2 Ting Wang,2 Ningxiang Jiang,3 Yun Wang,2 Qingshan Ye1,2 1Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China; 2Department of Anesthesiology, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China; 3Department of Breast Surgery, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Qingshan Ye; Yun Wang, Department of Anesthesiology, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, 750002, People’s Republic of China, Email yeqingshan@hotmail.com; wangyun10483@126.comPurpose: Minimally invasive rotary resection (MIRR) is crucial for diagnosing and treating breast tumors, but the optimal intravenous anesthesia regimen is unclear. Esketamine, an NMDA receptor antagonist with anesthetic, analgesic, and sympathomimetic properties, may provide an ideal adjunct to propofol sedation. This study aims to compare the safety and efficacy of esketamine versus sufentanil as adjuncts to propofol for analgesia and sedation during breast MIRR.Patients and Methods: A total of 90 patients undergoing elective breast MIRR were randomly assigned to receive either sufentanil-propofol or esketamine-propofol for analgesia and sedation. The primary outcome was the occurrence of hypoxia (SpO2 < 92% for > 10s or exhibiting a persistent downward trajectory). Other outcomes included incidence of subclinical respiratory depression (92% ≤ SpO2 < 95% for > 10s), number of airway interventions, awakening time, satisfaction scores, postoperative exhaust time, hemodynamic parameters, and side events.Results: Finally, 41 patients were assigned to the sufentanil group and 40 to the esketamine group. The occurrence of hypoxia was significantly lower in the esketamine group (17.5%) than in the sufentanil group (39%) (P = 0.032). Subclinical respiratory depression occurred in 32.5% of the esketamine group and 56.1% of the sufentanil group (P = 0.033). The sufentanil group required more airway interventions than the esketamine group (P = 0.032), and patients in the sufentanil group experiencing hypoxia received more mask-assisted ventilation (P = 0.029). Hemodynamic stability was better in the esketamine group. No significant differences were observed in awakening time, satisfaction score, postoperative exhaust time, or side events between groups.Conclusion: Esketamine-propofol anesthesia significantly reduces the risk of hypoxia (SpO2 < 92%) compared to sufentanil-propofol, while maintaining similar awakening time, satisfaction, postoperative exhaust time, and side events. Its hemodynamic advantages make it valuable for clinical use, especially in procedures requiring respiratory and hemodynamic stability.Keywords: esketamine, hypoxia, respiratory depression, minimally invasive rotary resection, breast tumor

Yang Chen,1,&ast; Lijie Sun,1,&ast; Minghui Chen,1,&ast; Hui Zhang,2 Bing Song,3 Hongxiao Wang,3 Aijun Jiang,1,4 Li Zhang,5 Sumei Li,1 Jumei Wang,1 Wei Wang,1 Haoqiang Zhang1 1Department of Endocrinology, Centre for Leading Medicine and Advanced Technologies of IHM, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People’s Republic of China; 2Henan Key Laboratory of Rare Diseases, Endocrinology and Metabolism Center, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, People’s Republic of China; 3Department of Endocrinology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, People’s Republic of China; 4University of Science and Technology of China, Hefei, People’s Republic of China; 5ShuCheng People’s Hospital, Luan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wei Wang; Haoqiang Zhang, Email hfww2001@ustc.edu.cn; drhqzhang@ustc.edu.cnPurpose: Our objective is to investigate the potential involvement of free triiodothyronine (FT3), a key bioactive compound found in thyroid hormones (THs) in the pathogenesis of diabetic peripheral neuropathy (DPN) in patients diagnosed with type 2 diabetes mellitus (T2DM).Patients and Methods: A total of 121 T2DM patients were recruited. And then, they were divided into the control group and the DPN group. Clinical parameters were collected for each patient. Additionally, nerve conduction velocity was tested using neurophysiological methods. Correlation and regression analyses were employed to examine the relationship between the concentrations of FT3 and DPN.Results: Compared to 57 patients without DPN, 64 patients with DPN showed increased HbA1c and low-density lipoprotein cholesterol (LDL-C) levels (P=0.001 and 0.042), as well as decreased concentrations of FT3 (P=0.042). Additionally, FT3 levels are positively associated with the motor and sensory fibers conduction velocity of the Ulnar nerve, as well as the motor conduction velocity of the Tibial nerve, with (R=0.205, P=0.025; R=0.191, P=0.038; R=0.220, p=0.016) or without (R=0.257, P=0.004; R=0.227, P=0.012; R=0.227, p=0.012) adjustment for HbA1c and LDL-C. Furthermore, multiple linear regression analysis suggests that decreased FT3 levels may influence the motor and sensory fibers conduction velocity of the Ulnar nerve (β=0.795, P=0.025 and β=0.909, P=0.038), as well as the motor conduction velocity of the Tibial nerve (β=0.727, P=0.016). Moreover, our study demonstrated that decreased FT3 levels are one of the risk factors for DPN in T2DM patients, as determined by binary logistic regression analysis (OR=0.542, P=0.022).Conclusion: Lower concentrations of FT3 are one of the risk factors for DPN in patients with T2DM. Additionally, decreased FT3 levels may influence peripheral neuropathy, particularly affecting the motor and sensory fibers conduction velocity of the ulnar nerve, as well as the motor fiber conduction velocity of the tibial nerve.Keywords: free triiodothyronine, diabetic peripheral neuropathy, type 2 diabetes mellitus, thyroid hormone, conduction velocity of nerve

Hongli Wang,1,2,* Mingzhu Wang,1,2,* Tengyue Wang,1,2 Xuanlin Li,1,2 Chengping Wen,1,2 Zhexing He,1,2 Lin Huang1,2 1Research Institute of Chinese Medical Clinical Foundation and Immunology, School of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, 310053, People’s Republic of China; 2Key Laboratory of Chinese Medicine Rheumatology of Zhejiang Province, Zhejiang Chinese Medical University, Hangzhou, 310053, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lin Huang; Zhexing He, College of Basic Medical Science, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, People’s Republic of China, Email huanglin@zcmu.edu.cn; hzx2015@zcmu.edu.cnBackground: Rheumatoid arthritis (RA) is an autoimmune disease characterized by joint inflammation and bone destruction, leading to severe complications. Previous research has suggested that high humidity conditions may exacerbate RA, however, the underlying mechanisms remain unclear. Furthermore, there is a lack of evidence linking humidity to the worsening of RA symptoms in animal models.Methods: The Collagen-induced arthritis (CIA) mouse model was established using C57BL/6 mice. The arthritis status of the mice was evaluated under two distinct humidity conditions (50% and 80%). The aim of the present study was to investigate the impact of elevated humidity levels on the types of splenic cells present using mass spectrometry flow. Additionally, the study utilized MDSCs, which are significantly upregulated by high humidity, to assess the levels of oxidative stress and conducted mRNA sequencing of sorted MDSCs to investigate their impact on arthritis in CIA mice.Results: Compared to normal humidity, high humidity exacerbated arthritis incidence in mice, resulting in increased arthritis scores, swelling, serum autoantibodies (anti-COII and anti-CCP), and upregulation of pro-inflammatory cytokines. Significant variations were observed in the spleen index under high humidity condition, accompanied by noticeable inflammatory alterations. Moreover, elevated humidity levels induced a substantial modulation in MDSCs population in the spleen of CIA mice, along with alterations in oxidative stress markers such as heightened serum ROS levels, and increased expression of COX, SOD, and Nrf2 mRNA. Following successful sorting of MDSCs, mRNA sequencing revealed a decrease in the expression of Rap1 signaling pathway under high humidity environment, which may contribute to the increase of MDSCs cells and aggravate the progression of RA disease.Conclusion: A comprehensive analysis of the available data reveals a detrimental impact of high humidity on MDSCs numbers within spleen tissue, with potential implications for the development of RA.Keywords: rheumatoid arthritis, high humidity environment, myeloid-derived suppressor cells, Rap1 signaling pathway

He Song,&ast; Aobo Wang,&ast; Lei Zang, Tianyi Wang, Shuo Yuan, Ning Fan, Peng Du Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Lei Zang, Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 5 JingYuan Road, Shijingshan District, Beijing, 100043, People’s Republic of China, Tel +86-010-51718268, Email zanglei@ccmu.edu.cnPurpose: Adjacent disc degeneration (ADD) is a common postoperative complication after percutaneous kyphoplasty (PKP). However, risk factors for ADD after PKP have not been reported. This study aimed to determine whether osteoporotic vertebral compression fracture (OVCF) following PKP is associated with a high risk for ADD and to identify the risk factors for ADD.Patients and methods: Consecutive patients who underwent PKP at our center between January 2015 and January 2021 were retrospectively reviewed. The incidence of ADD was calculated and specific subgroups of ADD were identified. Demographic, clinical baseline, and radiologic data were analyzed using univariate and multivariate analyses to identify the risk factors associated with ADD.Results: 130 eligible patients were included, and the incidence rate of ADD distinct from primary degeneration was 42.3%. Patients with OVCFs who underwent PKP had a high risk of developing ADD. The independent risk factors included the presence of intradiscal cement leakage (ICL; odds ratio [OR] 6.292; 95% confidence interval [CI] 2.588– 15.299; P < 0.001) and pre-operative cranial disc of the injured vertebrae degeneration (Pfirrmann grade ≥IV; OR 3.575; 95% CI 1.515– 8.438; P = 0.004).Conclusion: Patients with OVCFs who underwent PKP were more likely to develop ADD, and most of the degenerated discs occurred in the vertebrae above the level of injury. ICL and pre-operative cranial disc of the injured vertebrae degeneration (Pfirrmann grade ≥IV) were independent risk factors for developing ADD in these patients.Keywords: adjacent disc degeneration, percutaneous kyphoplasty, osteoporotic vertebral compression fracture, risk factors

Chenkai Wang,1,2 Zefan Shen,1,2 Yiyang Chen,1,2 Yifan Wang,2 Xuanyi Zhou,2 Xinyi Chen,1 Yuhang Li,2 Pu Zhang,2 Qi Zhang2 1The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China; 2Urology & Nephrology Center, Department of Urology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People’s Republic of ChinaCorrespondence: Qi Zhang; Pu Zhang, Email clinic@zju.edu.cn; zhangpuxjtuer@163.comAbstract: A key challenge in cancer treatment is the effective delivery of drugs into deep regions of tumor tissues, which are impermeable due to abnormal vascular network, increased interstitial fluid pressure (IFP), abundant extra cellular matrix (ECM), and heterogeneity of tumor cells. Cyclic peptides have been used for the surface engineering of nanoparticles to enhance the tumor-penetrating efficacy of drugs. Compared with other surface ligands, cyclic peptides are more easily produced by automated chemical synthesis, and they are featured by their higher binding affinity with their targets, tumor selectivity, stability against degradation, and low toxicity. In this review, different types of cyclic peptides, their physicochemical properties and their in vivo pharmacokinetics are introduced. Next, the progress of cyclic peptide-functionalized drug delivery nanodevices is updated, and the mechanism underlying the tumor-penetrating properties of cyclic peptide-functionalized drug delivery nanodevices is discussed.Keywords: cyclic peptide, tumor penetration, drug delivery, nanomaterial functionalization

Haopeng Li,1,&ast; Juan Zhou,2,&ast; Qinghua Wang,1 Yaru Zhu,1 Tong Zi,1 Xin Qin,1 Yan Zhao,1 Wei Jiang,1 Xilei Li,1 Xin’an Wang,1 Chengdang Xu,1 Xi Chen,1 Gang Wu1 1Department of Urology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200092, People’s Republic of China; 2Department of ICU, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200092, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xi Chen; Gang Wu, Email 15132767126@163.com; wg_urologist@163.comPurpose: This study aims to evaluate the predictive value of the renal resistive index (RRI) and β 2-microglobulin (β 2-MG) for acute kidney injury (AKI) in urosepsis patients and to develop a clinical prediction model for AKI risk.Methods: Data from 108 urosepsis patients at Tongji Hospital were analyzed. Patients were divided into AKI (67 patients) and non-AKI (41 patients) groups based on KDIGO guidelines. Univariate analysis identified potential AKI risk factors, which were further assessed using multivariate logistic regression. A nomogram was constructed based on significant predictors, with internal validation via the bootstrap method. The model’s accuracy and clinical utility were evaluated using ROC curves and Decision Curve Analysis (DCA).Results: Multivariate analysis identified RRI, β 2-MG, procalcitonin (PCT), and serum creatinine (Scr) as independent AKI risk factors. The combined predictive indicators yielded an AUC of 0.879, outperforming individual markers (P < 0.05). The prediction model achieved an AUC of 0.949, with high sensitivity (92.5%) and specificity (82.9%). Further analysis revealed that RRI, β 2-MG, PCT, and APACHE II scores were independent predictors of poor prognosis in urosepsis-related AKI, with combined RRI and β 2-MG predictions showing superior performance.Conclusion: Elevated RRI, β 2-MG, PCT, and Scr levels are independent predictors of AKI in urosepsis. RRI, β 2-MG, PCT, and APACHE II scores also predict poor prognosis in urosepsis-related AKI. The nomogram combining these factors demonstrates high predictive accuracy and clinical applicability.Keywords: renal resistive index, β 2-microglobulin, urosepsis, acute kidney injury

Chao Wu,&ast; Chunxia He,&ast; Haimeng Wang, Wenming Wang, Hongzhong Jin Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Hongzhong Jin, Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy Medical Science and Peking Union Medical College, No. 1 Shuai Fu Yuan Street, Beijing, 100730, People’s Republic of China, Fax +86-10-6915-1502, Email jinhongzhong@263.netPurpose: This prospective observational study investigated whether interleukin (IL)-17A inhibitors could reduce serum uric acid (SUA) levels in psoriatic patients with hyperuricemia. It also explored the risk factors for hyperuricemia in psoriatic patients and the effectiveness of IL-17A inhibitors for the skin lesions of psoriatic patients with hyperuricemia.Methods: Patients aged ≥ 18 years with moderate to severe plaque psoriasis along with concomitant hyperuricemia (defined as an SUA level > 416 μmol/L in men and > 357 μmol/L in women) at baseline were treated with either secukinumab or ixekizumab. SUA levels were longitudinally assessed over 1 year. We evaluated the changes in SUA level and factors associated with SUA changes. Binary logistic regression was conducted to identify risk factors for hyperuricemia in psoriatic patients. Additionally, we examined effectiveness of IL-17A inhibitors for patients with psoriasis and hyperuricemia including Psoriasis Area Severity Index (PASI) 75, 90, and 100 response rates at 1 year.Results: Our study included 196 individuals diagnosed with psoriasis and hyperuricemia. The mean SUA levels were 481± 68 μmol/L at baseline and 442± 78 μmol/L after 1 year of treatment with IL-17A inhibitors (p< 0.001). Subgroup analysis revealed a consistent and significant decrease in SUA levels across different genders, age groups (30– 39, 40– 49, ≥ 50 years), BMI categories, baseline PASI scores, PASI improvement rates, and among patients treated with different IL-17A inhibitors. Patients aged ≥ 50 years and with a BMI < 24 exhibited a higher SUA reduction rate. Male gender, age under 40 years, obesity, hypertension, hypertriglyceridemia, and a PASI score of ≥ 20 were independent risk factors for hyperuricemia in patients with psoriasis. The PASI 75, 90, and 100 response rates in psoriatic patients with hyperuricemia were 88.3%, 60.2%, and 28.6%, respectively, after 1 year of treatment with IL-17A inhibitors.Conclusion: Our findings suggest that SUA levels decrease significantly under IL-17A inhibitors treatment in psoriatic patients with hyperuricemia. Patients aged ≥ 50 years and with a BMI < 24 had greater benefits. This study provides a theoretical basis for the selection of biologics to treat psoriatic patients with hyperuricemia.Keywords: psoriasis, uric acid, hyperuricemia, IL-17A inhibitor

Shengyu Cui,1– 4 Xinyu Wang,1– 5 Kang Li,1– 4 Hailong Feng,6 Zhenlei Liu,1– 4 Fengzeng Jian,1– 4 Kai Wang1– 4 1Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Spine Center, China International Neuroscience Institute (CHINA-INI), Beijing, People’s Republic of China; 3Research Center of Spine and Spinal Cord, Beijing Institute of Brain Disorders, Capital Medical University, Beijing, People’s Republic of China; 4Lab of Spinal Cord Injury and Functional Reconstruction, China International Neuroscience Institute (CHINA-INI), Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of China; 5Baylor College of Medicine, Huston, TX, USA; 6Department of Neurosurgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu, People’s Republic of ChinaCorrespondence: Fengzeng Jian; Kai Wang, China International Neuroscience Institute (CHINA-INI), Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, People’s Republic of China, Tel +86-1083198277, Email jianfengzeng@xwh.ccmu.edu.cn; sammas1883@sina.comObjective: This study aims to establish a quantitative relationship between cervical lordosis (CL) and the rotation angle of the axis for the surgical reduction of atlantoaxial dislocation (AAD) and to explore the potential applications of this relationship in preoperative planning and selection of surgical techniques.Methods: To construct the correlation between horizontal gaze and location of axis, we introduced the angle B, defined as the angle between the Frankfort horizontal line and the extension line of the posterior edge of the axis, and explored its application in surgical planning. We retrospectively analyzed imaging data from computed tomography of 23 AAD patients who had undergone posterior reduction and fixation. Theoretical equations were deduced through a series of angular transformations, and linear regression analysis was used to validate our findings.Results: Our results showed a strong linear relationship between the change in CL (ΔCL) and the change in B(ΔB) (y=− 1.0402x, coefficient of determination R²=0.978, P< 0.001), supporting our deduction that ΔCL=ΔB. Furthermore, we found that the rotation angle of the axis (angle D) was equal to ΔCL. By resolving the atlantoaxial interval into the vertical dimension (h) and horizontal dimension (d), we could calculate the maximum vertical and horizontal distance that the axis could move theoretically according to a patient’s maximum ΔCL. This finding supports our theory that the introduction of angle B can provide more precise preoperative planning and surgical technique selection for patients with AAD.Conclusion: By introducing angle B and deducing the equation ΔB=ΔCL=D, we have provided an innovative tool for preoperative planning and surgical technique selection for patients with AAD. This equation not only helps surgeons achieve more precise and effective surgical reductions but also emphasizes the important role of angle B in surgical planning.Keywords: quantitative method, sagittal alignment reduction, atlanto-axial dislocation surgery

A finite element analysis model was employed to analyze the heat conduction behavior of glass fiber/metal (stainless steel, aluminum, or oxygen-free copper) composite materials under a constant thermal load of 100°C on the metal surface, i.e., the temperature distribution after reaching thermal equilibrium. By comparing and analyzing the effects of different metal materials, different air convection heat transfer capabilities, and different metal phase thicknesses, the heat transfer mechanism is elaborated. The results indicate that the metal with stronger heat conduction capacity induces more uniform temperature distribution, while the temperature uniformity on the fiber is relatively worse. Besides, with the increase of the air convection heat transfer coefficient, the temperature on the fiber phase shows a significant downward trend, however, the impact on the metal phase remains limited. In addition, the metal thickness primarily affects the weight or rigidity of the composite material, with minimal impact on temperature distribution.

This study investigated the role and mechanisms of cullin-1 (CUL1) in chronic obstructive pulmonary disease (COPD).

Mantle cell lymphoma (MCL) is a B-cell non-Hodgkin’s lymphoma. Ferroptosis, an iron-dependent programmed cell death, is closely related to cancer prognosis. In this study, we established a model of ferroptosis related genes for prognostic evaluation of patients with MCL.

Carbon nanotubes (CNTs) are one-dimensional nanomaterials exhibiting specialized structures and exceptional mechanical, electrical, and chemical properties. CNTs find application in the fabrication of composite materials, material modification, and hydrogen storage. However, their widespread adoption in material modification is challenging due to their expensive manufacturing and proclivity toward agglomeration. This review expounds the evolution and future directions of in situ growth of CNTs on fly ash substrates through chemical vapor deposition or microwave heating methods. The unique structure and composition of fly ash engenders low-carbon and environmentally friendly properties while facilitating the self-growth of CNTs on its substrate. This paper delves into the characteristics and growth mechanism of the in situ-grown CNTs, with an analysis of mechanical properties, wave absorption, friction, applications, and innovations of fly ash in situ-grown CNTs as modifiers, adsorbents, and additives. The prepared fly ash in situ-grown CNTs have various advantages such as better dispersion properties, lower carbon emissions, and reduced preparation cost, enhancing their applicability in material modification and creation.

Abstract Background Pueraria is a widely cultivated medicinal and edible homologous plant in Asia, and its tuberous roots are commonly used in the food, nutraceutical, and pharmaceutical industries. “Gange No. 5” is a local variety of Pueraria montana var. thomsonii (Bentham) M.R. Almeida (PMT) in Jiangxi Province, China. After optimizing its cultivation technique, we shortened the cultivation cycle of this variety from two years to one year, suggesting that the regulatory mechanism of the endogenous hormone system during tuberous root expansion may have changed significantly. In this study, we focused on the molecular mechanisms of endogenous hormones in promoting tuberous root expansion during one-year cultivation of “Gange No. 5”. Results The mid-late expansion period (S4) is critical for the rapid swelling of “Gange No. 5” tuberous roots during annual cultivation. At S4, the number of cells increased dramatically and their volume enlarged rapidly in the tuberous roots, the fresh weight of a single root quickly increased, and the contents of multiple nutrients (total protein, total phenol, isoflavones) and medicinal components (puerarin, puerarin apigenin, and soy sapogenin) were at their peak values. We compared the transcriptomes and metabolomes of S1 (the pre-expansion period), S4, and S6 (the final expansion period), and screened 42 differentially accumulated hormone metabolites and 1,402 differentially expressed genes (DEGs) associated with hormone biosynthesis, metabolism, and signaling. Most Auxin, cytokinins (CKs), jasmonic acids (JAs), salicylic acid (SA), melatonin (MLT), and ethylene (ETH), reached their maximum levels at S1 and then gradually decreased; however, abscisic acid (ABA) appeared in S6, indicating that most of the endogenous hormones may play a key role in regulating the initiation of tuberous root expansion, while ABA mainly promotes tuberous root maturation. Notably, multiple key genes of the ‘Tryptophan metabolism’ pathway (ko00380) were significantly differentially expressed, and COBRA1, COBRA2, YUCCA10, IAA13, IAA16, IAA20, IAA27, VAN3, ACAA2, and ARF were also identified to be significantly correlated with the expansion of “Gange No. 5” tuberous roots. Conclusions Our study has revealed how endogenous hormone regulation affects the expansion of “Gange No. 5” tuberous roots. These findings offer a theoretical foundation for improving the yield of PMT tuberous roots.

Pingzhi Wang,1 Zhengtao Wang,1 Junyan Zhang,2 Caiqin Lan,1 Yani Zhao,1 Xiaoqing Chen,1 Yu Li,1 Qi Mei,3 Huijing Feng,3 Shuang Wei,4 Zhifeng Xue,4 Fang Gao,5 Xiaolei Liu,6,7 Ying Liang1 1Department of Rehabilitation Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, People’s Republic of China; 2Department of Clinical Epidemiology and Evidence-Based Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, People’s Republic of China; 3Cancer Center, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, People’s Republic of China; 4Department of Pulmonary and Critical Care Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, People’s Republic of China; 5Department of Prevention Care in HealthCare, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, People’s Republic of China; 6Department of Neurology, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China; 7Yunnan Provincial Clinical Research Center for Neurological Diseases, Kunming, People’s Republic of ChinaCorrespondence: Ying Liang; Xiaolei Liu, Email Kfkliangying@126.com; ring@vip.163.comObjective: The aim of this study was to evaluate the impact of hyperbaric oxygen therapy (HBOT) on patients with SARS-CoV-2 infection and determine its efficacy and safety in reducing treatment failure events.Methods: A retrospective cohort study involving patients with COVID-19 was conducted. Inverse probability of treatment weighting (IPTW) was used to balance covariates between the HBOT and non-HBOT groups. The primary endpoint was the occurrence of a clinical treatment failure event, defined as all-cause mortality, abandonment of treatment, or transfer to the Intensive Care Unit due to worsening condition.Results: A total of 720 patients with COVID-19 were enrolled in the study, with 27 patients receiving HBOT and 693 patients not receiving HBOT. The occurrence of treatment failure was significantly lower in the HBOT group compared to the non-HBOT group, with no treatment failure events in the HBOT group versus 36 events in the non-HBOT group. The IPTW database analysis results showed that in comparison to the non-HBOT group, the hazard ratio (HR) for treatment failure in the HBOT group was less than 0.001 (95% CI: < 0.001 ~ < 0.001, p< 0.001). Lymphocyte count > 0.8× 109/L and HBOT was associated with a significantly lower risk of treatment failure. Glucocorticoid use was associated with a higher risk of treatment failure. The incidence of venous thrombosis events was significantly higher in the HBOT group compared to the non-HBOT group.Conclusion: This study revealed that adjunctive HBOT significantly reduces the risk of treatment failure in patients with COVID-19 and is associated with satisfactory safety. HBOT shows promise as a beneficial therapy for improving outcomes in COVID-19-infected patients.Keywords: hyperbaric oxygen therapy, COVID-19, retrospective cohort, inverse probability of treatment weighting, SARS-CoV-2 infection

Jing Wang,1 Xintian Wang,1 Yuyang Li,1 Xin Yao,1 Yuanyuan Shen,1 Ziling Song,1 Peihua Zhang,2 Xiaoqiong Huang2 1School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People’s Republic of China; 2National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People’s Republic of ChinaCorrespondence: Xiaoqiong Huang, Email 13906632387@eye.ac.cnPurpose: Exploring the mechanisms of fear of negative evaluation (FNE) and self-esteem between family functioning and social avoidance and distress (SAD) to inform the promotion of social functioning in people with strabismus.Patients and Methods: Convenience sampling was used to select 249 strabismus patients attending a tertiary-level ophthalmology hospital in Wenzhou City from July 2023 to February 2024. The Social Avoidance and Distress Scale, Rosenberg Self-Esteem Scale, Brief Fear of Negative Evaluation Scale, and Family APGAR Index Questionnaire were utilized to assess levels of social avoidance and distress, self-esteem, fear of negative evaluation, and family functioning. Structural equation modeling (SEM) was employed to explore the sequential mediating role of FNE and self-esteem in the relationship between family functioning and SAD.Results: Family functioning negatively predicted SAD directly (β=− 0.14, P< 0.01). Additionally, family functioning predicted FNE (β=− 0.19, P< 0.01) and self-esteem (β=0.41, P< 0.01). FNE positively predicted SAD (β=− 0.38, P< 0.01) and negatively predicted self-esteem (β=− 0.22, P< 0.01). Moreover, self-esteem negatively predicted SAD (β=− 0.33, P< 0.01). FNE and self-esteem mediated the relationship between family functioning and SAD, with a combined mediating effect of − 0.249, explaining 63.52% of the total variance.Conclusion: This study examined how FNE and self-esteem affect the link between family functioning and SAD in patients with strabismus. These findings complement our understanding of SAD mechanisms in strabismus patients, encompassing familial, cognitive, and emotional perspectives, and offer theoretical insights for enhancing social functioning in this population.Keywords: strabismus, social avoidance and distress, family functioning, fear of negative evaluation, self-esteem, chain mediation

Motor cognitive risk (MCR) syndrome is closely linked to cognitive impairment, with slow gait speed and self-reported cognitive decline often serving as independent predictors of such impairment. Presently, there is a paucity of research on the relationship between MCR syndrome and cognitive impairment in China. This review delineates the diagnosis and classification of MCR syndrome, its epidemiology, influencing factors, and the correlation with cognitive impairment. The aim is to provide a comprehensive understanding that can guide early prevention strategies for cognitive impairment in the future.

Fang An, Shiyan Wang, Lei Gao, Xiuli Sun, Jianliu Wang Department of Obstetrics and Gynecology, Peking University People’s Hospital, Beijing, 100044, People’s Republic of ChinaCorrespondence: Fang An, Department of Obstetrics and Gynecology, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China, Tel +86-13810267628, Email anfang_bjmu@hotmail.comPurpose: The purpose of this study is to examine the protective role of dietary vitamin B12 against depression, particularly as its prevalence is notably high among women experiencing urinary incontinence (UI). Nevertheless, the relationship between vitamin B12 intake, UI, and depression requires further clarification. This research aims to explore this association specifically among women.Methods: This cross-sectional study analyzed data from 14,154 women sourced from the National Health and Nutrition Examination Survey (NHANES) conducted between 2007 and 2018. Depression was measured using the Personal Health Questionnaire (PHQ-9). Vitamin B12 intake was assessed through 24-h dietary recall interviews. Weighted univariate and multivariate logistic regression models assessed the relationships between UI, vitamin B12 intake, and depression in women, with additional analyses conducted across different age, body mass index (BMI), and vaginal delivery groups. Results are presented as odds ratios (ORs) with 95% confidence intervals (CIs).Results: The study included 14,154 women, averaging 48.18± 0.27 years in age, of whom 1609 (11.37%) exhibited depressive symptoms. Women with stress UI (OR=1.55, 95% CI: 1.26– 1.91), urgency UI (OR=1.92, 95% CI: 1.52– 2.44), and mixed UI (OR=2.60, 95% CI: 2.13– 3.19) showed significantly greater odds of depression compared to those without UI. Vitamin B12 intake of ≥ 2.4 mcg/day was associated with lower odds of depression (OR=0.95, 95% CI: 0.080– 1.14). In patients with UI, the odds of depression gradually decreased with a vitamin B12 intake of ≥ 2.4 mcg/day. A moderating role of vitamin B12 intake was observed among women with UI aged ≤ 64 years, with BMI ≥ 25 kg/m2, and those with or without vaginal deliveries.Conclusion: UI is linked to elevated depression odds, while vitamin B12 intake appears to moderate this relationship. It is essential for healthcare providers to prioritize early depression assessments in women with UI and to offer timely interventions to enhance their quality of life.Keywords: urinary incontinence, depression, vitamin B12 intake, NHANES

Jingyi Wang,1,&ast; Wei Zhang,1,&ast; Peige Song,2,&ast; Tingting Wang,3 Ye Yao,1 Yun Chen,4 Haijiang Lin,3 Xiaoqi Yang,1 Xiaoxiao Chen,1,3 Chaowei Fu1 1School of Public Health; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, People’s Republic of China; 2School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China; 3Taizhou City Center for Disease Control and Prevention, Taizhou, Zhejiang Province, People’s Republic of China; 4Yale School of Nursing, Orange, CT, 06477, USA&ast;These authors contributed equally to this workCorrespondence: Chaowei Fu, School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, People’s Republic of China, Email fcw@fudan.edu.cn Xiaoxiao Chen, Taizhou City Center for Disease Control and Prevention, Taizhou, Zhejiang Province, 318000, People’s Republic of China, Email tzcdccxx@126.comBackground: COVID-19 threatened global health, however little is known about the long-term courses of loneliness and their effect on mental health in adolescents. This study aimed to explore the trajectories of loneliness among adolescents in Taizhou, Zhejiang Province, China, during the last phase of the pandemic. We also aimed to identify risk factors in each loneliness course and the impact of loneliness on emotional problems, peer problems, hyperactivity and conduct problems.Methods: The study employed multistage cluster sampling to collect four waves of data from 2347 Chinese adolescents (average baseline age of 14.7 years) covering a period of 20 months (October 2021 – May 2023). The UCLA 3-Item Loneliness Scale and the Strengths and Difficulties Questionnaire were utilized to assess loneliness and mental health problems, respectively. Growth mixture modelling was employed to identify latent classes of loneliness trajectories. Associated risk factors were investigated using multinomial logistic regression model. Mixed-effects logistic regression models were constructed to examine the long-term impact of loneliness classes on mental health outcomes.Results: The overall percentage of loneliness increased from 22.9% at baseline to 32.2% at the fourth wave in our sample. Three classes of loneliness were identified: Decreasing Low Loneliness (58.71%), Increasing Medium Loneliness (36.52%), and Increasing High Loneliness (4.77%). Risk factors for poorer loneliness trajectories included lack of physical exercise habits, poorer mental health literacy, medium or low perceived social support, having study difficulties, being female, higher grades, and lower economic status. Loneliness classes were associated with the severity and variability of emotional problems, peer problems, hyperactivity and conduct problems (ORs for the highest loneliness class: 10.24, 4.21, 3.87, 2.68, respectively). Individuals in the higher loneliness classes experienced a significant increase in these mental health problems over time (p < 0.05 for interactions between loneliness classes and time).Conclusion: During the last phase of the pandemic, a large proportion of adolescents in our study endured medium to high levels of loneliness with no signs of improvement. Both unfavorable loneliness trajectories adversely affected internalizing and externalizing problems and displayed an upward trend in these difficulties. Results highlight the importance of tackling loneliness and improving mental health in adolescents.Keywords: adolescents, loneliness, risk factors, internalizing problems, externalizing problems, COVID-19

Zizhang Cheng,1,&ast; Xiaoli Li,2,&ast; Shu Wang,1 Weijin Sun,1 Junhong Pan,1 Xiongfei Wang,1 Jian Zhou,1 Tianfu Li,3– 5 Guoming Luan,1,4,5 Yuguang Guan1,4,5 1Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing, 100093, People’s Republic of China; 2Department of Neurology, Affiliated Zhong Da Hospital, Southeast University, Nanjing, People’s Republic of China; 3Department of Neurology, Sanbo Brain Hospital, Capital Medical University, Beijing, People’s Republic of China; 4Beijing Key Laboratory of Epilepsy, Beijing, 100093, People’s Republic of China; 5Center of Epilepsy, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Laboratory for Clinical Medicine, Capital Medical University, Beijing, 100093, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yuguang Guan; Guoming Luan, Department of Neurosurgery, SanBo Brain Hospital Capital Medical University, Beijing, 100093, People’s Republic of China, Email guanyg2020@ccmu.edu.cn; luangm@ccmu.edu.cnPurpose: Sturge-Weber syndrome (SWS), a rare congenital neurological and skin disorder, is frequently associated with drug-resistant epilepsy. Translocation of high mobility group box 1 (HMGB1) protein from the nucleus to the cytoplasm or extracellular milieu has been implicated in neuroinflammatory processes contributing to the development of epileptogenesis. This study aimed to explore the expression and distribution of HMGB1 in brain tissue from SWS patients with drug-resistant epilepsy, with the goal of elucidating its potential involvement in the pathogenesis of epilepsy.Patients and Methods: The study enrolled eight patients with drug-resistant epilepsy who underwent hemispherectomy. Brain tissue specimens were obtained and analyzed using immunofluorescence staining to detect HMGB1 distribution in microglia, astrocytes, or different neuronal subtypes. Correlation analyses were performed to investigate the potential relationship between HMGB1 translocation within cells and the clinical characteristics of SWS patients.Results: In lesional tissues of SWS patients, we observed significantly higher cytoplasmic HMGB1 levels. Meanwhile, HMGB1 was widely distributed in the cytoplasm of microglia and neurons, while in astrocytes, it was primarily localized in the nucleus. This translocation occurred across many neuronal subtypes, including excitatory glutamatergic, inhibitory GABAergic, and cholinergic neurons. The lower proportion of HMGB1-translocated cholinergic neurons was seen compared to the other two neuronal subtypes. Furthermore, no correlation was found between cytoplasmic HMGB1 levels and clinical characteristics of SWS patients.Conclusion: The results suggest the involvement of HMGB1 in the pathogenesis of drug-resistant epilepsy in SWS patients. Additional research is required to elucidate the precise mechanisms and potential therapeutic targets associated with HMGB1 that underlie the epilepsy linked to SWS.Keywords: high mobility group box 1, translocation, Sturge Weber syndrome, drug-resistant epilepsy, cell subtype

Ting-Ting Ni, Yuan-Yuan Yao, Xiao-Xia Zhou, Tao Lv, Jing-Cheng Zou, Ge Luo, Jin-Ting Yang, Da-Wei Sun, Qi Gao, Ting-Ting Wang, Rui-Yu Wang, Xin-Chen Tao, Min Yan Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, 330100, People’s Republic of ChinaCorrespondence: Min Yan, Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, Zhejiang, 330100, People’s Republic of China, Email zryanmin@zju.edu.cnPurpose: Postinduction hypotension (PIH), occurring between anaesthesia induction and surgical incision, is particularly concerning in older adults undergoing transcatheter aortic valve replacement (TAVR) due to their multiple comorbidities and age-related cardiovascular changes. This study aimed to assess the relationship between PIH and postoperative adverse events in TAVR patients.Patients and Methods: A total of 777 patients underwent TAVR at The Second Affiliated Hospital of Zhejiang University School of Medicine from January 1, 2020 to February 28, 2023. Four thresholds of MAP were defined, including two absolute thresholds (< 65, < 60 mmHg) and two relative thresholds (20% and 30% lower than baseline). The relationships between PIH and the composite outcome, which included all-cause in-hospital mortality, stroke, acute kidney injury (AKI), and myocardial infarction (MI), were examined using unadjusted analysis, 1:1 propensity score matching(PSM), and inverse probability of treatment weighting (IPTW).Results: A total of 643 older adults were included in the study ultimately. The composite outcome incidence was significantly greater in patients with PIH than in those without PIH (relative risk [RR]: 2.47, 95% CI: 1.66– 3.73 for MAP < 60 mmHg; RR: 1.66, 95% CI: 1.14– 2.46 for a > 30% decrease from baseline). PIH was significantly associated with stroke (RR: 5.22, 95% CI: 1.98– 17.75) and AKI (RR: 2.82, 95% CI: 1.73– 4.79) with a MAP < 60 mmHg.Conclusion: PIH significantly increases the risk of composite outcomes, especially stroke and AKI, in TAVR patients.Keywords: postinduction hypotension, adverse postoperative outcomes, transcatheter aortic valve replacement, older adults

Yuling Liang,1,&ast; Yuqing Xie,1,&ast; Zhibo Dang,2,&ast; Mengge Li,3,&ast; Lihua Yu,1 Xinhui Wang,4 Peng Wang,5 Zhiyun Yang1 1Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Ethics Committee Office, Henan Province Hospital of TCM, Henan, People’s Republic of China; 3Department of Hepatobiliary Spleen and Stomach, Henan Province Hospital of TCM, Henan, People’s Republic of China; 4Beijing Children’s Hospital, Capital Medical University, Beijing, People’s Republic of China; 5Department of Pathology, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Peng Wang, Department of Pathology, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of China, Tel +86-10-84322530, Email dtpengwang@163.com; dtwangpeng@mail.ccmu.edu.cn Zhiyun Yang, Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of China, Tel +86-10-84,322,148, Email yangzhiyun2016@163.comPurpose: Yiqi Liangxue Jiedu prescription (YLJP), a Chinese medicine that is commonly used to prevent liver cancer and is authorized by a national patent (patent No. ZL202110889980.5) has a therapeutic effect on precancerous lesions; however, the underlying mechanism remains unclear. This study is aimed at determining the clinical therapeutic efficacy of YLJP in patients with precancerous liver lesions and to explore and validate its possible effector mechanism.Patients and Methods: The 1-year incidence of hepatocellular carcinoma (HCC) was retrospectively analyzed in 241 patients with cirrhosis complicated by abnormal alpha-fetoprotein precancer. Network pharmacological analysis, molecular docking, and molecular dynamics simulation were used to explore the key targets and compounds of YLJP in treating HCC. Immunohistochemical methods were used to detect the expression of key proteins in tumor and cirrhotic tissues. Finally, the mechanism underlying the effects of YLJP was verified in rats with precancerous lesions.Results: The 1-year incidence of HCC was lower in the YLJP group than in the Western medicine group. The Wnt pathway protein, CTNNB1, is a key target of YLJP in preventing and treating HCC, and the canonical Wnt pathway is the key signaling pathway and is overexpressed in human liver tumors. In vivo experiments showed that YLJP significantly inhibited the canonical Wnt pathway and reduced the abnormal differentiation of hepatic oval cells. The binding of CTNNB1 to oleanolic acid, stigmasterol, and beta-sitosterol was found to be stable, indicating the action of these compounds in treating HCC.Conclusion: YLJP reduces the 1-year incidence of HCC, with its mechanism likely due to oleanolic acid, beta-sitosterol, and stigmasterol inhibition of the CTNNB1 activation of the β-catenin protein, which in turn regulates the Wnt signaling pathway and prevents the abnormal differentiation of hepatic oval cells into cancer cells, thus delaying the occurrence and progression of the disease.Keywords: network pharmacological analysis, molecular docking, molecular dynamics simulation, hepatocellular carcinoma, Wnt / β-catenin

【Objective】 The Kuerle fragrant pear is a valuable cash crop in Xinjiang, with its production heavily relying on irrigation. This study investigates the influence of irrigation amount and drip irrigation pipeline configuration on its fruit quality. 【Method】 The experiment was conducted in an orchard, using the densely planted 7 year dwarf Kuerle fragrant pear as the model plant. Based on the number of drip irrigation pipelines per row of pear plants, three configurations were set up: 2 lines per row (P1), 3 lines per row (P2), and 4 lines per row (P3). Each configuration had two irrigation amount treatments: 6 750 m3/hm2 (W1) and 5 250 m3/hm2 (W2). For each treatment, we measured the spatiotemporal changes in soil water content and various fruit quality indices. 【Result】 Soil water content increased with soil depth, peaking at the depth of 70-90 cm before declining. The treatments did not significantly affect fruit hardness but had a notable impact on fruit weight and other quality indicators, including soluble sugar and vitamin C content. Under the same irrigation amount, an increase in the number of drip irrigation pipelines was associated with an increase in the longitudinal diameter of the fruits. When the irrigation amount was 6 750 m3/hm2, the vitamin C content in the fruits increased with the increase in the number of drip irrigation pipelines. Among all quality indices, the coefficient of variation for titratable acid and vitamin C content was the highest, both exceeding 30%. Correlation analysis revealed that fruit weight was positively correlated with longitudinal and transverse diameters of the fruits, as well as the solid-acid ratio, while negatively correlated with titratable acid, soluble sugar, and vitamin C content. 【Conclusion】 A comprehensive analysis indicated that the optimal drip irrigation scheme for Kuerle fragrant pear production in Xinjiang is three drip irrigation pipelines per row of pears plant, with an irrigation amount of 5 250 m3/hm2.

【Objective】 Ensuring the ecological security of cropped lands is a prerequisite for developing sustainable agriculture and safeguarding food security, which is influenced by various factors. In this paper, we analyse the spatiotemporal variation in ecological security of cultivated lands and its determinants in key agricultural production regions in Henan Province. 【Method】 The analysis was based on the pressure-state-response (PSR) model, comprehensive index approach, and resistance diagnosis model. In the analysis, we considered fifteen indicators to assess the changes in ecological security from 2007 to 2022 across the province. 【Result】 ① From 2007 to 2022, the ecological security of cultivated lands in the province initially declined before recovering, with the composite index increasing from 0.342 in 2007 to 0.435 in 2022. ② The ecological security of cropped lands varied significantly across the province, with heightened sensitivity in the central areas, general and comparative security in the eastern regions, and high sensitivity in remote areas. ③ Key factors affecting the ecological security of cropped land in the province included fertilizer application per unit area (26.1%), cultivated land per capita (18.69%), and per capita water resources (18.45%). 【Conclusion】 From 2007 to 2022, the ecological security of the cultivated lands in Henan Province has substantially shifted. The overall ecological security of the cropped land in the province is at a moderate level, underscoring the need to improve agricultural resource use efficiency, reduce fertilizer and pesticide application, and foster sustainable interactions between terrestrial ecosystems and food security. Priorities in improving ecological security of the agroecosystems in the province include optimizing fertilizer application and preserving cultivated lands. These findings provide baseline for developing sustainable land management to safeguard food security in the major agricultural production regions in Henan Province.

【Objective】 Subsurface drip irrigation is a water-saving technique that involves burying emitters in the soil. Its efficacy depends on irrigation amount. This paper investigates the impact of irrigation amount in subsurface drip irrigation on root growth and water use efficiency of maize cultivated in the Xiliao River Plain, Northeastern China. 【Method】 The experiment was conducted in a maize field in the Keerqin District of Tongliao City, comprising six treatments with its associated irrigation amount being 220 mm (CK), 195 mm (W1), 170 mm (W2), 145 mm (W3), 120 mm (W4), and 95 mm (W5), respectively. For each treatment, we measured root distribution and water use efficiency. 【Result】 The spatial distribution patterns of root dry matter, root length, root surface area, and root diameter in the 0-40 cm soil layer at the maturity stage were similar across all treatments. As the irrigation amount decreased, these root characteristics initially increased and then decreased. The total water consumption of the maize during its growing season decreased with reduced irrigation amount, while the relationship between kernel yield and irrigation amount followed a quadratic pattern. With increasing irrigation amount, water use efficiency initially increased and then declined, with W2 achieving the highest water use efficiency at 2.46 kg/m3. Grain yield showed significant positive correlations with root weight density, root length density, and root surface area density in the 0-20 cm soil layer, and root diameter in the 30-40 cm soil layer. Net benefit increased with reduced irrigation among initially and then declined, with the highest net benefit of 20 098 Yuan/hm2 achieved when the irrigation amount was 170 mm. 【Conclusion】 Subsurface drip irrigation is a water-saving technology, applicable for maize production in Xiliao River Plain in the northeastern China. The optimal irrigation amount was 170 mm.

Jia-Hao Weng,1 Feng-Gang Hou,2 Xue Wang,1 Zi-Yang Wang,1 Mei-Ping Wu1,3 1Department of Cardiology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, People’s Republic of China; 2Department of Oncology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, People’s Republic of China; 3School of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People’s Republic of ChinaCorrespondence: Mei-Ping Wu, School of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, No. 1200 of Cailun Road, Pudong District, Shanghai, 201203, People’s Republic of China, Tel +86 136 6197 7245, Email meipingwu2024@126.comObjective: This study evaluates the therapeutic effects of the Yangxin Huoxue Formula in the management of stable angina pectoris associated with Qi deficiency and blood stasis syndrome, co-occurring with anxiety and depressive disorders. The primary objective is to determine its efficacy in enhancing cardiac function and reducing emotional symptoms.Methods: A randomized, single-blind, placebo-controlled clinical trial was conducted with 94 individuals with stable angina pectoris. Participants were randomly allocated to either a treatment group receiving Yangxin Huoxue Formula granules or a placebo group receiving placebo granules, administered twice daily over a 12-week period. Primary outcome measures included assessments of cardiac function, angina frequency, PHQ-9 and GAD-7 scores, traditional Chinese medicine (TCM) syndrome improvements, and inflammatory markers.Results: The treatment group exhibited significantly greater improvements in cardiac output and reductions in peripheral vascular resistance compared to the placebo group. Additionally, a significant decrease in the frequency and duration of angina episodes was observed in the treatment group. Improvements in TCM syndrome scores and GAD-7 scores were also notably superior in the treatment group. No significant adverse reactions were recorded during the safety assessment of the treatment group.Conclusion: The Yangxin Huoxue Formula demonstrates efficacy in improving cardiac function, alleviating symptoms of anxiety and depression, reducing inflammatory mediator release, and enhancing quality of life in individuals with stable angina pectoris. The treatment was well-tolerated, confirming both its safety and therapeutic effectiveness.Keywords: Anxiety and depression disorders, qi deficiency and blood stasis, stable angina pectoris, traditional Chinese medicine treatment, Yangxin Huoxue Formula

Jin Cheng,1,&ast; Honglei Ju,1,&ast; Guixiang Wang,2,&ast; Chiyi He,1 Wei Wang1 1Department of Gastroenterology, Yijishan Hospital of Wannan Medical College, Wuhu, People’s Republic of China; 2Department of Gastroenterology, The Second Affiliated Hospital of Wannan Medical College, Wuhu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wei Wang, Department of Gastroenterology, Yijishan Hospital of Wannan Medical College, No. 2, Zheshan West Road, Wuhu, Anhui Prov, 241000, People’s Republic of China, Email wwwy@wnmc.edu.cnBackground: The Systemic Inflammation Response Index (SIRI) has demonstrated predictive capabilities for clinical outcomes in various diseases. However, its prognostic utility in decompensated liver cirrhosis (DLC) remains underexplored. This study aimed to investigate the association between SIRI and the risk of short-term (3 and 6 months) all-cause mortality in DLC patients.Methods: A total of 926 eligible patients with DLC from diverse etiologies was included in this study. In the initial cohort, the predictive accuracy of SIRI was evaluated using receiver operating characteristic (ROC) curve analysis. Patients were categorized into high- and low-SIRI groups based on the Youden index. Multivariable logistic regression analysis was employed to evaluate the independent association between SIRI and all-cause mortality. Restricted cubic spline (RCS) analysis was utilized to visualize the relationship between the continuous variable SIRI and mortality risk. These findings were validated in a validation cohort.Results: The initial cohort had mortality rates of 8.8% and 11.6% at 3 and 6 months, respectively. The SIRI level was significantly higher in the deceased group compared to the survival group. At both time points, SIRI was an independent indicator of all-cause mortality. RCS analysis demonstrated the risk of the risk of increased with an increase in SIRI value. The Validation cohort validated the independent association between higher SIRI levels and lower short-term all-cause mortality.Conclusion: This study’s findings underscore the prognostic value of SIRI in DLC patients, indicating that higher SIRI levels are significantly associated with short-term adverse outcomes.Keywords: decompensated liver cirrhosis, systemic inflammation response index, prognosis, all-cause mortality

Shaoxia Wang,1– 3 Xiang Zhang,1 Yanru Ding,1 Yanrong Wang,2,4 Chujun Wu,2,4 Shihao Lu,1,2 Jianqun Fang2,4 1School of First Clinical, Ningxia Medical University, Yinchuan, Ningxia, 750004, People’s Republic of China; 2Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, People’s Republic of China; 3Ningxia Civil Affairs Department Minkang Hospital, Yinchuan, Ningxia, 750001, People’s Republic of China; 4Mental Health Center, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, People’s Republic of ChinaCorrespondence: Jianqun Fang, Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, People’s Republic of China, Email fjq7887215@163.comObjective: Vitamin B12 is crucial for neurological functions and linked to various psychiatric disorders. Given its importance, this study explores the impact of vitamin B12 deficiency on sleep quality in Obsessive-Compulsive Disorder (OCD) patients, while also examining folate and homocysteine levels to explore their potential interactions with OCD symptoms and sleep quality.Methods: This cross-sectional study included 52 patients with OCD and 42 healthy controls. Serum levels of vitamin B12, homocysteine, and folate were measured. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the severity of OCD symptoms and the quality of sleep, respectively. Correlations and mediating effects between these variables were also assessed.Results: Vitamin B12 levels were significantly lower in OCD patients compared to healthy controls, and scores for sleep disturbances were significantly higher in the OCD group. No significant differences were observed in the levels of folate and homocysteine between the groups. Correlation analysis indicated that lower levels of vitamin B12 were significantly associated with more severe OCD symptoms and poorer sleep quality. Further mediation analysis suggested that low levels of vitamin B12 partially mediated the relationship between OCD symptoms and sleep disturbances.Conclusion: Lower levels of vitamin B12 not only affect sleep quality but also partially mediate the impact of OCD symptoms on sleep disturbances. Future clinical attention to vitamin B12 deficiency is crucial for further assessing the relationship between OCD symptoms and sleep disorders.Keywords: obsessive-compulsive disorder, sleep disturbances, vitamin b12, mediating effects

Kaiqiang Li,1,2,&ast; Jing Jin,3,&ast; Yimin Yang,4,&ast; Xuling Luo,4 Yaling Wang,1 Aibo Xu,1 Ke Hao,1,2 Zhen Wang1,2 1Laboratory Medicine Center, Allergy Center, Department of Transfusion Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People’s Republic of China; 2Key Laboratory of Biomarkers and In Vitro Diagnosis Translation of Zhejiang Province, Hangzhou, Zhejiang, 310063, People’s Republic of China; 3Laboratory Medicine Center, Zhejiang Center for Clinical Laboratories, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People’s Republic of China; 4College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ke Hao; Zhen Wang, Email haokehaokehaoke@aliyun.com; wangzhen@hmc.edu.cnAbstract: Allergen Immunotherapy (AIT) is the only etiological therapeutic method available for allergic rhinitis (AR). Currently, several options for AIT in the market, such as subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT), have different routes of administration. These traditional methods have achieved encouraging outcomes in clinic. However, the side effects associated with these methods have raised the need for innovative approaches for AIT that improve safety, shorten the course of treatment and increase local drug concentration. Nanoparticles (NPs) are particles ranging in size from 1 to 100 nm, which have been hired as potential adjuvants for AIT. NPs can be employed as agents for modulating immune responses in AR or/and carriers for loading proteins, peptides or DNA molecules. This review focuses on different kinds of nanoparticle delivery systems, including chitosan nanoparticles, exosomes, metal nanoparticles, and viral nanoparticles. We summarized the advantages and limitations of NPs for the treatment of allergic rhinitis. Overall, NPs are expected to be a therapeutic option for AR, which requires more in-depth studies and long-term therapeutic validation. Keywords: allergen immunotherapy, nanoparticles, allergic disease, subcutaneous immunotherapy

Yashi Ruan,1,&ast; Lixia Guan,2,&ast; Yuting Wang,2 Yifei Geng,2 Xiaoran Wang,2 Miao-Miao Niu,2 Li Yang,1 Cen Xu,1 Zhen Xu1 1Department of Urology, Reproductive Medicine and Oncology, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou, 225300, People’s Republic of China; 2Department of Pharmaceutical Analysis, China Pharmaceutical University, Nanjing, 211198, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Li Yang; Cen Xu, Department of Urology, Reproductive Medicine and Oncology, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou, 225300, People’s Republic of China, Email proyangli@163.com; cenxu263128@163.comPurpose: Dual inhibition of ataxia telangiectasia mutated (ATM) and histone deacetylase 2 (HDAC2) may be a potential strategy to improve antitumor efficacy in testicular cancer.Methods: A combined virtual screening protocol including pharmacophore modeling and molecular docking was used for screening potent dual-target ATM/HDAC2 inhibitors. In order to obtain the optimal lead compound, the dual ATM/HDAC2 inhibitory activity of the screened compounds was further evaluated using enzyme inhibition methods. The binding stability of the optimal compound to the dual targets was verified by molecular dynamics (MD) simulation. MTT assay and in vivo antitumor experiment were performed to validate antitumor efficacy of the optimal compound in testicular cancer.Results: Here, we successfully discovered six potent dual-target ATM/HDAC2 inhibitors (AMHs 1– 6), which exhibited good inhibitory activity against both ATM and HDAC2. Among them, AMH-4 showed strong inhibitory activity against both ATM (IC50 = 1.12 ± 0.03 nM) and HDAC2 (IC50 = 3.04 ± 0.08 nM). MD simulation indicated that AMH-4 binds to ATM and HDAC2 with satisfactory stability. Importantly, AMH-4 had significant antiproliferative activity on human testicular tumor cells, especially NTERA-2 cL.D1 cells, and no inhibitory effect on normal human testicular cells. In vivo experiments exhibited that AMH-4 was more effective than lartesertib and vorinostat in inhibiting the growth of NTERA-2 cL.D1 xenograft tumors with low toxicity.Conclusion: Overall, these results suggest that AMH-4 is an effective and low toxicity candidate for the treatment of testicular germ cell tumors.Keywords: ataxia telangiectasia mutated, histone deacetylase 2, dual-targeting inhibitors, testicular germ cell tumors, structure-based virtual screening

Pilong Shi,1,&ast; Yuetong Sha,1,&ast; Xinran Wang,1,&ast; Tao Yang,1 Jiawei Wu,1 Jiajun Zhou,1 Kai Liu,1 Xue Guan,2 Song Wang,1 Yongsheng Liu,1 Jingquan Gao,3 Hongli Sun,1 Tao Ban,1 Yonggang Cao1 1Department of Pharmacology, Harbin Medical University, Heilongjiang, 163319, People’s Republic of China; 2Morphological Experiment Center, Harbin Medical University, Heilongjiang, 163319, People’s Republic of China; 3Department of Nursing, School of Medicine, Lishui University, Lishui, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yonggang Cao; Hongli Sun, Email 437343482@qq.com; sunhongli@hmudq.edu.cnPurpose: Myocardial ischemia-reperfusion injury (MI/RI) is associated with increased oxidative damage and mitochondrial dysfunction, resulting in an elevated risk of mortality. MI/RI may be alleviated by protecting cardiomyocytes from oxidative stress. Lutein, which belongs to a class of carotenoids, has proven to be effective in cardiovascular disease treatment due to its remarkable antioxidant properties, but its application is limited due to its poor stability and low bioavailability in vivo.Methods: In this study, a delivery system was developed based on distearoyl phosphatidyl ethanolamine (DSPE)-thiol-ketone (TK)-PEG2K (polyethylene glycol 2000) (abbreviated as DTP) and PCM-SH (CWLSEAGPVVTVRALRGTGSW) to deliver lutein (abbreviated as lutein@DTPP) to damaged myocardium. First, lutein, lutein@DTP, or lutein@DTPP were injected through the tail vein once a day for 3 days and then MI/RI model rats were established by exposing rats to ischemia for 45 min and reperfusion for 6 h. We employed a range of experimental techniques including qRT-PCR, Western blotting, transmission electron microscopy, immunohistochemistry, immunofluorescence, flow cytometry, immunoprecipitation, molecular docking, and molecular dynamics simulations.Results: Lutein@DTPP exhibited good myocardial targeting and ROS-responsive release. Our data suggested that lutein@DTPP effectively suppresses ferroptosis in cardiomyocytes. Mechanistically, we observed an upregulation of mouse double minute-2 (MDM2) in the hearts of MI/RI models and cardiomyocytes exposed to hypoxia/reoxygenation (H/R) conditions. In addition, NADH-ubiquinone oxidoreductase 75 kDa Fe-S protein 1 (NDUFS1) translocation from the cytosol to the mitochondria was inhibited by MDM2 upregulation. Notably, no significant variation in the total NDUFS1 expression was observed in H/R-exposed cardiomyocytes following treatment with siMDM2. Further study indicated that lutein facilitates the translocation of NDUFS1 from the cytosol to mitochondria by directly binding and sequestering MDM2, thereby improving mitochondrial function and inhibiting ferroptosis.Conclusion: Lutein@DTPP promoted the mitochondrial translocation of NDUFS1 to restore mitochondrial function and inhibited the ferroptosis of cardiomyocytes by directly binding and sequestering MDM2. Keywords: myocardial ischemia-reperfusion injury, lutein, ROS, MDM2, NDUFS1, ferroptosis

Xiao Wang,1,&ast; Ying Cao,2,&ast; Jing Hu,3 Lian-Cheng Jia,4 Bo Li,3 Baoli Liu,5 Wei-Hai Yao,2 Xiao-Lu Pei,6 Wei Peng,2 Shuang Wang,2 Cun-Zhi Liu,1,7 Jian-Feng Tu,1,7 Zhi-Cheng Qu2 1School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, People’s Republic of China; 2Emergency Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, People’s Republic of China; 3Evidence Based Medicine Center, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, People’s Republic of China; 4Urinary Surgery, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, People’s Republic of China; 5Nephrology Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, People’s Republic of China; 6Nursing Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, People’s Republic of China; 7International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhi-Cheng Qu, Emergency Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, 23 Meishuguanhou Street, Dongcheng District, Beijing, 100010, People’s Republic of China, Email qzhch0824@163.com Jian-Feng Tu, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, People’s Republic of China, Email tujianfeng1@126.comIntroduction: Analgesia is often delayed for suspected acute renal colic due to urinary calculi (ARCUC) even in emergency department. Acupuncture has a rapid onset and is effective for analgesia, however, evidence about early-acupuncture for suspected ARCUC is limited. This trial aims to evaluate the efficacy of early-intervention acupuncture compared with sham acupuncture on pain relief among emergency department suspected ARCUC patients.Methods and Analysis: A total of 84 eligible patients who are suspected diagnosed with ARCUC will be randomly allocated to the acupuncture group or the sham acupuncture group. Each patient will receive 1 session of acupuncture or sham acupuncture before diagnostic imaging. The primary outcome will be the response rate at 10 min after needle manipulation, defined as the proportion of patients whose Numeric Rating Scale (NRS) score decrease by at least 50% from baseline. Secondary outcomes will include pain intensity assessed by NRS, further analgesia requirement, revisit rate, surgical intervention rate, satisfaction evaluation, and adverse events. The final diagnosis rate determined by radiography will be recorded and reported. All patients who receive randomization will be included in the intention-to-treat analysis.Conclusion: This study’s findings are anticipated to evaluate the analgesic effect of early-intervention acupuncture for acute renal colic in emergency department, which could be useful for moving the timing of analgesia forward and aligning pain management for acute renal colic more with the guidelines.Trial Registration Number: ChiCTR2100049069 (https://www.chictr.org.cn/showproj.html?proj=125338).Keywords: acupuncture, complementary medicine, pain management, emergency medicine, renal colic

Hanrui Wang,1– 4,&ast; Xiaoyu Song,1– 4,&ast; Yao Wang,1– 4 Ting Yang,1– 4 Wanchen Liu,1– 4 Yakui Mou,1– 4,&ast; Chao Ren,1– 5 Xicheng Song1– 4 1Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, People’s Republic of China; 2Shandong Provincial Key Laboratory of Neuroimmune Interaction and Regulation, Yantai Yuhuangding Hospital, Yantai, People’s Republic of China; 3Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai Yuhuangding Hospital, Yantai, People’s Republic of China; 4Yantai Key Laboratory of Otorhinolaryngologic Diseases, Yantai Yuhuangding Hospital, Qingdao University, Yantai, People’s Republic of China; 5Department of Neurology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xicheng Song; Chao Ren, Yantai Yuhuangding Hospital, Qingdao University, No. 20, East Road, Zhifu District, Yantai, 264000, People’s Republic of China, Tel +86535 6691999, Fax +86535 6240341, Email drxchsong@163.com; renchaotg@126.comBackground: The nasal mucosal epithelial barrier is the primary site of allergic rhinitis (AR). Interleukin-1β (IL-1β), as a crucial factor in immune inflammation, not only plays a crucial role in hypersensitivity reactions but also affects the digestive mucosa and skin epithelial barrier. However, the role of IL-1β in the nasal mucosal epithelial barrier in AR has not been reported, and this study aimed to investigate the effect and possible mechanisms involved.Methods: Dermatophagoides pteronyssinus 1 was used as an allergen to construct an AR mouse model and stimulate human nasal mucosal epithelial cells (HNEpCs) and observe the expression changes of IL-1β and epithelial barrier indicators CLDN1 and OCLN in mouse nasal mucosa and HNEpCs. Then, the possible mechanisms of action were explored via exogenous IL-1β stimulation and pharmacological inhibition of IL-1β or its receptor interleukin-1 receptor type 1 (IL-1R1).Results: The results showed that Dermatophagoides pteronyssinus 1-primed mouse nasal mucosa or human HENpCs had increased expression of IL-1β and decreased CLDN1 and OCLN, and IL-1β could directly lead to reduced expression of epithelial barrier indexes in HNEpCs. In addition, inhibition of IL-1β or IL-1R1 can effectively alleviate the damage to the epithelial barrier.Conclusion: IL-1β has a destructive effect on the nasal mucosal epithelial barrier in AR, and inhibition of IL-1β or its receptor IL-1R1 can effectively protect the nasal mucosal barrier. IL-1β is a potential target for the treatment of AR.Keywords: interleukin-1β, allergic rhinitis, nasal mucous membrane, epithelial barrier, DerP1

Qingpeng Xie,1,2,&ast; Jiawen Gu,1,2,&ast; Yujia Sun,3 Jinjia Hong,1,2 Jia Wang,1,2 Na Li,1,2 Yuan Zhang,1,2 Meixian Liu,1,2 Xiaoxuan Zhang,1,2 Xiangyu Zhao,1,2 Xiaohang Chen,1,2 Xing Wang1,2 1Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, People’s Republic of China; 2Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, People’s Republic of China; 3Nursing College of Shanxi Medical University, Taiyuan, 030001, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiaohang Chen; Xing Wang, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, People’s Republic of China, Tel +8618834896163 ; +8613934224604, Email kqyx__cxh@163.com; wangxing@sxmu.edu.cnPurpose: Periodontitis is a chronic inflammatory oral disease that causes defects in periodontal tissue. Conventional therapies are limited, and often lead to high recurrence rates. The emerging concept of medicinal food homology has shed light on the potential of ginger as a therapeutic adjuvant for periodontitis, given its antioxidant and anti-inflammatory properties. However, fresh ginger exhibits poor stability and bioavailability. Ginger exosome-like nanoparticles (GELNs), a derivative of ginger, have not been reported to exert therapeutic effects in periodontitis. This study aimed to explore the therapeutic effects of GELNs on tissue damage caused by periodontitis and their underlying mechanisms of action.Methods: The GELNs composition was analyzed using a widely targeted metabolome. Stability was assessed using nanoparticle tracking analysis (NTA) and zeta potential measurements, flavor was evaluated using an electronic nose, and membrane penetration was studied using confocal microscopy. A periodontitis model was established in SD rats, periodontal clinical indicators were monitored, and histological changes were assessed using H&E and TRAP staining. Co-culture experiments investigate the antioxidant and reparative abilities of GELNs on periodontal ligament fibroblasts (PDLFs) in inflammatory environment. NF-κB protein expression was examined by immunofluorescence and immunohistochemistry.Results: The findings revealed that GELNs demonstrated good stability in different environments and mitigated the pungent taste of the raw ginger. In vivo experiments showed that GELNs improved periodontal clinical parameters and pathology compared with ginger juice. In vitro data suggested that GELNs enhanced the proliferation and migration of PDLFs while reducing the reactive oxygen species (ROS) levels by inhibiting the NF-κB signaling pathway in an inflammatory setting.Conclusion: This study is the first to demonstrate that GELNs have a potential therapeutic effect on periodontitis. GELNs can alleviate oxidative stress (OS) and inflammatory reactions by inhibiting the NF-κB signaling pathway. These findings provide a promising method for the treatment of periodontitis by regulating an unbalanced OS state. Keywords: ginger exosome-like nanoparticles, periodontitis, tissue repair, oxidative stress, periodontal ligament fibroblasts