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Jie Li,1 Jiangtao Long,1 Zheng Zhao,2 Qianqian Wang,1 Wang Bo,2 Liang Ren,1 Yan Fan,3 Peng Wang,1 Yi Cheng,1 Binbin Liu,1 Xinkui Cheng,1 Hongwei Xi2 1Department of Orthopedics, Children’s Hospital Affiliated to Shanxi Medical University, Taiyuan, People’s Republic of China; 2Department of General Surgery, Children’s Hospital Affiliated to Shanxi Medical University, Taiyuan, People’s Republic of China; 3Department of Burn and Plastic Surgery, Children’s Hospital affiliated to Shanxi Medical University, Taiyuan, People’s Republic of ChinaCorrespondence: Hongwei Xi, Email xihongwei148@sina.comBackground: Multiple stages including hemostasis, inflammation, proliferation, and remodeling were involved in the wound healing process. The increase in nanomaterials in recent years has extended the scope of tools for wound healing; however, it is still difficult to achieve the four multistage procedures simultaneously.Materials and Methods: In this study, graphene-spiky silica heterostructured nanoparticles (GS) were synthesized for the procedural acceleration of the multistage in wound healing process. The nanobridge effect of GS was analyzed through the adhesion of two skins, the antibacterial effect was assessed in Gram-negative Escherichia coli (E. coli) and Gram-positive Staphylococcus aureus (S. aureus) bacteria, cell proliferation and migration were investigated in mouse embryonic fibroblast (NIH-3T3) cells, and the in vivo wound healing effect was examined in female BALB/c mice with a cutting wound and E. coli or S. aureus bacteria infection on the back.Results: First, GS has a strong nanobridge effect on the rapid closure of wounds because the spiky architecture on the surface of GS facilitates the adhesion of skins, promoting the hemostasis stage. Second, graphene exhibits antimicrobial activities both in chemical and physical interactions, especially under simulated sunlight irradiation. Third, graphene plays an important role in scaffolding function, together with the spiky topographical architecture of GS, accelerating the proliferation and maturation stages.Conclusion: By periodically promoting every stage of wound healing, GS combined with simulated sunlight irradiation could significantly accelerate wound healing. With a simple composition and compact structure but multiple functions, this strategy will be the guideline for the development of ideal wound-healing nanomaterials.Keywords: graphene-spiky silica heterostructured nanoparticles, wound healing, multistage

Xiang Cui,1 Ziyi Zhang,1,2 Hanqing Xi,1 Kun Liu,1 Bing Zhu,1 Xinyan Gao1 1Department of Physiology, Institute of Acupuncture and Moxibustion, Academy of Chinese Medical Sciences, Beijing, 100700, People’s Republic of China; 2College of Acupuncture and Tuina, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi Province, 712046, People’s Republic of ChinaCorrespondence: Xiang Cui; Xinyan Gao, Department of Physiology, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, People’s Republic of China, Tel +86-10-64089422 ; +86-10-64089420, Email drcuixiang@163.com; xinyangao2001@msn.comAbstract: A series of studies have demonstrated acupoint sensitization, in which acupoints can be activated in combination with sensory hypersensitivity and functional plasticity during visceral disorders. However, the mechanisms of acupoint sensitization remain unclear. Neuroanatomy evidence showed nociceptors innervated in acupoints contribute to the mechanism of acupoint sensitization. Increasing studies suggested sympathetic nerve plays a key role in modulating sensory transmission by sprouting or coupling with sensory neuron/nociceptor in the peripheral, forming the functional structure of the sympathetic-sensory coupling. Notably, the sensory inputs of the disease-induced sensitized acupoint contribute to the homeostatic regulation and also involve in delivering therapeutic information under acupuncture, hence, the role of sprouted sympathetic in acupoint function should be given attention. We herein reviewed the current knowledge of sympathetic and its sprouting in pain modulation, then discussed and highlighted the potential value of sympathetic-sensory coupling in acupoint functional plasticity.Keywords: referred pain, hyperalgesia, acupuncture, nociceptor, Somato-sympathetic-viscera reflex

Hongyu Chen,1 Jianxiang Liu,2 Qian Kang,1 Hao Luo,1 Ning Tan,1 Jiali Pan,1 Yuqing Yang,1 Min Yu,1 Dan Liu,1 Hongli Xi,1 Yifan Han,1 Ran Cheng,1 Yanyan Yu,1 Xiaoyuan Xu1 1Departments of Infectious Diseases, Peking University First Hospital, Beijing, People’s Republic of China; 2Department of Gastroenterology, Peking University First Hospital, Beijing, People’s Republic of ChinaCorrespondence: Xiaoyuan Xu; Yanyan Yu, Email xiaoyuanxu6@163.com; yyy@bjmu.edu.cnBackground: Since oral direct-acting antiviral agents (DAAs) became available, the global hepatitis C treatment situation has undergone tremendous changes. However there are still many issues worthy of attention in treatment.Methods: We selected 53 HCV-infected patients who were treated and followed up in the Peking University First Hospital from December 2017 to January 2021 to detect the RASs in HCV. Pearson correlation analysis was used to analyze HCV RNA and HCV cAg, the Fisher exact test and chi-square test was used to compare the effects of RASs on the rate of decline of HCV RNA and HCV core antigen (cAg) during DAA treatment.Results: The RASs and its prevalence on the NS3 are mainly Y56F 2.56% (1/39), Q80K 23.08% (9/39), S122G 71.79% (28/39), and V170I 38.46% (15/39). On the NS5A were R30Q 10.53% (4/38), P32A 5.26% (2/38), P58S 2.63% (1/39), and Y93H 21.05% (8/38). On NS5B were C316N 71.05% (27/38), C451H 2.63% (1/38), and I585C 2.63% (1/38). There was no significant correlation between the RASs (Y93H, V179I, Q80K, S122G, C316N) and HCV genotype (p > 0.05). The baseline serum HCV RNA and HCV cAg had a significant medium-degree correlation (r = 0.601, p = 0.002). After 1 week of DAA treatment was weak correlation (r = 0.413, p = 0.032). Q80K, S122G, V170I, Y93H, and C316N had no effect on the clearance of HCV RNA and HCV cAg within the first week of DAA treatment (p> 0.05).Conclusion: The HCV genotype may have a limited impact on the presence of the five RASs (Y93H, V179I, Q80K, S122G, and C316N) as shown in this study. HCV RNA and HCV cAg have a correlation, especially at baseline is the highest; the appearance of some RASs has no effect on DAA treatment in most chronic hepatitis C patients.Keywords: hepatitis C virus, chronic hepatitis C, drug resistance, sequencing

Shijie Yang,1 Kaixuan Zhao,2 Huan Xi,1 Zaixing Xiao,1 Wei Li,1 Yichuan Zhang,2 Zhiqiang Fan,1 Changqing Li,3,4 Erqing Chai3,4 1The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital), Gansu University of Chinese Medicine, Lanzhou, Gansu, People’s Republic of China; 2Clinical Medical College, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China; 3Cerebrovascular Disease Center, Gansu Provincial Hospital, Lanzhou, Gansu, People’s Republic of China; 4Key Laboratory of Cerebrovascular Disease of Gansu Province, Gansu Provincial Hospital, Lanzhou, Gansu, People’s Republic of ChinaCorrespondence: Erqing ChaiCerebrovascular Disease Center, Gansu Provincial Hospital, No. 204 West Donggang Road, Lanzhou, 730000, Gansu Province, People’s Republic of ChinaEmail happybirds998@126.comPurpose: This study aimed to determine the risk factors associated with the number of thrombectomy device passes and establish a nomogram for predicting the number of device pass attempts in patients with successful endovascular thrombectomy (EVT).Methods: We enrolled patients from a signal comprehensive stroke center (CSC) who underwent EVT because of large vessel occlusion stroke. Multivariate logistic regression analysis was used to develop the best-fit nomogram for predicting the number of thrombectomy device passes. The discrimination and calibration of the nomogram were estimated using the area under the receiver operating characteristic curve (AUC-ROC) and a calibration plot with a bootstrap of 1000 resamples. A decision curve analysis (DCA) was used to measure the availability and effect of this predictive tool.Results: In total, 130 patients (mean age 64.9 ± 11.1 years; 83 males) were included in the final analysis. Age (odds ratio [OR], 1.085; 95% confidence interval [CI], 1.005– 1.172; p = 0.036), baseline Alberta Stroke Program Early computed tomography (ASPECTS) score (OR, 0.237; 95% CI, 0.115– 0.486; p < 0.001), and homocysteine level (OR, 1.090; 95% CI, 1.028– 1.155; p = 0.004) were independent predictors of device pass number and were thus incorporated into the nomogram. The AUC-ROC determined the discrimination ability of the nomogram, which was 0.921 (95% CI, 0.860– 0.980), which indicated good predictive power. Moreover, the calibration plot revealed good predictive accuracy of the nomogram. The DCA demonstrated that when the threshold probabilities of the cohort ranged between 5.0% and 98.0%, the use of the nomogram to predict a device pass number > 3 provided greater net benefit than did “treat all” or “treat none” strategies.Conclusion: The nomogram comprised age, baseline ASPECTS score, and homocysteine level, can predict a device pass number > 3 in acute ischemic stroke (AIS) patients who are undergoing EVT.Keywords: acute ischemic stroke, endovascular thrombectomy, stentriever, nomogram

Xiaoyuan Liu,1,2 Wenhui Li,1 Youfeng Wen,1 Guochang Xu,3,* Guojian Zhou,1,* Quanying Qu,1,* Ying Hu,1,* Yueriguli Saitierding,1,* Maierdanjang Mohetaer,1,* Yeerkenbieke Buerlan,1,* Xuejun Zhong,1,* Huanjiu Xi1,* 1Biological Anthropology Institute, Jinzhou Medical University, Jinzhou, People’s Republic of China; 2Department of Prosthodontics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic of China; 3Institute of Anthropology, Nanyang Institute of Technology, Nanyang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Youfeng WenBiological Anthropology Institute, Jinzhou Medical University, Jinzhou, 121001, People’s Republic of ChinaTel +86 18641602627Email swyf@163.comIntroduction: This study aimed to investigate the somatotype and obesity of adults in the Xinjiang Uygur Autonomous Region of China and to explore multivariate path analysis for the feasibility and scientificity of using somatotypes to evaluate obesity.Subjects and Methods: According to anthropometric methods, a cross-sectional study was performed on 10 indexes of 3438 adults (1690 men and 1748 women, aged > 20 years) living in the Xinjiang Uygur Autonomous Region of China (including Kazakh, Kyrgyz, Xibe, Uzbek, Tatar and Tajik). The Heath-Carter anthropometric method and body mass index (BMI) were used to evaluate somatotype and obesity, respectively. The feasibility and scientificity of using somatotypes to evaluate obesity were analysed by correspondence analysis.Results: Among the six populations, the somatotypes were mainly distributed as endomorphic mesomorph, mesomorph-endomorph and mesomorphic endomorph populations, accounting for 66.5% of males and 78.8% of females. The obesity rate (27.4% in males, 27.8% in females) of the six populations in the Xinjiang Uygur Autonomous Region of China was much higher than the average Chinese adult obesity rate (12.1%) and the global adult obesity rate (male: 11%, female: 15%). The distribution of BMI was significantly different (male: P= 0.000, female: P= 0.033) in different populations, and the incidence of overweight and obesity in the Xinjiang Uygur Autonomous Region of China increased gradually. This study found that there were significant differences in somatotype distribution among different obesity groups in the Xinjiang Uygur Autonomous Region of China (P=0.000). There was a strong correlation between overweight or obesity and endomorph-mesomorph, endomorphic mesomorph and mesomorphic endomorph. Furthermore, this study indicated that using somatotypes to evaluate obesity was reliable and scientific.Conclusion: This study concluded that the somatotype of overweight or obese people was mainly related to endomorphic mesomorph, mesomorph-endomorph, and mesomorphic endomorph.Keywords: China, obesity, somatotype, Heath-Carter anthropometric method, body mass index, path analysis, Xinjiang

Kai Zhang, Junhao Wang, Haiyang Xi, Lepeng Li, Zhaohui Lou Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, People’s Republic of ChinaCorrespondence: Zhaohui LouDepartment of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, People’s Republic of ChinaTel/Fax +86-371-6796611Email zhaohuilou123@163.comIntroduction: Neuropathic pain is pretty common in modern society, and the treatment effect is far from satisfactory. This study aimed to find evidence of the neuroprotective effect of erythropoietin (EPO) in the treatment of neuropathic pain in a rat model of chronic constriction injury (CCI).Methods: A total of 30 rats were randomly divided into sham operation group, CCI group, or CCI+EPO group. The mechanical and thermal nociception thresholds are evaluated as behavioral assessments. The dorsal root ganglion cells were morphologically evaluated by hematoxylin and eosin staining, and AMPK, p-AMPK, mTOR, p70S6K, and AQP-2 proteins were compared and analyzed by Western blotting. Compared with the sham operation group, rats in the CCI group had shorter paw withdrawal threshold and paw withdrawal latency, abnormal morphology, and increased satellite glial cells.Results: After treatment with EPO, these changes were significantly reversed. In vivo administration of erythropoietin seems to be able to regulate the expression of AQP-2 through the AMPK/mTOR/p70S6K pathway. Our study provides behavioral, morphological, and immunoblot evidence to prove the neuroprotective effect of EPO in the treatment of chronic neuropathic pain in the CCI rat model.Conclusion: Our results indicate that EPO has the potential to treat neuropathic pain caused by peripheral nerve injury, although further verification is needed.Keywords: erythropoietin, chronic contractile injury, dorsal root ganglia, neuropathic pain, satellite glial cells, AQP-2

Junjun Sun,1 Yanyan Luo,1 Hongjuan Chang,1 Ruiqin Zhang,1 Rui Liu,1 Yuanyuan Jiang,1 Huifang Xi2 1School of Nursing, Xinxiang Medical University, Xinxiang, People’s Republic of China; 2The First Affiliated Hospital of Xinxiang Medical University, Weihui, People’s Republic of ChinaCorrespondence: Yanyan LuoSchool of Nursing, Xinxiang Medical University, 601 Jinsui Avenue, Hongqi District, Xinxiang 453000, People’s Republic of ChinaTel +86-13937315599Email 13937315599@163.comBackground: The behavioral inhibition system (BIS) and behavioral activation system (BAS), which primarily underlie emotions and behaviors, are associated with depression and anxiety. However, the reasons behind these associations require further exploration.Objective: This study aims to examine the mediating effects of cognitive emotion regulation between BIS/BAS and depression/anxiety among community-dwelling elderly Chinese.Methods: A cross-sectional survey was conducted with a sample of 836 elderly individuals. Structural equation modeling was used to determine relationships among BIS/BAS, cognitive emotion regulation, and depression/anxiety.Results: Participants reporting higher BIS sensitivity were more likely to use maladaptive cognitive emotion regulation strategies, which were in turn associated with higher rates of depression and anxiety. BAS sensitivity was more likely to lead to adaptive cognitive emotion regulation strategies, which resulted in lower levels of depression and anxiety.Conclusion: Our findings suggest that incorporating emotional regulation in interventions targeting BIS/BAS sensitivities may enhance the accuracy and efficiency of these treatments for depression and anxiety.Keywords: behavioral inhibition system, behavioral activation system, cognitive emotion regulation, depression, anxiety

Pengpeng Wang,1,2 Kecheng Zhang,2 Hongqing Xi,2 Wenquan Liang,2 Tianyu Xie,1,2 Yunhe Gao,2 Bo Wei,2 Lin Chen1,2 1School of Medicine, Nankai University, Tianjin 300071, People’s Republic of China; 2Department of General Surgery, Chinese People’s Liberation Army General Hospital, Beijing 100853, People’s Republic of ChinaCorrespondence: Bo Wei; Lin ChenDepartment of General Surgery, Chinese People’s Liberation Army General Hospital, Fuxing Road 28#, Haidian District, Beijing 100853, People’s Republic of ChinaEmail weibo@vip.163.com; chenlin@301hospital.com.cnPurpose: To compare the lymph node yields of lymph node packet submission (PS), packet submission after isolation by surgeons (PSI), and en bloc lymph node submission (EBS) after gastrectomy.Methods: We conducted a prospective study including 118 gastric cancer patients who underwent gastrectomy between June 2016 and August 2016. We also retrospectively reviewed 607 patients who underwent gastrectomy from May 2015 to May 2016. Following gastrectomy, lymph node specimens were either submitted en bloc (EBS group), divided into packets with accompanying adipose tissue according to the lymph node stations (PS group), or isolated individually based on the surgeon’s visualization and palpation before submission to the Pathology Department (PSI group).Results: The average lymph node yield was significantly higher in the PSI compared with the PS group in the prospective study (46.5±19.4 vs 31.8±11.1), and significantly higher in the PS compared with the EBS group in the retrospective study (31.5±12.6 vs 23.9±8.9) (both P

Lin Chen,1,2,5 Hongyun Huang,3 Haitao Xi,4,5 Gengsheng Mao3 1Medical Center, Tsinghua University, 2Tsinghua University Yuquan Hospital, 3General Hospital of Chinese People's Armed Police Forces, 4Beijing Rehabilitation Hospital of Capital Medical University, 5Beijing Hongtianji Neuroscience Academy, Beijing, People’s Republic of China Abstract: Amyotrophic lateral sclerosis is a progressive and fatal neurodegenerative disease characterized by progressive paralysis and motor neuron death. In addition to symptomatic managements such as ventilation and nutritional support, neurorestorative therapies have demonstrated anti-neurodegenerative potential and may improve quality of life for patients. Currently, clinical neurorestorative strategies include pharmacological management (granulocyte colony stimulating factor), neuromodulatory intervention (repetitive transcranial magnetic and cortical stimulation), cell transplantation (bone marrow stromal cells, olfactory ensheathing cells, granulocyte colony stimulating factor-mobilized peripheral blood stromal cells, hematopoietic stem and progenitor cells, neural stem/progenitor cells, CD133+ cells and CD34+ cells), bioengineering and tissue engineering therapy, and combined neurorehabilitative treatment. In this review, we describe the latest progress in clinical neurorestorative management of amyotrophic lateral sclerosis and discuss the underlying evidence base. Keywords: amyotrophic lateral sclerosis, neurorestorative treatment, cell transplantation, clinical trial

The pressure-time relation in the shock flow field of a near-earth air blast is complex. The triple point (TP) path is the physical boundary between the free and non-free shock flow fields. Accurately predicting the TP path is the basis for studying the evolution law of the reflection flow field and the guarantee of effectively assessing the damage power of the warhead. Based on the assumption that the Mach stem center is on the projection point of the blast center on the ground, the TP path calculation method was constructed by the geometric relationship. The unknown coefficients were solved using the existing TP data and the least square method. The TP prediction model proposed was compared with the existing ones on the calibration, new numerical simulation TP, and the measured real blast datasets. The error of the new numerical simulation TP data is within ±15% of the real value. The results show that the TP path prediction model proposed performs better. Most of its prediction results are within ±20% of three datasets compared to other models for the working conditions with the scaled height of burst from 0.397 to 2.777 m/kg1/3 and the horizontal scaled distance within 10 m/kg1/3 in the conventional cylindrical TNT explosion with the length-diameter of 1 in the air. The reliability of the prediction model is verified. [ABSTRACT FROM AUTHOR]

This article discusses a study that identified two novel mutations in the GREB1L gene in two Chinese families with renal agenesis (RA), a developmental disorder of the kidney. The mutations were associated with bilateral RA with deafness and unilateral RA with uterine abnormalities. The findings expand the understanding of the mutation spectrum of GREB1L and can improve prenatal counseling for future pregnancies. The study highlights the importance of retinoic acid signaling in kidney development and provides evidence of GREB1L mutations as a cause of renal abnormalities. [Extracted from the article]

Abstract This study profiled global single cell-spatial-bulk transcriptome landscapes of hepatocellular carcinoma (HCC) ecosystem from six HCC cases and a non-carcinoma liver control donor. We discovered that intratumoral heterogeneity mainly derived from HCC cells diversity and pervaded the genome-transcriptome-proteome-metabolome network. HCC cells are the core driving force of taming tumor-associated macrophages (TAMs) with pro-tumorigenic phenotypes for favor its dominant growth. Remarkably, M1-types TAMs had been characterized by disturbance of metabolism, poor antigen-presentation and immune-killing abilities. Besides, we found simultaneous cirrhotic and HCC lesions in an individual patient shared common origin and displayed parallel clone evolution via driving disparate immune reprograms for better environmental adaptation. Moreover, endothelial cells exhibited phenotypically conserved but executed differential functions in a space-dependent manner. Further, the spatiotemporal traits of rapid recurrence niche genes were identified and validated by immunohistochemistry. Our data unravels the great significance of HCC cells in shaping vibrant tumor ecosystems corresponding to clinical scenarios.

Abstract Previous studies have reported that a potential association between exposure to outdoor light at night (LAN) and diseases. However, there is no evidence regarding the impacts of outdoor LAN exposure on lipid metabolism in humans. This study aims to evaluate the associations between outdoor LAN exposure and the prevalence of dyslipidemia, using a nationwide sample of 10,894 adults aged ≥ 45 years from 150 investigated sites across China in 2011–2012. Outdoor LAN exposure was assessed by using satellite imaging data. The prevalence ratio (PR) was calculated. The present study found that a per-quintile LAN exposure was positively associated with the prevalence of high LDL-cholesterol (PR = 1.10, 95% CI = 1.04–1.16), high triglyceride (PR = 1.07, 95% CI = 1.03–1.12), low HDL-cholesterol (PR = 1.11, 95% CI = 1.08–1.16), and dyslipidemia (PR = 1.06, 95% CI = 1.03–1.09). The fifth quintile of LAN exposure was associated with a significantly increased prevalence of dyslipidemia (PR = 1.20, 95% CI = 1.07–1.35) compared with the first quintile of exposure. Long-term exposure to outdoor LAN was positively associated with dyslipidemia prevalence. Public policies aimed at reducing light pollution at night, guided by the spatial distribution patterns, could lessen the adverse effects.

Abstract Tile and Young-Burgess classification systems have been widely used to classify pelvic ring injuries in clinical settings; however, these two systems are rarely mentioned in the literature despite their reproducibility and practical application. The purpose of this study was to assess the interobserver and intraobserver reliability of the Tile and Young-Burgess classification of pelvic ring injuries. Eight hundred seven patients with pelvic fractures who presented to two I-level trauma centres between January 2016 and June 2020 were recruited for this study. The anteroposterior, inlet, and outlet of the pelvis were observed on radiographic images, and CT scans were performed on each patient. The anteroposterior, inlet, and outlet of the pelvis were radiographed at each visit, and CT scans were performed. Four observers were recruited to classify the injury type according to the Young-Burgess and Tile classification systems. Interobserver and intraobserver reliability (kappa coefficient, κ) were applied to assess the reproducibility of the two classification systems. A total of 174 patients (21.56%) could not be classified with the Young-Burgess classification, and all patients could be classified according to the Tile system. The mean κ value of the interobserver reliability was 0.558 (range, 0.444 to 0.653) for the Tile classification, indicating moderate agreement, whereas the mean κ value was 0.637 (range, 0.560 to 0.713), indicating substantial agreement, when the Young-Burgess classification was used. The mean κ value for intraobserver reliability was 0.597 (range, 0.567 to 0.653) for the Tile classification and 0.776 (range, 0.748 to 0.803) for the Young-Burgess classification. More pelvic ring injuries could be classified with the Tile classification than could be classified with the Young-Burgess classification. However, the reproducibility of the Young-Burgess classification was greater than that of the Tile classification.

Abstract Background Depression and anxiety are common psychological issues among international medical students in universities, which have serious negative impacts on their learning and life. The present study aimed to evaluate the efficacy of positive emotional writing in alleviating symptoms of anxiety and depression, as well as enhancing subjective well-being among this population. Method This study was conducted at an international college of a comprehensive university in central China. A total of ninety-two participants who met the inclusion criteria were recruited to participate in a single-blind randomized controlled trial, in which participants were not aware that there was an experimental group and a control group. Participants in control received daily psychological care weekly for 8 weeks (n = 46). Correspondingly, participants in experimental group received the positive emotional writing intervention on the basis of daily psychological care. Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS) and General Well-being Scale (GWB) were used to evaluate the effect of the intervention. Data from 89 students who completed the entire study (experimental group, n = 44; control group, n = 45) were analyzed. Results After the intervention, the scores of SDS and SAS in the experimental group significantly decreased, while the subjective well-being score significantly increased. Although the SAS score of the control group after intervention was significantly lower than before, the decrease in SDS and SAS scores, as well as the increase in GWB score, were significantly greater in the experimental group than in the control group. Conclusion The findings suggest that positive emotional writing can effectively reduce the depression and anxiety of international medical students, and significantly enhance their subjective well-being, providing ideas for management to solve the psychological problems of international medical students. Trial registration number ChiCTR2400087815. Registered at Chinese Clinical Trial Registry.

Abstract Low-grade heat is abundant and ubiquitous, but it is generally discarded due to the lack of cost-effective recovery technologies. Ion thermoelectric cells are an affordable and straightforward approach of converting low-grade heat into usable electricity for sustainable power. Despite their potential, ion thermoelectric cells face challenges such as limited Seebeck coefficient and required series integration. Here, we demonstrate that the N-type and P-type conversion of ion thermoelectric cells can be achieved through the phase transition of temperature-sensitive hydrogel containing the triiodide/iodide redox couple. Through the strong interaction between the hydrophobic region of the hydrogel and triiodide, the hydrophobic side selectively captures triiodide and the hydrophilic side repels triiodide, raising the concentration difference of triiodide and thereby increasing the Seebeck coefficient. Specifically, the Seebeck coefficient of the N-type ion thermoelectric cells is 7.7 mV K−1, and the Seebeck coefficient of P-type ion thermoelectric cells is −6.3 mV K−1 (ΔT = 15 K). By connecting 10 pairs of the N-type and P-type ion thermoelectric cells, we achieve a voltage of 1.8 V and an output power of 85 μW, surpassing the reported triiodide/iodide-based ion thermoelectric cells. Our work proposes a phase transition strategy for the N-P conversion of ion thermoelectric cells, and highlights the prospect of series integrated hydrogel ion thermoelectric cells for low-grade heat harvesting.

Objective Femoral head necrosis is a challenging condition in orthopaedics, and the occurrence of collapse is an important factor affecting the prognosis of femoral head necrosis. Sclerosis bands are known to influence the collapse of the femoral head, yet there is a lack of research on the biomechanical role of sclerosis bands in non‐vascularized fibular grafting surgery. This study aims to evaluate the biomechanical impact of sclerosis bands in femoral head necrosis and their role in non‐vascularized fibular grafting surgery (NVFG) using finite element analysis. Methods We constructed 11 finite element models based on CT scan data of a normal hip joint, simulating different sclerosis band thicknesses and defect scenarios. The models were analyzed for changes in femoral head displacement and von Mises stress. We constructed a hip joint model based on CT data from a normal hip joint, and after reconstruction, assembly, and optimization using 3‐matic. We created five groups consisting of 11 finite element analysis models of the hip joint. Mesh partitioning and mechanical parameter settings were performed in ANSYS. The changes and differences in femoral head displacement and von Mises stress of these models were analyzed. Results Increasing sclerosis band thickness led to reduced peak displacement of the femoral head by 28.6%, 42.9%, and 47.6%, and increased surface von Mises stress by 28.3%, 13.8%, and 13.0%, respectively. Post‐surgery, peak displacement decreased in all groups compared to pre‐surgery levels. Increasing sclerosis band thickness post‐surgery resulted in decreased maximum von Mises stress of the femoral head by 13.9%, 3.0%, and 8.1%. Defect volume in the defect groups correlated with increased peak displacement of the femoral head by 10.0%, 30.0%, and 100.0%, and increased surface maximum von Mises stress of the femoral head by 9.3%, 14.0%, and 15.1%. Conclusion Sclerosis band formation exacerbates von Mises stress concentration on the femoral head surface. However, thicker sclerosis bands improve post‐NVFG stability and mechanical performance. Larger anterior lateral sclerosis band defects significantly compromise postoperative stability, increasing the risk of collapse. Protecting the anterior lateral sclerosis band during NVFG surgery is crucial.

Abstract There are service communities with different functions in the Bitcoin transactions system. Identifying community categories helps to further understand the Bitcoin transactions system and facilitates targeted regulation of anonymized Bitcoin transactions. To this end, a Bitcoin service community classification method based on Random Forest and improved K‐Nearest Neighbor (KNN) algorithm is proposed. First, the transaction characteristics of different types of communities are analyzed and summarized, and the corresponding transaction features are extracted from the address and entity levels; then multiple classification algorithms are compared, the optimal model to filter the effective features is selected, and the feature vector of entity addresses is constructed. Finally, a classification model is constructed based on Random Forest and improved KNN algorithm to classify the entities. By constructing different classification models for experimental comparison, the accuracy and stability advantages of the proposed method for classification in service community classification research are verified.

Taking TiCp/Al-5Cu-1.9Mg-0.9Mn composite materials reinforced with 0.27%（volume fraction）TiC particles as the matrix， the effects of different Sm element contents on the microstructure and mechanical properties of the composite material were investigated. The results show that the addition of the Sm element significantly refines the dendritic microstructure and facilitates the dissolution of the second phase during the solid solution treatment. Consequently， an increase in the density of precipitated phases， including T-Al20Cu2Mn3 and S'-Al2CuMg， was observed in the aged microstructure. When the Sm element content is high （0.3%， mass fraction， the same below）， the microstructure exhibits blocky insoluble rare earth-containing compounds. With the addition of the Sm， the composite materials show a gradual increase in yield strength at both room temperature and 250 ℃. However， it will cause a decrease in plasticity. When the Sm element content is 0.3%， the yield strength at room temperature increases from 246 MPa to 310 MPa， and the yield strength at 250 ℃ increases from 191 MPa to 220 MPa. The analysis suggests that the increase in strength is attributed to the microstructural refinement and the increased density of precipitated phases induced by Sm. Conversely， the reduction in plasticity is attributed to the presence of coarse blocky insoluble rare earth compounds cutting through the matrix， leading to the easy generation of crack sources.

Diabetes mellitus (DM) is a chronic metabolic disorder that can affect the balance of bone metabolism and bone microenvironment, leading to impaired fracture healing. There are several underlying mechanisms which contributing to the impaired diabetic bone microenvironment such as hyperglycemia, the production of advanced glycation end products (AGEs), inflammation, and oxidative stress, etc. Recent studies have achieved great progress in developing novel smart biomaterials in improving the diabetic bone microenvironment to promote diabetic fracture healing. In this paper, we reviewed the mechanisms on DM-induced impaired fracture healing. Meanwhile, we also summarized the smart biomaterials used to improve the local microenvironment of diabetic fractures healing, which provides a novel perspective for the future treatment of fractures in diabetic patients.