Polycystic ovary syndrome (PCOS) is the predominant cause of subfertility in reproductive-aged women; however, its pathophysiology remains unknown. Neurotensin (NTS) is a member of the gut-brain peptide family and is involved in ovulation; its relationship with PCOS is unclear. Here, we found that NTS expression in ovarian granulosa cells and follicular fluids was markedly decreased in patients with PCOS. In the in vitro culture of cumulus-oocyte complexes, the neurotensin receptor 1 (NTSR1) antagonist SR48692 blocked cumulus expansion and oocyte meiotic maturation by inhibiting metabolic cooperation and damaging the mitochondrial structure in oocytes and surrounding cumulus cells. Furthermore, the ERK1/2-early growth response 1 pathway was found to be a key downstream mediator of NTS/NTSR1 in the ovulatory process. Animal studies showed that in vivo injection of SR48692 in mice reduced ovulation efficiency and contributed to irregular estrus cycles and polycystic ovary morphology. By contrast, NTS partially ameliorated the ovarian abnormalities in mice with dehydroepiandrosterone-induced PCOS. Our findings highlighted the critical role of NTS reduction and consequent abnormal NTSR1 signaling in the ovulatory dysfunction of PCOS, suggesting a potential strategy for PCOS treatment.
Polycystic Ovary Syndrome/physiopathology* ; Female ; Animals ; Neurotensin/metabolism* ; Receptors, Neurotensin/antagonists & inhibitors* ; Mice ; Ovulation/drug effects* ; Humans ; Granulosa Cells/metabolism* ; Adult ; Oocytes/metabolism* ; MAP Kinase Signaling System ; Signal Transduction ; Follicular Fluid/metabolism* ; Disease Models, Animal ; Gonadotropin-Releasing Hormone/analogs & derivatives*

Precise management of the activity dose is a core component of the(early mobilization,EM)plan for ICU patients.However,the lack of clinical practice guidelines related to EM dose of existing programs hinders the implementation and development of EM in ICU patients to some extent.Therefore,this review focuses on 4 aspects,covering the definition of activity dose,assessment tools,the current clinical implementation status,and implications for future nursing.The aim is to systematically review the assessment tools and intervention strategies for the activity dose of EM in ICU patients,providing a reference for optimization of EM programs.

The growth and atrophy of bones are closely related to the mechanical stress they experience. Mechanotransduction, a fundamental biological signal transmission mechanism, enables cells to convert external mechanical forces into intracellular signaling responses through the secretion of protein factors and activation of signaling pathways. Piezo1 is a mechanosensitive ion channel that detects mechanical stress (such as pressure, stretch, and shear force), induces Ca 2+ influx, and transduces these signals into intracellular responses, playing a crucial role in bone homeostasis. Encoded by the Fam38A gene, Piezo1 possesses a distinctive 38-transmembrane helical structure that forms a bowl-shaped, trimeric propeller-like configuration. This unique structure allows it to function as a mechanical transducer, sensing mechanical stimuli at the cell membrane and transmitting mechanical signals. In the skeletal system, Piezo1 contributes to maintaining the dynamic balance between bone formation and resorption by regulating the functions of macrophages, bone marrow mesenchymal stem cells, chondrocytes, osteocytes, osteoblasts, and osteoclasts, as well as through signaling pathways such as Akt, Wnt/β-catenin, TGF-β, and MAPK. Additionally, studies have demonstrated a significant association between Piezo1 gene polymorphisms and bone mineral density, highlighting its potential therapeutic applications in osteoporosis treatment via the osteogenic-angiogenic coupling mechanism. This review summarizes the mechanisms and recent research progress on the Piezo1 mechanosensitive ion channel in bone homeostasis. By elucidating Piezo1’s role in bone metabolism, this review aims to provide a theoretical foundation and potential strategies for the prevention and treatment of osteoporosis and other bone-related diseases in clinical practice.

The growth and atrophy of bones are closely related to the mechanical stress they experience. Mechanotransduction, a fundamental biological signal transmission mechanism, enables cells to convert external mechanical forces into intracellular signaling responses through the secretion of protein factors and activation of signaling pathways. Piezo1 is a mechanosensitive ion channel that detects mechanical stress (such as pressure, stretch, and shear force), induces Ca 2+ influx, and transduces these signals into intracellular responses, playing a crucial role in bone homeostasis. Encoded by the Fam38A gene, Piezo1 possesses a distinctive 38-transmembrane helical structure that forms a bowl-shaped, trimeric propeller-like configuration. This unique structure allows it to function as a mechanical transducer, sensing mechanical stimuli at the cell membrane and transmitting mechanical signals. In the skeletal system, Piezo1 contributes to maintaining the dynamic balance between bone formation and resorption by regulating the functions of macrophages, bone marrow mesenchymal stem cells, chondrocytes, osteocytes, osteoblasts, and osteoclasts, as well as through signaling pathways such as Akt, Wnt/β-catenin, TGF-β, and MAPK. Additionally, studies have demonstrated a significant association between Piezo1 gene polymorphisms and bone mineral density, highlighting its potential therapeutic applications in osteoporosis treatment via the osteogenic-angiogenic coupling mechanism. This review summarizes the mechanisms and recent research progress on the Piezo1 mechanosensitive ion channel in bone homeostasis. By elucidating Piezo1’s role in bone metabolism, this review aims to provide a theoretical foundation and potential strategies for the prevention and treatment of osteoporosis and other bone-related diseases in clinical practice.

Precise management of the activity dose is a core component of the(early mobilization,EM)plan for ICU patients.However,the lack of clinical practice guidelines related to EM dose of existing programs hinders the implementation and development of EM in ICU patients to some extent.Therefore,this review focuses on 4 aspects,covering the definition of activity dose,assessment tools,the current clinical implementation status,and implications for future nursing.The aim is to systematically review the assessment tools and intervention strategies for the activity dose of EM in ICU patients,providing a reference for optimization of EM programs.

Objective To evaluate the effect of virtual reality(VR)on cognitive function and quality of life in patients with Parkin-son's disease. Methods A systematic search of CBM,CNKI,Wanfang data,VIP,Cochrane Library,Web of Science,Embase,and PubMed was carried out to identify randomized control trials(RCT)about the effect of VR technology on pa-tients with Parkinson's disease from inception to February 29th,2024.The control group received routine cogni-tive training,balance training or physical therapy,and the experimental group received VR technology.The quali-ty of articles was evaluated using the Cochrane Collaboration's 5.1.0 RCT risk assessment tool for bias.The meta-analysis was performed using Revman5.4.GRADE was used to evaluate the evidence quality of outcome indica-tors. Results A total of 13 literatures involving 426 patients were included.Allocation concealment and blind methods were not described in most literatures,and selective reporting of research results or other biases was unclear.VR tech-nology could improve the Motreal Cognitive Assessment(MoCA)score(MD=1.11,95%CI 0.31 to 1.90,P=0.006),Trail Making Test(TMT)-A score(MD=-6.25,95%CI-11.71 to-0.78,P=0.030)and depression scale score(SMD=-0.56,95%CI-0.95 to 0.18,P=0.004)of patients with Parkinson's disease;however,it did not improve TMT-B score(MD=-6.01,95%CI-28.16 to 16.14,P=0.590),Unified Parkinson's Disease Rat-ing Scale(UPDRS)-Part II score(MD=-2.11,95%CI-4.97 to 0.75,P=0.150)and Parkinson's Disease Ques-tionnaire(PDQ-39)score(MD=-0.92,95%CI-4.03 to 2.19,P=0.560).For quality of evidence,MoCA score,UPDRS-Part II score and PDQ-39 score were low,and depression score and TMT score were moderate. Conclusion VR technology can improve the cognitive function and depression of patients with Parkinson's disease;how-ever,no significant improvement is found in activities of daily living and quality of life.

BACKGROUND: Low-back pain (LBP) in nurses is a major health concern that affects their quality of life and ability to work, with consequences for their economic status. OBJECTIVE: This study evaluates the effect of low-level laser acupuncture combined with auricular acupressure (LAA) on pain intensity, pain interference and quality of life in nurses with LBP. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This randomized controlled trial recruited a convenience sample of hospital-based nurses from one teaching hospital in Taiwan, China. Participants were randomly assigned to the LAA group (n = 38) receiving low-level laser acupuncture and auricular acupressure for 4 weeks, and the control group (n = 38) receiving only sham laser acupuncture treatment without laser energy output. MAIN OUTCOME MEASURES: Data were collected for the primary pain outcome using the Short Form of the Brief Pain Inventory, while the secondary outcome, quality of life, was evaluated using the Roland-Morris Disability Questionnaire. Both primary and secondary outcomes were scored before the intervention, and after 2-week and 4-week intervention. The rate of LBP recurrence was evaluated at the 4th week and 8th week after the end of intervention. RESULTS: After controlling for prior pain, the result of linear mixed model analysis showed trends in significant between-group differences in the level of current pain occurring in week 4 (P < 0.001), worst pain in week 2 (P < 0.001) and week 4 (P < 0.001), least pain in week 2 (P = 0.032) and week 4 (P < 0.001), pain interference in week 2 (P = 0.009) and week 4 (P < 0.001), and in the life dysfunction in week 2 (P < 0.001) and week 4 (P < 0.001). Recurrence rates of LBP at the 4th and 8th weeks after the end of intervention were 0% and 36.89% in the LAA group, and 69.44% and 36.11% in the control group. CONCLUSION: This study shows that 4-week LAA intervention reduced pain intensity and pain interference, and improved quality of life for hospital-based nurses with LBP. These effects were maintained continuously for at least 4 weeks after the intervention. The nonpharmacological intervention, LAA, may be another efficacious, feasible, noninvasive, analgesic intervention for LBP. TRIAL REGISTRATION This study is registered at Clinicaltrials.gov (registration number NCT04423445).
Humans ; Acupressure ; Quality of Life ; Treatment Outcome ; Low Back Pain/therapy* ; Acupuncture Therapy ; Nurses

Objective:To evaluate artificial intelligence constructed by deep convolutional neural network (DCNN) for the site identification in upper gastrointestinal endoscopy.Methods:A total of 21 310 images of esophagogastroduodenoscopy from the Cancer Hospital of Chinese Academy of Medical Sciences from January 2019 to June 2021 were collected. A total of 19 191 images of them were used to construct site identification model, and the remaining 2 119 images were used for verification. The performance differences of two models constructed by DCCN in the identification of 30 sites of the upper digestive tract were compared. One model was the traditional ResNetV2 model constructed by Inception-ResNetV2 (ResNetV2), the other was a hybrid neural network RESENet model constructed by Inception-ResNetV2 and Squeeze-Excitation Networks (RESENet). The main indices were the accuracy, the sensitivity, the specificity, positive predictive value (PPV) and negative predictive value (NPV).Results:The accuracy, the sensitivity, the specificity, PPV and NPV of ResNetV2 model in the identification of 30 sites of the upper digestive tract were 94.62%-99.10%, 30.61%-100.00%, 96.07%-99.56%, 42.26%-86.44% and 97.13%-99.75%, respectively. The corresponding values of RESENet model were 98.08%-99.95%, 92.86%-100.00%, 98.51%-100.00%, 74.51%-100.00% and 98.85%-100.00%, respectively. The mean accuracy, mean sensitivity, mean specificity, mean PPV and mean NPV of ResNetV2 model were 97.60%, 75.58%, 98.75%, 63.44% and 98.76%, respectively. The corresponding values of RESENet model were 99.34% ( P<0.001), 99.57% ( P<0.001), 99.66% ( P<0.001), 90.20% ( P<0.001) and 99.66% ( P<0.001). Conclusion:Compared with the traditional ResNetV2 model, the artificial intelligence-assisted site identification model constructed by RESENNet, a hybrid neural network, shows significantly improved performance. This model can be used to monitor the integrity of the esophagogastroduodenoscopic procedures and is expected to become an important assistant for standardizing and improving quality of the procedures, as well as an significant tool for quality control of esophagogastroduodenoscopy.

In skeletal system, the coupling effect between angiogenesis and osteogenesis can promote bone growth and maintain bone mass balance. Type H vessel is a special capillary subtype in bone with high expression of Endomucin (Emcn) and CD31. The essence of type H vessel is vascular endothelial cells, mainly distributed in the metaphysis, surrounded by bone progenitor cells, which mediates the coupling mechanism of angiogenesis and osteogenesis, involving a variety of cytokines and signaling pathways. Factors including platelet-derived growth factor type BB, slit guidance ligand 3, hypoxia-inducible factor 1-alpha, Notch, and vascular endothelial growth factor are involved in the coupling of angiogenesis and osteogenesis. Type H vessels transmit signals through a variety of cytokines to enhance the connection between angiogenesis and bone formation, thus regulating bone growth and bone homeostasis. In addition, this article discusses the research prospects of improving bone loss by using it as a target, so as to provide reference for clinical bone injury repair and anti-osteoporosis treatment.

Objective To study the correlation between the genetic polymorphism of tumor necrosis factor-α(TNF-α)-308 with benazepril treatment response in the patients with hypertensive renal damage in Ningxia area.Methods Two hundred and eighty-four patients initially diagnosed as hypertension were enrolled and the hypertensive renal damage defined by the measurement of urinary albumin excretion rate(UAER).At the same time 160 individuals undergoing healthy physical examination were selected as the normal blood pressure control group.The plasma samples were obtained from all the subjects,and plasma level of TNF-α and TNF-α-308 gene polymorphism were detected.Then the patients with hypertensive renal damage were interfered with benazepril as one of the antihypertensive drugs,and the treatment response of different TNF-α-308 genotypes to benazepril was observed,and the comparative analysis was performed.Results Among the TNF-α-308 genotypes in the patients with simple hypertension,genotype GA was the most common,followed by GG and AA successively,with the G/A allele frequency of 53 ％/47 ％ (P＜0.05).In the patients with hypertensive renal damage,genotype GG was the most common,followed by GA and AA successively,with the G/A allele frequency of 70％/30％,the genotypes and allele frequency had no statistical difference(P＜0.05).Before and after benazepril treatment,the change range of UAER in the patients with genotype AA was maximal,followed by the genotype GA and GG,the difference among 3 groups was statistically significant(P＜0.05).Conclusion The TNF-α-308 gene is correlated with hypertensive renal damage and its response to benazepril treatment.