Objective To explore the predictive effect of serum 25-hydroxyvitamin D3 [25(OH)D3] and blood lipid metabolism indexes on the occurrence of osteoporosis in type 2 diabetes mellitus (T2DM). Methods Totally 98 patients with T2DM in the hospital from January 2022 to January 2024 were classified into osteoporosis group (38 cases) and non-osteoporosis group (60 cases) by means of concurrent osteoporosis status. The levels of serum 25(OH)D3 and blood lipid metabolism indexes [high density lipoprotein (HDL), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), VLDL] were measured in study subjects. The association of serum 25(OH)D3 and blood lipid metabolism indexes with osteoporosis was explored by Logistic regression analysis. The predictive value of serum 25(OH)D3 and blood lipid metabolism indexes on osteoporosis was analyzed by receiver operating characteristic curve (ROC). Results Serum 25(OH)D3 and HDL levels in the osteoporosis group were lower while TG and LDL levels were higher than those in the non-osteoporosis group (P<0.05). The differences in the levels of TC and VLDL were insignificant between groups (P>0.05). After logistic regression analysis, the levels of serum 25(OH)D3, HDL, TG and LDL were closely related to the occurrence of osteoporosis (P<0.05). ROC curve indicated that the area under the curve (AUC), sensitivity and specificity of combined prediction of osteoporosis by serum 25(OH)D3, HDL, TG, and LDL were 0.943, 92.11% and 85.00%, and the efficiency of combined prediction was better than that of each index alone (P<0.05). Conclusion The levels of serum 25(OH)D3, HDL, TG and LDL in T2DM are closely related to osteoporosis. Early combined monitoring of the indicators can provide reference value for clinical prediction of osteoporosis occurrence in patients with T2DM.

Risk prediction models for postoperative pulmonary complications (PPCs) can assist healthcare professionals in assessing the likelihood of PPCs occurring after surgery, thereby supporting rapid decision-making. This study evaluated the merits, limitations, and challenges of these models, focusing on model types, construction methods, performance, and clinical applications. The findings indicate that current risk prediction models for PPCs following lung cancer surgery demonstrate a certain level of predictive effectiveness. However, there are notable deficiencies in study design, clinical implementation, and reporting transparency. Future research should prioritize large-scale, prospective, multi-center studies that utilize multiomics approaches to ensure robust data for accurate predictions, ultimately facilitating clinical translation, adoption, and promotion.

Tumor drug resistance is an important problem in the failure of chemotherapy and targeted drug therapy, which is a complex process involving chromatin remodeling. SWI/SNF is one of the most studied ATP-dependent chromatin remodeling complexes in tumorigenesis, which plays an important role in the coordination of chromatin structural stability, gene expression, and post-translation modification. However, its mechanism in tumor drug resistance has not been systematically combed. SWI/SNF can be divided into 3 types according to its subunit composition: BAF, PBAF, and ncBAF. These 3 subtypes all contain two mutually exclusive ATPase catalytic subunits (SMARCA2 or SMARCA4), core subunits (SMARCC1 and SMARCD1), and regulatory subunits (ARID1A, PBRM1, and ACTB, etc.), which can control gene expression by regulating chromatin structure. The change of SWI/SNF complex subunits is one of the important factors of tumor drug resistance and progress. SMARCA4 and ARID1A are the most widely studied subunits in tumor drug resistance. Low expression of SMARCA4 can lead to the deletion of the transcription inhibitor of the BCL2L1 gene in mantle cell lymphoma, which will result in transcription up-regulation and significant resistance to the combination therapy of ibrutinib and venetoclax. Low expression of SMARCA4 and high expression of SMARCA2 can activate the FGFR1-pERK1/2 signaling pathway in ovarian high-grade serous carcinoma cells, which induces the overexpression of anti-apoptosis gene BCL2 and results in carboplatin resistance. SMARCA4 deletion can up-regulate epithelial-mesenchymal transition (EMT) by activating YAP1 gene expression in triple-negative breast cancer. It can also reduce the expression of Ca²⁺ channel IP3R3 in ovarian and lung cancer, resulting in the transfer of Ca²⁺ needed to induce apoptosis from endoplasmic reticulum to mitochondria damage. Thus, these two tumors are resistant to cisplatin. It has been found that verteporfin can overcome the drug resistance induced by SMARCA4 deletion. However, this inhibitor has not been applied in clinical practice. Therefore, it is a promising research direction to develop SWI/SNF ATPase targeted drugs with high oral bioavailability to treat patients with tumor resistance induced by low expression or deletion of SMARCA4. ARID1A deletion can activate the expression of ANXA1 protein in HER2+ breast cancer cells or down-regulate the expression of progesterone receptor B protein in endometrial cancer cells. The drug resistance of these two tumor cells to trastuzumab or progesterone is induced by activating AKT pathway. ARID1A deletion in ovarian cancer can increase the expression of MRP2 protein and make it resistant to carboplatin and paclitaxel. ARID1A deletion also can up-regulate the phosphorylation levels of EGFR, ErbB2, and RAF1 oncogene proteins.The ErbB and VEGF pathway are activated and EMT is increased. As a result, lung adenocarcinoma is resistant to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs). Although great progress has been made in the research on the mechanism of SWI/SNF complex inducing tumor drug resistance, most of the research is still at the protein level. It is necessary to comprehensively and deeply explore the detailed mechanism of drug resistance from gene, transcription, protein, and metabolite levels by using multi-omics techniques, which can provide sufficient theoretical basis for the diagnosis and treatment of poor tumor prognosis caused by mutation or abnormal expression of SWI/SNF subunits in clinical practice.

BACKGROUND:Currently,spinal endoscopic technology has become the mainstream technology in minimally invasive spinal surgery.The specifications of the instruments for different operating systems are different,and the choice of specific surgical protocols needs to be combined with the actual situation of the patient and the choice of the clinical surgeon. OBJECTIVE:To compare the early efficacy of percutaneous endoscopic interlaminar discectomy for L5-S1 disc herniation under the iLESSYS Delta System and Endo-Surgi Plus System. METHODS:Totally 80 patients with L5-S1 disc herniation were treated with percutaneous endoscopic interlaminar discectomy.Patients were divided into two groups based on the endoscopic system used.Among them,37 cases received the iLESSYS Delta System(Delta group)and 43 cases received the Endo-Surgi Plus System(Plus group).Patient demographic characteristics,perioperative indicators,and complications were analyzed between the two groups.Clinical outcomes were quantified using back and leg visual analog scale scores,Oswestry Disability Index,and Japanese Orthopaedic Association scores at 1 day,1,3,and 6 months after surgery.Patient satisfaction was assessed according to modified MacNab criteria at final follow-up. RESULTS AND CONCLUSION:(1)The operative time and number of arthroplasties in the Plus group were less than those in the Delta group,and the differences were statistically significant(P<0.05).(2)Compared with the preoperative period,the visual analog scale scores,Oswestry Disability Index,and Japanese Orthopaedic Association scores of patients in both groups improved at all follow-up time points,and the difference was statistically significant(P<0.001).(3)There was no statistically significant difference in the comparison of pain visual analog scale scores,Oswestry Disability Index,and Japanese Orthopaedic Association scores of patients in the two groups(P>0.05).(4)At 6-month follow-up after surgery,the MacNab standard excellent and good rates in the Delta group and Plus group were 81%and 79%,respectively,with no significant difference(P=0.823).(5)The incidence of complications was 3%in the Delta group and 2%in the Plus group,but there was no significant difference between the two groups(P=0.914).(6)It is concluded that both iLESSYS Delta and Endo-Surgi Plus surgical systems achieved satisfactory early clinical results in the treatment of lumbar disc herniation,with Endo-Surgi Plus surgical moulding being more efficient and safer.

OBJECTIVE: To explore the association between acupuncture during controlled ovarian hyperstimulation (COH) and the live birth rate (LBR) using different propensity score methods. METHODS: In this retrospective cohort study, eligible women who underwent a COH were divided into acupuncture and non-acupuncture groups. The primary outcome was LBR, as determined by propensity score matching (PSM). LBR was defined as the delivery of one or more living infants that reached a gestational age over 28 weeks after embryo transfer. The propensity score model encompassed 16 confounding variables. To validate the results, sensitivity analyses were conducted using three additional propensity score methods: propensity score adjustment, inverse probability weighting (IPW), and IPW with a "doubly robust" estimator. RESULTS: The primary cohort encompassed 9751 patients (1830 [18.76%] in the acupuncture group and 7921 [81.23%] in the non-acupuncture group). Following 1:1 PSM, a higher LBR was found in the acupuncture cohort (41.4% [755/1824] vs 36.4% [664/1824], with an odds ratio of 1.23 [95% confidence interval, 1.08-1.41]). Three additional propensity score methods produced essentially similar results. The risk of serious adverse events did not significantly differ between the two groups. CONCLUSION This retrospective study revealed an association between acupuncture and an increased LBR among patients undergoing COH, and that acupuncture is a safe and valuable treatment option. Please cite this article as: Zheng XY, Jiang ZY, Li YT, Li CL, Zhu H, Yu Z, Yu SY, Yang LL, Tang SY, Lü XY, Liang FR, Yang J. Association between acupuncture and live birth rates after fresh embryo transfer: A cohort study based on different propensity score methods. J Integr Med. 2025; 23(5):528-536.
Humans ; Female ; Propensity Score ; Embryo Transfer ; Adult ; Acupuncture Therapy ; Retrospective Studies ; Pregnancy ; Live Birth ; Birth Rate ; Cohort Studies

OBJECTIVE: To explore and quantify the association of hot night exposure during the sperm development period (0-90 lag days) with semen quality. METHODS: A total of 6,640 male sperm donors from 6 human sperm banks in China during 2014-2020 were recruited in this multicenter study. Two indices (i.e., hot night excess [HNE] and hot night duration [HND]) were used to estimate the heat intensity and duration during nighttime. Linear mixed models were used to examine the association between hot nights and semen quality parameters. RESULTS: The exposure-response relationship revealed that HNE and HND during 0-90 days before semen collection had a significantly inverse association with sperm motility. Specifically, a 1 °C increase in HNE was associated with decreased sperm progressive motility of 0.0090 (95% confidence interval [ CI]: -0.0147, -0.0033) and decreased total motility of 0.0094 (95% CI: -0.0160, -0.0029). HND was significantly associated with reduced sperm progressive motility and total motility of 0.0021 (95% CI: -0.0040, -0.0003) and 0.0023 (95% CI: -0.0043, -0.0002), respectively. Consistent results were observed at different temperature thresholds on hot nights. CONCLUSION Our findings highlight the need to mitigate nocturnal heat exposure during spermatogenesis to maintain optimal semen quality.
Humans ; Male ; Semen Analysis ; Adult ; Sperm Motility ; Hot Temperature/adverse effects* ; China ; Middle Aged ; Spermatozoa/physiology* ; Young Adult

OBJECTIVE: To reveal the effects and potential mechanisms by which synaptic vesicle glycoprotein 2A (SV2A) influences the distribution of amyloid precursor protein (APP) in the trans-Golgi network (TGN), endolysosomal system, and cell membranes and to reveal the effects of SV2A on APP amyloid degradation. METHODS: Colocalization analysis of APP with specific tagged proteins in the TGN, ensolysosomal system, and cell membrane was performed to explore the effects of SV2A on the intracellular transport of APP. APP, β-site amyloid precursor protein cleaving enzyme 1 (BACE1) expressions, and APP cleavage products levels were investigated to observe the effects of SV2A on APP amyloidogenic processing. RESULTS: APP localization was reduced in the TGN, early endosomes, late endosomes, and lysosomes, whereas it was increased in the recycling endosomes and cell membrane of SV2A-overexpressed neurons. Moreover, Arl5b (ADP-ribosylation factor 5b), a protein responsible for transporting APP from the TGN to early endosomes, was upregulated by SV2A. SV2A overexpression also decreased APP transport from the cell membrane to early endosomes by downregulating APP endocytosis. In addition, products of APP amyloid degradation, including sAPPβ, Aβ _1-42, and Aβ _1-40, were decreased in SV2A-overexpressed cells. CONCLUSION These results demonstrated that SV2A promotes APP transport from the TGN to early endosomes by upregulating Arl5b and promoting APP transport from early endosomes to recycling endosomes-cell membrane pathway, which slows APP amyloid degradation.
Amyloid beta-Protein Precursor/genetics* ; Membrane Glycoproteins/genetics* ; Animals ; Protein Transport ; Nerve Tissue Proteins/genetics* ; Humans ; Mice ; Endosomes/metabolism* ; trans-Golgi Network/metabolism*

Purpose: Coronavirus disease 2019 (COVID-19) infection may affect serum hormones levels and male sexual function. This study aims to provide evidence for the causal relationship between COVID-19 infection, serum testosterone levels and the risk of erectile dysfunction (ED) using a two-sample Mendelian randomization (MR) approach. Materials and Methods: Summary-level data for serum testosterone levels (199,569 samples and 12,321,875 single nucleotide polymorphisms [SNPs]) were obtained from Rebecca’s study, while data for ED (6,175 cases and 217,630 controls) were sourced from Bovijn’s study. Genetic variations linked to COVID-19 were used as instrumental variables (IVs) in meta-analyses of genome-wide association studies (GWASs) involving 6,406 cases and 902,088 controls from the COVID-19 Host Genetics Initiative.The inverse-variance weighted (IVW) method was primarily employed to evaluate the potential associations between COVID-19 infection, serum testosterone levels, and the risk of ED. The weighted mode, weighted-median and simple-median method were employed to evaluate the sensitivity. Heterogeneity and pleiotropic outlier were assessed using Cochran’s Q test and MREgger regression. Results: The MR analysis demonstrated that COVID-19 infection was associated with reduced serum testosterone levels (odds ratio [OR] 0.966, 95% confidence interval [CI] 0.938–0.993, p=0.016) and an increased risk of ED (OR 1.205, 95% CI 1.063–1.367, p=0.004) when using IVW methods. Sensitivity analyses utilizing various IV sets and MR approach remained consistent. Conclusions COVID-19 infection is associated with a decrease in serum testosterone levels and an increased risk of ED. Male patients recovering from COVID-19 need to pay special attention to their sex hormone levels and sexual health.

Objective:To investigate whether exosome-derived microRNA (miR)-877-5p can affect the malignant biological behaviors of glioma cells by regulating transmembrane 4 superfamily member 1 (TM4SF1).Methods:(1) Tumor tissues and corresponding adjacent tissues from 42 patients with glioma who underwent surgical resection in Department of Neurosurgery, the First Affiliated Hospital of Nanyang Medical College from September 2024 to February 2025 were collected. The miR-877-5p and TM4SF1 mRNA expressions in tumor tissues and corresponding adjacent tissues were detected by quantitative reverse transcription polymerase chain reaction (qRT-PCR), and the correlation between miR-877-5p and TM4SF1 mRNA expressions in tumor tissues was analyzed by Pearson correlation. (2) HEB, U87, LN229, and U251 cells at the logarithmic growth phase were cultured and their miR-877-5p and TM4SF1 mRNA expressions were detected by qRT-PCR. Exosomes from U87, LN229, and U251 cells were isolated, and their morphology was observed under a transmission electron microscope; protein expressions of CD9, CD63, tumor susceptibility gene 101 (TSG101), and Calnexin in exosomes were detected by Western blotting. The miR-877-5p expression in exosomes of U87, LN229, and U251 cells was detected by qRT-PCR. The diameter of exosomes from LN229 cells was measured using a Malvern Zetasizer particle size and zeta potential analyzer, and the uptake efficiency of exosomes in LN229 cells was detected by flow cytometry. LN229 cells were divided into a normal control group, a miR-877-5p negative control group, a miR-877-5p mimic group, a miR-877-5p mimic+pcDNA empty vector group, and a miR-877-5p mimic+pcDNA-TM4SF1 group; except for the normal control group, the other groups were transfected with corresponding plasmids through exosomes and cultured for 24 hours; and then, miR-877-5p mRNA expression was detected by qRT-PCR; cell viability was detected by CCK-8 assay, cell apoptosis was detected by flow cytometry, cell invasion was detected by Transwell assay, and TM4SF1, Cyclin D1, Bcl-2 associated X protein (Bax), and matrix metalloproteinase 2 (MMP2) protein expressions and expressions of TM4SF1 downstream pathway proteins phosphorylated protein kinase B (p-AKT) and β-catenin were detected by Western blotting. The targeting relation between miR-877-5p and TM4SF1 was validated using a dual-luciferase reporter assay. A U251 cell experiment was performed for universal verification: U251 cells were divided into a normal control group, a miR-877-5p negative control group, a miR-877-5p mimic group, a miR-877-5p mimic+pcDNA empty vector group, and a miR-877-5p mimic+pcDNA-TM4SF1 group; cell apoptosis was detected by flow cytometry, and TM4SF1 protein expression was detected by Western blotting. (3) Eighteen male BALB/c nude mice were randomly divided into a control group, a miR-877-5p mimic group, and a miR-877-5p mimic+pcDNA-TM4SF1 group, with 6 mice in each group; 100 μL LN229 cell suspension, LN229 cell suspension transfected with miR-877-5p mimic, and LN229 cell suspension transfected with miR-877-5p mimic and pcDNA-TM4SF1 were, respectively, subcutaneously injected into the lateral abdomen of nude mice in these 3 groups. After 28 days of feeding, the mass and volume of the transplanted tumors were measured, and the TM4SF1, Cyclin D1, Bax, and MMP2 protein expressions in the transplanted tumors were detected by Western blotting. Results:(1) Compared with that in the corresponding adjacent tissues, miR-877-5p mRNA expression in the tumor tissues was significantly decreased and TM4SF1 mRNA expression was statistically increased ( P<0.05). Correlation analysis showed that the miR-877-5p and TM4SF1 mRNA expressions in the tumor tissues were negatively correlated ( r=-0.966, P<0.001). (2) Compared with those in the HEB cells, statistically decreased miR-877-5p mRNA expression and increased TM4SF1 mRNA expression in U87, LN229, and U251 cells were noted ( P<0.05). Under the transmission electron microscope, the exosomes in glioma cells were all biconcave disc-shaped and had a complete lipid bilayer membrane structure. Western blotting indicated positive CD9, CD63, and TSG101 protein expressions and negative Calnexin protein expression in the exosomes of glioma cells. Flow cytometry results indicated a relatively high uptake efficiency of exosomes in LN229 cells. Compared with that in the U87 and U251 cells, the miR-877-5p mRNA expression in exosomes of LN229 cells was significantly decreased ( P<0.05). The diameter of exosomes in LN229 cells was 80-150 nm. Compared with the miR-877-5p negative control group, the miR-877-5p mimic group had an increased miR-877-5p mRNA expression, decreased cell survival rate (negative control group: [95.43±0.23]%; miR-877-5p mimic group: [51.24±5.67]%), increased cell apoptosis rate ([3.34±0.22]% vs. [35.24±4.17]%), reduced number of invasive cells ([127.33±13.63] cells per high-power field vs.[59.67±6.87] cells per high-power field), downregulated TM4SF1, Cyclin D1 and MMP2 protein expressions, upregulated Bax protein expression, and decreased p-AKT and β-catenin protein expressions, with significant differences ( P<0.05). Compared with the miR-877-5p mimics+pcDNA empty vector group, the miR-877-5p mimic+pcDNA-TM4SF1 group had a decreased miR-877-5p expression, increased cell survival rate (miR-877-5p mimics+pcDNA empty vector group: [56.27±5.24]%; miR-877-5p mimic+pcDNA-TM4SF1 group[75.31±8.13]%), decreased cell apoptosis rate ([36.27±4.42]% vs. [15.37±1.73]%), increased number of invasive cells ([62.67±6.14] cells per high-power field vs. [95.50±10.58] cells per high-power field), upregulated TM4SF1, Cyclin D1 and MMP2 protein expressions, decreased Bax protein expression, and upregulated p-AKT and β-catenin protein expressions, with significant differences ( P<0.05). Dual-luciferase assay results showed that in the plasmids carrying wild-type TM4SF1 sequence, the luciferase activity in the miR-877-5p mimics group was significantly lower than that in the miR-877-5p negative control group ( P<0.05); in the plasmids carrying the mutant TM4SF1 sequence, no significant change in the luciferase activity was noted between the miR-877-5p negative control group and miR-877-5p mimic group ( P>0.05). Universal verification results: in U251 cells, compared with the miR-877-5p negative control group, the miR-877-5p mimic group had a significantly increased cell apoptosis rate and a statistically decreased TM4SF1 protein expression ( P<0.05); compared with the miR-877-5p mimic+pcDNA empty vector group, the miR-877-5p mimic+pcDNA-TM4SF1 group showed significantly decreased apoptosis rate and statistically increased TM4SF1 protein expression ( P<0.05). (3) Compared with the normal control group, the miR-877-5p mimic group had statistically reduced tumor mass and volume, significantly decreased TM4SF1, Cyclin D1 and MMP2 protein expressions, and significantly increased Bax protein expression ( P<0.05). Compared with the miR-877-5p mimic group, the miR-877-5p mimic+pcDNA-TM4SF1 group had significantly increased tumor mass and volume, statistically increased TM4SF1, Cyclin D1 and MMP2 protein expressions, and statistically decreased Bax protein expression ( P<0.05). Conclusion:Exosome-derived miR-877-5p may inhibit the proliferative and invasive capacities of glioma cells and promote cell apoptosis by targetedly inhibiting the TM4SF1 expression, thereby exerting an anti-tumor effect.