Objective To identify and delineate the developmental trajectories of depressive symptoms in the middle-aged and elderly population in China,and to explore the risk factors for depressive symptom trajectories in China's middle-aged and elderly population.Methods According to our inclusion and exclusion criteria,7 600 participants were subjected based on the data from the China Health and Aged Care Tracking Survey(CHARLS)published by Peking University.The data from 5 waves of the survey from 2011 to 2023 were collected and analyzed with latent growth curve model(LGCM),latent class growth model(LGCM)to identify the developmental trajectories of depressive symptoms in the participants.Multicategorical logistic regression analyses were conducted to analyze whether gender,marital status,educational level,urban/rural residence,annual income,self-rated health status,and childhood bullying experience were risk factors for different trajectories of depressive symptoms.Results Two developmental trajectories of depressive symptoms were identified and classified in this study,that is,low-level stable(n=5 545,72.96%)and high-level ascending(n=2 055,27.04%).With the low-level stable group as a reference,multicategorical logistic regression analysis revealed that female(OR=1.373,95CI%:1.191～1.584,P<0.001),residence of rural area(OR=1.634,95CI%:1.410～1.895,P<0.001),and poor self-rated health status(OR=2.059,95%CI:1.890～2.243,P<0.001),and experience of childhood bullying(OR=1.76,95%CI:1.489～2.080,P<0.001)were associated with an increased risk of high-level ascending trajectory of depression.Conclusion There are 2 different trajectories of depressive mood in Chinese middle-aged and elderly population.And poor self-rated health status,history of childhood bullying,being female,and residence of rural area are risk factors for a high-level ascending trajectory of depressive symptoms.

Objective To investigate the characteristic changes in motor function and psychological factors among Parkinson's disease(PD)patients with different phenotypic patterns of freezing of gait(FOG),and to explore the trends in phenotypic heterogeneity of these features.Methods A cross-sectional study was conducted on 17 PD patients without FOG(PD-NFOG)and 25 PD patients with FOG(PD-FOG)[including 13 cases of trembling-in-place(TP)and 12 cases of shuffling-with-small-steps(SS)].Another 28 demographically matched(age,gender,education level and others)healthy individuals were recruited from community and served as healthy controls(HC).Motor function was assessed using quantitative gait analysis and clinical scales,including the unified Parkinson's disease rating scale part Ⅲ(UPDRS-Ⅲ)and H&Y staging.Psychological evaluations were carried out with Hospital Anxiety and Depression Scale(HADS-A/HADS-D),Generalized Anxiety Disorder-7(GAD-7),Patient Health Questionnaire-9(PHQ-9),Snaith-Hamilton Pleasure Scale(SHAPS),Reading the Mind in the Eyes Test(RMET),Montreal Cognitive Assessment(MoCA),and digital symbol substitution test(DSST).Results ① There were significant differences between the PD-FOG and PD-NFOG groups in terms of motor parameters(stride width,length,height and cadence)and cognitive function(MoCA)score(P<0.05).The largest effect sizes were found for cognitive function scores of RMET[η2=0.716(95%CI:0.611～0.761),P<0.05],DSST[η2=0.667(95%CI:0.553～0.744),P<0.05],and MoCA[η2=0.597(95%CI:0.425～0.750),P<0.05],all of which were classified as medium effect sizes.② Associative characteristics of motor and psychological factors in the PD-FOG group:H&Y stage was positively correlated with HADS-A[r=0.470(95%CI:0.080～0.735),P=0.018]and HADS-D[r=0.560(95%CI:0.199～0.787),P=0.004],while the total score of UPDRS-Ⅲ was negatively correlated with DSST[r=-0.574(95%CI:-0.794～-0.219),P=0.003].③Subgroup analysis revealed significant differences(P<0.05)between the TP and SS patterns in motor parameters(stride length and cadence).Moderate effect sizes were observed for HADS-A[δ=0.752(95%CI:-0.070～1.558),P=0.072],SHAPS[δ=0.512(95%CI:-0.291～1.305),P=0.132]and HADS-D[δ=0.481(95%CI:-0.321～1.273),P=0.253],with mean increase by 39.0%,8.3%,and 24.5%,respectively,in the TP subgroups when compared to the SS subgroups.Conclusion PD-FOG patients exhibit characteristic changes in motor function and psychological factors.Cognitive impairment in PD patients may serve as a characteristic marker for FOG progression.Additionally,psychological features in PD-FOG patients with different motor phenotypes show trends of phenotypic heterogeneity.

Objective In response to the practical issues of pilot ground simulation ejection training relying on subjective evaluation,which requires high professionalism and lacks objectivity and systematicity,an objective evaluation system and method for ejection training based on pressure detection has been designed.Methods According to the rules of ejection training about posture,maneuver and time,and utilizing technologies such as pressure detection,infrared detection,and time-triggered detection,this paper designed separate modules for ejection posture detection,ejection timing detection,and comprehensive analysis and evaluation.These modules are closely integrated with the ejection training process,achieving objective evaluation of the ejection training.Results This system and method can provide a scientific and real-time objective evaluation of the posture,movements,and time in ejection training without affecting the normal organization and process.Conclusion The objective evaluation system can provide a new approach that is highly objective and easy to operate for comprehensively evaluating and enhancing the effectiveness of ejection training,as well as for scientifically conducting ejection training and assessment.

OBJECTIVES: Nasopharyngeal carcinoma is often diagnosed at a late stage due to its concealed location and exhibits marked regional clustering, posing a significant public health challenge in China. This study aims to analyze the disease burden of nasopharyngeal carcinoma in China using the latest 2021 Global Burden of Diseases (GBD) database, providing epidemiological evidence for precise prevention and control of nasopharyngeal carcinoma. METHODS: Age-standardized incidence rate (ASIR), mortality rate, and disability-adjusted life year (DALY) rate were used as indicators of disease burden. Stratified analyses were conducted by age, sex, socio-demographic index (SDI), and relevant risk factors. The autoregressive integrated moving average (ARIMA) model and Bayesian age-period-cohort (BAPC) model were employed to project ASIR trends through 2050. RESULTS: In 2021, China's age-standardized incidence, mortality, and DALY rates of nasopharyngeal carcinoma were 3.4/100 000, 1.5/100 000, and 48.7/100 000, respectively, all higher than the global average. Across all age groups, Chinese males exhibited higher ASIR, mortality, and DALY rates than females. From 1990 to 2021, the disease burden of nasopharyngeal carcinoma in China decreased gradually with rising SDI. The proportion of nasopharyngeal carcinoma burden attributed to alcohol consumption, smoking, and occupational formaldehyde exposure in China exceeded global levels, especially among males. Projections from both models indicate a rising trend in ASIR for males, females, and the general population in China and globally from 2022 to 2050. CONCLUSIONS Over the past 30 years, the disease burden of nasopharyngeal carcinoma in China has decreased with the increasing SDI values but remains higher than the global average. Furthermore, ASIR is projected to increase over the next 30 years. It is imperative for China to enhance healthcare resource allocation for nasopharyngeal carcinoma prevention, diagnosis, and treatment, particularly among high-risk male populations.
Humans ; China/epidemiology* ; Male ; Nasopharyngeal Carcinoma/mortality* ; Female ; Middle Aged ; Nasopharyngeal Neoplasms/mortality* ; Adult ; Incidence ; Global Burden of Disease ; Disability-Adjusted Life Years ; Aged ; Risk Factors ; Adolescent ; Databases, Factual ; Young Adult ; Cost of Illness ; Child ; Bayes Theorem

Background::As a non-invasive and effective diagnostic method for small intestinal bacterial overgrowth (SIBO), wild-use of breath test (BT) has demonstrated a high comorbidity rate in patients with diarrhea-predominant irritable bowel syndrome (IBS-D) and SIBO. Patients overlapping with SIBO respond better to rifaximin therapy than those with IBS-D only. Gut microbiota plays a critical role in both of these two diseases. We aimed to determine the microbial difference between IBS-D overlapping with/without SIBO, and to study the underlying mechanism of its sensitivity to rifaximin.Methods::Patients with IBS-D were categorized as BT-negative (IBSN) and BT-positive (IBSP). Healthy volunteers (BT-negative) were enrolled as healthy control. The patients were clinically evaluated before and after rifaximin treatment (0.4 g bid, 4 weeks). Blood, intestine, and stool samples were collected for cytokine assessment and gut microbial analyses.Results::Clinical complaints and microbial abundance were significantly higher in IBSP than in IBSN. In contrast, severe systemic inflammation and more active bacterial invasion function that were associated with enrichment of opportunistic pathogens were seen in IBSN. The symptoms of IBSP patients were relieved in different degrees after therapy, but the symptoms of IBSN rarely changed. We also found that the presence of IBSN-enriched genera ( Enterobacter and Enterococcus) are unaffected by rifaximin therapy. Conclusions::IBS-D patients overlapping with SIBO showed noticeably different fecal microbial composition and function compared with IBS-D only. The better response to rifaximin in those comorbid patients might associate with their different gut microbiota, which suggests that BT is necessary before IBS-D diagnosis and use of rifaximin.Registration::Chinese Clinical Trial Registry, ChiCTR1800017911.

Myostatin gene (MSTN) encodes a negative regulator for controlling skeletal muscle growth in animals. In this study, MSTN^-/- homozygous mutants with "double muscle" phenotypic traits and stable inheritance were bred on the basis of MSTN gene editing rabbits, with the aim to establish a method for breeding homozygous progeny from primary MSTN biallelic mutant rabbits. MSTN^-/- primary mutant rabbits were generated by CRISPR/Cas9 gene editing technology. The primary mutant rabbits were mated with wild type rabbits to produce F1 rabbits, whereas the F2 generation homozygous rabbits were bred by half-sibling mating or backcrossing with F1 generation rabbits of the same mutant strain. Sequence analysis of PCR products and its T vector cloning were used to screen homozygous rabbits. The MSTN mutant rabbits with 14-19 week-old were weighed and the difference of gluteus maximus tissue sections and muscle fiber cross-sectional area were calculated and analyzed. Five primary rabbits with MSTN gene mutation were obtained, among which three were used for homozygous breeding. A total of 15 homozygous rabbits (5 types of mutants) were obtained (M2-a: 3; M2-b: 2; M3-a: 2; M7-a: 6; M7-b: 2). The body weight of MSTN^-/- homozygous mutant rabbits aged 14-19 weeks were significantly higher than that of MSTN^+/+ wild-type rabbits of the same age ((2 718±120) g vs. (1 969±53) g, P < 0.01, a 38.0% increase). The mean cross sections of gluteus maximus muscle fiber in homozygous mutant rabbits were not only significantly higher than that of wild type rabbits ((3 512.2±439.2) μm² vs. (1 274.8±327.3) μm², P < 0.01), but also significantly higher than that of MSTN^+/- hemizygous rabbits ((3 512.2±439.2) μm² vs. (2 610.4±604.4) μm², P < 0.05). In summary, five homozygous mutants rabbits of MSTN^-/- gene were successfully bred, which showed a clear lean phenotype. The results showed that the primary breeds were non-chimeric mutant rabbits, and the mutant traits could be inherited from the offspring. MSTN^-/- homozygous mutant rabbits of F2 generation could be obtained from F1 hemizygous rabbits by inbreeding or backcrossing. The progenies of the primary biallelic mutant rabbits were separated into two single-allelic mutants, both of which showed a "double-muscle" phenotype. Thus, this study has made progress in breeding high-quality livestock breeds with gene editing technology.
Animals ; CRISPR-Cas Systems/genetics* ; Gene Editing ; Muscle, Skeletal/metabolism* ; Mutation ; Myostatin/metabolism* ; Phenotype ; Rabbits

Objective:To summarize and compare the characteristics of oral microbiota in women during the preconception period and the third trimester.Methods:This retrospective cohort study involved 55 women who were recruited in the Preconceptional Offspring Trajectory Study (PLOTS) conducted by Fudan University and followed up to the third trimester in the Maternal and Child Health Care Hospital of Jiading District of Shanghai from September 2016 to December 2019. A total of 110 unstimulated saliva samples were collected in the preconception period ( n=55) and the third trimester ( n=55). Features of oral microbiota in the samples were analyzed by 16S rRNA gene-based sequencing. Moreover, the related factors were also analyzed. Paired t test or Wilcoxon matched-pairs signed-ranks test were used to analyze the differences in α-diversity during preconception and the third trimester; t test, analysis of variance (ANOVA), Kruskal-Wallis test and Mann-Whitney U test for comparison between groups with different characteristics and permutational multivariate analysis of variance (PerMANOVA) for β-diversity were used; Linear discriminant analysis (LDA) effect size (LEfSe 1.0) was used to identify the iconic oral flora. Results:(1) The Ace index of oral microbiota was significantly lower in the third trimester than that in the preconception period [661.14(578.15-752.85) vs 730.64 (632.40-911.00), T=1 077.00, P=0.010]. There was also a significance difference in β-diversity ( F=12.539, R2=0.104, P=0.001). Some species such as Saccharibacteria_TM7_G3, Prevotella_7, Absconditabacteria_SR1_G1, Porphyromonas, Ruminococcaceae_UCG_014, Prevotella, Peptostreptococcus, Prevotella_2, Alloprevotella, Parvimonas, Solobacterium and Eubacterium_nodatum_group in saliva were statistically more abundant in the third trimester than those in the preconception period (all P<0.05). (2) The third-trimester Shannon index was lower among those with lower income [5.44 (5.08-5.77) vs 5.75 (5.44-6.12), U=219.00, P=0.029] and those with gargle habit after meal or dessert [5.36 (4.91-5.48) vs 5.72 (5.44-6.05), U=374.00, P=0.046]. Conclusions:The features of oral microbiota vary in women during the preconception period and the third trimester. There is a significant increase in the abundance of oral pathogenic and opportunistic bacteria in the third trimester.

Objective:To investigate the clinical effect of remote injection device assisted percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures.Methods:Using retrospective research and analysis methods, 168 patients with osteoporotic vertebral compression fractures admitted to Heze Municipal Hospital from September 2019 to August 2020 were selected. A total of 139 cases were followed up, with a follow-up rate of 82.7%, including 22 males and 117 females, with an average age of 74.17 years. According to the different equipment used, they were divided into two groups. Seventy-two cases used remote injection device to assist percutaneous vertebroplasty (observation group), 67 cases used traditional puncture needle puncture percutaneous vertebroplasty (control group). All patients were completed follow-up at 3 months after surgery. The operation time, intraoperative blood loss, bone cement injection volume, bone cement leakage rate, VAS score and ODI score of 1 day, 1 month and 3 months after operation were observed. Measurement data were expressed as ( Mean± SD), using t test, counting data were expressed as percentage [ n(%)], using χ2 test. Results:Both groups of patients successfully completed the operation without complications such as paraplegia, pulmonary embolism, or infection. There was no statistically significant difference between the two groups in operation time of two groups[(47.71±6.05) min vs (47.61±5.66) min, t=0.100, P=0.920]. The intraoperative blood loss of the two groups was no statistically significant difference [(7.08±3.00) mL vs (8.06±3.48) mL, t=1.782, P=0.079]. The difference between two groups of the amount of bone cement injected was statistically significant, [(6.44±1.03) mL vs (5.73±1.41) mL, t=3.369, P=0.001]. The bone cement leakage rate of the observation group was 27.78% (19/72), and the control group was 43.28% (29/67), and there was statistically significant( χ2=4.382, P=0.036). The preoperative VAS score of the observation group was (6.75±1.14) , and the control group was (6.64±1.08), and there was no significant difference between two groups( t=0.583, P=0.561) The VAS scores of the observation group and the control group were (1.28±0.75) and (1.21±0.77) respectively at 1 day after surgery. There was no statistically significant difference between two groups( t=0.583, P=0.588). The VAS scores of the observation group and the control group were (0.89±0.76) and (1.09±0.67) respectively at 1 month after operation. There was no statistically significant difference between two groups( t=1.641, P=0.103). The VAS scores of the observation group and the control group were (0.74±0.63) and (0.87±0.74) respectively at 3 months after operation. There was no statistically significant difference between two groups( t=1.118, P=0.266). The preoperative ODI scores of the observation group and the control group were (60.32±7.46) and (61.96±9.76) respectively, and there was no statistically significant difference between two groups( t=1.121, P=0.264). The ODI scores of the observation group and the control group were (14.93±6.01) and (15.10±6.43) respectively at 1 day after operation, there was no statistically significant difference between two groups( t=0.161, P=0.872). The ODI scores of the observation group and the control group were (10.54±4.24) and (11.31±3.71) respectively at 1 month after operation, and there was no statistically significant difference between two groups( t=1.136, P=0.258). The ODI scores of the observation group and the control group were (10.64±3.70) and (10.39±3.74) respectively at 3 months after operation, and there was no statistically significant difference between two groups( t=0.396, P=0.693). Conclusion:Compared with traditional puncture needle puncture percutaneous vertebroplasty, the remote injection device assisted percutaneous vertebroplasty has a definite clinical effect in the treatment of osteoporotic vertebral compression fractures, and the bone cement leakage rate is low.

OBJECTIVE To review the clinical and image features of the patients with grade III-IV tracheal stenosis, and the surgical outcomes of tracheal sleeve resection and end-to-end anastomosis in the treatment of severe tracheal stenosis. METHODS Between July 2008 and July 2016, 20 patients with grade III-IV tracheal stenosis underwent tracheal sleeve resection and end-to-end anastomosis. RESULTS Postoperative decannulation was achieved in 17 patients(85.0％), and restenosis developed in 3 patients(15.0％). Postoperative complications were: 1 case wound infection, 4 cases subcutaneous emphysema, 3 cases temporary unilateral vocal fold palsy. Suture dehiscence, irreversible injury of the recurrent laryngeal nerves was not observed in our patients. No perioperative mortality occurred. CONCLUSION The tracheal sleeve resection and end-to-end anastomosis represent a viable treatment for severe tracheal stenosis. Long segment stenosis should not be considered as a contraindication. This surgical method should be considered cautiously in patients with diabetes.

Objective To explore the value of diffusion tensor imaging (DTI) in differential diagnosis of intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC).Methods Fifty-two patients including 20 patients with ICC (ICC group) and 32 patients with HCC (HCC group) confirmed by histopathological examination were recruited in the study.All the patients were performed MR exams on a 1.5T scanner in a protocol containing the routine T1WI,T2WI,DWI and DTI.The values of ADC,fractional anisotropy (FA),diffusion coefficient (D) were blindly reviewed and analyzed by two experienced observers,and were compared between two groups.The ROC curve was used to evaluate the di agnostic efficiency.Results The border clear percentage of ICC group (9/20,45.00％) had no significant difference compared with that of HCC group (15/32,46.88％;x2 =0.02,P=0.90),the detection rate of bile duct expansion in ICC group (11/20,55.00％) was higher than that in HCC group (4/32,12.50％;x2=10.83,P=0.001).Theintraclasscor relation coefficient value of ADC,D and FA in the ICC group and HCC group were all more than 0.90.The mean FA of ICCgroup (0.45±0.16) were significantly higher than that of HCC group (0.30±0.13;P=0.001),while the mean ADC and D values in ICC and HCC groups had no significant difference (both P＞0.05).The area under the ROC curve of FA was 0.76.And when FA=0.31,there was a higher sensitivity (85.0％) in identifying ICC and HCC.Conclusion The FA of DTI shows a stronger capability than the ADC and D values in differentiating the ICC from HCC.