Objective To investigate the correlation between the combined assessment of preoperative 5-factor modified frailty index(mFI-5)and Naples prognostic score(NPS)with overall survival in patients with unresectable hepatocellular carcinoma(uHCC)following interventional therapy.Methods A retrospective cohort study enrolled 292 patients with uHCC who underwent interventional therapy at the Department of Hepatobiliary Pancreatic Surgery of the Second Affiliated Hospital in Army Medical University from October 2017 to December 2021.Patients were stratified into high-risk and low-risk groups based on mFI-5(≥1),NPS(≥3),and CONUT(≥4)scores.Propensity score matching(PSM)was performed to balance baseline characteristics(post-matching n=186).The primary endpoint was overall survival(OS),analyzed using Kaplan-Meier curves with log-rank tests.The predictive performance of combined indicators was evaluated by receiver operating characteristic(ROC)curves,and prognostic factors were assessed via Cox regression analysis.Results After PSM,baseline characteristics(including age,tumor markers,and treatment-related parameters)showed no significant differences between the two groups.Survival analysis demonstrated a 2.252-fold higher risk of death in the mFI-5 plus NPS high-risk group(95%CI:1.60～3.18,P<0.001).The combination of mFI-5 and NPS scores yielded an area under curve(AUC)of 0.718 for predicting 3-year overall survival,significantly outperforming either index alone(P=0.007).Multivariable Cox regression analysis identified that dual positivity for mFI-5 and NPS(HR=1.46;95%CI:1.01～2.11,P=0.044),portal vein tumor thrombosis(HR=1.49;95%CI:1.03～2.16,P=0.035),tumor diameter>5 cm(HR=2.01;95%CI:1.27～3.17,P=0.003),Barcelona clinic liver cancer(BCLC)stage C disease(HR=2.05;95%CI:1.37～3.07,P<0.001)were independent predictors of poor prognosis.Postoperative combination targeted therapy and immunotherapy was associated with significantly reduced mortality risk(HR=0.57;95%CI:0.39～0.81,P=0.002).Conclusion The combination of mFI-5 and NPS scores is significantly associated with overall survival in patients with unresectable hepatocellular carcinoma(uHCC)undergoing locoregional therapy,providing a validated tool for clinical risk stratification and personalized treatment planning.

Objective:To observe the efficacy and safety of combined lienal polypeptide injection therapy in the treatment of Mycoplasma pneumoniae pneumonia（MPP）in children aged 3 to 14 years old in multiple clinical centers.Methods:A randomized，controlled，multi-center clinical study design was adopted.A total of 240 hospitalized children aged 3 to 14 years old with MPP from 7 hospitals from September 1，2023 to January 31，2024 were included.According to the severity of pneumonia，they were divided into the mild MPP group with 80 cases and the severe MPP/refractory MPP（SMPP/RMPP）group with 160 cases，and then randomly divided into the control group and the experimental group at a ratio of 1 ∶1，using the random number table method.After screening，subjects entered a treatment period of 5 to 7 days.The control group was treated with azithromycin，while the experimental group was treated with azithromycin plus lienal polypeptide injection .The recovery of lung CT，length of hospital stay，duration of fever，cough score，whether mild cases developed into severe or refractory cases，duration of hormone use，use of intravenous immunoglobulin（IVIG），bronchoscopy treatment，and immune function were observed between the two groups to evaluate the efficacy of lienal polypeptide injection.Adverse events after medication，vital signs，blood routine，urine routine，liver function，myocardial enzymes，renal function，and electrocardiogram were observed to evaluate the safety. Results:A total of 231 subjects have completed the trial in the 7 hospitals，including 118 cases in the experimental group and 113 cases in the control group.Main observation index：the rate of lung CT aggravation in the experimental group was lower than that in the control group（2.6% vs 15.3%， P<0.01），and the difference was statistically significant.Secondary indexes：there were no statistically significant differences in the length of hospital stay，duration of fever，cough score，duration of hormone use，whether IVIG treatment was used，the number of bronchoscopy treatment cases，and immunoglobulin between the two groups（all P>0.05）.However，the rate of cases of plastic bronchitis（PB）found under bronchoscopy in the experimental group was lower than that in the control group（0 vs 18.8%， P=0.03），and the difference was statistically significant.Among the mild MPP（72 cases），there were no statistically significant differences in the length of hospital stay，duration of fever，cough score，duration of hormone use，whether IVIG treatment was used，the number of bronchoscopy treatment cases，and the improvement rate of lung CT between the two groups（all P>0.05）.However，compared with the control group，the rate of cases developing into SMPP/RMPP in the experimental group was less（24.3% vs 48.6%， P=0.03），and the difference in IgG before and after treatment was small［0.53（-0.04，1.18）g/L vs 1.33（0.48，2.25）g/L， P=0.01］.Among the SMPP/RMPP cases（159 cases），the rate of cases of PB found under bronchoscopy in the experimental group was less than that in the control group（0 vs 20%， P=0.04），and the rate of cases with aggravated lung CT in the experimental group was less than that in the control group（1.3% vs 19.5%， P<0.01），and the improvement rate of lung CT in the experimental group was higher than that in the control group（88.8% vs 75.3%， P=0.03），with statistically significant differences.There were no statistically significant differences in the length of hospital stay，duration of fever，cough score，duration of hormone use，whether IVIG treatment was used，the number of bronchoscopy treatment cases，and immunoglobulin between the two groups（all P>0.05）.Two cases in the experimental group developed rashes，which improved after the drug was discontinued.There were no serious adverse reactions such as abnormal vital signs like dyspnea and cyanosis due to the use of lienal polypeptide injection.There were no obvious changes in blood routine，liver function，myocardial enzymes，renal function，electrocardiogram，and urine routine values before and after medication compared with the baseline. Conclusion:The combined use of lienal polypeptide injection in the treatment of MPP in children can reduce the probability of the transformation from mild cases to SMPP/RMPP，reduce the rate of aggravation of the image findings，promote the absorption of lung inflammation，reduce the rate of PB found under bronchoscopy，and has good safety.

Periodontal bone defects, primarily caused by periodontitis, are highly prevalent in clinical settings and manifest as bone fenestration, dehiscence, or attachment loss, presenting a significant challenge to oral health. In regenerative medicine, harnessing developmental principles for tissue repair offers promising therapeutic potential. Of particular interest is the condensation of progenitor cells, an essential event in organogenesis that has inspired clinically effective cell aggregation approaches in dental regeneration. However, the precise cellular coordination mechanisms during condensation and regeneration remain elusive. Here, taking the tooth as a model organ, we employed single-cell RNA sequencing to dissect the cellular composition and heterogeneity of human dental follicle and dental papilla, revealing a distinct Platelet-derived growth factor receptor alpha (PDGFRA) mesenchymal stem/stromal cell (MSC) population with remarkable odontogenic potential. Interestingly, a reciprocal paracrine interaction between PDGFRA⁺ dental follicle stem cells (DFSCs) and CD31⁺ Endomucin⁺ endothelial cells (ECs) was mediated by Vascular endothelial growth factor A (VEGFA) and Platelet-derived growth factor subunit BB (PDGFBB). This crosstalk not only maintains the functionality of PDGFRA⁺ DFSCs but also drives specialized angiogenesis. In vivo periodontal bone regeneration experiments further reveal that communication between PDGFRA⁺ DFSC aggregates and recipient ECs is essential for effective angiogenic-osteogenic coupling and rapid tissue repair. Collectively, our results unravel the importance of MSC-EC crosstalk mediated by the VEGFA and PDGFBB-PDGFRA reciprocal signaling in orchestrating angiogenesis and osteogenesis. These findings not only establish a framework for deciphering and promoting periodontal bone regeneration in potential clinical applications but also offer insights for future therapeutic strategies in dental or broader regenerative medicine.
Receptor, Platelet-Derived Growth Factor alpha/metabolism* ; Humans ; Neovascularization, Physiologic/physiology* ; Dental Sac/cytology* ; Single-Cell Analysis ; Transcriptome ; Mesenchymal Stem Cells/metabolism* ; Bone Regeneration ; Animals ; Dental Papilla/cytology* ; Periodontium/physiology* ; Stem Cells/metabolism* ; Regeneration ; Angiogenesis

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

Objective:This study aims to develop a questionnaire for transsexualism screening and validate its reliability and validity, to provide a culturally adapted screening tool for Chinese clinicians.Methods:Referencing internationally validated instruments related to transsexualism, items closely aligned with the diagnostic criteria of the International Classification of Diseases, 10th Revision (ICD-10) for transsexualism were extracted. Items reflecting Chinese family cultural characteristics were integrated. The overall structure of the questionnaire was refined through expert consultations. A total of 111 patients diagnosed with transsexualism according to ICD-10 diagnostic criteria (78 male-to-female (MtF), 33 female-to-male (FtM)) were recruited from the outpatient clinic of Shanghai Mental Health Center between June 2021 and April 2024. Additionally, 232 cisgender participants, whose self-reported gender identity aligned with their birth sex, were recruited via the Wenjuanxing platform from June 14 to 22, 2022, comprising 64 heterosexual males, 16 non-heterosexual males, 120 heterosexual females, and 32 non-heterosexual females. Both the transsexual and cisgender groups completed the screening questionnaire. The internal consistency reliability was assessed using Cronbach′s α coefficient, and the corrected item-total correlation (CITC) was employed to measure the relationship between individual items and the total score. Structural validity was verified through structural equation modeling (SEM) using AMOS software. The receiver operating characteristic (ROC) curve analysis was conducted to determine the optimal screening cutoff value, with the area under the curve (AUC) used to evaluate diagnostic accuracy. Effect sizes (Cohen's d) were calculated to compare the average scores of the questionnaire across groups. Results:The Transsexualism Screening Questionnaire consists of 15 items including 4 reverse-scored questions, rated on a 5-point Likert scale. The Cronbach′s α coefficient was 0.953 and the CITC for all items exceeded the recommended threshold of 0.3. After rotation based on eigenvalues>1, one principal component explained 61.67% of the total variance. Confirmatory factor analysis indicated acceptable model fit (χ2/ df = 3.887, standardized root mean square residual (SRMR) = 0.064, root mean square error of approximation (RMSEA)=0.092, comparative fit index (CFI)=0.952, normed fit index (NFI)=0.936, Tucker-Lewis index (TLI)=0.943, incremental fit index (IFI)=0.952). Factor loadings for each item ranged from 0.435 to 0.914. ROC curve analysis revealed that the optimal cutoff values were a mean score of 2.83 and a total score of 42.5, achieving 100% sensitivity and 98.7% specificity, with a Youden index of 0.987. Effect size comparisons showed a Cohen′s d of 6.112 between MtF individuals and cisgender heterosexual males, and a Cohen′s d of 9.287 between FtM individuals and cisgender heterosexual females. Conclusion:The Transsexualism Screening Questionnaire exhibits acceptable reliability, validity, sensitivity, and specificity, and is suitable for screening transsexualism in the Chinese population.

Objective The relationship between serum uric acid(UA)levels and gait kinematics characteristics in patients with cerebral small vessel disease(CSVD)was investigated.Methods Retrospective analysis was conducted on patients with CSVD from outparient clinics of the Neurology and Rehabilitation Department of Zhongshan Hospital affiliated with Guangzhou University of Chinese Medicine from January 2023 to December 2023.The general information of patients were collected and the gait of patients was analyzed using three-dimensional gait analysis.Patients were then divided into mild gait disorder group(0-1 points),moderate gait disorder group(2-3 points),and severe gait dysfunction group(4-5 points)based on gait results.The total burden of CSVD imaging and serum results such as UA were collected.The relationship between UA level and CSVD gait disorders was analyzed.Results This study recruited 105 CSVD patients.Patients were divided into different groups based on the severity of their gait disorder including 40 in the mild group,49 in the moderate group,and 16 in the severe group.The blood uric acid level in the moderate group(358.43±13.44)μmol/L was higher than that in the mild group(336.00±12.48)μmol/L,and the blood uric acid level in the severe group(289.94±11.88)μmol/L was lower than that in the mild and moderate groups(P<0.05).The MoCA score in the severe gait disorder group(21.38±0.13)was lower than that in the mild and moderate groups(28.05±0.09 vs.25.22±0.10)(P<0.05).The step width of the CSVD severe load group was(13.26±2.80)cm compared to the light and moderate load groups[(11.22±1.70)cm vs.(11.65±2.70)cm]increased(P<0.05),and the left swing phase in the severe group(35.90%)decreased compared to the mild and moderate groups(38.50%vs.37.20%)(P<0.05).Spearman correlation analysis showed a negative correlation between UA levels and CMB(r=-0.20,P=0.04).Hyperuricemia was negatively correlated with brain atrophy(r=-0.20,P=0.04).In patients with mild to moderate gait disorders,there was a positive correlation between hyperuricemia and the total burden of gait disorders(r=0.25,P=0.02),and hyperuricemia and right gait speed(r=-0.22,P=0.04),Right stride(r=-0.29,P<0.01),Left step speed(r=-0.32,P<0.01),Left step frequency(r=-0.29,P<0.01),The left stride was negatively correlated(r=-0.26,P=0.01).Conclusion In CSVD patients with mild to moderate gait disorders,the levels of uric acid and hyperuricemia are positively correlated with the total burden of gait disorders.The gait disorders are mainly characterized by reduced bilateral pace,bilateral stride,and left step frequency.

Objective The relationship between serum uric acid(UA)levels and gait kinematics characteristics in patients with cerebral small vessel disease(CSVD)was investigated.Methods Retrospective analysis was conducted on patients with CSVD from outparient clinics of the Neurology and Rehabilitation Department of Zhongshan Hospital affiliated with Guangzhou University of Chinese Medicine from January 2023 to December 2023.The general information of patients were collected and the gait of patients was analyzed using three-dimensional gait analysis.Patients were then divided into mild gait disorder group(0-1 points),moderate gait disorder group(2-3 points),and severe gait dysfunction group(4-5 points)based on gait results.The total burden of CSVD imaging and serum results such as UA were collected.The relationship between UA level and CSVD gait disorders was analyzed.Results This study recruited 105 CSVD patients.Patients were divided into different groups based on the severity of their gait disorder including 40 in the mild group,49 in the moderate group,and 16 in the severe group.The blood uric acid level in the moderate group(358.43±13.44)μmol/L was higher than that in the mild group(336.00±12.48)μmol/L,and the blood uric acid level in the severe group(289.94±11.88)μmol/L was lower than that in the mild and moderate groups(P<0.05).The MoCA score in the severe gait disorder group(21.38±0.13)was lower than that in the mild and moderate groups(28.05±0.09 vs.25.22±0.10)(P<0.05).The step width of the CSVD severe load group was(13.26±2.80)cm compared to the light and moderate load groups[(11.22±1.70)cm vs.(11.65±2.70)cm]increased(P<0.05),and the left swing phase in the severe group(35.90%)decreased compared to the mild and moderate groups(38.50%vs.37.20%)(P<0.05).Spearman correlation analysis showed a negative correlation between UA levels and CMB(r=-0.20,P=0.04).Hyperuricemia was negatively correlated with brain atrophy(r=-0.20,P=0.04).In patients with mild to moderate gait disorders,there was a positive correlation between hyperuricemia and the total burden of gait disorders(r=0.25,P=0.02),and hyperuricemia and right gait speed(r=-0.22,P=0.04),Right stride(r=-0.29,P<0.01),Left step speed(r=-0.32,P<0.01),Left step frequency(r=-0.29,P<0.01),The left stride was negatively correlated(r=-0.26,P=0.01).Conclusion In CSVD patients with mild to moderate gait disorders,the levels of uric acid and hyperuricemia are positively correlated with the total burden of gait disorders.The gait disorders are mainly characterized by reduced bilateral pace,bilateral stride,and left step frequency.

Aim To investigate the effect of cordycepin(COR)on gentamicin(GEN)-induced nephrotoxicity and the molecular mechanism of inhibiting oxidative stress and ferroptosis induced by GEN.Methods The oral SD rats were divided into a control group,GEN group,and GEN+COR group.Following the success-ful setting up of the animal model,the serum creatinine(CR)and urea nitrogen(BUN)levels of rats were measured,and renal tissue injury was assessed using HE staining.In addition,the contents of malondialde-hyde and glutathione in kidney tissues of SD rats in each group were detected,and the expressions of fer-roptosis markers GPX4 and SLC7A11 were analyzed by Western blot.Results Compared with the control group,CR and BUN in GEN-stimulated group signifi-cantly increased(P＜0.01),and the level of CR and BUN was effectively reduced after 50 mg·kg-1 COR oral administration.HE results also showed that COR could alleviate the kidney tissue damage caused by GEN.COR could reverse the increase of malondialde-hyde level and the decrease of glutathione level caused by GEN in rat kidney tissue,and COR could restore the decrease of GPX4 and SLC7A11 protein levels induced by GEN.Conclusion COR can reduce GEN-induced kidney injury by inhibiting oxidative stress and ferrop-tosis.

Aim To investigate the effect of cordycepin(COR)on gentamicin(GEN)-induced nephrotoxicity and the molecular mechanism of inhibiting oxidative stress and ferroptosis induced by GEN.Methods The oral SD rats were divided into a control group,GEN group,and GEN+COR group.Following the success-ful setting up of the animal model,the serum creatinine(CR)and urea nitrogen(BUN)levels of rats were measured,and renal tissue injury was assessed using HE staining.In addition,the contents of malondialde-hyde and glutathione in kidney tissues of SD rats in each group were detected,and the expressions of fer-roptosis markers GPX4 and SLC7A11 were analyzed by Western blot.Results Compared with the control group,CR and BUN in GEN-stimulated group signifi-cantly increased(P＜0.01),and the level of CR and BUN was effectively reduced after 50 mg·kg-1 COR oral administration.HE results also showed that COR could alleviate the kidney tissue damage caused by GEN.COR could reverse the increase of malondialde-hyde level and the decrease of glutathione level caused by GEN in rat kidney tissue,and COR could restore the decrease of GPX4 and SLC7A11 protein levels induced by GEN.Conclusion COR can reduce GEN-induced kidney injury by inhibiting oxidative stress and ferrop-tosis.

Objective:This study aims to develop a questionnaire for transsexualism screening and validate its reliability and validity, to provide a culturally adapted screening tool for Chinese clinicians.Methods:Referencing internationally validated instruments related to transsexualism, items closely aligned with the diagnostic criteria of the International Classification of Diseases, 10th Revision (ICD-10) for transsexualism were extracted. Items reflecting Chinese family cultural characteristics were integrated. The overall structure of the questionnaire was refined through expert consultations. A total of 111 patients diagnosed with transsexualism according to ICD-10 diagnostic criteria (78 male-to-female (MtF), 33 female-to-male (FtM)) were recruited from the outpatient clinic of Shanghai Mental Health Center between June 2021 and April 2024. Additionally, 232 cisgender participants, whose self-reported gender identity aligned with their birth sex, were recruited via the Wenjuanxing platform from June 14 to 22, 2022, comprising 64 heterosexual males, 16 non-heterosexual males, 120 heterosexual females, and 32 non-heterosexual females. Both the transsexual and cisgender groups completed the screening questionnaire. The internal consistency reliability was assessed using Cronbach′s α coefficient, and the corrected item-total correlation (CITC) was employed to measure the relationship between individual items and the total score. Structural validity was verified through structural equation modeling (SEM) using AMOS software. The receiver operating characteristic (ROC) curve analysis was conducted to determine the optimal screening cutoff value, with the area under the curve (AUC) used to evaluate diagnostic accuracy. Effect sizes (Cohen's d) were calculated to compare the average scores of the questionnaire across groups. Results:The Transsexualism Screening Questionnaire consists of 15 items including 4 reverse-scored questions, rated on a 5-point Likert scale. The Cronbach′s α coefficient was 0.953 and the CITC for all items exceeded the recommended threshold of 0.3. After rotation based on eigenvalues>1, one principal component explained 61.67% of the total variance. Confirmatory factor analysis indicated acceptable model fit (χ2/ df = 3.887, standardized root mean square residual (SRMR) = 0.064, root mean square error of approximation (RMSEA)=0.092, comparative fit index (CFI)=0.952, normed fit index (NFI)=0.936, Tucker-Lewis index (TLI)=0.943, incremental fit index (IFI)=0.952). Factor loadings for each item ranged from 0.435 to 0.914. ROC curve analysis revealed that the optimal cutoff values were a mean score of 2.83 and a total score of 42.5, achieving 100% sensitivity and 98.7% specificity, with a Youden index of 0.987. Effect size comparisons showed a Cohen′s d of 6.112 between MtF individuals and cisgender heterosexual males, and a Cohen′s d of 9.287 between FtM individuals and cisgender heterosexual females. Conclusion:The Transsexualism Screening Questionnaire exhibits acceptable reliability, validity, sensitivity, and specificity, and is suitable for screening transsexualism in the Chinese population.