Microglia, the resident immune cells in the central nervous system (CNS), rapidly transition from a resting to an active state in the acute phase of ischemic brain injury. This active state mediates a pro-inflammatory response that can exacerbate the injury. Targeting the pro-inflammatory response of microglia in the semi-dark band during this acute phase may effectively reduce brain injury. Shionone (SH), an active ingredient extracted from the dried roots and rhizomes of the genus Aster (Asteraceae), has been reported to regulate the inflammatory response of macrophages in sepsis-induced acute lung injury. However, its function in post-stroke neuroinflammation, particularly microglia-mediated neuroinflammation, remains uninvestigated. This study found that SH significantly inhibited lipopolysaccharide (LPS)-induced elevation of inflammatory cytokines, including interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and inducible nitric oxide synthase (iNOS), in microglia in vitro. Furthermore, the results demonstrated that SH alleviated infarct volume and improved behavioral performance in middle cerebral artery occlusion (MCAO) mice, which may be attributed to the inhibition of the microglial inflammatory response induced by SH treatment. Mechanistically, SH potently inhibited the phosphorylation of serine-threonine protein kinase B (AKT), mammalian target of rapamycin (mTOR), and signal transducer and activator of transcription 3 (STAT3). These findings suggest that SH may be a potential therapeutic agent for relieving ischemic stroke (IS) by alleviating microglia-associated neuroinflammation.
Animals ; Microglia/immunology* ; Mice ; Male ; Mice, Inbred C57BL ; Brain Ischemia/immunology* ; Neuroinflammatory Diseases/drug therapy* ; Neuroprotective Agents/administration & dosage* ; Interleukin-1beta/genetics* ; STAT3 Transcription Factor/genetics* ; TOR Serine-Threonine Kinases/genetics* ; Tumor Necrosis Factor-alpha/genetics* ; Proto-Oncogene Proteins c-akt/immunology* ; Nitric Oxide Synthase Type II/genetics* ; Lipopolysaccharides

Objective:To explore the impact of residents′ health literacy on healthcare choices.Methods:This mixed cross-sectional study utilized data from the 2009, 2011, and 2015 waves of the China Health and Nutrition Survey (CHNS), including adults aged≥18 years. Guided by Andersen′s Behavioral Model of Health Services Use and the Knowledge-Attitude-Practice (KAP) framework, variables were collected across three dimensions-predisposing, enabling, and need factors-including gender, marital status, age, education level, employment status, urban/rural residence, health management awareness, income, health insurance coverage, self-rated health, and chronic disease status. A multinomial Logistic regression model was applied to assess the association between health literacy and healthcare choice. Bootstrap analysis was conducted to test the mediating effect of health management awareness.Results:After excluding cases with missing or invalid data, 4 736 valid observations were included. The proportions of choosing township-, county-, and city-level hospitals were 60.60%, 15.08%, and 24.32%, respectively. After adjusting for confounders, health literacy showed a significant effect on healthcare choice ( P<0.05): individuals with higher health literacy were more likely to choose county-level hospitals ( RR=1.035, P<0.05) and city-level hospitals ( RR=1.044, P<0.01). Health management awareness mediated the relationship between health literacy and healthcare choice ( P<0.05). Conclusions:Health literacy significantly influences healthcare choices; individuals with higher health literacy are more inclined to utilize higher-level medical institutions. Furthermore, health literacy affects healthcare choices partly through the mediating role of health management awareness.

To address the problem of data silos in dental specialties caused by equipment heterogeneity, this study developed an Intelligent Internet of Things (IoT)-enabled dental chair platform (hereinafter referred to as the intelligent platform) based on the concept of medical-engineering integration. The platform adopts a three-tier chair-domain interconnection architecture: the bottom tier integrates multi-source sensors and standardized interfaces for automated data acquisition and linkage with hospital information systems; the middle tier provides clinic-level management and remote teaching collaboration; and the top tier employs a blockchain-based secure cloud database for resource allocation and data management. Clinical validation at The Affiliated Stomatological Hospital of Nanjing Medical University demonstrated that, compared with a control group from the same period in 2023, the trial group achieved a 38.0% increase in average daily patient visits (80.6±6.8 vs. 58.4±5.2, t=15.16, P<0.001), a 24.6% reduction in average treatment time [(36.1±6.3) min vs. (47.9±8.5) min, t=7.72, P<0.001], a 39.2% reduction in waiting time [23.3 (16.5, 30.1) min vs. 38.3 (28.3, 48.3) min, U=32.00, P<0.001], a 30.4% reduction in equipment idle rate [8.7% (5.1%, 12.3%) vs. 12.5% (7.4%, 17.6%), U=251.00, P=0.003], and an increase in patient satisfaction from 88.2% (1 519/1 723) to 94.3% (2 186/2 318) ( t=7.26, P<0.001). User research confirmed that the functions most favored by clinicians and patients were "dental chair parameter updating and clinical data integration" [74.7% (80/107)] and "chairside display of diagnostic images" [76.8% (119/155)], respectively. Looking forward, the intelligent platform has the potential to integrate artificial intelligence-assisted diagnosis and 5G-enabled multicenter collaboration to further expand its clinical applications and accelerate the digital transformation of dental healthcare.

Oral cancer, as one kind of mucosal epithelial tumor, constitutes approximately 2% of all cancers, while the most common type, oral squamous cell carcinoma (OSCC) represents around 90% histopathology of oral cancers. Although the treatment of OSCC has been improved in recent 20 years, its 5-year survival rate has not raised significantly. The crux to improve the survival rate and prognosis of OSCC patients lies in the early diagnosis and intervention of this disease. Hence, exploring new diagnostic and therapeutic strategies for OSCC is therefore an urgent priority. Exosomes, the small membrane vesicles originated from endosomes, have been detected in a wide array of bodily fluids. Exosomes have biological properties of derived cells based on containing a diversity of proteins, lipids, DNA fragments, mRNAs, and non-coding RNAs, including microRNAs, long non-coding RNAs, piRNAs, circular RNAs, tsRNAs, and ribosomal RNAs, which are delivered to neighboring cells or even transported to distant sites. They participate in cellular communication as well as play an important role in many diseases and immune response. Exosomes have been associated with the tumorigenesis of OSCC, promoting the proliferation, colonization, and metastasis of OSCC by transferring their cargos to the target cells. Furthermore, exosomes participate in the regulation of the tumor microenvironment to affect cancer progression in vivo. In this review, we summarize the crucial role of exosomes in the tumorigenesis and progression of OSCC and discuss the potential clinical application of exosomes in OSCC treatment.

Objective To establish the regression equation for the maximum oxygen uptake(VO2max)of male young endurance athletes at altitudeby modeling relevant indicators.Methods A total of 81 young male endurance athletes(long-distance runner,marathoner,and race walker)aged 15～18 years old were selected as the research subjects.The VO2max,3000-meter timed run,400-meter timed run,body morphology,body composition,hematological indicators,and cardiac function of the ath-letes were tested in Kunming,Yunnan Province(1890 meters altitude high)in four consecutive days.The testing sequence of the exercise was randomly arranged.The data of the first 65 athletes were used for multiple linear regression modeling,while those of the rest 16 were employed for the verifica-tion of the established model.Results Based on the data of 65 athletes,the multiple linear regression equation of VO2max was:VO2max=2616.661+60.389×lean body mass(kg)-3.108×3000-meter run-ning time(s)-16.665×lower limb length A(cm)+6.356×maximum heart rate(bpm),R2=0.858,and that of the relative VO2max was:relative VO2max=119.685-0.058×3000-meter running time(s)-0.224×body weight(kg)-0.452×Achilles tendon length(cm),R2=0.681.Accord-ing to the data of the rest 16 athletes,there was no significant difference in the calculated values of VO2max and relative VO2max.Moreover,the calculated values and the direct test values of VO2max and rel-ative VO2max were positively correlated(r=0.735,P=0.001;r=0.509,P=0.044).Conclusion A regression model of VO2max and relative VO2max for young male endurance athletes at altitude(1890 meters altitude high)was established and verified through direct testing.The model established is worth popularization and application,and can provide references for indicators selection of young male endurance athletes at altitude(1890 meters altitude high).

This study was conducted at a tertiary hospital,where the PDCA(Plan-Do-Check-Act)cycle was applied to establish a refined electricity conservation management system encompassing organizational structure,institutional frameworks,technical measures,and awareness campaigns.Through data analysis,on-site investigations,and case validation,multidimen-sional initiatives were implemented,including enhancing institutional frameworks,carrying out energy-saving technological up-grades,leveraging information technology,adopting market-based electricity procurement,and conducting publicity and educa-tion.The results demonstrated that after the implementation of the system,the hospital's annual electricity consumption growth rate showed a year-on-year decline,reaching 2.25％in 2024-a reduction of 3.66 percentage points compared to 2022.This study verifies the scientific rationale and practical effectiveness of the PDCA cycle in electricity conservation management,offering rep-licable experience for healthcare institutions striving to achieve energy savings and carbon emission reduction goals.

Objective:To investigate the causal impact of maternal smoking around birth(MSAB)on off-spring's risk of attention deficit hyperactivity disorder(ADHD),autism spectrum disorder(ASD),bipolar disorder(BD),and major depressive disorder(MDD).Methods:The datasets for MSAB and 4 psychiatric disorders were extracted from genome-wide association studies(GWAS).Mendelian randomization(MR)was employed,using in-verse variance weighting(IVW)as the primary analysis method.Sensitivity analyses and outlier correction were conducted using weighted median(WM),MR-Egger regression,and MR-PRESSO.The results were expressed as odds ratios(OR)and corrected for false discovery rate(FDR).Results:MR analysis showed significant causal re-lationships between MSAB and increased risk of ADHD(OR=5.36,95％CI=2.58-7.63,PFDR=0.003),MDD(OR=1.92,95％CI=1.29-2.88,PFDR=0.003),and BD(OR=6.33,95％CI=1.56-8.73,PFDR=0.013).However,no statistically significant association was found between MSAB and ASD(OR=1.66,95％CI=0.23-5.87,PFDR=0.616).Conclusion:This study suggests a potential causal link between maternal smoking around the time of birth and an increased risk of attention deficit hyperactivity disorder,bipolar disorder,and major depressive disorder in offspring.

To address the problem of data silos in dental specialties caused by equipment heterogeneity, this study developed an Intelligent Internet of Things (IoT)-enabled dental chair platform (hereinafter referred to as the intelligent platform) based on the concept of medical-engineering integration. The platform adopts a three-tier chair-domain interconnection architecture: the bottom tier integrates multi-source sensors and standardized interfaces for automated data acquisition and linkage with hospital information systems; the middle tier provides clinic-level management and remote teaching collaboration; and the top tier employs a blockchain-based secure cloud database for resource allocation and data management. Clinical validation at The Affiliated Stomatological Hospital of Nanjing Medical University demonstrated that, compared with a control group from the same period in 2023, the trial group achieved a 38.0% increase in average daily patient visits (80.6±6.8 vs. 58.4±5.2, t=15.16, P<0.001), a 24.6% reduction in average treatment time [(36.1±6.3) min vs. (47.9±8.5) min, t=7.72, P<0.001], a 39.2% reduction in waiting time [23.3 (16.5, 30.1) min vs. 38.3 (28.3, 48.3) min, U=32.00, P<0.001], a 30.4% reduction in equipment idle rate [8.7% (5.1%, 12.3%) vs. 12.5% (7.4%, 17.6%), U=251.00, P=0.003], and an increase in patient satisfaction from 88.2% (1 519/1 723) to 94.3% (2 186/2 318) ( t=7.26, P<0.001). User research confirmed that the functions most favored by clinicians and patients were "dental chair parameter updating and clinical data integration" [74.7% (80/107)] and "chairside display of diagnostic images" [76.8% (119/155)], respectively. Looking forward, the intelligent platform has the potential to integrate artificial intelligence-assisted diagnosis and 5G-enabled multicenter collaboration to further expand its clinical applications and accelerate the digital transformation of dental healthcare.

Oral cancer, as one kind of mucosal epithelial tumor, constitutes approximately 2% of all cancers, while the most common type, oral squamous cell carcinoma (OSCC) represents around 90% histopathology of oral cancers. Although the treatment of OSCC has been improved in recent 20 years, its 5-year survival rate has not raised significantly. The crux to improve the survival rate and prognosis of OSCC patients lies in the early diagnosis and intervention of this disease. Hence, exploring new diagnostic and therapeutic strategies for OSCC is therefore an urgent priority. Exosomes, the small membrane vesicles originated from endosomes, have been detected in a wide array of bodily fluids. Exosomes have biological properties of derived cells based on containing a diversity of proteins, lipids, DNA fragments, mRNAs, and non-coding RNAs, including microRNAs, long non-coding RNAs, piRNAs, circular RNAs, tsRNAs, and ribosomal RNAs, which are delivered to neighboring cells or even transported to distant sites. They participate in cellular communication as well as play an important role in many diseases and immune response. Exosomes have been associated with the tumorigenesis of OSCC, promoting the proliferation, colonization, and metastasis of OSCC by transferring their cargos to the target cells. Furthermore, exosomes participate in the regulation of the tumor microenvironment to affect cancer progression in vivo. In this review, we summarize the crucial role of exosomes in the tumorigenesis and progression of OSCC and discuss the potential clinical application of exosomes in OSCC treatment.

Objective To establish the regression equation for the maximum oxygen uptake(VO2max)of male young endurance athletes at altitudeby modeling relevant indicators.Methods A total of 81 young male endurance athletes(long-distance runner,marathoner,and race walker)aged 15～18 years old were selected as the research subjects.The VO2max,3000-meter timed run,400-meter timed run,body morphology,body composition,hematological indicators,and cardiac function of the ath-letes were tested in Kunming,Yunnan Province(1890 meters altitude high)in four consecutive days.The testing sequence of the exercise was randomly arranged.The data of the first 65 athletes were used for multiple linear regression modeling,while those of the rest 16 were employed for the verifica-tion of the established model.Results Based on the data of 65 athletes,the multiple linear regression equation of VO2max was:VO2max=2616.661+60.389×lean body mass(kg)-3.108×3000-meter run-ning time(s)-16.665×lower limb length A(cm)+6.356×maximum heart rate(bpm),R2=0.858,and that of the relative VO2max was:relative VO2max=119.685-0.058×3000-meter running time(s)-0.224×body weight(kg)-0.452×Achilles tendon length(cm),R2=0.681.Accord-ing to the data of the rest 16 athletes,there was no significant difference in the calculated values of VO2max and relative VO2max.Moreover,the calculated values and the direct test values of VO2max and rel-ative VO2max were positively correlated(r=0.735,P=0.001;r=0.509,P=0.044).Conclusion A regression model of VO2max and relative VO2max for young male endurance athletes at altitude(1890 meters altitude high)was established and verified through direct testing.The model established is worth popularization and application,and can provide references for indicators selection of young male endurance athletes at altitude(1890 meters altitude high).