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:To investigate the effects of Huaiqihuang Granules on airway remodeling and immune function in asthmatic young rats through IL36/lL36R/MyD88 signaling pathway.Methods:The young mice were divided into normal group, model group, Chinese materia medica low-, medium-, and high-dosage groups using a random number table method, with 10 mice in each group. Except for the normal group, asthma models were established in all other groups. Chinese materia medica low-, medium-, and high-dosage groups were orally administered with 2, 4, and 8 g/kg Huaiqihuang Granules, respectively. The normal group and model group were orally administered with an equal volume of physiological saline once a day for 2 consecutive weeks of intervention. Pulmonary function apparatus was used to detect inspiratory resistance (Ri), expiratory resistance (Re) and dynamic compliance (Cdyn) of the pups; flow cytometry was used to detect interleukin 2/4 (IL-2, IL-4), interferon (IFN-γ) and immunoglobulin E (IgE) in peripheral blood; HE staining was used to observe the changes of lung tissue cases of the pups; Western blotting was used to detect the protein expressions of IL-36, IL-36R and MyD88.Results:Compared with the model group, the Chinese materia medica medium- and high-dosage groups showed a decrease in Ri and Re ( P<0.05), and an increase in Cdyn ( P<0.05); the thickness of airway wall and the number of smooth muscle cells decreased ( P<0.05); the levels of IL-4 and IgE in peripheral blood decreased ( P<0.05), while the levels of IFN-γ and IL-2 increased ( P<0.05); the expressions of IL-36, IL-36R, and MyD88 proteins in lung tissue decreased ( P<0.05), and there was a certain dosage-dependent relationship among the Chinese materia medica low-, medium-, and high-dosage groups ( P<0.05). The HE staining results showed that the airway and lung tissues of the model group mice were accompanied by a large number of inflammatory pathological changes. The alveolar cavities and inflammatory infiltration of the mice in each treatment group were improved, with the Chinese materia medica high-dosage group showing the most significant improvement. Conclusion:Huaiqihuang Granules can improve airway remodeling and immune function in asthmatic model mice, and its mechanism may be related to regulating IL36/lL36R/MyD88 signaling pathway, improving airway remodeling and reducing inflammatory response.

Objective To analyze the correlation of inflammatory indicators of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),monocyte-to-lymphocyte ratio(MLR),and systemic immune-inflammation index(SII)with traditional Chinese medicine(TCM)syndrome types and Chinese version of Thyroid Imaging Reporting and Data System(C-TIRADS)classification and properties of nodules in the patients with thyroid nodules(TN),thus to provide evidence for guiding TCM syndrome differentiation and treatment,and for assessing C-TIRADS classification and properties of the nodules in patients with TN.Methods A retrospective analysis was carried out in 140 inpatients who were diagnosed as TN and had underwent thyroidectomy during the period of January 2021 to January 2024 in the Department of General Surgery of Guangzhou Integrated Chinese and Western Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine(Guangzhou Hospital of Integrated Traditional and West Medicine).The patients were allocated to various group with reference to TCM syndrome types,C-TIRADS classification,and the properties of TN.The correlation of each clinical indicator with TCM syndrome types and C-TIRADS classification and properties of TN was analyzed.The Spearman correlation coefficient was employed for evaluating the correlation of clinical indicators with the C-TIRADS classification and properties of TN,receiver operating characteristic curve(ROC)was used to analyze the predictive value of NLR,MLR,PLR,and SII for the properties of nodules in patients with TN,and the Youden's Index was used to determine the cutoff value for optimal prediction.Results(1)According to the criteria of TCM syndrome differentiation,72 cases were differentiated as qi stagnation and phlegm obstruction syndrome,65 cases as phlegm accumulation and blood stasis syndrome,and 3 cases as heart-liver yin deficiency syndrome.For the number of cases of heart-liver yin deficiency syndrome was too small,only the first two syndromes were included for the analysis.(2)The levels of free T3(FT3)and free T4(FT4)in the patients of qi stagnation and phlegm obstruction syndrome were higher,and the levels of anti-thyroid peroxidase antibody(A-TPO),anti-thyroglobulin antibody(A-TG),neutrophil(NEU),NLR,and SII were lower than those in the patients of phlegm accumulation and blood stasis syndrome,the differences being all statistically significant(P<0.05 or P<0.01).(3)The levels of NLR,PLR,and SII in the patients with C-TIRADS3 classification were lower than those in the patients with C-TIRADS4 classification,the differences being all statistically significant(P<0.05 or P<0.01);no statistically significant difference of MLR was presented between the patients with C-TIRADS3 classification and those with C-TIRADS4 classification(P>0.05).(4)The levels of NLR,PLR,MLR,and SII in patients with benign nodules were lower than those in patients with malignant nodules,the differences being statistically significant(P<0.05 or P<0.01).(5)The Spearman correlation analysis showed that NLR,PLR,and SII were positively correlated with the C-TIRADS classification of the nodules,and NLR,PLR,MLR,and SII were positively correlated with the properties of the nodules,the differences being all statistically significant(P<0.05 or P<0.01).(6)The levels of NLR,MLR,PLR,and SII in patients with high-risk TN exerted a certain predictive value for the properties of the nodules,and their area under the curve(AUC)was 0.645,0.641,0.604,and 0.716,respectively,the differences being statistically significant(P<0.05 or P<0.01).For the prediction of nodule properties by NLR,MLR,PLR,and SII levels in patients with high-risk TN,their cutoff values and the corresponding sensitivities and specificities were 2.261(0.551,0.791),138.108(0.735,0.527),5.132(0.714,0.495),493.114(0.776,0.615),respectively;and their Youden's Index was 0.342,0.262,0.209,0.391,respectively.Conclusion The results indicated that in patients with TN,the FT3 and FT4 levels are positively correlated with the qi stagnation and phlegm obstruction syndrome;the values of A-TPO,A-TG,NEU,NLR,and SII are positively correlated with the phlegm accumulation and blood stasis syndrome;NLR,PLR and SII values are positively correlated with C-TIRADS classification;NLR,PLR,PLR,SII values are positively correlated with malignant TN.NLR,MLR,PLR,SII values exert high efficiency for the prediction of the properties of nodules in patients with TN.

Objective To establish an intelligent detection algorithm model for acute promyelocytic leukemia(M3 model)based on a contrast large model using machine learning statistical software and validate its effectiveness.Methods The data from 8 256 outpa-tients and inpatients who underwent complete blood cell analysis at Peking Union Medical College Hospital were retrieved and analyzed using the laboratory information system(LIS)and hospital information system(HIS).A M3 screening model was established and vali-dated using the data from outpatients and inpatients who underwent complete blood cell analysis at our hospital from July to October 2023.Results The M3 model demonstrated potential application value in screening for M3 disease in complete blood cell analysis,which showed certain efficacy in screening for neutrophil toxicity changes,particularly in identifying two cases of blue-green inclusion bodies in neutrophils.Conclusion The M3 model exhibited low specificity for M3 diagnosis.Future research should focus on increas-ing the number of M3-positive cases to optimize the model,ensuring high sensitivity while improving specificity.This model will provide assistance for the intelligent review of complete blood cell analysis.

The obstruction of post-insulin receptor signaling is the main mechanism of insulin-resistant diabetes. Progestin and adipoQ receptor 3 (PAQR3), a key regulator of inflammation and metabolism, can negatively regulate the PI3K/AKT signaling pathway. Here, we report that gentiopicroside (GPS), the main bioactive secoiridoid glycoside of Gentiana manshurica Kitagawa, decreased lipid synthesis and increased glucose utilization in palmitic acid (PA) treated HepG2 cells. Additionally, GPS improved glycolipid metabolism in streptozotocin (STZ) treated high-fat diet (HFD)-induced diabetic mice. Our findings revealed that GPS promoted the activation of the PI3K/AKT axis by facilitating DNA-binding protein 2 (DDB2)-mediated PAQR3 ubiquitinated degradation. Moreover, results of surface plasmon resonance (SPR), microscale thermophoresis (MST) and thermal shift assay (TSA) indicated that GPS directly binds to PAQR3. Results of molecular docking and cellular thermal shift assay (CETSA) revealed that GPS directly bound to the amino acids of the PAQR3 NH₂-terminus including Leu40, Asp42, Glu69, Tyr125 and Ser129, and spatially inhibited the interaction between PAQR3 and the PI3K catalytic subunit (P110α) to restore the PI3K/AKT signaling pathway. In summary, our study identified GPS, which inhibits PAQR3 expression and directly targets PAQR3 to restore insulin signaling pathway, as a potential drug candidate for the treatment of diabetes.

To examine the growth activity and osteogenic differentiation of bone mesenchymal stem cells (BMSCs) in rats with Type 2 diabetes mellitus (T2DM) as well as the expression level of Dickkopf-1 (DKK-1) in bone marrow, and to explore the relationship between the osteogenic activity of BMSCs and the expression of DKK-1.
 Methods: The BMSCs were isolated from T2DM rats and were cultured in vitro. The BMSCs were divided into a T2DM group and a control group. The proliferation of BMSCs was detected by cell counting kit-8 (CCK8). Apoptosis rate was detected by annexin V- fluorescein isothiocyanate (FITC)/propidium iodide (PI) double staining. In the osteogenic induction phase, the expression level of alkaline phosphatase (ALP) in BMSCs was detected by ALP staining and ALP activity assay kit. The osteogenic differentiation of BMSCs was analyzed by alizarin red staining and mineralized nodule quantification. In addition, the expression of Runx2 and DKK-1 in BMSCs was detected by qRT-PCR.
 Results: Compared with the control group, the proliferation of BMSCs was decreased and the apoptosis was increased in the T2DM group (both P<0.01). In the osteogenic induction process of BMSCs, the expression of ALP significantly decreased, the formation of calcium nodules reduced, and the expression of osteoblast transcription factor Runx2 was down-regulated in the T2DM group compared with those in the control group (all P<0.01). The levels of DKK-1 protein and mRNA were up-regulated in the T2DM group, which were higher than those in the control group (both P<0.01). The levels of DKK-1 protein and mRNA were related to the increase of Runx2 (both P<0.01).
 Conclusion: The growth activity of BMSCs and the potential of osteogenic differentiation are attenuated in the T2DM rats, which may be related to the increase of DKK-1 expression in BMSCs.
Animals ; Bone Marrow Cells ; Cell Differentiation ; Cells, Cultured ; Diabetes Mellitus, Experimental ; Diabetes Mellitus, Type 2 ; physiopathology ; Gene Expression Regulation ; Intercellular Signaling Peptides and Proteins ; genetics ; Mesenchymal Stem Cells ; Osteogenesis ; genetics ; Rats

Aim To observe the expression of MRTF-A in rat glomerular mesangial cells(GMCs) induced by advanced glycation end products(AGEs) and its effect on ICAM-1 and FN;to explore whether MRTF-A is involved in the process of diabetic nephropathy by affecting NF-κB pathway.Methods Under the condition of AGEs, CCG-1423 and anti-MRTF-A small interfering RNA were used to knock down MRTF-A and MRTF-A plasmid was used to activatt MRTF-A, The expression level of MRTF-A, ICAM-1, FN and p65 in nucleus were detected by Western blot.Results The protein expressions of MRTF-A was increased in AGEs-induced GMCs.The expressions of FN and ICAM-1 and p65 in nucleus were downregulated by knocking down MRTF-A.However, the expressions of FN, ICAM-1 and p65 in nucleus were upregulated by overexpressing MRTF-A.Conclusions AGEs can upregulate the expression of MRTF-A in GMCs, and MRTF-A mediates the protein expressions of FN and ICAM-1 by affecting NF-κB signaling pathway in AGEs-induced GMCs.

Objective Central nervous system trauma, ischemia, hemorrhagic stroke were all experienced the same pathological damage, in related animal experiments,histone deacetylase inhibitors have a wide range of neuroprotective effect, it is expected to become a new class of potential therapeutic agents.However,the specific mechanism is not clear.In this paper, the research progress of neuroprotective effect of histone deacetylase inhibitors is reviewed,in order to improve recognition of histone deacetylase inhibitors and provide foundation for futher study.

Objective To design and formulate a electronic preoperative preparation checklist for applying in the preoperative preparation,to reduce missing rate in preoperative preparation and transfer,to improve patient satisfaction,to avoid operation delay and medical accident caused by inappropriate preparation.Methods A total of 145 patients with surgery from March 2013 to February 2013 were as experimental group,and 158 patients with surgery from March 2012 to February 2012 were as control group.The experimental group was used electronic preoperative preparation checklist for preoperative preparation and transition,and the control group was used conventional methods.The incidence of mistake for preoperative preparation and transfer and both surgeon's and patient's satisfactory were compared between two groups.Results After applying the electronic preoperative preparation checklist,the incidence of mistake for preoperative preparation and transfer in experimental group reduced significandy to 1.37％(2/145) and 4.83％ (7/145),compared with the incidence of control group 6.33％(10/158),11.39％(18/158),and the differences between two groups were statistically different (x2=4.870,4.305,P ＜ 0.05).Both surgeon's and patient's satisfactory were improved dramatically,the satisfactory in experimental group improved to 100.00％(50/50)and 97.93％(142/145),compared with the satisfactory of control group 90.00％(45/50) and 90.51％(143/158),and the differences between two groups were statistically different(x2=5.263,7.459,P ＜ 0.05).Conclusions Implementing the electronic preoperative preparation checklist can reduce the incidence of mistake before operation and ensure patient operation schedule.Therefore,it could improve nursing care quality and efficiency.