Objective: To investigate the scientific research capacity building of administrative offices of Centers for Disease Control and Prevention (CDCs) across 31 provinces (autonomous regions, municipalities), the Xinjiang Production and Construction Corps, and 5 separately listed cities in China, so as to provide the reference for improving the positioning of office functions and promoting the enhancement of scientific research capabilities. Methods: A self-administered questionnaire survey was conducted among heads and staff members of administrative offices in 37 CDCs. Data on office setup, general information, staffing, scientific research incentive measures and outputs were collected and analyzed. Results: The 37 administrative offices of the CDCs had an average authorized staffing size of 12 personnel. There were 17 of them setting independently allocated budgets. A total of 511 staff members were surveyed, comprising 238 males and 273 females, resulting in a male-to-female ratio of 0.87∶1. In terms of educational attainment, the majority held bachelor's degrees (225 individuals, 44.03%) or master's degrees and above (157 individuals, 30.72%). Professional technical personnel constituted the main occupational category, 302 individuals accounting for 59.10%. Intermediate professional titles were most common, 138 individuals accounting for 27.00%. From 2021 to 2023, a total of 68 research incentive measures have been implemented, and 579 personnel have received further training. These offices cumulatively led or participated in 80 scientific research projects and published 253 papers. Sixteen offices reported 10 and above scientific research outputs. These offices generally exhibited higher proportions of independently allocated budgets, greater numbers of senior professional titles, more staff with master's degrees or above, more implemented research incentive measures, and higher frequencies of staff further trainings. Conclusions The staff in the administrative offices of CDCs generally have a high level of educational attainment and include a significant number of professional technical personnel. However, their scientific research capacity remains relatively underdeveloped. It is recommended to conduct targeted professional training and research-focused lectures to enhance research literacy, leverage the strengths of multidisciplinary backgrounds, and promote cross-departmental and cross-institutional scientific research activities.

Objective:To investigate the perioperative safety, short-term and long-term efficacy, and surgical strategy of laparoscopic partial gastrectomy for gastrointestinal stromal tumors at the esophagogastric junction.Methods:Seventy-eight patients with mesenchymal tumors in the esophagogastric junction were retrospectively enrolled from September 2018 to August 2023 in which the upper edge of the tumor is less than 2 cm from the Z-line or has invaded the Z-line <1/2 circumference. There were 31 males (39.7%) and 47 females (60.3%), with an average age of (57.2±11.8) years and an average body mass index of (24.5±3.5) kg/m 2. All cases were divided into the wedge resection (WR) group ( n=51) and the resection by opening all of the layers of the stomach wall (RASW) group ( n=27) according to the surgical methods. Surgical outcomes, complications, recover and postoperative gastroesophageal reflux of both groups were compared. The measurement data with a normal distribution were represented by mean±standard deviation ( ± s), and values were compared using the independent sample t-test. The measurement data with a skewed distribution were represented by median (interquartile range) [ M( Q1, Q3)], and values were compared using the Mann-Whitney U test. Count data were expressed as examples (percentages) [ n(%)], and the χ2 test was used to compare countable data. A non-parametric test was used to compare the grade data. Results:The WR group had shorter operation time [(97.1±32.6) min vs (149.9±54.9) min, t=-5.33, P<0.001], less intraoperative blood loss [15(10, 20) mL vs 20(10, 50) mL, z=-2.47, P=0.014], shorter postoperative exhaust time [2(1, 3) d vs 3(2, 3) d, z=-2.49, P=0.013], shorter postoperative oral intake time [2(2, 3) d vs 4(2, 5) d, t=-3.70, P<0.001], shorter postoperative semi-liquid diet time[5(4, 6) d vs 7(5, 8) d, z=-3.57, P<0.001], and shorter postoperative hospital stay [5(4, 6) d vs 7(6, 8) d, z=-4.16, P<0.001] than the RASW group, with statistically significant differences. There was no significant difference in short-term (≤30 days) complications between the two groups (2.0% vs 3.7%, z=-0.46, P=0.648). No cases of cardia stenosis occurred in either group. In the WR group, 3 patients developed gastroesophageal reflux at 6 months postoperatively, with 2 patients relieved after taking acid-suppressing drugs and 1 patient not completely relieved. In the RASW group, 1 patient developed gastroesophageal reflux at 6 months postoperatively and was not completely relieved after taking acid-suppressing drugs. No other patients had gastroesophageal reflux. No other patients have gastroesophageal reflux. Conclusions:WR and RASW are safe and feasible for mesenchymal tumors at the esophagogastric junction in which the upper edge of the tumor is less than 2 cm from the Z-line or has invaded the Z-line <1/2 circumference, and has achieved an excellent short-term effect. The choice of surgical approach can be determined based on varions factors such as the location of the tumor, the relationship of the position between the tumor and the cardia, and whether the tumor is exophytic growth.

Objective:To investigate the application of time series models in forecasting pre-hospital emergency ambulance trips in Handan City and develop the LPro ensemble model for improved prediction accuracy to support emergency resource allocation.Methods:Pre-hospital emergency data from Handan Emergency Medical Command Center (2019-2023) were retrospectively analyzed. From 324 799 original records, 289 949 valid records were included after cleaning. The training set (2019-2022: 215 918 records) included 35 527 records in 2019, 52 015 in 2020, 61 836 in 2021, and 66 540 in 2022. The validation set (2023) contained 74 031 records. ARIMA, linear trend seasonal, exponential smoothing, and Prophet models were fitted to the training set. The LPro ensemble model was constructed using MAPE-based weighting (linear trend seasonal model: 0.38, Prophet: 0.62). Performance metrics included MAPE, RMSE, MAE, and R 2. Results:Data showed annual growth (compound annual growth rate 23.27%) and seasonal patterns (October peaks, February troughs). Ambulance dispatches increased annually with monthly cyclical patterns. For 2023 validation predictions: ARIMA (MAPE 8.76%, RMSE 619, MAE 491, R 2 0.4563), linear trend seasonal (MAPE 9.83%, RMSE 671, MAE 545, R 2 0.3608), Prophet (MAPE 8.43%, RMSE 562, MAE 503, R 2 0.5513), exponential smoothing (MAPE 8.08%, RMSE 643, MAE 410, R 2 0.4124). LPro model showed superior performance (MAPE 7.05%, RMSE 491, MAE 393, R 2 0.6570), with 16.37% lower MAPE, 12.63% lower RMSE, 21.87% lower MAE, and 19.17% higher R 2 versus Prophet. Conclusion:The LPro ensemble model substantially enhances prediction accuracy and reliability, offering scientific support for emergency resource optimization and dispatch scheduling in Handan City.

In recent years, idiopathic macular hole (IMH) surgery has a very high success rate due to the development of small-gauge vitrectomy, while the recovery of visual acuity is not satisfactory.Current studies have found that continuity of retinal blood vessels in the macular area and changes in retinal and choroidal perfusion are closely related to the formation and healing of MH, and have a significant impact on the visual prognosis in IMH patients.This article reviews the research progress on variations of parameters for retinal and choroidal vessels in IMH patients, as well as their relationship with visual prognosis.For retinal parameters, the changes in the foveal avascular zone, superficial and deep capillary plexus density, paracentral intraretinal cystoid spaces, retinal vessels position are discussed.Relevant research related to choroidal blood flow perfusion changes and the effects of different surgical methods on macular perfusion in patients with IMH are summarized to provide basis for further understanding the etiology and prognosis of IMH.

Objective To investigate whether Piceatannol(PIC)improves diabetic retinopathy(DR)mediated by microglial polarization and to elucidate the underlying molecular mechanisms.Methods Network pharmacology and bioinformatics were used to analyze the common targets of DR,PIC,and microglia.Human retinal vascular endothelial cells(HRVECs)were cultured in vitro and randomly divided into the NG-HRVECs group,HG-HRVECs group,and HG+PIC-HRVECs group.Cell viability was assessed by the CCK-8 assay,apoptosis was detected by the TUNEL assay,and the concentrations of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)were measured using ELISA kits.BV-2 cells were cultured in vitro and randomly divided into the NG-BV-2 group,HG-BV-2 group,HG+PIC-BV-2 group,HG+Si-NC-BV-2 group,HG+Si-CXCR4-BV-2 group,and HG+Ibrutinib-BV-2 group.The levels of arginase-1(Arg-1)and inducible ni-tric oxide synthase(iNOS)were measured using ELISA kits.Furthermore,conditioned medium(CM)from BV-2 cells of each group was collected to treat HRVECs,after which the viability,apoptosis rate,and TNF-α and IL-6 concentrations of the HRVECs were measured.A DR rat model was established and intervened with PIC to investigate the ameliorative effects of PIC on retinal pathology.Results Bioinformatics analysis identified CXCR4 as the key target of this study.Compared with the NG-HRVECs group,the apoptosis rate and the concentrations of TNF-α and IL-6 were increased in the HG-HRVECs group.Compared with the HG-HRVECs group,the HG+PIC-HRVECs group showed a decreased apoptosis rate and reduced concentrations of TNF-α and IL-6(all P＜0.05).Compared with the NG-BV-2 group,the HG-BV-2 group ex-hibited decreased Arg-1 levels and increased iNOS levels.Compared with the HG-BV-2 group,the HG+PIC-BV-2,HG+Si-CXCR4-BV-2,and HG+Ibrutinib-BV-2 groups all showed increased Arg-1 levels and decreased iNOS levels(all P＜0.05).Compared with the NG-BV-2-CM group,the HG-BV-2-CM group led to decreased viability,increased apoptosis rate,and in-creased concentrations of TNF-α and IL-6 in HRVECs.In contrast,the HG+PIC-BV-2-CM,HG+Si-CXCR4-BV-2-CM,and HG+Ibrutinib-BV-2-CM groups reversed the effects induced by HG-BV-2-CM on HRVECs(all P＜0.05).Animal experiment results showed that compared with DR model rats,rats treated with different doses of PIC exhibited significantly ameliora-ted retinal histopathological damage,and the protein expressions of Arg-1,iNOS,CXCR4,and p-BTK were reversed.Con-clusion PIC ameliorates DR progression mediated by microglial polarization by inhibiting the CXCR4/BTK pathway.

Background and purpose:In recent years,chimeric antigen receptor T(CAR-T)cell therapy has achieved breakthrough progress in cancer treatment.γδ T cells,with their non-major histocompatibility complex(MHC)-restricted antigen recognition,broad antitumor activity,and low risk of graft-versus-host disease(GVHD),have garnered significant interest in CAR-γδ T cell therapy.However,critical challenges including suboptimal in vitro expansion and low viral transduction efficiency severely hinder the research and clinical application of CAR-γδ T cells.This study aimed to establish an efficient platform for preparing CAR-γδ T cells by optimizing the in vitro expansion conditions of γδ T cells and refining lentiviral transduction strategies.Methods:We first optimized the expansion protocol for γδ T cells by screening various cytokine combinations and the concentrations of individual cytokines within combination,and evaluating cell purity,viability,fold expansion,and expressions of cytotoxicity and exhaustion markers to identify the optimal culture conditions.Subsequently,the transduction conditions for CAR-γδ T cells were improved by determining the optimal activation duration of γδ T cells prior to gene transfer,as well as the optimal multiplicity of infection(MOI)for lentiviral transduction.Finally,CAR-γδ T cells were successfully generated using the optimized protocol,and their cytotoxic activity against target cells was validated via calcein-release assay and flow cytometry,with a preliminary assessment of the potential risk of GVHD induction.Results:Experimental data demonstrated that,compared with the interleukin(IL)-2-only culture,the IL-2+IL-7+IL-15 combination significantly enhanced the expansion capacity of γδ T cells(876.50±238.35-fold vs 1 627.50±472.15-fold),cell purity(73.67%±1.53%vs 90.69%±2.00%),and cell viability(63.01%±7.05%vs 89.00%±3.61%).It also increased the expression of the cytotoxicity marker CD16(4.20%±1.73%vs 14.66%±0.58%)and reduced the expression of the exhaustion marker programmed death-1(PD-1)(35.67%±6.26%vs 21.10%±6.49%).A cytokine concentration gradient orthogonal assay further identified 10 ng/mL IL-7 and 10 ng/mL IL-15 as the optimal concentrations within the IL-2+IL-7+IL-15 combination.Gene transduction performed 96-120 h after activation using a multiplicity of infection(MOI)of 5-10 resulted in the highest transduction efficiency for CAR-γδ T cells(96 h:12.87%±4.35%;120 h:11.37%±2.35%).CAR-γδ T cells generated using the optimized system exhibited specific cytotoxic effects against tumor cells expressing the target antigen,and no evidence of GVHD induction was observed.Conclusion:CAR-γδ T cells produced using the IL-2+IL-7(10 ng/mL)+IL-15(10 ng/mL)regimen combined with a 96-120 h activation period prior to transduction using a multiplicity of infection(MOI)of 5-10 significantly outperformed conventional methods in terms of expansion efficiency,cell purity,and transduction efficiency.The synergistic antitumor effects mediated by both natural immune receptors and CAR-specific recognition,along with the initial absence of GVHD risk,provide critical technical support for the clinical translation of CAR-γδ T cell therapy,establishing a solid theoretical and practical foundation.

The original version of this article (Yang et al., 2023) unfortunately contained a mistake. In Acknowledgments, the funding information for the Zhejiang Provincial Natural Science Foundation of China (No. LBY21H160001) was wrong. The correct funding should be the Zhejiang Health Science and Technology Project (No. 2022KY682), China.

Objective To explore the different potential subtypes of psychosocial adaptation among young and middle-aged stroke patients,and analyze the relationship between different potential subtypes and quality of life,so as to provide references for the subsequent development of targeted interventions.Methods A total of 406 young and middle-aged stroke patients in 4 tertiary hospitals in Suzhou from June 2023 to June 2024 were recruited by convenience sampling.The General Information Questionnaire,the Self-Report Psychosocial Adjustment to Illness Scale and the EuroQol five-dimensional questionnaire were conducted for investigation.Latent profile analysis was used to explore the potential subtypes of psychosocial adaptation among young and middle-aged stroke patients.Generalized linear regression analysis was conducted with quality of life as dependent variables.Results A total of 380 young and middle-aged stroke patients were included.The psychosocial adaptation of patients could be classified into 3 potential subtypes:high adaptation level type(23.90％),medium adaptation level with health concerns type(46.40％),and low adaptation level with psychological barriers type(29.70％).The results of generalized linear regression analysis showed that potential subtypes of psychosocial adaptation were the influencing factors for quality of life in young and middle-aged stroke patients(P＜0.05).Conclusion There was group heterogeneity in psychosocial adaptation among young and middle-aged stroke patients,and the potential subtype of psychosocial adaption was an important factor affecting the quality of life of patients.It is suggested that medical staff should focus on patients with low adaptation level with psychological barriers type,and take targeted interventions according to characteristics of different subtypes of patients,so as to improve their quality of life.

Objective To investigate the relationship between prolactin and mild cognitive impairment(MCI)in postmenopausal women with type 2 diabetes mellitus(T2DM).Methods A total of 319 postmenopausal women with T2DM who were hospitalized in the Department of Endocrinology,Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University were enrolled in this study from August 2016 to October 2023.All the patients were divided into two groups according whether they had MCI:T2DM group(n=161)and MCI group(n=158).Differences in clinical characteristics were compared between the two groups.Pearson correlation was used to analyze the correlation between sex hormones and cognitive domains,and Logistic regression analysis was used to evaluate the influencing factors for MCI development.Results Serum prolactin levels were significantly lower in the MCI group than in the T2DM group[(5.5±2.1)vs(7.2±2.9)μg/L,P<0.05].Serum prolactin level was positively correlated with mini-mental state examination score,Montreal cognitive assessment score,immediate memory score,visuopatial constructional score,attention score and hippocampal volume(P<0.05),and negatively correlated with processing speed test(time)and executive function test(time)(P<0.05).Logistic regression analysis demonstrated that serum prolactin level was an influencing factor for the risk of MCI in postmenopausal women with T2DM(OR 0.715,95%CI 0.605～0.845,P<0.01).Conclusions The decrease of serum prolactin level is associated with an increased risk of MCI in postmenopausal women with T2DM.

Objective To investigate the relationship between prolactin and mild cognitive impairment(MCI)in postmenopausal women with type 2 diabetes mellitus(T2DM).Methods A total of 319 postmenopausal women with T2DM who were hospitalized in the Department of Endocrinology,Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University were enrolled in this study from August 2016 to October 2023.All the patients were divided into two groups according whether they had MCI:T2DM group(n=161)and MCI group(n=158).Differences in clinical characteristics were compared between the two groups.Pearson correlation was used to analyze the correlation between sex hormones and cognitive domains,and Logistic regression analysis was used to evaluate the influencing factors for MCI development.Results Serum prolactin levels were significantly lower in the MCI group than in the T2DM group[(5.5±2.1)vs(7.2±2.9)μg/L,P<0.05].Serum prolactin level was positively correlated with mini-mental state examination score,Montreal cognitive assessment score,immediate memory score,visuopatial constructional score,attention score and hippocampal volume(P<0.05),and negatively correlated with processing speed test(time)and executive function test(time)(P<0.05).Logistic regression analysis demonstrated that serum prolactin level was an influencing factor for the risk of MCI in postmenopausal women with T2DM(OR 0.715,95%CI 0.605～0.845,P<0.01).Conclusions The decrease of serum prolactin level is associated with an increased risk of MCI in postmenopausal women with T2DM.