Objective To explore the relationship between circadian rhythm genes and the occurrence, development, prognosis, and tumor microenvironment (TME) of lung adenocarcinoma (LUAD). Methods The Cancer Genome Atlas data were used to evaluate the expression, copy number variation, and somatic mutation frequency of circadian gene sets in LUAD. Gene ontology, Kyoto encyclopedia of genes and genomes, and gene set enrichment analysis were used to explore the potential mechanisms by which circadian rhythm genes affected LUAD progression. Cox regression, least absolute shrinkage and selection operator regression, support vector machine recursive feature elimination, and random forest screened circadian genes and established prognostic models, and on this basis constructed nomogram to predict patients’ 1-, 3-, and 5-year survival rates. Kaplan-Meier survival curves, receiver operating characteristic (ROC) curves, and time-dependent ROC curves were drawn to evaluate the predictive ability of the model, and the external dataset of GEO further verified the prognostic value of the prediction model. In addition, we evaluated the association of the prognostic model with immune cells and immune checkpoint genes. Single cell RNA sequencing (scRNA-seq) analysis was used to explore the molecular characteristics between prognostically relevant circadian genes and different immune cell populations in TME. Results Differentially expressed circadian rhythm genes were mainly enriched in biological processes related to cGMP-PKG signaling pathway, lipid and atherosclerosis, and JAK-STAT signaling pathway. Seven circadian rhythm genes: LGR4, CDK1, KLF10, ARNTL2, RORA, NPAS2, PTGDS were screened out, and a RiskScore model was established. According to the median RiskScore, samples were divided into a high-risk group and a low-risk group. Compared with patients in the low-risk group, patients in the high-risk group showed a poorer prognosis (P<0.001). Immunological characterization analysis showed that there were differences in the infiltration of multiple immune cells between the low-risk group and high-risk group. Most immune checkpoint genes had higher expression levels in the high-risk group than those in the low-risk group, and RiskScore was positively correlated with the expression of CD276, TNFSF4, PDCD1LG2, CD274, and TNFRSF9, and negatively correlated with the expression of CD40LG and TNFSF15. The scRNA-seq analysis showed that RORA and KLF10 were mainly expressed in natural killer cells. Conclusion The prognostic model based on seven feature circadian rhythm genes has certain predictive value for predicting survival of LUAD patients. Dysregulated expression of circadian genes may regulate the occurrence, progression as well as prognosis of LUAD through affecting TME, which provides a possible direction for finding potential strategies for treating LUAD from the perspective of mechanism by which circadian disorder affects immune cells.

Objective To determine the prognostic biomarkers and new therapeutic targets of the lung adenocarcinoma (LUAD), based on which to establish a prediction model for the survival of LUAD patients. Methods An integrative analysis was conducted on gene expression and clinicopathologic data of LUAD, which were obtained from the UCSC database. Subsequently, various methods, including screening of differentially expressed genes (DEGs), Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis and Gene Set Enrichment Analysis (GSEA), were employed to analyze the data. Cox regression and least absolute shrinkage and selection operator (LASSO) regression were used to establish an assessment model. Based on this model, we constructed a nomogram to predict the probable survival of LUAD patients at different time points (1-year, 2-year, 3-year, 5-year, and 10-year). Finally, we evaluated the predictive ability of our model using Kaplan-Meier survival curves, receiver operating characteristic (ROC) curves, and time-dependent ROC curves. The validation group further verified the prognostic value of the model. Results The different-grade pathological subtypes' DEGs were mainly enriched in biological processes such as metabolism of xenobiotics by cytochrome P450, natural killer cell-mediated cytotoxicity, antigen processing and presentation, and regulation of enzyme activity, which were closely related to tumor development. Through Cox regression and LASSO regression, we constructed a reliable prediction model consisting of a five-gene panel (MELTF, MAGEA1, FGF19, DKK4, C14ORF105). The model demonstrated excellent specificity and sensitivity in ROC curves, with an area under the curve (AUC) of 0.675. The time-dependent ROC analysis revealed AUC values of 0.893, 0.713, and 0.632 for 1-year, 3-year, and 5-year survival, respectively. The advantage of the model was also verified in the validation group. Additionally, we developed a nomogram that accurately predicted survival, as demonstrated by calibration curves and C-index. Conclusion We have developed a prognostic prediction model for LUAD consisting of five genes. This novel approach offers clinical practitioners a personalized tool for making informed decisions regarding the prognosis of their patients.

After being treated with acupuncture, some patients with idiopathic tinnitus may experience a short-term aggravation of tinnitus symptoms on the original basis. These symptoms can be gradually relieved and the overall condition fluctuates towards recovery. This phenomenon has brought some difficulties to patients and clinicians. Based on the academic view of TCM, "destroying pathogens and re-building balance", and in association with the existing understanding of acupuncture in modern medicine for tinnitus, this paper briefly discusses the mechanism and influencing factors of symptom fluctuation in patients with idiopathic tinnitus after acupuncture treatment in terms of both TCM and modern medicine, and proposes the future direction in the research of symptom fluctuation, so as to promote the recognition of clinicians and patients on symptom fluctuation and make rational use of its positive effects. Besides, it is hoped that more researchers will pay attention to symptom fluctuation and advance the exploration of it in academic field.
Humans ; Tinnitus/physiopathology* ; Acupuncture Therapy ; Male ; Female

OBJECTIVE: To explore and quantify the association of hot night exposure during the sperm development period (0-90 lag days) with semen quality. METHODS: A total of 6,640 male sperm donors from 6 human sperm banks in China during 2014-2020 were recruited in this multicenter study. Two indices (i.e., hot night excess [HNE] and hot night duration [HND]) were used to estimate the heat intensity and duration during nighttime. Linear mixed models were used to examine the association between hot nights and semen quality parameters. RESULTS: The exposure-response relationship revealed that HNE and HND during 0-90 days before semen collection had a significantly inverse association with sperm motility. Specifically, a 1 °C increase in HNE was associated with decreased sperm progressive motility of 0.0090 (95% confidence interval [ CI]: -0.0147, -0.0033) and decreased total motility of 0.0094 (95% CI: -0.0160, -0.0029). HND was significantly associated with reduced sperm progressive motility and total motility of 0.0021 (95% CI: -0.0040, -0.0003) and 0.0023 (95% CI: -0.0043, -0.0002), respectively. Consistent results were observed at different temperature thresholds on hot nights. CONCLUSION Our findings highlight the need to mitigate nocturnal heat exposure during spermatogenesis to maintain optimal semen quality.
Humans ; Male ; Semen Analysis ; Adult ; Sperm Motility ; Hot Temperature/adverse effects* ; China ; Middle Aged ; Spermatozoa/physiology* ; Young Adult

Objective To explore the role and underlying mechanism of the transcriptional coactivator with PDZ-binding motif(TAZ)and a histone variant of acute histone H2A(H2A.Z)in the repair of hypoxia-induced lung injury.Methods A mouse model of hypoxic lung injury was established by being placed in a hypoxia chamber(simulating an altitude of 5 800 m)for 4 d.HE staining was used to observe the severity of lung injury.A hypoxia model of murine alveolar epithelial cells(murine lung epithelial-12,MLE12)was constructed by treating the cells in a hypoxia workstation(1%O2 concentration)for 24 h.Western blotting was employed to detect TAZ expression.The proliferation of alveolar epithelial cells(AECs)was evaluated by CCK-8 assay.Co-immunoprecipitation(Co-IP)assay was utilized to verify the interaction between TAZ and H2A.Z.CUT&Tag sequencing was performed to determine the effect of TAZ on the chromatin deposition of H2A.Z.Results Hypoxia significantly induced alveolar atrophy and inflammatory infiltration in mouse lung tissues(P＜0.01).Hypoxia significantly up-regulated the protein level of TAZ in MLE12 cells(P＜0.05).CCK-8 assay showed that knockdown of TAZ significantly reduced the proliferative capacity of AECs(P＜0.01).Co-IP assay confirmed the physical interaction between TAZ and H2A.Z.CUT&Tag sequencing revealed that hypoxia promoted the deposition of H2A.Z on chromatin(31 817 peaks under normoxia,44 078 peaks under hypoxia),which was partially reversed by TAZ knockdown(37 840 peaks).Conclusion Hypoxia significantly up-regulates the expression of TAZ,which combines with H2A.Z and promotes the deposition of H2A.Z on chromatin,thus enhancing the proliferation of AECs in response to hypoxic injury.

The elimination of biofilms is a crucial step in controlling hospital-acquired infections.Once biofilms colonize luminal instruments,it is difficult to remove them using traditional disinfection methods.Conventional disinfection approaches now face a series of challenges,including microbial resistance,corrosiveness,cytotoxicity,residual disinfection byproducts,and environmental pollution.Therefore,developing novel disinfection technologies specifically targeting biofilm removal is vitally important.New disinfection technologies,such as slightly acidic electrolyzed water,plasma technology,surface modification techniques,nanomaterial-based disinfection,bacteriophage disinfection,and enzymatic disinfection,are constantly emerging.These technologies exhibit excellent performance against biofilms by leveraging the synergistic effects of multiple mechanisms,including the reactive oxygen species(ROS)burst,photocatalytic oxidation,physical disruption,and biological targeting.This review summarizes the characteristics,underlying mechanisms,and potential application scenarios of these novel disinfection technologies,with a particular focus on their effects against biofilms formed by common pathogenic bacteria on surfaces in hospital settings.It aims to provide a reference basis for the practical application and translation of these disinfection technologies and the development of new disinfection strategies.

The theories of "absence of kidney excess syndrome" and "treating kidney disease only by the tonifying method without the purgative method" have been highly praised by medical practitioners throughout history. However,the syndrome of intermingled deficiency and excess of kidney in clinical practice is not uncommon,and there are many cases that treating kidney disease with the method of expelling kidney turbidity. However,its theoretical basis has not been systematically organized and studied. This article,based on the consideration of the "three purging" herbs of Liuwei Dihuang Pill,finds that "kidney" in traditional Chinese medicine not only stores essence,but also removes turbidity. From the theory of storage-expelling of five zang viscera,the physiological characteristic of kidney is integrated with storing and expelling functions. In addition to storing essence and qi to maintain normal life activities in the human body,it also exercises the function of excretion through the bladder and sanjiao. Under pathological conditions,both the function of storing essence and excretion of turbidity in kidney can be affected,which manifests as lack of essence and accumulation of turbidity. The pathological features of this disease are characterized by kidney qi deficiency as the root cause,accumulation of turbidity as the result,and intertwined with each other. Based on the physiology and pathology of visceral manifestation of kidney in traditional Chinese medicine,the theory of "retaining essence and removing turbidity" can be used in the clinical diagnosis and treatment of kidney disease. When treating kidney disease,the method of invigorating the kidney can also be combined with the method of expelling kidney turbidity,such as promoting diuresis,dissipating phlegm,promoting blood circulation,or removing toxin. Flexible selection of the above treatment methods can improve the therapeutic effect.

Objective This study aims to test the reliability and validity of the Chinese version of the Asher-McDade aesthetic index and clarify its feasibility for the postoperative outcome evaluation of cleft lip in China.Methods The Chinese version of the Asher-McDade aesthetic index was established through translation,back translation,debugging,and pre-survey.Eighty postoperative photographs of patients with cleft lip admitted to the West China Hospital of Stoma-tology,Sichuan University were included.Ten healthcare professionals,including surgeons,nurses,and students,in the department of cleft lip and palate surgery finished the index to test its reliability and validity.Results The Cronbach's alpha coefficient and retest reliability of this index are 0.804 and 0.895,respectively.The item-level content validity in-dex(I-CVI)and scale-level content validity index ave-rage(S-CVI/ave)of the index are 1.000 and 0.95,respec-tively.For this index,the Kaiser-Meyer-Olkin(KMO)test score is 0.706,the χ2 value of Bartlett's test for the consistency of the index is 962.260(P<0.01),and the cu-mulative variance contribution rate is 63.095%.Conclu-sion The Chinese version of the Asher-McDade aesthe-tic index has good reliability and validity and is applica-ble to the professional evaluation of the effect of postoperative photographs in Chinese patients with cleft lip.

Objective:To analyze the trend of disease burden, including mortality and disability-adjusted life years (DALYs) , of occupational lung cancer in China from 1990 to 2019.Methods:In June 2022, the data of occupational lung cancer was obtained from Global Burden of Disease Study 2019 (GBD) . Excel summarized the data, and the mortality rate, DALYs and age-normalized rate were analyzed. Applying Joinpoint Regression Program software annual Percentage Change (APC) and Average Annual Percentage Change Rate (AAPC) .Results:Age-standardized mortality rates ranged from 2.41 in 1990 to 3.14 per 100 000 in 2019, with gender differences and a positive correlation with age. DALYs increased from 580, 000 person-years in 1990 to 1 509 900 person-years in 2019. The rate of standardized DALYs increased from 63.03 per 100 000 in 1990 to 71.65 per 100 000 in 2019. According to the annual percentage change (APC) analysis by Joinpoint Regression Program software, the age-normalized mortality and DALY rates decreased from 2011 to 2016, and the increasing trend from 2016 to 2019 was significantly lower than that before 2011. And the increase at this stage was not statistically significant. The APCC values of mortality rate, standardized mortality rate, DALYs rate and changed DALYs rate were 3.28, 0.92, 2.64 and 0.44, respectively, and the trend differences were statistically significant.Conclusion:The disease burden of occupational lung cancer is increasing from 1990 to 2019. Lung cancer screening should be carried out among high-risk populations to achieve early diagnosis and treatment.

Objective To understand the infection status of patients with maintenance hemodialysis(MHD)in Guizhou Province,and provide basis for the prevention and control of hemodialysis-related infection.Methods MHD patients in hemodialysis centers of 124 secondary and or higher grade medical institutions in Guizhou Province from July to December 2022 were surveyed.Survey content included the general conditions of patients,hemodialysis-related conditions,infection of pathogens of blood-borne diseases,and other infection-related conditions.Results A total of 15 114 MHD patients were surveyed,with age mainly ranging from 36 to＜60 years old(55.83％).Hemodialysis history ranged mainly from 1 year to＜5 years(59.37％),and the frequency of hemodi-alysis was mainly 3 times per week(73.91％).Autologous arteriovenous fistula(AVF)was the major vascular access for dialysis,with a total of 12 948 cases(85.77％).The main primary disease was chronic renal failure(99.89％).The infection rates of hepatitis B virus(HBV),hepatitis C virus(HCV),human immunodeficiency vi-rus(HIV),and Treponema pallidum in MHD patients were 5.29％,0.64％,0.24％,and 1.70％,respectively.HBV infection rates among MHD patients of different ages,different numbers of dialysis hospitals,and dialysis in-stitutions of different scales showed statistically significant differences(all P＜0.05).HCV infection rates among MHD patients of different ages,with different dialysis times and from institutions of different scales were signifi-cantly different(all P＜0.05).TP infection rates among MHD patients of different ages and different numbers of dialysis hospitals were all significantly different(all P＜0.05).Infection rates of HBV and HCV in MHD patients aged from 36 to 60 years old(not included)were relatively higher(6.10％and 0.84％,respectively).Patients with dialysis time ≥10 years had a higher HCV infection rate(1.64％).Infection rates of HCV,HIV,and TP in pa-tients dialyzed in medical institutions with ≥90 dialysis beds were relatively higher(0.74％,0.28％,and 1.94％,respectively).Medical institutions with＜30 dialysis beds had the highest HBV infection rate(18.64％).There were 9 cases(0.06％)of vascular puncture infection,12 cases(0.08％)of bloodstream infection,7 cases(0.05％)of vascular access-related bloodstream infection,and 30 cases(0.20％)of pulmonary infection.Vascular access-re-lated bloodstream infection rate and pulmonary infection rate among MHD patients with different types of vascular access showed statistically significant difference(all P＜0.05).Vascular access-related bloodstream infection rate(0.37％)and pulmonary infection rate(1.10％)of patients with non-cuffed catheters vascular access were higher than those of other types.Conclusion MHD patients in Guizhou Province are mainly middle-aged and young peo-ple,with more males than females.The dialysis frequency is mostly 3 times per week,and AVF is the major vascu-lar access.MHD patients are prone to complications such as infections of HBV,HCV,HIV,and TP,as well as bloodstream infection and pulmonary infection.