Objective:To study the results of detection of pulmonary nodules among military flying personnel and analyze the contributors to pulmonary nodules so as to provide data for early prevention and interventions.Methods:The physical examination data of 1 465 military flying personnel was retrospectively analyzed who had received the annual health checkup and undergone chest CT examinations at Lintong Rehabilitation and Recuperation Center. They were grouped by age (<40 years and ≥40 years), flying hour (<1 000 h and ≥1 000 h) and type of personnel [pilots and air support (technical) personnel]. The detection rates of pulmonary nodules among flying personnel were compared across groups, and a multivariate Logistic regression analysis was conducted to analyze the contributing factors to pulmonary nodules.Results:Among the 1 465 military flying personnel, 212 cases (14.47%) with pulmonary nodules were detected. A total of 230 pulmonary nodules were detected, including 35 pulmonary nodules (15.22%) in the left upper lung, 42 pulmonary nodules (18.26%) in the left lower lung, 52 pulmonary nodules (22.61%) in the right upper lung, 47 pulmonary nodules (20.43%) in the right middle lung, and 54 pulmonary nodules (23.48%) in the right lower lung. The detection rate of pulmonary nodules among military flying personnel in the ≥1 000 h group was higher than in the <1 000 h group, and the difference was statistically significant ( χ2=4.14, P=0.042). More pulmonary nodules were detected among military flying personnel who smoked than among those who did not, and the difference was statistically significant ( χ2=9.34, P=0.002). Age, types of personnel, body mass index, and complications with other lung diseases made no significant difference in the detection rate of pulmonary nodules (all P>0.05). Multivariate Logistic regression analysis showed that smoking was a risk factor for pulmonary nodules ( OR=1.692, 95% CI: 1.217-2.351). Conclusions:Among military flying personnel, pulmonary nodules are more likely to occur in the right lung. Smoking is an independent risk factor for pulmonary nodules, suggesting that routine chest CT screening should be carried out during the annual physical examinations of military flying personnel in order to exercise early interventions.

Objective:To study the results of detection of pulmonary nodules among military flying personnel and analyze the contributors to pulmonary nodules so as to provide data for early prevention and interventions.Methods:The physical examination data of 1 465 military flying personnel was retrospectively analyzed who had received the annual health checkup and undergone chest CT examinations at Lintong Rehabilitation and Recuperation Center. They were grouped by age (<40 years and ≥40 years), flying hour (<1 000 h and ≥1 000 h) and type of personnel [pilots and air support (technical) personnel]. The detection rates of pulmonary nodules among flying personnel were compared across groups, and a multivariate Logistic regression analysis was conducted to analyze the contributing factors to pulmonary nodules.Results:Among the 1 465 military flying personnel, 212 cases (14.47%) with pulmonary nodules were detected. A total of 230 pulmonary nodules were detected, including 35 pulmonary nodules (15.22%) in the left upper lung, 42 pulmonary nodules (18.26%) in the left lower lung, 52 pulmonary nodules (22.61%) in the right upper lung, 47 pulmonary nodules (20.43%) in the right middle lung, and 54 pulmonary nodules (23.48%) in the right lower lung. The detection rate of pulmonary nodules among military flying personnel in the ≥1 000 h group was higher than in the <1 000 h group, and the difference was statistically significant ( χ2=4.14, P=0.042). More pulmonary nodules were detected among military flying personnel who smoked than among those who did not, and the difference was statistically significant ( χ2=9.34, P=0.002). Age, types of personnel, body mass index, and complications with other lung diseases made no significant difference in the detection rate of pulmonary nodules (all P>0.05). Multivariate Logistic regression analysis showed that smoking was a risk factor for pulmonary nodules ( OR=1.692, 95% CI: 1.217-2.351). Conclusions:Among military flying personnel, pulmonary nodules are more likely to occur in the right lung. Smoking is an independent risk factor for pulmonary nodules, suggesting that routine chest CT screening should be carried out during the annual physical examinations of military flying personnel in order to exercise early interventions.

Objective To observe the effect of wrist-hand orthosis combined with modified constraint-induced movement therapy(mCIMT)on upper limb and hand function in patients with stroke. Methods From February,2022 to December,2023,32 patients after stroke in Huashan Hospital,Fudan University were randomly assigned to control group(n=16)and experimental group(n=16).Both groups underwent routine re-habilitation,and wore constraint glove almost four hours a day.The experimenal group wore dynamic wrist-hand orthosis four hours everyday,additionally;five days every week,for three weeks.They were evaluated with Wolf Motor Function Test(WMFT),Action Reach Arm Test(ARAT),the strength of gripping,Amount of Use(AOU)and Quality of Movement(QOM)of Motor Activity Log(MAL),Hamilton Anxiety Scale(HAMA)and Hamil-ton Depression Scale(HAMD)before and after treatment,while root mean square ratio of affected/healthy exten-sor muscle of wrist was measured with surface electromyography Results After treatment,the scores of WMFT,ARAT,MAL-QOM,HAMA and the root mean square ratio of affected/healthy extensor muscle of wrist improved in both groups(|t|＞2.179,P＜0.05),and the improvement of WMFT score and the strength of gripping was greater in the experimental group than in the control group(|t|＞2.343,P＜0.05);the strength of gripping,the scores of MAL-AOU and HAMD improved in the experimental group(|t|＞2.819,P＜0.05). Conclusion mCIMT assisted with dynamic wrist-hand orthosis could improve upper limb and hand function in stroke pa-tients.

Objective To investigate the gray matter volume(GMV)changes and molecular basis underlying antipsychotic-induced weight gain(AIWG).Methods One hundred twenty-nine first-episode schizophrenia patients from October 2019 to December 2021 were enrolled in this study.Patients with≥7%weight gain(weight gain,WG)and patients with<3%weight changes(weight stable,WS)were studied.All patients underwent T1-weighted MRI scanning at baseline and after 8 week treatment.Transcriptome-neuroimaging correlations were used to investigate brain gene profiles from the Allen Human Brain Atlas and GMV changes induced by AIWG.Results Thirty-three patients with WG and 27 with WS completed the GMV measures.Compared with baseline,the WG group showed reduced GMV in right hippocampus,left basal ganglia,and right inferior parietal lobule,etc.and increased GMV in bilateral thalamus(P<0.05).The WS group showed reduced GMV in bilateral orbital gyrus,bilateral inferior frontal gyrus and bilateral hippocampus(P<0.05).These GMV changes in WG group were spatially correlated with expression levels of 354 genes,which were exclusively enriched in Cushing syndrome,neuroinflammation and glutamatergic signaling,and Pnoc+.Conclusion The study has demonstrated increased GMV in thalamus in schizophrenia patients with AIWG which may be associated with Cushing syndrome and Pnoc+.These findings may provide important insights into the molecular mechanisms of AIWG.

Objective:To preliminarily compare the effectiveness of different end-effectors on upper limb motor function im-provement in chronic stroke patients undergoing motor imagery-based brain-computer interface(BCI) rehabilitation. Method:Thirty-two chronic stroke patients who received motor imagery-based BCI rehabilitation were includ-ed. Based on the BCI training received,patients were divided into two groups:BCI combined with virtual re-ality feedback and BCI combined with wrist joint robot feedback. Assessment of upper limb motor function (upper limb Fugl-Meyer assessment),active range of motion of the paralyzed wrist,surface electromyography reflecting active contraction of wrist extensor muscles,and motor-evoked potentials (MEP) were conducted be-fore and after intervention. Thus,to compare the impact of virtual reality feedback and wrist joint robot feed-back on upper limb motor function recovery in chronic stroke patients.Result:Prior to intervention,baseline results were comparable between the two groups(P=0.160). After inter-vention,significant improvements in upper limb motor function were observed in both groups (P<0.001). The wrist joint robot feedback group showed a trend significant improvement in Fugl-Meyer scores and the changes in Fugl-Meyer scores compared to the virtual reality feedback group (P=0.06). Regarding active range of mo-tion of the paralyzed wrist,both groups initially lacked active flexion-extension movements,and after interven-tion,the improvement was 33.13°±24.96° in the wrist joint robot group and 27.81°±37.17° in the virtual reali-ty group,with no significant difference between the two groups (P>0.638). In the assessment of surface elec-tromyography for wrist extensor muscle group on the paralyzed side,both groups showed significant improve-ment in average amplitude and area under the curve after intervention (P<0.001),with the wrist joint robot group demonstrating a more significant improvement in average amplitude(P<0.001),while area under curve showed a trend of improvement. In the MEP evaluation,the elicitation rate after intervention was 56.25％ in the wrist joint robot group and 18.75％ in the virtual reality group. Conclusion:Motor imagery-based BCI rehabilitation systems effectively improve upper limb motor function in chronic stroke patients. Wrist joint robot feedback appears to be more significant in improvement compared to virtual reality feedback. Integrating sensory and motor information might better affect upper limb motor recov-ery. These might help to optimize the feedback strategy of BCI training.

Objective:To preliminarily compare the effectiveness of different end-effectors on upper limb motor function im-provement in chronic stroke patients undergoing motor imagery-based brain-computer interface(BCI) rehabilitation. Method:Thirty-two chronic stroke patients who received motor imagery-based BCI rehabilitation were includ-ed. Based on the BCI training received,patients were divided into two groups:BCI combined with virtual re-ality feedback and BCI combined with wrist joint robot feedback. Assessment of upper limb motor function (upper limb Fugl-Meyer assessment),active range of motion of the paralyzed wrist,surface electromyography reflecting active contraction of wrist extensor muscles,and motor-evoked potentials (MEP) were conducted be-fore and after intervention. Thus,to compare the impact of virtual reality feedback and wrist joint robot feed-back on upper limb motor function recovery in chronic stroke patients.Result:Prior to intervention,baseline results were comparable between the two groups(P=0.160). After inter-vention,significant improvements in upper limb motor function were observed in both groups (P<0.001). The wrist joint robot feedback group showed a trend significant improvement in Fugl-Meyer scores and the changes in Fugl-Meyer scores compared to the virtual reality feedback group (P=0.06). Regarding active range of mo-tion of the paralyzed wrist,both groups initially lacked active flexion-extension movements,and after interven-tion,the improvement was 33.13°±24.96° in the wrist joint robot group and 27.81°±37.17° in the virtual reali-ty group,with no significant difference between the two groups (P>0.638). In the assessment of surface elec-tromyography for wrist extensor muscle group on the paralyzed side,both groups showed significant improve-ment in average amplitude and area under the curve after intervention (P<0.001),with the wrist joint robot group demonstrating a more significant improvement in average amplitude(P<0.001),while area under curve showed a trend of improvement. In the MEP evaluation,the elicitation rate after intervention was 56.25％ in the wrist joint robot group and 18.75％ in the virtual reality group. Conclusion:Motor imagery-based BCI rehabilitation systems effectively improve upper limb motor function in chronic stroke patients. Wrist joint robot feedback appears to be more significant in improvement compared to virtual reality feedback. Integrating sensory and motor information might better affect upper limb motor recov-ery. These might help to optimize the feedback strategy of BCI training.

Background:The musk glands of adult male Chinese forest musk deer(Moschus berezovskii Flerov,1929)(FMD),which are considered as special skin glands,secrete a mixture of sebum,lipids,and proteins into the musk pod.Together,these components form musk,which plays an important role in attracting females during the breeding season.However,the relationship between the musk glands and skin of Chinese FMD remains undiscovered.Here,the musk gland and skin of Chinese FMD were examined using histological analysis and RNA sequencing(RNA-seq),and the expression of key regulatory genes was evaluated to determine whether the musk gland is derived from the skin.Methods:A comparative analysis of musk gland anatomy between juvenile and adult Chinese FMD was conducted.Then,based on the anatomical structure of the musk gland,skin tissues from the abdomen and back as well as musk gland tissues were obtained from three juvenile FMD.These tissues were used for RNA-seq,hematoxylin-eosin(HE)staining,immunohistochemistry(IHC),western blot(WB),and quantitative real-time polymerase chain reaction(qRT-PCR)experiments.Results:Anatomical analysis showed that only adult male FMD had a complete glandular organ and musk pod,while juvenile FMD did not have any well-developed musk pods.Transcriptomic data revealed that 88.24%of genes were co-expressed in the skin and musk gland tissues.Kyoto Encyclopedia of Genes and Genomes(KEGG)signaling pathway analysis found that the genes co-expressed in the abdomen skin,back skin,and musk gland were enriched in biological development,endocrine system,lipid metabolism,and other pathways.Gene Ontology(GO)enrichment analysis indicated that the genes expressed in these tissues were enriched in biological processes such as multicellular development and cell division.Moreover,the Metascape predictive analysis tool demonstrated that genes expressed in musk glands were skin tissue-specific.qRT-PCR and WB revealed that sex-determining region Y-box protein 9(Sox9),Caveolin-1(Cav-1),and androgen receptor(AR)were expressed in all three tissues,although the expression levels differed among the tissues.According to the IHC results,Sox9 and AR were expressed in the nuclei of sebaceous gland,hair follicle,and musk gland cells,whereas Cav-1 was expressed in the cell membrane.Conclusions:The musk gland of Chinese FMD may be a derivative of skin tissue,and Sox9,Cav-1,and AR may play significant roles in musk gland development.

Objective:To survey the teaching ability of general practitioners(GPs) in community health centers of Shanghai, and its influencing factors.Methods:A questionnaire survey on the teaching ability of general practice trainers was conducted from January to February 2017. The participants of the survey were GPs with teaching experiences from community health centers in Shanghai selected by a stratified and proportional cluster sampling method. The questionnaire included two aspects: the general information and teaching ability of the participants. The influencing factors of teaching ability were analyzed by univariate and multivariate regression analysis.Results:A total of 1 138 GPs from 116 selected community health centers participated in the questionnaire survey, among whom 63.6% (724/1 138) worked in community teaching bases and 78.5% (893/1 138) had received training for trainers. The total score of teaching ability was 38.00 (30.00, 40.00). The score of the item"interesting in teaching"was (3.46±0.80), 75%—80% of the other questions answered "yes". The score of"application of multi-teaching methods"was (3.78±0.72). Multivariate analyses showed that working for 5—9 and 10—19 years [ OR=7.14 (2.47—11.81), P=0.003; OR=5.32 (1.30—9.33), P=0.009], working in community teaching bases [ OR=13.23 (9.88—16.57), P<0.001] and receiving training for trainers [ OR=17.76 (13.80—21.71), P<0.001] were influencing factors of teaching ability. Conclusion:The main problems related to teaching ability in community GPs are lack of teaching interest and the poor application of multi-teaching methods, the relevant training is necessary for them in the future.

Studies of cellular dynamic processes have shown that cells undergo state changes during dynamic processes, controlled mainly by the expression of genes within the cell. With the development of high-throughput sequencing technologies, the availability of large amounts of gene expression data enables the acquisition of true gene expression information of cells at the single-cell level. However, most existing research methods require the use of information beyond gene expression, thus introducing additional complexity and uncertainty. In addition, the prevalence of dropout events hampers the study of cellular dynamics. To this end, we propose an approach named gene interaction network entropy (GINE) to quantify the state of cell differentiation as a means of studying cellular dynamics. Specifically, by constructing a cell-specific network based on the association between genes through the stability of the network, and defining the GINE, the unstable gene expression data is converted into a relatively stable GINE. This method has no additional complexity or uncertainty, and at the same time circumvents the effects of dropout events to a certain extent, allowing for a more reliable characterization of biological processes such as cell fate. This method was applied to study two single-cell RNA-seq datasets, head and neck squamous cell carcinoma and chronic myeloid leukaemia. The GINE method not only effectively distinguishes malignant cells from benign cells and differentiates between different periods of differentiation, but also effectively reflects the disease efficacy process, demonstrating the potential of using GINE to study cellular dynamics. The method aims to explore the dynamic information at the level of single cell disorganization and thus to study the dynamics of biological system processes. The results of this study may provide scientific recommendations for research on cell differentiation, tracking cancer development, and the process of disease response to drugs.
Cell Differentiation/genetics* ; Entropy ; Gene Regulatory Networks ; High-Throughput Nucleotide Sequencing ; Single-Cell Analysis/methods*

Objective: To explore and analyze the possible mechanism of liver injury in patients with coronavirus disease 2019 (novel coronavirus pneumonia, NCP). Methods: The correlation between ALT, AST and other liver enzyme changes condition and NCP patients’ disease status reported in the literature was comprehensively analyzed. ACE2 expression in liver tissue for novel coronavirus was analyzed based on single cell sequencing (GSE115469) data. RNA-Seq method was used to analyze Ace2 expression and transcription factors related to its expression in liver tissues at various time-points after hepatectomy in mouse model of acute liver injury with partial hepatectomy. t-test or Spearman rank correlation analysis was used for statistical analysis. Results: ALT and AST were abnormally elevated in some patients with novel coronavirus infection, and the rate and extent of ALT and AST elevation in severe NCP patients were higher than those in non-severe patients. Liver tissue results of single cell sequencing and immunohistochemistry showed that ACE2 was only expressed in bile duct epithelial cells of normal liver tissues, and very low in hepatocytes. In a mouse model of acute liver injury with partial hepatectomy, Ace2 expression was down-regulated on the first day, but it was elevated up to twice of the normal level on the third day, and returned to normal level on seventh day when the liver recovered and hepatocyte proliferation stopped. Whether this phenomenon suggests that the bile duct epithelial cells with positive expression of Ace2 participate in the process of liver regeneration after partial hepatectomy deserves further study. In RNA-Seq data, 77 transcription factors were positively correlated with the expression of ACE2 (r > 0.2, FDR < 0.05), which were mainly enriched in the development, differentiation, morphogenesis and cell proliferation of glandular epithelial cells. Conclusion We assumed that in addition to the over activated inflammatory response in patients with NCP, the up-regulation of ACE2 expression in liver tissue caused by compensatory proliferation of hepatocytes derived from bile duct epithelial cells may also be the possible mechanism of liver tissue injury caused by 2019 novel coronavirus infection.