Objective: To assess the nutritional supply status of school meals for primary and secondary school students in Henan Province, so as to provide a basis for scientific guidance of school meals. Methods: During 2021-2023, 115 lunch and dinner samples were collected from 25 primary and secondary schools in Zhoukou, Anyang and Luoyang of Henan Province by a direct selection method, and 13 nutrients were determined for each sample. The nutrient supply was evaluated based on Nutrition Guidelines of School Meals and Reference Intake of Dietary Nutrients for Chinese Residents (2023 Edition). Mann-Whitney U test was used to compare the differences of nutritional supply between urban and rural schools. Results: The median values for energy (709.77 kcal,1 kcal=4.18 kJ), fat energy supply ratio (0.27) and carbohydrate energy supply ratio (0.55) in the 66 lunches and dinners from primary school were within the recommended range. The supply of protein (28.39 g) and sodium (1 464.59 mg) was excessive. The median values of zinc (2.62 mg) and dietary fiber (5.19 g) were lower than the reference values. No statistically significant differences were observed in the supply of 13 nutrients between urban and rural primary schools( U = 427.00 -633.00, P > 0.05 ). Among 49 samples from secondary schools, the median value of energy supply (930.02 kcal), carbohydrate energy ratio ( 0.54 ) and fat energy supply ratio(0.25) were within the recommended range; and the median values of protein (38.82 g) and sodium (2 556.80 mg) were higher than the standard; and the median values of calcium (250.32 mg) and vitamin B1 (0.16 mg) were lower than the standard. Additionally, the differences in the level of vitamin B2 ( U =372.00) and zinc ( U =375.00) between the urban and rural secondary schools were statistically significant ( P <0.05). Conclusion Nutrient supply of primary and secondary school meals in three cities of Henan Province is inadequate and imbalanced, and the recipe need to be further optimized and improved.

Objective　Exploring the role of Nestin in liver repair in mice infected with Echinococcus multilocularis. Methods The expression of Nestin in the liver of normal Nestin-cre/Rosa26-tdTomato transgenic mice at 1, 2 and 8 weeks of birth was detected by immunofluorescence method, and the transgenic mice model of Echinococcus multilocularis infection was established. HE was used to detect the pathological damage of Echinococcus multilocularis infected liver, and the expression of Nestin in the liver after Echinococcus multilocularis infection was detected by immunofluorescence. Transwell experiment detected the migration ability of Nestin positive cells stimulated by EmP. Immunofluorescence assay was used to detect the co localization of Nestin and ALB in the liver of transgenic mice infected with Echinococcus multilocularis, and immunohistochemistry was used to detect the expression of Ki67 in the liver of infected mice. Results A Nestin-cre/Rosa26-tdTomato transgenic mouse genotype was established. Immunofluorescence detection revealed that Nestin expression was highest in the liver of mice at 1 week of birth, and gradually decreased after 2 and 8 weeks (P<0.001); The Nestin content in the liver of mice infected with Echinococcus multilocularis gradually increased after 1, 3, and 5 months of infection, and the difference was statistically significant (P<0.001). Transwell experiments showed that EmP at a concentration of 5 μg/mL enhanced the migration ability of Nestin positive cells (P<0.001). Immunofluorescence detection revealed co localization of Nestin and ALB in the liver of mice infected with Echinococcus multilocularis. Immunohistochemistry showed that the expression level of Ki67 in the liver of infected mice gradually increased with infection time of 1, 3, and 5 months (P<0.001). Conclusion After infection with Echinococcus multilocularis, Nestin expression is enhanced in the liver, and Nestin-positive cells are recruited to participate in the process of liver injury repair.

Gastrointestinal (GI) cancers are a leading cause of cancer morbidity and mortality worldwide. Despite advances in treatment, cancer relapse remains a significant challenge, necessitating novel therapeutic strategies. In this study, we engineered nanobody-based chimeric antigen receptor (CAR) natural killer (NK) cells targeting cadherin 17 (CDH17) for the treatment of GI tumors. In addition, to enhance the efficacy of CAR-NK cells, we also incorporated CV1, a CD47-SIRPα axis inhibitor, to evaluate the anti-tumor effect of this combination. We found that CDH17-CAR-NK cells effectively eliminated GI cancers cells in a CDH17-dependent manner. CDH17-CAR-NK cells also exhibit potent in vivo anti-tumor effects in cancer cell-derived xenograft and patient-derived xenograft mouse models. Additionally, the anti-tumor activity of CDH17-CAR-NK cells is synergistically enhanced by CD47-signal regulatory protein α (SIRPα) axis inhibitor CV1, likely through augmented macrophages activation and an increase in M1-phenotype macrophages in the tumor microenvironment. Collectively, our findings suggest that CDH17-targeting CAR-NK cells are a promising strategy for GI cancers. The combination of CDH17-CAR-NK cells with CV1 emerges as a potential combinatorial approach to overcome the limitations of CAR-NK therapy. Further investigations are warranted to speed up the clinical translation of these findings.

Abstract Kidney stones are common and frequently occurring diseases in urology. In recent years, the incidence of urinary stones has increased year by year, affecting people′s quality of life and aggravating the social and economic burden. The occurrence and development of kidney stones are closely related to metabolic factors. This review mainly conducts a systematic overview of the research on the relationship between electrolyte metabolism abnormalities, dyslipidemias and other metabolic disorder diseases and kidney stones in recent years.By exploring the relationship between various metabolic disorder diseases and kidney stones, this review provides reference for exploring the occurrence and development of kidney stones from the perspective of metabolism.

Objective:To investigate the hepatoprotective effect of N-acetylcysteine(NAC)on rats with liver injury induced by cisplatin and its effect on intestinal flora and the expression of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and nuclear factor-kappa B(NF-κB).Methods:Male Sprague-Dawley rats were randomly divided into control group(CG),cisplatin group(CP),and NAC group.The rats in the NAC group were given NAC 15 mg/kg by gavage for 8 consecutive days.At half an hour after intragastric administration on the fifth day,all rats except those in the NC group were given intraperitoneal injection of 8 mg/kg cisplatin to induce acute liver injury.An automatic biochemical analyzer was used to measure the content of aspartate aminotransferase(AST),alanine aminotransferase(ALT),alkaline phosphatase(ALP),and total bilirubin(TBIL);liver index was calculated for the rats;Western blot was used to measure the relative expression levels of NF-κB,IL-6,and TNF-α in liver tissue;the 16S rDNA technique was used to measure and analyze the amplification information of the V3-V4 regions of each sample.Results:Compared with the NC group,the CP group had significant increases in the content of AST,ALT,ALP,and TBIL,while NAC reversed the abnormal liver function caused by cisplatin.Compared with the NC group,the CP group had a sig-nificant increase in liver index(P=0.000),while the NAC group had a significant reduction in liver index compared with the CP group(P=0.007).Compared with the NC group,the CP group had signifi-cant increases in the expression levels of IL-6,TNF-α,and NF-κB,while the NAC group showed reductions in the expression of these genes,with significant differences in the expression of IL-6 and TNF-α(P=0.006 and 0.000).Compared with the NC group,the CP group had a significant increase in the α-diversity index of intesti-nal flora,while compared with the CP group,the NAC group tended to have a reduction in the α-diversity index of intestinal flora.Com-pared with the CP group at the phylum level,the NAC group had an increase in the abundance of Actinobacteria and a reduction in the abundance of Firmicutes.Compared with the CP group at the genus level,the NAC group had a reduction in the abundance of Rumino-coccaceae and increases in the abundance of Bifidobacterium and Allobaculum.Conclusion:NAC can alleviate acute liver injury caused by cisplatin,possibly by downregulating the expression of IL-6,TNF-α,and NF-κB and regulating the abundance and diver-sity of intestinal flora.

Objective To determine the effect of thalamic nucleus reuniens(RE)on sleep spindles and neuronal activity in the medial prefrontal cortex(mPFC)during non-rapid eye movement(NREM)sleep.Methods Thirteen wild-type C57BL/6 male mice(8～12 weeks old,weighing 22～28 g)were randomly divided into an experimental group(n=7)and a control group(n=6).Optogenetic inhibition combined with multi-channel recording technology was used to specifically inhibit RE projections to mPFC during NREM sleep with yellow light for 20 s,in a 5-min interval between 2 times of light stimuli.The types and distribution of neurons were identified based on the waveform width and firing frequency of neurons.The changes in spindle activity in the mPFC following inhibition,as well as in firing of interneurons and pyramidal neurons were analyzed.Results Morphological data confirmed that neural fibers originating from the RE densely projected to the mPFC,primarily distributed in the deep layers.In the experimental group,light stimulation significantly affected the spindle activity in the mPFC when compared with the period before light stimulation,mainly manifested as a decrease in spindle rate,central frequency,and peak-to-peak amplitude(P<0.05).However,no impacts on spindle duration,number of cycles,symmetry,and power were observed.Meanwhile,there were no significant changes in the spindle activity of the control group.The proportion of interneurons in the mPFC area was 21.9%,while pyramidal neurons accounted for 78.1%.The firing rates of interneurons in the experimental group decreased significantly during light stimulation(P<0.05),whereas there was no significant change in the firing rates of pyramidal neurons.In addition,the firing activities of both interneurons and pyramidal neurons in the control group remained unaffected.Conclusion During NREM sleep,RE inputs may participate in the generation of sleep spindles network oscillations in the mPFC by activating interneurons.

Objective To explore the relationship between serum S100 calcium-binding protein(S100)A4,S100A12 and the infection type and prognosis of neonatal infectious pneumonia(NIP).Methods A total of 300 children with NIP admitted to the Neijiang Second People's Hospital from January 2021 to March 2024 were selected and divided into the bacterial infection group(214 cases)and the non-bacterial infection group(86 cases)according to the types of pathogenic bacteria.Another 150 healthy newborns in the same hospital during the same period were selected as the control group.The levels of serum S100A4 and S100A12 were de-tected by enzyme-linked immunosorbent assay.Pearson correlation analysis was conducted to examine the cor-relations between serum S100A4,S100A12 and procalcitonin(PCT),white blood cell count(WBC),albumin(Alb),and platelet count(PLT).The receiver operating characteristic(ROC)curve was used to evaluate the differential value of serum S100A4,S100A12,PCT,WBC,Alb,and PLT alone and in combination for NIP bac-terial infection.According to the prognosis,children with NIP were divided into the poor prognosis group(63 cases)and the good prognosis group(237 cases).Multivariate Logistic regression model was used to analyze the influencing factors of poor prognosis in children with NIP,and ROC curve was used to analyze the value of each factor in predicting poor prognosis in children with NIP.Results The levels of serum S100A4,S100A12,PCT,WBC,and PLT in the bacterial infection group were higher than those in the non-bacterial infection group and the control group,while Alb was lower than that in the non-bacterial infection group and the control group,the differences were statistically significant(P<0.05).Pearson correlation analysis showed that serum S100A4 and S100A12 in children with NIP were positively correlated with PCT,WBC and PLT(P<0.05),and negatively correlated with Alb(P<0.05).The results of ROC curve analysis showed that the area under the curve(AUC)of serum S100A4 and S100A12 in differentiating NIP infection types was slightly lower than that of PCT,WBC,Alb,and PLT in differentiating NIP infection types.The results of multivariate Logistic re-gression analysis showed that elevated S100A4,elevated S100A12,elevated PCT,bacterial infection,and lung consolidation were independent risk factors for poor prognosis in children with NIP(P<0.05).The AUC of bacterial infection,lung consolidation,PCT,S100A4,and S100A12 for predicting the poor prognosis of chil-dren with NIP was 0.903.It was greater than the AUC predicted separately by bacterial infection,lung consol-idation,PCT,S100A4,and S100A12 levels(Z=9.989,9.460,5.514,4.084,4.376,P<0.001).Conclusion The combination of serum S100A4 and S100A12 with traditional markers has certain discrimina-tory value for the infection types of NIP,and the levels of serum S100A4 and S100A12 are related to the prog-nosis of NIP.

Objective:To prepare decellularized extracellular matrix (dECM)-gelatin methacryloyl (GelMA) composite hydrogels and to study their effects on hepatocyte proliferation.Methods:Hepatic dECM was prepared by elution, and GelMA hydrogel and 10%, 30% and 50% dECM-GelMA composite hydrogels were prepared by pepsin solubilization. The morphology of normal liver and dECM liver was observed by eyes and scanning electron microscopy using hematoxylin-eosin, Sirius red and periodate-Schiff staining, respectively. The internal structure of the dECM-GelMA composite hydrogels was observed by scanning electron microscopy, and the pore diameter was measured. Liver HL-7702 cells were co-cultured with GelMA hydrogel and 10%, 30% and 50% dECM-GelMA composite hydrogels, and the cell proliferation viability was determined by cell counting kit-8. The expression of proliferating cell nuclear antigen (PCNA), Wnt family protein 5a (Wnt5a), β-catenin, extracellular-regulated protein kinase 1/2 (ERK1/2) and phosphorylated ERK1/2 (p-ERK1/2) were detected by Western blotting. Comparisons were made using independent sample t-test or one-factor analysis of variance. Results:After decellularization, the hepatocyte morphology showed rounded depressions, and the extracellular matrix structure was intact. The GelMA hydrogel and 10%, 30% and 50% dECM-GelMA composite hydrogels showed inernally porous structures. The pore diameter increased from (3.06±1.35) μm in the GelMA hydrogel to (16.01±4.02) μm in the 50% dECM-GelMA composite hydrogel. On the 3rd, 5th and 7th day, the relative cell proliferation was higher in the 50% dECM-GelMA composite hydrogel group than that in the GelMA hydrogel group (1.89±0.04 vs 1.53±0.01, 9.36±0.04 vs 3.89±0.09, 7.15±0.27 vs 4.89±0.15, all P<0.05). The relative expression levels of PCNA, Wnt5a, β-catenin, and p-ERK1/2/ERK1/2 proteins in the 50% dECM-GelMA composite hydrogel group were higher than those in the GelMA hydrogel group (2.14±0.04 vs 1.00±0.03, 2.36±0.09 vs 1.00±0.08, 1.45±0.03 vs 1.00±0.04, 1.43±0.04 vs 1.00±0.01, all P<0.05). Conclusions:A dECM-GelMA composite hydrogel can be prepared, which may promote hepatocyte proliferation by upregulating the phosphorylation of ERK1/2 and activating Wnt/β-catenin signaling pathway.

Objective:To analyze the related factors of membranous urethral length in patients with benign prostatic hyperplasia (BPH) and the early recovery of urinary control function after Holmium laser enucleation of the prostate (HoLEP).Methods:A retrospective study was conducted to analyze the case data of 124 patients with BPH admitted to the Yan′an University Affiliated Hospital from January 2017 to January 2023. According to the recovery of postoperative urinary control function, the patients were divided into the urinary control group ( n=81) and the urinary incontinence group ( n=43). The clinical data of the two groups of patients were collected, including age, body mass index, comorbidities, etc. The perioperative indicators [including prostate volume, prostatic specific antigen, membranous urethral length, international prostate symptom score (IPSS), maximum bladder capacity, degree of prostate protrusion into the bladder, etc.], the urodynamic indicators before the operation and 6 months after the operation (including maximum urine flow rate, maximum urethral pressure and bladder compliance) and the urinary control situation of the two groups of patients were observed. Measurement data were expressed as mean±standard deviation ( ± s), and the independent sample t-test was used for comparison between groups; count data were expressed as the cases and percentage, and Chi-square test was used for comparison between groups. Univariate and multivariate Logistic regression analysis were used to evaluate the influencing factors of early urinary control function recovery after HoLEP. Results:All patients successfully completed the surgery, and the follow-up was conducted 6 months after the operation as the time point. The results of univariate analysis showed that there were no statistically significant differences in age, body mass index, comorbidities, prostatic specific antigen, IPSS score and the degree of prostate protrusion into the bladder between the urinary control group and the urinary incontinence group ( P>0.05). The operation time, indwelling catheter time, prostate volume, preoperative membranous urethral length, postoperative membranous urethral length and the postoperative maximum bladder capacity of the two groups of patients all showed statistically significant differences ( P<0.05). Before the operation, there were no statistically significant differences in urodynamic indicators such as maximum urinary flow rate, maximum urethral pressure and bladder compliance between the two groups of patients ( P>0.05). Six months after the operation, the maximum urinary flow rate, the maximum urethral pressure and the bladder compliance in the two groups of patients increased compared with those before the operation. Moreover, the maximum urinary flow rate [(10.48±0.65) mL/s vs (9.41±0.53) mL/s], the maximum urethral pressure [(41.25±3.46) cmH 2O vs (38.21±3.16) cmH 2O], and bladder compliance [(32.23±3.13) cmH 2O vs (30.23±2.35) cmH 2O] were higher than those in the urinary incontinence group, and the differences were statistically significant ( P<0.05). The results of multivariate Logistic regression analysis showed that operation time ≥1 h, indwelling catheter time ≥5 d, prostate volume ≥60 mL, preoperative membranous urethral length <14 mm, and postoperative membranous urethral length <13 mm were independent risk factors for the recovery of early urinary control function after HoLEP ( OR>1, P<0.05), the maximum bladder capacity after surgery was an independent protective factor for the recovery of early postoperative urinary control function ( OR<1, P<0.05). Conclusions:Preoperative membranous urethral length <14 mm and postoperative membranous urethral length <13 mm are risk factors affecting the recovery of early urinary control function after HoLEP in patients with BPH. A longer membranous urethral length can reduce the risk of postoperative complications and accelerate the recovery of urinary control function in patients.

Objective To construct risk prediction models of death or readmission in patients with acute heart failure(AHF)during the vulnerable phase based on machine learning algorithms and screen the optimal model.Methods A total of 651 AHF patients with admitted to Department of Cardiology of the Second Affiliated Hospital of Army Medical University from October 2019 to July 2021 were included.The clinical data consisting of admission vital signs,comorbidities and laboratory results were collected from electronic medical records.The composite endpoint was defined as all-cause death or readmission for worsening heart failure within 3 months after discharge.The patients were divided into a training set(521 patients)and a test set(130 patients)in a ratio of 8:2 through the simple random sampling.Six machine learning models were developed,including logistic regression(LR),random forest(RF),decision tree(DT),light gradient boosting machine(LGBM),extreme gradient boosting(XGBoost)and neural networks(NN).Receiver operating characteristic(ROC)curve and decision curve analysis(DCA)were used to evaluate the predictive performance and clinical benefit of the models.Shapley additive explanation(SHAP)was used to explain and evaluate the effect of different clinical characteristics on the models.Results A total of 651 AHF patients were included,of whom 203 patients(31.2%)died or were readmitted during the vulnerable phase.ROC curve analysis showed that the AUC values of the LR,RF,DT,LGBM,XGBoost and NN model were 0.707,0.756,0.616,0.677,0.768 and 0.681,respectively.The XGBoost model had the highest AUC value.DCA showed that the XGBoost model exhibited greater clinical net benefit compared with other models,with the best predictive performance.SHAP algorithm analysis showed that the clinical features that had the greatest impact on the output of the model were serum uric acid,D-dimer,mean arterial pressure,B-type natriuretic peptide,left atrial diameter,body mass index,and New York Heart Association(NYHA)classification.Conclusion The XGBoost model has the best predictive performance in predicting the risk of death or readmission of AHF patients during the vulnerable phase.