Background/Aims: Non-pharmacological treatments are crucial for managing irritable bowel syndrome (IBS), yet patient engagement remains a challenge. Understanding patients' knowledge, attitudes, and practices regarding these treatments is essential for improving care. Methods: A cross-sectional study was conducted across 5 hospitals, from October 2023 to February 2024. A self-designed knowledge, attitudes, and practices questionnaire along with the IBS quality of life and IBS severity scoring system was administered, and 496 valid responses were analyzed. Statistical analyses included correlation tests, multivariate linear regression, and mediation effect analysis. Results: The median scores for knowledge, attitude, and practice were 28, 25.5, and 21, respectively. Significant positive correlations were found between knowledge-attitude (r = 0.195), knowledge-practice (r = 0.364), and attitude-practice (r = 0.151). The multivariate linear regression analysis further indicated that knowledge (β = 0.399, P < 0.001) and attitude (β = 0.219, P = 0.022) positively correlated with the practical performance. SEM revealed that knowledge had a significant direct effect on both attitude (β = 0.186, P = 0.013) and practice (β = 0.356, P = 0.006). However, the direct effect of attitude on practice was not significant, and attitude did not mediate the relationship between knowledge and practice. Conclusions IBS patients exhibit a significant gap between their positive attitudes and their actual practices concerning non-pharmacological treatments. Knowledge is a direct driver of practice, but positive attitudes alone are insufficient to translate into behavior. Healthcare providers must move beyond simply fostering positive attitudes and focus on targeted educational interventions that provide actionable knowledge and skills to improve patient outcomes.

OBJECTIVES: To analyze sex and age distribution of global disease burden of calcific aortic valve disease (CAVD) from 1990 to 2021. METHODS: CAVD data during 1990-2021 were obtained from the IHME website for Global Burden of Disease (GBD). The prevalence, mortality, years lived with disability (YLDs), and disability-adjusted life years (DALYs) were analyzed by gender and age groups. Joinpoint regression was used to calculate annual percentage change (APC) and average annual percentage change (AAPC). RESULTS: In 2021, there were 13.32 million CAVD patients and 142 000 deaths caused by CAVD globally. Age-standardized prevalence was higher in males (193.2/10⁵) than that in females (128.9/10⁵). Patients in 65-<85 age group accounted for 64.0% of total cases, while those ≥85 years old accounted for 16.1%. From 1990 to 2021, prevalence increased in both sexes with an AAPC of 0.72% for males and 0.57% for females, respectively. Prevalence grew fastest from 2000 to 2010, slowed thereafter, and declined from 2015 to 2021. In <65 years old, the mortality of males was 2.4 times higher than that of females, while in ≥85 years old, mortality of females (117.3/10⁵) exceeded that of males (99.1/10⁵). YLD rates increased with age, and were higher in males for all age groups. DALY rates decreased overall but increased in ≥85 years old, with a greater increase in females. CONCLUSIONS There are significant gender and age disparities in global disease burden of CAVD, with the elderly, especially super-elderly females deserving particular attention. It is recommended to develop personalized intervention strategies for these populations.
Humans ; Male ; Female ; Aged ; Calcinosis/mortality* ; Prevalence ; Global Burden of Disease ; Aged, 80 and over ; Middle Aged ; Aortic Valve/pathology* ; Aortic Valve Stenosis/epidemiology* ; Age Distribution ; Adult ; Disability-Adjusted Life Years ; Sex Distribution ; Global Health ; Aortic Valve Disease/epidemiology* ; Sex Factors

Amoenucles A-F (1-6), six previously undescribed nucleoside derivatives, and two known analogs (7 and 8) were isolated from the culture of Aspergillus amoenus TJ507. Their structures were elucidated through spectroscopic analysis, single-crystal X-ray crystallography, and chemical reactions. Notably, 3 and 4 represent the first reported instances of nucleosides with an attached pyrrole moiety. Of particular significance, the absolute configuration of the sugar moiety of 1-4 was determined using nuclear magnetic resonance (NMR), electric circular dichroism (ECD) calculations, and a hydrolysis reaction, presenting a potentially valuable method for confirming nucleoside structures. Furthermore, 1, 2, and 5-8 exhibited potential tumor necrosis factor α (TNF-α) inhibitory activities, which may provide a novel chemical template for the development of agents targeting autoimmune and inflammatory diseases.
Aspergillus/chemistry* ; Tumor Necrosis Factor-alpha/antagonists & inhibitors* ; Molecular Structure ; Nucleosides/isolation & purification* ; Crystallography, X-Ray ; Animals ; Humans ; Mice ; Magnetic Resonance Spectroscopy

Objective:To quantitatively detect plasma ceramide (Cer) levels using high-performance liquid chromatography tandem mass spectrometry (LC-MS/MS) and analyze plasma ceramide levels in homozygous familial hypercholesterolemia (HoFH) patients.Methods:A case-control study was conducted. Plasma samples were collected from 70 healthy individuals who underwent physical examinations at the Health Check-Up Center of Suzhou Municipal Hospital between October 2023 and December 2023, as well as from 34 HoFH patients (including 11 patients with concomitant coronary artery disease) who were treated in the Cardiology Department of the same hospital during the same period. Deuterated isotopes were used as internal standards, and a Phenomenex Kinetex C18 column (2.1×100 mm, 2.6 μm) was employed for separation. An LC-MS/MS method was developed using an AB Sciex 6500+triple quadrupole mass spectrometer for the detection of ceramides, followed by method validation. Additionally, the differences in ceramide levels among healthy individuals, HoFH patients, and HoFH patients with concomitant coronary artery disease were compared. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic value of various ceramides for HoFH.Results:A method for the quantification of 9 plasma ceramides was established, showing excellent linearity ( r>0.99), precision (1.8%-11.0%), and recovery rates (89.9%-114.7%), meeting the requirements for detection. Compared to the control group, the HoFH group exhibited significantly higher levels of Cer(d18∶1/14∶0), Cer(d18∶1/16∶0), Cer (d18∶1/18∶0), Cer (d18∶1/18∶1), Cer (d18∶1/20∶0), Cer(d18∶1/22∶0), Cer(d18∶1/24∶0), and Cer(d18∶1/24∶1) ( P<0.05). ROC curve analysis revealed that Cer(d18∶1/18∶0) had the highest diagnostic value for HoFH, with an area under the curve (AUC) of 0.83, a cutoff value of 64.6 ng/ml, and sensitivity and specificity of 82.4% and 87.1%, respectively. In HoFH patients complicated with coronary artery disease, the plasma ceramide levels of Cer(d18∶1/18∶0) [(155.7±25.1) ng/ml vs (103.0±11.1) ng/ml, P=0.03] and the ratio of Cer (d18∶1/18∶0) to Cer(d18∶1/24∶0) (0.077±0.012 vs 0.048±0.006, P=0.03) were significantly higher than in HoFH patients without coronary artery disease. Conclusion:A quantitative LC-MS/MS method was developed for detecting ceramides in human plasma, which shows potential diagnostic value for patients with HoFH.

Pulpitis is a prevalent inflammatory disease in dentistry, and root canal therapy remains the primary clinical treatment for it. However, pulp removal leads to reduced tooth fracture resistance and complications such as secondary infection and tooth fracture. As a potential alternative, vital pulp therapy (VPT) relies on precise assessment of pulp status; yet current clinical diagnostic methods lack specificity. The establishment of appropriate animal models for pulpitis is crucial for investigating its pathogenesis, developing specific diagnostic biomarkers, and optimizing VPT strategies. This review systematically summarizes experimental animals selection based on anatomical compatibility and pathological similarity, as well as model construction methods and multimodal evaluation systems for pulpitis animal models, aiming to provide insights for related researches.

OBJECTIVE: To analyze the acupoint selection patterns and core prescriptions of acupuncture for polycystic ovary syndrome (PCOS) using data mining, and to explore the molecular mechanisms of core acupoints through network acupuncture medicine. METHODS: The randomized controlled trials (RCTs) on acupuncture for PCOS published from January 1, 2004 to July 21, 2024 were retrieved from CNKI, VIP, Wanfang, PubMed, and Web of Science databases. R software (version 4.4.0) was used for acupoint frequency and association rule analysis to identify core acupoint prescriptions. Potential targets were predicted via the STITCH and Swiss Target Prediction databases, and a "core prescription-active compounds-targets- PCOS" network was constructed. Cytoscape 3.7.1 was applied to build protein-protein interaction (PPI) networks of potential targets of core acupoint prescriptions. Key therapeutic targets were subjected to gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) enrichment analyses using the DAVID and Microbioinformatics platforms. RESULTS: A total of 176 RCTs were included, covering 208 prescriptions and 89 acupoints. The five most frequently used acupoints were Guanyuan (CV4), Sanyinjiao (SP6), Zigong (EX-CA1), Zusanli (ST36) and Zhongji (CV3). Association rule analysis yielded 13 core acupoint combinations, with Guanyuan (CV4), Sanyinjiao (SP6), Zigong (EX-CA1) and Zusanli (ST36) as the core prescription. Twenty-seven active compounds were involved, with 852 potential therapeutic targets, among which 208 targets overlapped with PCOS-related targets. Network acupuncture medicine analysis suggested that the core prescription may act through targets such as estrogen receptor 1 (ESR1), proto-oncogene tyrosine-protein kinase Src (SRC), signal transducer and activator of transcription 3 (STAT3), peroxisome proliferator-activated receptor gamma (PPARG), and RAC-alpha serine/threonine-protein kinase (AKT1). GO and KEGG analyses indicated that the main pathways included the hypoxia-inducible factor 1 (HIF-1) signaling pathway, phosphatidylinositol 3-kinase-protein kinase B (PI3K-AKT) signaling pathway, and advanced glycation end products-receptor for advanced glycation end products (AGE-RAGE) signaling pathway, involving processes such as signal transduction, receptor complex formation, and cytokine activity. CONCLUSION The core acupoint prescription for PCOS might exert therapeutic effects through multiple targets and pathways, providing a theoretical basis for mechanistic research on acupoint prescriptions.
Humans ; Acupuncture Therapy ; Data Mining ; Acupuncture Points ; Polycystic Ovary Syndrome/metabolism* ; Female ; Protein Interaction Maps ; Randomized Controlled Trials as Topic

The incidence of cardiovascular diseases (CVD) together with their associated risk factors increasingly impact public health. According to the data provided in the 2024 Annual Report on Cardiovascular Health and Diseases in China, the crude incidence of cardiovascular and cerebrovascular diseases among Chinese residents aged ≥18 years, including acute myocardial infarction (AMI), angina pectoris treated by percutaneous transluminal coronary angioplasty/stent implantation and/or coronary artery bypass grafting, stroke, and sudden cardiac death was 620.33 per 100,000 population, with 87.6 for AMI. Stroke had an incidence of 491.0 per 100,000 population. The prevalence of adult coronary heart disease (CHD, aged ≥18 years) was 758 per 100,000 population. The CVD mortality in 2021 remained the highest, exceeding that of cancer and other causes. The crude mortality rate of CVD in 2021 was 364.16 per 100,000 population in rural areas and 305.39 per 100,000 population in urban areas. The crude mortality rates of cerebrovascular diseases and CHD among urban and rural residents in 2021 were 140.02 and 175.58, 135.08 and 148.19 per 100,000 population, respectively. In addition to interpreting the key findings of CVD incidence and mortality in China, we also update the data of associated risk factors, including tobacco use, physical activity, diet and nutrition, overweight and obesity, hypertension, dyslipidemia, diabetes, chronic kidney disease, sleep and psychological factors, environmental factors, and the diagnostic conditions of CVD diseases, aiming to provide a scientific foundation for advancing CVD prevention and control, and to inform relevant public health policy development.
Humans ; China/epidemiology* ; Cardiovascular Diseases/mortality* ; Risk Factors ; Adult ; Male ; Female ; Middle Aged ; Incidence ; Cerebrovascular Disorders/epidemiology* ; Aged

This review described the potential health threats to the cardiovascular system from micro-nano plastics (MNPs) and their multifaceted toxicity mechanisms. The article reviewed the environmental distribution of MNPs, exposure pathways, and their toxic effects on the cardiovascular system, and summarized the specific mechanisms of MNPs involving oxidative stress, inflammatory response, mitochondrial damage, apoptosis, pyroptosis, and autophagy dysregulation. Meanwhile, the combined toxic effects of MNPs with other environmental pollutants (e.g., heavy metals and polycyclic aromatic hydrocarbons), including synergistic, antagonistic, and dual effects, were analyzed, and the potential risks of MNPs as carriers of microorganisms and toxic chemicals were pointed out. The widespread presence of MNPs and their complex toxicity mechanisms may make them important triggers for cardiovascular diseases, but current research still suffers from unbalanced studies across environmental systems, incomplete understanding of plastic properties, and limited knowledge of long-term biological effects. Future research should focus on the long-term effects of MNPs, the joint toxicity mechanisms with other pollutants, and the differential effects across population subgroups. It is suggested to accelerate plastic recycling technology innovation, promote biodegradable materials, and optimize waste treatment process to mitigate the potential threat of MNPs pollution to human health. Through multidisciplinary collaboration and in-depth research, combining innovative concepts from toxicology, public health policy, and environmental science, it is expected to provide new methods and approaches for the prevention and treatment of cardiovascular diseases associated with MNPs.

Objective To establish a reliable prediction model for radiation pneumonitis(RP)based on multi-regional radiomics analysis of localizable CT images.Methods A retrospective analysis was conducted on 185 patients who received radiotherapy from January 2021 to June 2023 in the Department of Radiotherapy,Xuzhou Cancer Hospital.Patients were classified as having RP or not based on imaging combined with clinical diagnosis.Three regions of interest(ROI)were defined in the localizable CT images:Lung,Lung-PTV and PTV,and their radiomics features were extracted.After feature screening using methods such as Mann-Whitney Utest,recursive feature elimination,and Lasso,a prediction model was established using support vector machine classification algorithm.The model performance was validated using 6 evaluation metrics:the area under the receiver operating characteristic curve(AUC),accuracy,specificity,sensitivity,positive predictive value,and negative predictive value.Results The prediction model consisted of 7 radiomics features.The clinical model of target-to-lung ratio,PTV model,Lung model,and Lung-PTV model achieved AUC values of 0.535,0.801,0.672,and 0.706 in the test set,respectively.The AUC value and accuracy of PTV model reached 0.843 and 0.775 in the training set,while 0.801 and 0.750 in the test set.PTV model was superior to Lung model,Lung-PTV model,and clinical model in predictive performance.The AUC values of the combined PTV+(Lung-PTV)model in the training and test sets were 0.867 and 0.806,respectively,higher than those of PTV model and Lung-PTV model.Conclusion The predictive ability of the prediction models constructed from radiomics features in different ROI for symptomatic RP varies.The radiomics prediction model using PTV as ROI exhibits superior predictive performance,and the combined multi-regional radiomics model can further improve the predictive ability for RP.

The radiation-free and unmarked body surface monitoring technology is developed for reducing the additional radiation dose generated by positioning error verification during radiotherapy positioning,and further reducing the positioning error and monitoring the displacement deviation of patients during radiotherapy in real time.At present,the widely used optical surface guided radiotherapy technology is also a type of radiotherapy guided by body surface monitoring.The system mainly uses optical imaging equipment as a tool to complete body surface scanning,three-dimensional reconstruction,real-time monitoring,etc.,thereby assisting doctors to carry out radiotherapy more accurately.Herein the study elaborates on the methods,technologies and research results of guided radiotherapy from the aspects of body surface markers,three-dimensional surface imaging systems and mobile devices,and provides prospects for future researches.