In this study, araucarene diterpenes, characterized by a pimarene skeleton with a variably oxidized side chain at C-13, were investigated. A total of 16 araucarene diterpenoids and their derivatives were isolated from the woods of Agathis dammara, including 11 previously unreported compounds: dammaradione (1), dammarones D-G (2, 5, 14, 15), dammaric acids B-F (8-12), and dammarol (16). The structures of these new compounds were elucidated using high-resolution electrospray ionization mass spectroscopy (HR-ESI-MS) and one-dimensional/two-dimensional (1D/2D) nuclear magnetic resonance (NMR), while their absolute configurations were determined through the electronic circular dichroism (ECD) exciton chirality method and Snatzke's method. The hypoglycemic activity of all isolated compounds was evaluated using a transgenic zebrafish model, and a structure-activity relationship (SAR) analysis was conducted. Araucarone (3) and dammaric acid C (9), serving as representative compounds, demonstrated significant hypoglycemic effects on zebrafish. The primary mechanism involves the promotion of pancreatic β cell regeneration and glucose uptake. Specifically, these compounds enhance the differentiation of pancreatic endocrine precursor cells (PEP cells) into β cells in zebrafish.
Zebrafish ; Animals ; Diterpenes/isolation & purification* ; Insulin-Secreting Cells/cytology* ; Glucose/metabolism* ; Hypoglycemic Agents/isolation & purification* ; Molecular Structure ; Structure-Activity Relationship ; Plant Extracts/pharmacology* ; Regeneration/drug effects*

Objective: To preliminarily develop a multidimensional blood donor role scale based on role theory and systematically compare the psychosocial characteristic differences between award-winning donors and first-time donors in Guangzhou, and to provide an empirical reference for formulating differentiated donor retention strategies. Methods: A cross-sectional survey design was adopted. A random sample of award-winning donors and concurrently sampled first-time donors yielding 1 361 valid responses collected (721 from the award group, 640 from the first-time group). Exploratory factor analysis was used to assess the scale structure. Data were post-stratified and weighted according to the gender and age distributions of the general donor population. Independent samples t-tests, multivariate analysis of covariance (MANCOVA), and generalized linear models were employed to compare dimensional scores between the two groups. A paired t-test was conducted to analyze the annual donation frequency of award-winning donors before and after receiving the award. Results: Exploratory factor analysis yielded a 5-factor structure, including Role Identity and Expectations, Role Adaptation and Maintenance, Role Environment and Experience, Role Relationships and Conflict, and Role Incentives and Rewards, with a cumulative variance contribution rate of 56.43%. The scale demonstrated good internal consistency reliability (Cronbach's α=0.906). Known-group validity test showed that award-winning donors scored significantly higher than first-time donors on Role Identity and Expectations (t=4.366, P<0.001, d=0.240), Role Adaptation and Maintenance (t=5.436, P<0.001, d=0.500), and Role Relationships and Conflict (t=4.844, P<0.001, d=0.220). These differences remained significant after controlling for selected demographic variables (MANCOVA, Wilks' λ=0.943, P<0.001). Generalized linear models suggested that donation frequency was an independent predictor for these dimensions. Additionally, the annual donation frequency of award-winning donors was slightly higher after receiving the award than before (t=2.007, P=0.045). Conclusion: The preliminary blood donor role scale demonstrates acceptable reliability and validity and can effectively distinguish groups with different donation behavior characteristics. The study reveals that award-winning donors exhibit more positive psychological characteristics across multiple role identity dimensions and maintain their donation behavior after receiving an award. External incentives and internal role identity may jointly contribute to behavioral persistence. The findings provide a preliminary reference for further exploring the formation pathways of donor role identity and developing differentiated donor retention strategies.

Purpose To observe the clinical and pathological characteristics of indolent NK-cell lymphoprolifera-tive disorder(iNKLPD)of the gastrointestinal tract.Methods A retrospective analysis was conducted on the clinical pathological features,endoscopic findings,and immunophenotypes of 7 cases of iNKLPD.The study included in situ hybridization detection and literature review.Results The cohort comprised two males and five females,aged 28 to 54 years,with a median age of 40 years.The clinical manifestations varied,including acid reflux(two cases),nausea(three cases),stomach flatulence(five cases),and abdominal pain(one case).Lesions were observed at single sites in five cases and multiple sites in two cases.Involvement of the stomach,small intestine,and colon showed mucosal infiltration of small lymphocytes with abundant and clear cytoplasm,fine nuclear chromatin,and rare mitoses.Scat-tered eosinophils were observed in the background.Cases involving the gallbladder and bladder exhibited structural damage.The gallbladder lesion demonstrated cell with clear cytoplasm,condensed chromatin and prominent nucleoli.All cases were positive for CD3,CD56,CD7,TIA1 and Granzyme B,but negative for CD20,CD8 and CD5.Ki67 proliferation index from 10％to 50％.EBER in situ hybridization was negative in all cases.Follow-up periods ranged from 25 to 57 months(mean:38 months).All patients survived:four were asymptomatic,one had multiple-site in-volvement,and two experienced recurrence.Conclusion iNKLPD has an indolent clinical course and can involve multiple sites in the gastrointestinal tract and other organs.Differentiating it from invasive gastrointestinal lymphomas is critical to avoid misdiagnosis.

Purpose To compare the expression and pattern of EBNA2 in infectious mononucleosis(IM),EBV-positive diffuse large B-cell lymphoma(EBV+DLBCL),and EBV+DLBCL arising in immune deficiency/dysregulation(IDD-related EBV+DLBCL),and to investigate the potential diagnostic value of EBNA2 in IM and EBV-associated diffuse large B-cell lymphoma.Methods A retrospective study was conducted on 46 cases of IM,31 cases of EBV+DLBCL,and 16 cases of IDD(post-transplantation)-related EBV+DLBCL.Clinical information,immunohistochemis-try and EBER were reviewed to further confirm the diagnoses.All samples were stained for EBNA2.The expression ra-tio and intensity of EBER and EBNA2 in the same area were assessed.Results EBER was positive in all IM,EBV+DLBCL,and IDD(post-transplantation)-related EBV+DLBCL,while the positivity rate of EBNA2 was 95.65％,6.45％,and 100％,respectively.The positive intensity of EBNA2 was weak(71.73％),strong(87.5％)and nega-tive(93.54％)in IM,IDD(post-transplantation)-related EBV+DLBCL and EBV+DLBCL respectively.The average values of EBNA2/EBER were 31％,3％,and 78％among the three groups.The positivity rate and average value of EBNA2/EBER in IM were significantly higher than those in EBV+DLBCL(P＜0.001);however,the average value of EBNA2/EBER was significantly lower than that in IDD(post-transplantation)-related EBV+DLBCL(P＜0.001).The weak positive expression of EBNA2 in IM was significantly higher than that in EBV+DLBCL(P＜0.001),where-as strong positive expression of EBNA2 in IDD(post-transplantation)-related EBV+DLBCL was higher than that in IM(P＜0.001).Conclusion EBNA2 is often positive in IM and predominantly weakly positive,which is distinct from the pattern in EBV+DLBCL and IDD(post-transplantation)-related EBV+DLBCL.EBNA2 can serve as an effective marker for distinguishing them.

Objective:To understand the pathogenic composition and epidemiological characteristics of febrile respiratory syndrome (FRS) in elderly people aged 60 and above in China, and to provide a reference basis for the scientific and precise prevention and control of FRS in the elderly.Methods:Based on FRS cases surveillance data from information management system of National Technical Platform for Infectious Disease Surveillance, National Science and Technology Major Project of China, the surveillance pathogens included 8 viruses, including influenza virus (IFV), respiratory syncytial virus (RSV), adenovirus (HAdV), parainfluenza virus (HPIV), metapneumovirus (HMPV), coronavirus (HCoV), bocavirus and rhinovirus (HRV); 7 bacterias, namely Streptococcus pneumoniae ( S.pneumoniae), Staphylococcus aureus ( S.aureus), Klebsiella pneumoniae ( K.pneumoniae), Pseudomonas aeruginosa ( P.aeruginosa), Group A Streptococcus ( GAS), Haemophilus influenzae ( H.influenzae) and Legionella pneumophila ( L. pneumophila), in addition to Chlamydia pneumoniae ( C. pneumoniae) and Mycoplasma pneumoniae ( M. pneumoniae). A descriptive epidemiological approach was used to analyze the pathogenic composition and major epidemiological characteristics of FRS cases aged 60 years and older nationwide from 2009 to 2021. Results:The predominant viruses of FRS cases aged≥60 years accounted for 87.93% of the pathogen spectrum in China, including IFV (42.42%), HRV (16.71%), HPIV (11.53%), HCoV (9.52%), and RSV (7.75%), while the pathogen spectrum of the major bacteria accounted for 94.60%, including S. pneumoniae (25.71%), P. aeruginosa (24.97%), K. pneumoniae (22.47%), H. influenzae (12.23%), and S. aureus (9.22%). Influenza viruses have always been at the top of the viral pathogen spectrum, and P. aeruginosa, K. pneumoniae and S. pneumoniae, ranked high in the bacterial pathogen spectrum. Among them, the proportions of HRV, HPIV, RSV, K. pneumoniae, and H. influenzae fluctuated and increased during the 13 years of observation. The positive rate of any pathogen in FRS cases was higher in out patient emergencies (32.83%) than in hospitalized cases (27.26%) ( χ2 =125.89, P<0.001). The positive rate of IFV was higher in cases aged 60-74 years (13.66%). The positive rate of P. aeruginosa and K. pneumoniae were higher in cases aged ≥90 years (10.71%, 9.40%) and in northern regions (8.32%, 7.30%). The positive rate of any pathogen in FRS cases was higher in winter (33.82%) than in other seasons ( χ2=212.03, P<0.001). The positive rate of IFV and HRV were higher in winter (22.87%) and autumn (5.98%) and the positive rate of P.aeruginosa (8.11%) and K.pneumoniae (8.30%) were higher in summer. Conclusions:IFV, HRV, HPIV, S. pneumoniae, P. aeruginosa and K. pneumoniae were respectively the top three pathogens in the viral and bacterial pathogen spectrum of FRS cases aged 60 years and above in China from 2009 to 2021, and the positive rate of these main pathogens showed differences between age groups, seasons, and geographic regions. In the future, the dynamic surveillance of various pathogens in the elderly with respiratory tract infections should be continuously strengthened.

Antley-Bixler syndrome (ABS) is a rare developmental malformation, usually caused by mutations in the fibroblast growth factor 2 (FGFR2) or cytochrome P450 oxidoreductase (POR) genes. This article reports an 18-year-old male patient with both ulcerative colitis and ABS to explore the possible association between the two diseases, to raise clinicians' awareness, and to provide reference value for early diagnosis and treatment in the future.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.

Objective:To investigate the clinicopathological features, diagnosis and differential diagnosis of primary bladder lymphoma.Methods:A retrospective study was conducted on 23 cases of primary bladder lymphoma diagnosed at Beijing Friendship Hospital of Capital Medical University between February 2010 and April 2024. The clinicopathological data were collected and analyzed, and literature was reviewed.Results:Among the 23 cases, 7 were male and 16 were female, with a male-to-female ratio of 1.0∶2.5. The median age was 65 (58, 71) years, ranged 38-84 years. The main clinical manifestation was painless visible hematuria, followed by frequent urination, urgency, and lower abdominal discomfort. Only one case presented with fever, and all cases primarily presented as bladder masses or lesions. The histological types included 17 cases of extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (EMZL), 4 cases of diffuse large B-cell lymphoma (DLBCL), 1 case of ALK-negative anaplastic large cell lymphoma (ALCL), and 1 case of indolent NK-cell lymphoproliferative disease (INKLPD). EMZL exhibited relatively uniform morphology. Among them, 2 cases showed marked plasmacytic differentiation, 1 case had an increased number of large cells, 6 cases had residual germinal centers, and 2 cases presented with lymphoepithelial lesions. All cases demonstrated irregular FDC networks. DLBCL cells were larger in size; 3 cases showed diffuse infiltration, while 1 case had scattered, clustered distribution in a background of small lymphocytes,and with aberrant expression of GATA3. ALCL negative ALCL showed classic anaplastic morphology with "kidney-shaped" nuclei. INKLPD cells were of medium size and irregular in shape, with some cells containing eosinophilic granules in the cytoplasm. EBER in situ hybridization was negative.Conclusions:The primary histological types of bladder lymphoma are EMZL and DLBCL, with occasional cases of T-cell lymphoma and INKLPD. Clinical manifestations lack specificity and may overlap with inflammatory conditions or epithelial tumors. Both clinicians and pathologists should be aware of these rare diseases to facilitate accurate diagnosis and treatment.

Purpose To observe the clinical and pathological characteristics of indolent NK-cell lymphoprolifera-tive disorder(iNKLPD)of the gastrointestinal tract.Methods A retrospective analysis was conducted on the clinical pathological features,endoscopic findings,and immunophenotypes of 7 cases of iNKLPD.The study included in situ hybridization detection and literature review.Results The cohort comprised two males and five females,aged 28 to 54 years,with a median age of 40 years.The clinical manifestations varied,including acid reflux(two cases),nausea(three cases),stomach flatulence(five cases),and abdominal pain(one case).Lesions were observed at single sites in five cases and multiple sites in two cases.Involvement of the stomach,small intestine,and colon showed mucosal infiltration of small lymphocytes with abundant and clear cytoplasm,fine nuclear chromatin,and rare mitoses.Scat-tered eosinophils were observed in the background.Cases involving the gallbladder and bladder exhibited structural damage.The gallbladder lesion demonstrated cell with clear cytoplasm,condensed chromatin and prominent nucleoli.All cases were positive for CD3,CD56,CD7,TIA1 and Granzyme B,but negative for CD20,CD8 and CD5.Ki67 proliferation index from 10％to 50％.EBER in situ hybridization was negative in all cases.Follow-up periods ranged from 25 to 57 months(mean:38 months).All patients survived:four were asymptomatic,one had multiple-site in-volvement,and two experienced recurrence.Conclusion iNKLPD has an indolent clinical course and can involve multiple sites in the gastrointestinal tract and other organs.Differentiating it from invasive gastrointestinal lymphomas is critical to avoid misdiagnosis.