ObjectiveTo clarify whether METTL14 mediates the core role of acupuncture at Neiguan (PC6) in promoting myelination and improving behavior in young autistic rats through gene intervention technology. MethodsThe ASD model was established by intraperitoneal injection of valproic acid (VPA) in pregnant rats. Male offspring were intracerebroventricularly injected with adenovirus-packaged METTL14 shRNA (sh-METTL14) or its control (sh-NC) on postnatal day 1, with a model group set as well. Subsequently, the juvenile rats were divided into model group, acupuncture group, acupuncture+sh-NC group, and acupuncture+sh-METTL14 group. The acupuncture group received acupuncture at Neiguan (PC6) from postnatal day 7, once daily for 21 consecutive days. Neurobehavioral changes were evaluated by behavioral tests; METTL14 knockdown efficiency and the expression of METTL14, METTL3, and PTEN were detected by quantitative real-time PCR (qRT-PCR) and Western blot (WB); PTEN m⁶A levels were measured by RNA immunoprecipitation-qPCR (RIP-qPCR); myelin ultrastructure, expression of myelin basic protein (MBP) and neurofascin 155 (NF155), and dendritic spine density were observed using transmission electron microscopy (TEM), enzyme-linked immunosorbent assay (ELISA), immunofluorescence, qRT-PCR, and primary neuron culture. ResultsBehaviorally, knockdown of METTL14 significantly counteracted the beneficial effects of acupuncture in improving self-grooming, open field exploration, three-chamber social interaction, and Morris water maze learning and memory (P<0.05, P<0.01). Compared with the acupuncture+sh-NC group, the acupuncture+sh-METTL14 group showed significantly decreased mRNA and protein expression of hippocampal METTL14 (P<0.01), and the upregulating effects of acupuncture on METTL3 and PTEN expression were reversed (P<0.01). Meanwhile, knockdown of METTL14 significantly inhibited the acupuncture-induced increase in PTEN m⁶A levels (P<0.01). Morphologically, knockdown of METTL14 attenuated the improvement of myelin structure by acupuncture, reversed the downregulation of MBP and upregulation of NF155 induced by acupuncture, and blocked the increase in dendritic spine density (P<0.05, P<0.01). ConclusionMETTL14 is a key molecule mediating the therapeutic effect of acupuncture at Neiguan. Acupuncture at Neiguan upregulates METTL14, thereby enhancing m⁶A methylation modification of PTEN mRNA to stabilize its expression, ultimately promoting myelin development and improving behavioral symptoms in ASD juvenile rats. This preliminarily reveals the modern biological connotation of “opening Xuanfu and dredging myelin”.

ObjectiveTo clarify whether METTL14 mediates the core role of acupuncture at Neiguan (PC6) in promoting myelination and improving behavior in young autistic rats through gene intervention technology. MethodsThe ASD model was established by intraperitoneal injection of valproic acid (VPA) in pregnant rats. Male offspring were intracerebroventricularly injected with adenovirus-packaged METTL14 shRNA (sh-METTL14) or its control (sh-NC) on postnatal day 1, with a model group set as well. Subsequently, the juvenile rats were divided into model group, acupuncture group, acupuncture+sh-NC group, and acupuncture+sh-METTL14 group. The acupuncture group received acupuncture at Neiguan (PC6) from postnatal day 7, once daily for 21 consecutive days. Neurobehavioral changes were evaluated by behavioral tests; METTL14 knockdown efficiency and the expression of METTL14, METTL3, and PTEN were detected by quantitative real-time PCR (qRT-PCR) and Western blot (WB); PTEN m⁶A levels were measured by RNA immunoprecipitation-qPCR (RIP-qPCR); myelin ultrastructure, expression of myelin basic protein (MBP) and neurofascin 155 (NF155), and dendritic spine density were observed using transmission electron microscopy (TEM), enzyme-linked immunosorbent assay (ELISA), immunofluorescence, qRT-PCR, and primary neuron culture. ResultsBehaviorally, knockdown of METTL14 significantly counteracted the beneficial effects of acupuncture in improving self-grooming, open field exploration, three-chamber social interaction, and Morris water maze learning and memory (P<0.05, P<0.01). Compared with the acupuncture+sh-NC group, the acupuncture+sh-METTL14 group showed significantly decreased mRNA and protein expression of hippocampal METTL14 (P<0.01), and the upregulating effects of acupuncture on METTL3 and PTEN expression were reversed (P<0.01). Meanwhile, knockdown of METTL14 significantly inhibited the acupuncture-induced increase in PTEN m⁶A levels (P<0.01). Morphologically, knockdown of METTL14 attenuated the improvement of myelin structure by acupuncture, reversed the downregulation of MBP and upregulation of NF155 induced by acupuncture, and blocked the increase in dendritic spine density (P<0.05, P<0.01). ConclusionMETTL14 is a key molecule mediating the therapeutic effect of acupuncture at Neiguan. Acupuncture at Neiguan upregulates METTL14, thereby enhancing m⁶A methylation modification of PTEN mRNA to stabilize its expression, ultimately promoting myelin development and improving behavioral symptoms in ASD juvenile rats. This preliminarily reveals the modern biological connotation of “opening Xuanfu and dredging myelin”.

Human stem cell preparations and related products have been widely utilized in clinical trials and treatments for refractory diseases both domestically and internationally.Due to the complexity of the prepa-ration process for stem cell preparations,current microbial detection methods struggle to meet the safety testing requirements,particularly for release testing within medical institutions.Therefore,it is imperative to develop novel alternative methods to ensure the safe and timely clinical application of stem cell preparations.This article elaborates on the microbial testing procedures and relevant regulatory standards involved in stem cell preparations,covering aspects such as raw material selection,preparation processes,release testing,therapeutic application,and sample retention testing.The aim is to provide a foundation for microbial quality control in the clinical use of stem cell preparations.

Objective To carry out emergency medical system modification design for EC135 P3H helicopter without compromising the original airframe structure so as to enhance aeromedical rescue capabilities.Methods Firstly,the original cabin seats were removed and medical floor was installed in the cabin;secondly,the medical chair,medical stretcher trolley and its fixing components,storage boxes and oxygen cylinders were mounted onto the floor;finally,a medical equipment fixing frame was formed based on the original helicopter sill structure so as to accommodate medical devices such as defibrillators,ventilators and injection pumps.The modification design scheme had its effectiveness verified with overall aircraft load balance analysis,mechanical analysis,dynamic impact tests of seats and actual modification and flight tests.Results EC135 P3H helicopter proved to meet all the airworthiness certification requirements after emergency medical system modification.Conclusion The proposed modification scheme enables EC135 P3H helicopter to rapidly transition between standard and medical configurations,enhancing its emergency medical rescue capabilities and providing references for medical modifications of helicopters with similar configurations.

Objective To develop a predictive model for postoperative mortality risk in patients with acute aortic dissection(AAD)using the Extreme Gradient Boosting(XGBoost)algorithm combined with Shapley Additive Explanation(SHAP),and to establish a prediction website to serve as a diagnostic and therapeutic support platform for clinicians and patients.Methods A retrospective cohort study design was adopted.Data from 782 AAD patients who underwent surgical treatment at the Fourth Hospital of Hebei Medical University from January 2013 to December 2023 were collected,including basic information and initial serum biomarker test results.Patients were randomly divided into training and test sets at a 7:3 ratio.An external validation set consisting of 313 AAD patients admitted to the Second Hospital of Hebei Medical University from January 2020 to December 2023 was also established for further model validation.Variables were screened using LASSO regression,and an XGBoost machine learning model was constructed and interpreted using SHAP.The predictive performance of the model was evaluated using receiver operating characteristic(ROC)curve analysis.Using the Shiny package,the XGBoost model was deployed to shinyapps.io to create a prediction website for postoperative mortality risk in AAD patients.One patient was selected by simple random sampling from the test set and the external validation set respectively for the prediction example on the Shiny webpage.Results The XGBoost model demonstrated high predictive performance for postoperative mortality in AAD patients,with area under the ROC curve(AUC)values of 0.928(95%CI 0.901-0.956)in the training set,0.919(95%CI 0.891-0.949)in the test set,and 0.941(95%CI 0.915-0.967)in the external validation set.SHAP values indicated the following order of variable importance in the model(from highest to lowest):"lactate dehydrogenase""blood chlorine""multiple organ injury""carbon dioxide combining power""prothrombin time""α-hydroxybutyric acid""creatine kinase isoenzyme""Stanford classification""combined use of bedside blood purification""gender""acute kidney injury""gastrointestinal bleeding""brain injury"and"shock".A risk prediction website for adverse postoperative outcomes in AAD patients was developed using XGBoost-SHAP method(https://dun-dunxiaolu.shinyapps.io/document/)and validated with examples.One randomly selected patient from each of the test and external validation sets was applied:the predicted mortality risk value for patient 1(who died postoperatively)was 0.9539,and that for patient 2(who survived postoperatively)was 0.0206.Conclusions The XGBoost-SHAP model demonstrates high accuracy in predicting postoperative mortality risk for AAD patients.The online prediction tool established based on this model enhances the identification efficiency of high-risk postoperative mortality patients.

Objective To carry out emergency medical system modification design for EC135 P3H helicopter without compromising the original airframe structure so as to enhance aeromedical rescue capabilities.Methods Firstly,the original cabin seats were removed and medical floor was installed in the cabin;secondly,the medical chair,medical stretcher trolley and its fixing components,storage boxes and oxygen cylinders were mounted onto the floor;finally,a medical equipment fixing frame was formed based on the original helicopter sill structure so as to accommodate medical devices such as defibrillators,ventilators and injection pumps.The modification design scheme had its effectiveness verified with overall aircraft load balance analysis,mechanical analysis,dynamic impact tests of seats and actual modification and flight tests.Results EC135 P3H helicopter proved to meet all the airworthiness certification requirements after emergency medical system modification.Conclusion The proposed modification scheme enables EC135 P3H helicopter to rapidly transition between standard and medical configurations,enhancing its emergency medical rescue capabilities and providing references for medical modifications of helicopters with similar configurations.

Objective:Constructing a risk prediction model to assess the impact of various factors on the need for auxiliary bone grafting with implant placement following alveolar ridge preservation (ARP) in posterior teeth.Methods:According to the sample size calculation formula, the sample size was calculated using the pmsampsize package of R 4.1.3 software, based on inclusion and exclusion criteria, a total of 110 posterior teeth in 98 patients who underwent ARP at the Department of Periodontology, School and Hospital of Stomatology, China Medical University, from January 2018 to May 2024 were conducted. Teeth were randomly divided into modeling group and validation group with 7∶3 ratio according to the random number table. The modeling group was divided into direct implantation group and auxiliary bone grafting group on the basis of whether auxiliary bone grafting was performed 6 months after ARP. Univariate and multivariate analyses were conducted to identify factors influencing auxiliary bone grafting with implant placement following ARP. Nomogram was constructed using R software. Receiver operator characteristic (ROC) curve and calibration curve were drawn to evaluate model differentiation and consistency. The decision curve analysis (DCA) was used to assess the clinical application value of the model.Results:Age ( OR=1.06, P=0.001), maximum attachment loss (AL) ( OR=1.75, P<0.001), reason of tooth extraction ( OR=12.73, P<0.001), smoking [<10 cigarettes/d ( OR=7.59, P<0.001);≥10 cigarettes/d ( OR=28.12, P<0.001)] and stage of periodontitis [stage Ⅱ ( OR=2.57, P=0.430); stage Ⅲ ( OR=21.00, P=0.007); stage Ⅳ ( OR=76.50, P<0.001)] influenced the necessity for auxiliary bone grafting with implant placement after ARP. After multivariate analysis of the above influencing factors, it was found that smoking [<10 cigarettes/d ( OR=7.02, P=0.009);≥10 cigarettes/d ( OR=10.27, P=0.026)] was an independent risk factor for the need of auxiliary bone grafting with implant placement after ARP. The area under the ROC curve for internal verification was 0.90 (95 %CI: 0.84-0.97), and the H-L goodness of fit test results were χ 2=4.79, P=0.780, indicating a good agreement. The area under the externally verified ROC curve was 0.97 (95 %CI: 0.92-1.00), suggesting that the fitting effect was slightly lower than that of the modeling group, and the predicted value of the model was slightly lower than the true value, which might underestimate the risk of additional surgery in patients. Results:of H-L goodness of fit test were χ 2=5.03, P=0.754. The DCA curve showed that when the probability of high-risk threshold was between 0.06 and 0.93, the clinical application value of the prediction model was higher. Conclusions:Age, smoking, reason of tooth extraction, stage of periodontitis, and maximum AL of the affected teeth were related to the necessity for auxiliary bone grafting with implant placement 6 months after ARP. Smoking was an independent risk factor for auxiliary bone grafting surgery. The constructed nomogram model had good discrimination and consistency.

Objective:Constructing a risk prediction model to assess the impact of various factors on the need for auxiliary bone grafting with implant placement following alveolar ridge preservation (ARP) in posterior teeth.Methods:According to the sample size calculation formula, the sample size was calculated using the pmsampsize package of R 4.1.3 software, based on inclusion and exclusion criteria, a total of 110 posterior teeth in 98 patients who underwent ARP at the Department of Periodontology, School and Hospital of Stomatology, China Medical University, from January 2018 to May 2024 were conducted. Teeth were randomly divided into modeling group and validation group with 7∶3 ratio according to the random number table. The modeling group was divided into direct implantation group and auxiliary bone grafting group on the basis of whether auxiliary bone grafting was performed 6 months after ARP. Univariate and multivariate analyses were conducted to identify factors influencing auxiliary bone grafting with implant placement following ARP. Nomogram was constructed using R software. Receiver operator characteristic (ROC) curve and calibration curve were drawn to evaluate model differentiation and consistency. The decision curve analysis (DCA) was used to assess the clinical application value of the model.Results:Age ( OR=1.06, P=0.001), maximum attachment loss (AL) ( OR=1.75, P<0.001), reason of tooth extraction ( OR=12.73, P<0.001), smoking [<10 cigarettes/d ( OR=7.59, P<0.001);≥10 cigarettes/d ( OR=28.12, P<0.001)] and stage of periodontitis [stage Ⅱ ( OR=2.57, P=0.430); stage Ⅲ ( OR=21.00, P=0.007); stage Ⅳ ( OR=76.50, P<0.001)] influenced the necessity for auxiliary bone grafting with implant placement after ARP. After multivariate analysis of the above influencing factors, it was found that smoking [<10 cigarettes/d ( OR=7.02, P=0.009);≥10 cigarettes/d ( OR=10.27, P=0.026)] was an independent risk factor for the need of auxiliary bone grafting with implant placement after ARP. The area under the ROC curve for internal verification was 0.90 (95 %CI: 0.84-0.97), and the H-L goodness of fit test results were χ 2=4.79, P=0.780, indicating a good agreement. The area under the externally verified ROC curve was 0.97 (95 %CI: 0.92-1.00), suggesting that the fitting effect was slightly lower than that of the modeling group, and the predicted value of the model was slightly lower than the true value, which might underestimate the risk of additional surgery in patients. Results:of H-L goodness of fit test were χ 2=5.03, P=0.754. The DCA curve showed that when the probability of high-risk threshold was between 0.06 and 0.93, the clinical application value of the prediction model was higher. Conclusions:Age, smoking, reason of tooth extraction, stage of periodontitis, and maximum AL of the affected teeth were related to the necessity for auxiliary bone grafting with implant placement 6 months after ARP. Smoking was an independent risk factor for auxiliary bone grafting surgery. The constructed nomogram model had good discrimination and consistency.

Human Respiratory Stem Cells (RSCs) play a crucial role in the maintenance, repair and regeneration of the respiratory system. As a novel therapeutic method, stem cell therapy is a popular research direction in the medical field. And with the in-depth research on the mechanism of pneumonia caused by respiratory infections in recent years, the use of RSCs to explore pneumonia caused by respiratory infections and its therapeutic strategies has become a hot topic. In this paper, we firstly outlined the types of RSCs, summarized the mechanism of pneumonia caused by respiratory tract infections, discussed the advantages of RSCs application and the progress of culture differentiation, and elaborated the therapeutic exploration of RSCs in pneumonia caused by respiratory tract infections.

OBJECTIVE: To evaluate the effect and safety of Chinese medicine (CM) Fuzheng Huazhuo Decoction (FHD) in treating patients with coronavirus disease 2019 (COVID-19) who persistently tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: This retrospective cohort study was conducted at Shanghai New International Expo Center shelter hospital in China between April 1 and May 30, 2022. Patients diagnosed as COVID-19 with persistently positive SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) test results for ⩾8 days after diagnosis were enrolled. Patients in the control group received conventional Western medicine (WM) treatment, while those in the FHD group received conventional WM plus FHD for at least 3 days. The primary outcome was viral clearance time. Secondary outcomes included negative conversion rate within 14 days, length of hospital stay, cycle threshold (Ct) values of the open reading frame 1ab (ORF1ab) and nucleocapsid protein (N) genes, and incidence of new-onset symptoms during hospitalization. Adverse events (AEs) that occurred during the study period were recorded. RESULTS: A total of 1,765 eligible patients were enrolled in this study (546 in the FHD group and 1,219 in the control group). Compared with the control group, patients receiving FHD treatment showed shorter viral clearance time for nucleic acids [hazard ratio (HR): 1.500, 95% confidence interval (CI): 1.353-1.664, P<0.001] and hospital stays (HR: 1.371, 95% CI: 1.238-1.519, P<0.001), and a higher negative conversion rate within 14 days (96.2% vs. 82.6%, P<0.001). The incidence of new-onset symptoms was 59.5% in the FHD group, similar to 57.8% in the control group (P>0.05). The Ct values of ORF1ab and N genes increased more rapidly over time in the FHD group than those in the control group post-randomization (ORF1ab gene: β =0.436±0.053, P<0.001; N gene: β =0.415 ±0.053, P<0.001). The incidence of AEs in the FHD group was lower than that in the control group (24.2% vs. 35.4%, P<0.001). No serious AEs were observed. CONCLUSION FHD was effective and safe for patients with persistently positive SARS-CoV-2 PCR tests. (Registration No. ChiCTR2200063956).
Humans ; Drugs, Chinese Herbal/adverse effects* ; Retrospective Studies ; Male ; Female ; Middle Aged ; COVID-19 Drug Treatment ; SARS-CoV-2/drug effects* ; COVID-19/virology* ; Adult ; Aged ; Treatment Outcome