Objective:To conduct survival analysis of patients with Kashin-Beck disease (KBD) and explore influencing factors of mortality in KBD patients.Methods:A retrospective analysis was conducted on data on management services and deaths of KBD patients from January 1, 2023 to August 31, 2024 in Shaanxi Province, which were collected from the "Shaanxi Provincial Endemic Disease Information Platform", and death of KBD patients was considered as the outcome event. The direct method was used to calculate standardized mortality rates. The survival rate, and cumulative survival rate of KBD patients were calculated using the life table method. Kaplan-Meier method and Log-rank test were used to plot and compare survival curves, respectively, with residential area as the time-dependent covariate, and stratified by gender for multivariate analysis using time-dependent Cox proportional hazards regression model.Results:A total of 54 957 KBD patients were included, with females accounting for 51.66% (28 390/54 957), the age [ M( Q1, Q3)] was 66 (59, 72) years. Patients with gradeⅠ,Ⅱ, and Ⅲ KBD accounted for 63.90% (35 120/54 957), 31.16% (17 125/54 957), and 4.93% (2 712/54 957), respectively. During the observation period, 2 989 deaths (5.44%) occurred, with an age standardized mortality rate of 1.94%. The cumulative survival rates at 6th, 12th, and 18th months were 97.63%, 96.11%, and 94.64%, respectively. The standardized mortality rate of gradeⅠKBD patients was lower than that of gradeⅡandⅢ KBD patients in all, female, and male KBD patients, and their cumulative survival rate was higher than that of gradeⅡand Ⅲ KBD patients ( P < 0.001). Age, education level, residential area, severity of illness, poverty, and relocation were influencing factors for mortality in KBD patients ( P < 0.05). Conclusions:The standardized mortality rate of gradeⅠKBD patients in Shaanxi Province is lower than that of gradeⅡand Ⅲ KBD patients, and their cumulative survival rate is higher than that of grade Ⅱand Ⅲ KBD patients. The influencing factors for mortality in KBD patients include age, education level, residential area, severity of illness, poverty, and relocation.

Objective To compare the efficacy and adherence of rivaroxaban versus low-molecular-weight heparin for prophylactic anticoagulation in cancer patients with venous thromboembolism(VTE).Methods A total of 120 intermediate-to-high VTE risk patients with malignant tumors admitted to Depart-ment of Hematology and Oncology,West China Longquan Hospital of Sichuan University between September 2021 and December 2022,were randomly assigned to the rivaroxaban group(n=60)and the low-molecular-weight heparin group(n=60)using the random number table.The rivaroxaban group received oral Rivaroxa-ban,while the low-molecular-weight heparin group received subcutaneous injections of low-molecular-weight heparin sodium for prophylactic anticoagulation.All patients were followed up for 180 days.The primary end-point was medication adherence.The secondary endpoints included the incidence of VTE,bleeding events,and changes in coagulation parameters.Results The rate of good medication adherence was significantly higher in the rivaroxaban group than in the low-molecular-weight heparin group(95.00％vs.88.33％,P＜0.05).However,there were no statistically significant differences in the incidence of VTE or overall bleeding events between the two groups(P＜0.05).Following treatment,parameters including fibrinogen,prothrombin time(PT),and D-dimer levels showed significant improvement from baseline in both groups.Compared to the low-molecular-weight heparin group,the Rivaroxaban group demonstrated significantly higher fibrinogen levels,shorter PT,and lower D-dimer levels(P＜0.05).Stepwise logistic regression analysis identified the post-treatment platelet(PLT)count as a significant factor influencing bleeding events during prophylactic antico-agulation(P＜0.05).Khorana score≥3(high risk)was identified as a risk factor for bleeding events(P＜0.05).The incidence of clinically relevant non-major bleeding(CRNMB)was higher in the rivaroxaban group[11.67％(7/60)]compared to the low-molecular-weight heparin group[8.33％(5/60)],although the differ-ence was not statistically significant(P＜0.05).Kaplan-Meier curve analysis revealed no significant difference in the cumulative incidence of bleeding-free events between the two groups(P＜0.05).Conclusion Oral ri-varoxaban and subcutaneous low-molecular-weight heparin demonstrate comparable efficacy and safety for VTE prevention in cancer patients,but rivaroxaban significantly improves patient's adherence.

Objective:To conduct survival analysis of patients with Kashin-Beck disease (KBD) and explore influencing factors of mortality in KBD patients.Methods:A retrospective analysis was conducted on data on management services and deaths of KBD patients from January 1, 2023 to August 31, 2024 in Shaanxi Province, which were collected from the "Shaanxi Provincial Endemic Disease Information Platform", and death of KBD patients was considered as the outcome event. The direct method was used to calculate standardized mortality rates. The survival rate, and cumulative survival rate of KBD patients were calculated using the life table method. Kaplan-Meier method and Log-rank test were used to plot and compare survival curves, respectively, with residential area as the time-dependent covariate, and stratified by gender for multivariate analysis using time-dependent Cox proportional hazards regression model.Results:A total of 54 957 KBD patients were included, with females accounting for 51.66% (28 390/54 957), the age [ M( Q1, Q3)] was 66 (59, 72) years. Patients with gradeⅠ,Ⅱ, and Ⅲ KBD accounted for 63.90% (35 120/54 957), 31.16% (17 125/54 957), and 4.93% (2 712/54 957), respectively. During the observation period, 2 989 deaths (5.44%) occurred, with an age standardized mortality rate of 1.94%. The cumulative survival rates at 6th, 12th, and 18th months were 97.63%, 96.11%, and 94.64%, respectively. The standardized mortality rate of gradeⅠKBD patients was lower than that of gradeⅡandⅢ KBD patients in all, female, and male KBD patients, and their cumulative survival rate was higher than that of gradeⅡand Ⅲ KBD patients ( P < 0.001). Age, education level, residential area, severity of illness, poverty, and relocation were influencing factors for mortality in KBD patients ( P < 0.05). Conclusions:The standardized mortality rate of gradeⅠKBD patients in Shaanxi Province is lower than that of gradeⅡand Ⅲ KBD patients, and their cumulative survival rate is higher than that of grade Ⅱand Ⅲ KBD patients. The influencing factors for mortality in KBD patients include age, education level, residential area, severity of illness, poverty, and relocation.

The oral and maxillofacial region comprises a variety of organs made up of multiple soft and hard tissue, which are anatomically vulnerable to the pathogenic factors of trauma, inflammation, and cancer. The studies of this intricate entity have been long-termly challenged by a lack of versatile preclinical models. Recently, the advancements in the organoid industry have provided novel strategies to break through this dilemma. Here, we summarize the existing biological and engineering approaches that were employed to generate oral and maxillofacial organoids. Then, we detail the use of modified co-culture methods, such as cell cluster co-inoculation and air-liquid interface culture technology to reconstitute the vascular network and immune microenvironment in assembled organoids. We further retrospect the existing oral and maxillofacial assembled organoids and their potential to recapitulate the homeostasis in parental tissues such as tooth, salivary gland, and mucosa. Finally, we discuss how the next-generation organoids may benefit to regenerative and precision medicine for treatment of oral-maxillofacial illness.
Organoids ; Humans ; Tissue Engineering/methods* ; Coculture Techniques ; Regenerative Medicine ; Mouth

Objective:To investigate the effects of compound Duzhong Jiangu Granules on joint function and gut microbiota in patients with Kashin-Beck disease.Methods:A single group pre- and post-experimental design was conducted, the patients with Kashin-Beck disease were selected as the subjects in Xunyi County, Xianyang City, Shaanxi Province; and treated with oral administration of compound Duzhong Jiangu Granules (12 g/bag, 1 bag/time, 3 times/day) for a period of 1 month. The improvement of joint function was evaluated using the joint dysfunction index scoring method before and after treatment. Morning stool samples of patients were collected and the changes in gut microbiota were analyzed before and after treatment using 16S rDNA sequencing technology.Results:A total of 87 patients with Kashin-Beck disease were included, including 44 males and 43 females; the age was (60.38 ± 7.12) years old, and the body mass index was (23.67 ± 3.59) kg/m 2. The comprehensive scores of joint dysfunction index for patients with Kashin-Beck disease before and after treatment were (7.27 ± 2.05) and (5.86 ± 2.01) points, respectively, and the difference was statistically significant ( t = 5.88, P < 0.001). The sequencing results of gut microbiota showed that there were statistically significant differences in the alpha diversity (chao1, observed species index) and beta diversity of gut microbiota in patients with Kashin-Beck disease before and after treatment ( Z = - 5.08, - 5.03, R = 0.09, P < 0.001). In the distribution of gut microbiota, Firmicutes was the dominant phylum, with relative abundances of 50.21% and 52.09% before and after treatment, respectively; the Bifidobacterium was the dominant bacterial genus, with relative abundances of 16.83% and 18.81% before and after treatment, respectively. At the genus level, a total of 17 gut microbiota genera were screened out, among which the relative abundances of Hafnia-Obesumbacterium, Gammaproteobacteria_unclassified, Acinetobacter, Pantoea, Leuconostoc, and Akkermanisia were significantly higher than before treatment ( Z = - 2.40, - 2.24, - 2.06, - 3.59, - 2.24, - 2.11, P < 0.05). The relative abundances of Dubosiella, Selenomonas, Anaeroplasma, Lachnospiraceae_ NK4A136_group, Rikenella, Prevotella, Megasphaera, Lactobacillus, Prevotella-9, Phascolarctobacterium, and Desulfovibrio were significantly lower than before treatment ( Z = - 9.38, - 2.61, - 2.18, - 8.43, - 2.45, - 2.46, - 2.49, - 7.29, - 2.29, - 2.55, - 2.08, P < 0.05). Conclusions:Compound Duzhong Jiangu Granules can effectively improve the joint function of patients with Kashin-Beck disease, and alter the diversity and richness of the gut microbiota community. It may reduce clinical symptoms in patients by regulating the structure of gut microbiota.

Objective:To explore the mediating role of psychological resilience between work stress and sleep quality in psychiatric nurses.Methods:From April to August 2023, convenience sampling was used to select 457 psychiatric nurses working in three psychiatric hospitals in Henan Province as the research subjects. The survey was conducted using the General Information Questionnaire, the Chinese version of the Connor-Davidson Resilience Scale (CD-RISC), the Chinese Nursing Stressor Scale (CNSS), and the Pittsburgh Sleep Quality Index (PSQI). Pearson correlation was used to analyze the correlation between psychological resilience, work stress, and sleep quality among psychiatric nurses. SPSS 26.0 software was used to analyze the data, and Process macro program and Bootstrap method were used to test the mediating effect.Results:Among 457 psychiatric nurses, the total scores of the Chinese version of CD-RISC, CNSS, and PSQI were (58.89±13.27), (78.02±14.31), and (8.04±3.46), respectively. Pearson correlation showed that work stress was positively correlated with sleep quality ( r=0.703, P<0.01). In contrast, work stress was negatively correlated with psychological resilience ( r=-0.413, P<0.01), and psychological resilience was negatively correlated with sleep quality ( r=-0.712, P<0.01). Psychological resilience partially mediated the relationship between work stress and sleep quality, with a mediating effect value of 0.051, accounting for 30.0% of the total effect. Conclusions:Psychological resilience partially mediates the relationship between work stress and sleep quality in psychiatric nurses. Nursing managers should attach importance to and enhance the psychological resilience of psychiatric nurses, regularly relieve stress, improve sleep quality, and enhance the physical and mental health of nurses.

A decline in mucosal vascularity is a histological hallmark of oral submucous fibrosis(OSF),a premalignant disease that is largely induced by betel quid chewing.However,the lack of available models has challenged studies of angiogenesis in OSF.Here,we found that the expression of thrombospondin 1(THBS1),an endogenous angiostatic protein,was elevated in the stroma of tissues with OSF.Using a fibroblast-attached organoid(FAO)model,the overexpression of THBS1 in OSF was stably recapitulated in vitro.In the FAO model,treatment with arecoline,a major pathogenic component in areca nuts,enhanced the secretion of transforming growth factor(TGF)-β1 by epithelial cells,which then promoted the expression of THBS1 in fibroblasts.Furthermore,human umbilical vein endothelial cells(HUVECs)were incorporated into the FAO to mimic the vascularized component.Overexpression of THBS1 in fibroblasts drastically suppressed the sprouting ability of endothelial cells in vascularized FAOs(vFAOs).Consistently,treatment with arecoline reduced the expression of CD31 in vFAOs,and this effect was attenuated when the endothelial cells were preincubated with neutralizing antibody of CD36,a receptor of THBS1.Finally,in an arecoline-induced rat OSF model,THBS1 inhibition alleviated collagen deposition and the decline in vascularity in vivo.Overall,we exploited an assembled organoid model to study OSF pathogenesis and provide a rationale for targeting THBS1.

The oral and maxillofacial region comprises a variety of organs made up of multiple soft and hard tissue,which are anatomically vulnerable to the pathogenic factors of trauma,inflammation,and cancer.The studies of this intricate entity have been long-termly challenged by a lack of versatile preclinical models.Recently,the advancements in the organoid industry have provided novel strategies to break through this dilemma.Here,we summarize the existing biological and engineering approaches that were employed to generate oral and maxillofacial organoids.Then,we detail the use of modified co-culture methods,such as cell cluster co-inoculation and air-liquid interface culture technology to reconstitute the vascular network and immune microenvironment in assembled organoids.We further retrospect the existing oral and maxillofacial assembled organoids and their potential to recapitulate the homeostasis in parental tissues such as tooth,salivary gland,and mucosa.Finally,we discuss how the next-generation organoids may benefit to regenerative and precision medicine for treatment of oral-maxillofacial illness.

Objective To describe the distribution characteristics of knee and ankle joint range of motion and muscle atrophy related indexes in patients with Kashin-Beck disease(KBD)in Shaanxi Province so as to explore the correlation of knee and ankle joint range of motion(ROM)with muscle atrophy indexes and provide reference for clinical characteristics analysis of KBD patients.Methods To investigate the registered KBD patients from KBD areas in Shaanxi Province,we measured the general demographic data of the patients were collected and the ROM of the knee joint(flexion and extension),the ankle joint(dorsiflexion and plantar flexion),and the muscle atrophy related indexes such as the upper arm circumference,thigh circumference,calf circumference and grip strength.According to the population characteristics,i.e.,gender,age,body mass index(BMI)and KBD grade,the median and quartile of joint ROM and muscle atrophy of KBD patients were reported,and then the differences in each index among different groups were analyzed.Partial correlation analysis was used to explore the correlation between indicators after controlling for variables such as gender,age and BMI.Results A total of 480 patients with KBD were investigated in this study,who consisted of 249(51.9％)males and 231(48.1％)females,with an average age of(63.10±7.32)years and an average BMI of(23.49±8.90)kg/m2.The knee flexion ROM,knee extension ROM,ankle dorsiflexion ROM and ankle plantar flexion ROM were[105.0(95.0,120.0)]°,[0.0(-15.0,0.0)]°,[5.0(0.0,15.0)]° and[20.0(15.0,30.0)]°,respectively,in KBD patients in Shaanxi Province.The left thigh circumference,right thigh circumference,left calf circumference,right calf circumference,and upper arm circumference were[43.0(40.0,47.0)]cm,[43.0(39.0,47.0)]cm,[29.0(27.0,32.0)]cm,[29.5(27.0,32.0)]cm,[27.0(25.0,30.0)]cm,respectively.The left hand grip strength and right hand grip strength were[13.4(9.5,18.4)]kg and[13.9(9.8,18.2)]kg,respectively.With the increase of age,the extension range of the left and right knee joints of KBD patients showed a decreasing trend(H=31.499,31.847;all P＜0.001).The range of motion of bilateral knee flexion was higher in the normal BMI group than in the overweight or obese group,with statistically significant differences(H=7.753,12.333;P=0.021,0.002).The knee flexion,thigh circumference,and calf circumference of the left and right sides showed a decreasing trend under different KBD grades(H=14.345,17.256,8.000,8.462,8.558,9.633;all P＜0.05).Correlation analysis showed that knee flexion ROM was positively correlated with thigh circumference,calf circumference,and grip strength in patients with KBD(all P＜0.05).There was a positive correlation between knee extension ROM and thigh circumference in patients with KBD(P＜0.01).Conclusion The impaired joint ROM and muscle atrophy are serious in KBD patients in Shaanxi Province,and there is a correlation between joint motion and muscle atrophy.