ObjectiveTo investigate the triglyceride-glucose (TyG) index and the level of serum homocysteine (Hcy) in association with the incidence of stroke in type 2 diabetes mellitus (T2DM) patients. MethodsBased on the chronic disease risk factor surveillance cohort in Pudong New Area, Shanghai, excluding those with stroke in baseline survey, T2DM patients who joined the cohort from January 2016 to October 2020 were selected as the research subjects. During the follow-up period, a total of 318 new-onset ischemic stroke patients were selected as the case group, and a total of 318 individuals matched by gender without stroke were selected as the control group. The Cox proportional hazards regression model was used to adjust for confounding factors and explore the serum TyG index and the Hcy biochemical indicator in association with the risk of stroke. ResultsThe Cox proportional hazards regression results showed that after adjusting for confounding factors, the risk of stroke in T2DM patients with 10 μmol·L⁻¹-¹ and Hcy>15 μmol·L⁻¹ was 1.532 times (95%CI: 1.017‒2.309 times, P=0.041) and 1.738 times (95%CI: 1.119‒2.699 times, P=0.014) higher respectively, compared to T2DM patients with Hcy≤10 μmol·L⁻¹. T2DM patients with TyG>9.074 had 1.396 times higher risk of stroke (95%CI: 1.091‒1.787, P=0.008) compared to those with TyG≤9.074. The study found that urea and α1-antitrypsin (α1-AT) were independent risk factors for the incidence of stroke in T2DM patients. For every unit increase in urea andα1-AT, the risk of stroke in T2DM patients increased by 233.6% (HR=3.336, 95%CI: 1.588‒7.009, P=0.001) and 11.3% (HR=1.113, 95%CI: 1.028‒1.205, P=0.008), respectively. Cumulative risk curves showed that Hcy>10 μmol·L⁻¹ and TyG>9.074 accelerated the time to stroke occurrence in T2DM patients. ConclusionElevated levels of Hcy>10 μmol·L⁻¹ and a higher TyG index are risk factors for stroke in T2DM patients. Effective interventions for Hcy and TyG should be conducted for diabetic patients to reduce the incidence of stroke.

Dendrobium moniliforme (D. moniliforme) is a traditional medicinal herb widely cultivated in Asia. Flavonoids, one of the largest groups of secondary metabolites in plants, are significant medicinal components in Dendrobium species. Several subgroups of R2R3-MYB proteins have been validated to directly regulate flavonoid biosynthesis. Using PacBio sequencing technology, we assembled a high-quality chromosome-level D. moniliforme genome with a total length of 1.20 Gb and a contig N50 of 3.97 Mb. The BUSCO assessment of genome annotation was 91.4%. By integrating the genome and transcriptome, we identified biosynthesis pathway enzyme genes related to flavonoids, polysaccharides, carotenoids, and alkaloids. A total of 90 R2R3-MYBs were identified in D. moniliforme and classified into 21 subgroups. Studies on the functions of R2R3-MYB transcription factors revealed that R2R3-MYB in SG6 can up-regulate flavonoid biosynthesis. Various validation experiments, including subcellular localization, transient overexpression, UPLC-MS/MS, HPLC, yeast one-hybrid, and dual-luciferase assays, demonstrated that DMYB69 directly up-regulates the expression of enzyme genes involved in flavonoid biosynthesis, increasing the content of flavonoids such as anthocyanin, flavone, and flavonol. Additionally, DMYB44 was shown to directly up-regulate the expression of carotenoid biosynthesis enzyme genes, thereby increasing carotenoid content. This study provides an essential genome resource and theoretical basis for molecular breeding research in D. moniliforme.

BACKGROUND:As a temporary matrix for new bone growth,the porous scaffold plays a key role in the process of bone repair.The structural design of porous scaffolds is a research priority in the process of bone repair.OBJECTIVE:To summarize traditional bone scaffolds(regular,uniform scaffolds)and bionic scaffolds(irregular,inhomogeneous scaffolds)in the field of bone tissue engineering research.METHODS:A computerized search was performed in the databases of CNKI,VIP,WanFang,Web of Science,Science Direct,PubMed,and EI.Literature published from January 2008 to March 2024 was selected.The search terms in Chinese included"bone tissue engineering,bionic scaffolds,bone trabeculae,traditional scaffolds,bone repair,triple-period minimal surfaces."The search terms in English were"bone tissue engineering,bionic scaffolds,bone trabeculae,traditional scaffolds,bone repair,TPMS."Finally,81 articles were included for review.RESULTS AND CONCLUSION:The structural design of bone scaffolds is the key to achieve bone repair and bone regeneration,and scaffold technology in bone tissue engineering has made remarkable progress.Traditional regular porous scaffolds are widely used due to their simple manufacturing process and good mechanical properties.However,these scaffolds often lack biological activity and are difficult to mimic the complex microenvironment of natural bone tissue,limiting their ability to promote cell proliferation and bone regeneration.On the contrary,bionic scaffolds provide a more suitable physiological microenvironment by mimicking the structural features of natural bone tissues,which promotes the proliferation and differentiation of osteoblasts,as well as the formation of new bone,and provides a new way of thinking for the effective treatment of bone defects.Despite the great potential of bionic scaffolds in theory,they still face many challenges in practical applications.Factors such as the scaffold's biocompatibility,bioactivity,and its long-term stability still need to be further verified through clinical trials.

Objective To explore the effects and mechanisms of bone marrow mesenchymal stem cell(BMMSC)-derived exosomes(BMMSC-Exo)on hypoxia/reoxygenation(H/R)-induced injury in rat cardiomyocyte cell line(H9c2).Methods BMMSC-Exosomes were isolated by ultracentrifugation.The cells were divided into three groups:control,H/R,and H/R+BMMSC-Exo(H/R+Exo).A hypoxia/reoxygenation(H/R)injury model was es-tablished by exposing cells to 12 hours of hypoxia followed by 6 hours of reoxygenation.Flow cytometry was used to detect cell apoptosis,DHE staining was used to assess cellular ROS levels,JC-1 immunofluorescence staining was used to evaluate mitochondrial membrane potential,and Western blot was used to detect mitochondrial autophagy-re-lated proteins.Results BMMSC-Exo treatment significantly alleviated oxidative stress,restored mitochondrial mem-brane potential,reduced mitochondrial autophagy levels,and effectively decreased cardiomyocyte apoptosis.Conclu-sions Bone marrow mesenchymal stem cell-derived exosomes alleviate H/R-induced cardiomyocyte injury.

BACKGROUND:As a temporary matrix for new bone growth,the porous scaffold plays a key role in the process of bone repair.The structural design of porous scaffolds is a research priority in the process of bone repair.OBJECTIVE:To summarize traditional bone scaffolds(regular,uniform scaffolds)and bionic scaffolds(irregular,inhomogeneous scaffolds)in the field of bone tissue engineering research.METHODS:A computerized search was performed in the databases of CNKI,VIP,WanFang,Web of Science,Science Direct,PubMed,and EI.Literature published from January 2008 to March 2024 was selected.The search terms in Chinese included"bone tissue engineering,bionic scaffolds,bone trabeculae,traditional scaffolds,bone repair,triple-period minimal surfaces."The search terms in English were"bone tissue engineering,bionic scaffolds,bone trabeculae,traditional scaffolds,bone repair,TPMS."Finally,81 articles were included for review.RESULTS AND CONCLUSION:The structural design of bone scaffolds is the key to achieve bone repair and bone regeneration,and scaffold technology in bone tissue engineering has made remarkable progress.Traditional regular porous scaffolds are widely used due to their simple manufacturing process and good mechanical properties.However,these scaffolds often lack biological activity and are difficult to mimic the complex microenvironment of natural bone tissue,limiting their ability to promote cell proliferation and bone regeneration.On the contrary,bionic scaffolds provide a more suitable physiological microenvironment by mimicking the structural features of natural bone tissues,which promotes the proliferation and differentiation of osteoblasts,as well as the formation of new bone,and provides a new way of thinking for the effective treatment of bone defects.Despite the great potential of bionic scaffolds in theory,they still face many challenges in practical applications.Factors such as the scaffold's biocompatibility,bioactivity,and its long-term stability still need to be further verified through clinical trials.

Objective:To compare and analyze the accuracy of the invasive glucose detecting device and the non-invasive glucose device(NeoGlu01)based on artificial intelligence(AI)algorithm in detecting peripheral blood glucose.Methods:A total of 96 diabetic voluntary patients were recruited from the community of Beijing district from December 2022 to March 2023.The Roche ACCU-CHECK? Guide invasive glucose device was used to detect the peripheral blood glucose of volunteers,and the NeoGlu 01 type of non-invasive glucose device was used to collect the signal of the finger,so as to obtain the blood glucose value that was calculated by AI algorithm at the same time.Pearson correlation analysis was adopted to analyze the detected blood glucose values of the two kinds of devices.Results:Both the peripheral blood glucose values of invasive glucose detecting device and the calculated AI values of NeoGlu01 type of non-invasive glucose device for 96 diabetic patients had favorable consistency with calibration value(R2=0.978,0.882,P<0.05),respectively.Both the detected values of peripheral blood glucose of invasive glucose detecting device and the calculated AI values of NeoGlu01 type of non-invasive glucose device were between 6.2 and 16.7 mmol/L for 96 diabetic patients,and the difference was no significant(P>0.05).Parkes error grid analysis,that referred to the values of peripheral blood glucose,indicated the two times of the results of the values of mean absolute relative difference(MARD)of total accuracy indicator of calculated AI value of non-invasive glucose device were respectively 11.05%and 11.44%,and both the accuracy rate and repeatability of that were favorable.Conclusion:The predictive blood glucose value of NeoGlu01 non-invasive blood glucose device has favorable consistency and accuracy with the detected value of invasive glucose detecting device in detecting peripheral blood glucose.

ObjectiveTo investigate the effect of multimodal mirror therapy on upper limb and hand function in stroke patients. MethodsFrom April, 2021 to August, 2022, 60 stroke patients from the Department of Rehabilitation Medicine of Zhejiang Provincial People's Hospital were randomly divided into group A (n = 20), group B (n = 20) and group C (n = 20). All the patients accepted routine rehabilitation, while group B accepted mirror therapy, and group C accepted multimodal mirror therapy, in addition, for six weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Upper Extremity Function Test (UEFT) and modified Barthel Index (MBI), while the maximum grip strength and pinch strength of the affected hand were measured. ResultsThe FMA-UE score, UEFT score, maximum hand grip strength and pinch strength, and MBI scores improved in all groups after treatment (|t| > 7.878, P < 0.001), and it was the most in group C (F > 12.563, P < 0.001). ConclusionMultimodal mirror therapy may further improve the upper limb motor function and hand function of stroke patients, as well as the strength of the affected hand and the activities of daily living.

Objective: To explore the clinical features, diagnosis and prognosis of renal transplant recipients with NCP. Method: The clinical data of 2 cases of kidney transplant recipients with NCP were retrospectively analyzed. Based onclinical manifestations, blood routine, inflammatory factors, cell immunity, chest CT andtherapeutic effects, the diagnosis and treatment of NCP in kidney transplant recipients (5th edition) were compared to that ofordinary NCP patients. Both recipients developed onset of low andmoderate fever, with no cough or fatigue at the initial stage. Blood routine indicated a normal range of leukocytes,buta significant decrease in lymphocyte counts, increased C-reactive protein (CRP) , and slightly higher procalcitonin (PCT) . The cellular immunity was extremely low, and the chest CT showed multiple patchy ground glass shadows in both lungs. Result: After 1 week of onset, both patients had significant disease progression. The pathogenesis and imaging changes were highly similar tothatreported in ordinary NCP patients.Two patients were givensymptomatic supportive treatment by antiviral agents, stop uses ofimmunosuppression agents, small amount of hormone maintenance, intravenous drip of gamma globulin andrespiratory support toavoid secondary infections. At present, the condition of both patients is obviously improved, and renal function is stable. One of them has recovered and was discharged. Conclusion The clinical manifestations of NCP in renal transplant recipients were generally consistent with that of ordinary NCP patients. Although there is no established method for the treatment of NCP, it is effective by stopping uses of immunosuppressive agents, maintaining small and medium doses of hormones, actively restoring immunity, and providing respiratory support in a timely manner.

Objective To compare the effects of levosimendan (Levo) and recombinant human brain natriuretic peptide (rhBNP) in patients with acute decompensated heart failure (ADHF). Methods Seventy-five patients were included into this randomized positive-controlled and parallel-group study to receive either Levo (Levo group), rhBNP (rhBNP group) or dobutamine therapy (control group). Heart rate, respiratory rate, 24-hour urine volume,improvement in six-minute walk-test after 72-h treatment were compared between three groups. The blood level of BNP and values of left ventricular end dia?stolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) after one-week treatment were compared between three groups. Results After 72-h treatment, heart rate and respiratory rate were significantly decreased, and 24-hour urine volume, six-minute walk-test were significantly increased in three groups (P<0.05). The NT-proBNP and LVEF were im?proved after one week treatment (P>0.05), but the LVEDD was improved barely (P>0.05). The improvements were more significant in Levo group and rhBNP group compared to those of control group (P<0.05). There were no significant differenc?es in improvements between Levo group and rhBNP group. The common adverse reactions were hypotension and ventricular premature beats. There were no significant differences in adverse event rates between three groups (P<0.05). Conclusion As compared with dobutamine, Levo and rhBNP have optimized efficacy, fewer side effects and good safety in the treatment of ADHF. They are worth of clinical application.

Objective: To explore the relationship between the ratio of neutrophil/lymphocyte (NLR) and in-hospital major adverse cardiac events (MACE) in patients with acute ST-elevation myocardial infarction (STEMI) at early admission.
Methods: A total of 420 acute STEMI patients admitted and received primary PCI in our hospital from 2010-01 to 2014-12 were retrospectively studied. The patients were divided into 2 groups:In-hospital MACE group, n=47 and Normal discharged group, n=373. Uni-and multivariate analyses were conducted to assess whether high NLR is the independent predictor for in-hospital MACE occurrence.
Results: Univariate regression analysis indicated that the occurrence rate of in-hospital MACE in high NLR patients were higher than those in low NLR patients (OR=3.19, 95%CI 1.55-2.65, P=0.012). Multivariate regression analysis showed that high NLR was the independent risk factor for in-hospital MACE occurrence in STEMI patients (OR=3.05, 95%CI 1.59-10.54, P=0.015).
Conclusion: High NLR is the independent risk factor for in-hospital MACE occurrence in STEMI patients at the early admission.