BACKGROUND:Inter-limb asymmetry is a common phenomenon observed during human growth and development.Prolonged specialized training can lead to specific adaptations in inter-limb asymmetry among athletes.OBJECTIVE:To review the formation causes,manifestations,and impacts of inter-limb asymmetry on sports performance,and provide an overview of the relevant assessment methods and intervention strategies.METHODS:A literature search was conducted in the CNKI,WanFang,PubMed,and Web of Science databases from their inception to September 2024.The search terms included"asymmetry,asymmetries,asymmetric,asymmetrical,imbalance,strength,power,force,jump,sprint,athletic performance,anthropometry,injury"in English and Chinese.After excluding duplicate publications,irrelevant content,and conference papers,a total of 131 articles were finally included for analysis.RESULTS AND CONCLUSION:(1)Inter-limb asymmetry can be influenced by various factors including genetics,task demands,training regimens,injuries,fatigue,and limb preference.These factors lead to being primarily manifested in anatomical structure,strength performance,and task-specific asymmetry.(2)An increase in inter-limb asymmetry can result in impaired performance in bilateral in-phase symmetric movements.However,the relationship between increased inter-limb asymmetry and bilateral out-of-phase symmetric movements remains unclear and requires further investigation.(3)Training interventions have been shown to effectively mitigate inter-limb asymmetry,with unilateral training demonstrating superior outcomes compared with bilateral training.The choice of training methods and content should be tailored to meet the specific demands of the sport.(4)To further clarify the relationship between inter-limb asymmetry and athletic performance,it is recommended that future research adopt the concept of"task specificity"in inter-limb asymmetry.This includes standardizing study designs,selecting sensitive testing methods and indicators,unifying calculation methods to provide more high-quality evidence,and establishing categorized warning threshold standards for inter-limb asymmetry in different sports.

Objective To construct a prediction model for the population with hypertension and diabetes to assess the risk of chronic kidney disease (CKD), and to provide a scientific basis for formulating targeted CKD prevention and control measures. Methods Based on physical examination data from community residents aged 60 years and above in Nanjing in 2022, 10 221 patients with hypertension and diabetes were selected as the study subjects. Variables associated with CKD prevalence were screened using univariate analysis, and further variable selection was performed using LASSO regression. Finally, a CKD risk prediction model was constructed based on logistic regression. The model's performance was evaluated using the ROC curve and calibration curve. Results The prevalence rate of CKD in the study population was 22.71%, with a mean age of 71.66 years. LASSO regression identified seven variables associated with CKD: age, blood urea nitrogen (BUN), hemoglobin, uric acid, triglyceride-glucose (TyG) index, urine protein-to-creatinine ratio (UPCR), and medical insurance type. The final logistic regression model incorporated six variables: age [OR=1.067 (95% CI: 1.058-1.076)], BUN [OR=1.377 (95% CI: 1.338-1.418)], hemoglobin [OR=0.992 (95% CI: 0.989-0.995)], uric acid [OR=1.004 (95% CI: 1.003-1.004)], TyG index [OR=1.445 (95% CI: 1.324-1.577)], and self-payment medical insurance [OR=1.732 (95% CI: 1.542-1.945)]. The model had an AUC of 0.759 (95% CI: 0.747-0.770) and a Brier score of 0.140 (95% CI: 0.136-0.145), indicating good predictive performance. The calibration curve showed good agreement between the predicted risk and the observed value. Conclusion The constructed LASSO-logistic regression risk prediction model in this study can effectively assess the risk of CKD in elderly individuals aged 60 years and above with hypertension and diabetes, providing a basis for early identification of high-risk individuals and the formulation of targeted CKD prevention and control measures.

BACKGROUND:Inter-limb asymmetry is a common phenomenon observed during human growth and development.Prolonged specialized training can lead to specific adaptations in inter-limb asymmetry among athletes.OBJECTIVE:To review the formation causes,manifestations,and impacts of inter-limb asymmetry on sports performance,and provide an overview of the relevant assessment methods and intervention strategies.METHODS:A literature search was conducted in the CNKI,WanFang,PubMed,and Web of Science databases from their inception to September 2024.The search terms included"asymmetry,asymmetries,asymmetric,asymmetrical,imbalance,strength,power,force,jump,sprint,athletic performance,anthropometry,injury"in English and Chinese.After excluding duplicate publications,irrelevant content,and conference papers,a total of 131 articles were finally included for analysis.RESULTS AND CONCLUSION:(1)Inter-limb asymmetry can be influenced by various factors including genetics,task demands,training regimens,injuries,fatigue,and limb preference.These factors lead to being primarily manifested in anatomical structure,strength performance,and task-specific asymmetry.(2)An increase in inter-limb asymmetry can result in impaired performance in bilateral in-phase symmetric movements.However,the relationship between increased inter-limb asymmetry and bilateral out-of-phase symmetric movements remains unclear and requires further investigation.(3)Training interventions have been shown to effectively mitigate inter-limb asymmetry,with unilateral training demonstrating superior outcomes compared with bilateral training.The choice of training methods and content should be tailored to meet the specific demands of the sport.(4)To further clarify the relationship between inter-limb asymmetry and athletic performance,it is recommended that future research adopt the concept of"task specificity"in inter-limb asymmetry.This includes standardizing study designs,selecting sensitive testing methods and indicators,unifying calculation methods to provide more high-quality evidence,and establishing categorized warning threshold standards for inter-limb asymmetry in different sports.

The application of immunosuppressants has significantly reduced the incidence rate of rejection reaction after liver transplantation， but the clinical efficacy of immunosuppressants is greatly affected by individual differences between patients. This article systematically reviews the recent research advances in the interaction between immunosuppressants and gut microbiota， with a focus on the regulatory role and mechanism of intestinal microflora communities on the efficacy of immunosuppressants. Studies have shown that intestinal microbiome is one of the key factors influencing the efficacy of immunosuppressive therapy after liver transplantation. This review aims to provide a theoretical basis for in-depth research in this field and provide new insights for developing individualized immunosuppressive treatment regimens based on the regulation of intestinal microflora.

ObjectiveTo investigate a suspected outbreak of healthcare-associated infection with carbapenem-resistant Klebsiella pneumoniae (CRKP) in a geriatric emergency ward, and to provide references for the prevention and control of multidrug-resistant bacteria in a hospital in Shanghai. MethodsOn-site epidemiological investigation, combined with environmental hygiene monitoring and pulsed field gel electrophoresis (PFGE) molecular typing method, were adopted to investigate a suspected outbreak of CRKP infection in the geriatric emergency ward of a hospital from October to November 2022, aiming at finding out factors caused the outbreak before taking corresponding control measures. ResultsA total of 3 cases of healthcare-associated CRKP infection were identified, of which 2 cases were homologous to a previous case of community-associated CRKP infection. What’s more, the 2 cases lived in the same ward with the latter and with adjacent beds, but the third case was non-homologous to the community-associated infection case. A total of 46 samples were collected from the environmental surfaces and the hands of healthcare workers, of which 7 samples tested positive for CRKP and were identical to the strains from the 2 healthcare-associated infection cases and the 1 community-associated infection case, originating from the bedrails, bedside tables, surface of non-invasive ventilator, bed curtains and panels of monitoring equipment, with a detection rate of 15.22%. But none of the 11 samples from the hands of healthcare workers tested positive for CRKP. The outbreak was effectively controlled after taking specific prevention and control measures such as strengthening personnel management, intensifying environmental cleaning and disinfection and strictly enforcing hand hygiene among healthcare workers. Subsequently, no similar new cases were reported during the 14-day follow-up period. ConclusionIncomplete environmental cleaning and disinfection, as well as inadequate enforcement of hand hygiene among heatheare workers may have contributed to the suspected outbreak of CRKP in the geriatric emergency ward. Early warning and timely investigation of suspected outbreaks of multidrug-resistant bacteria are crucial for preventing and controlling such outbreaks in hospitals.

Liver fibrosis is a chronic liver injury resulting from factors like viral hepatitis, autoimmune hepatitis, non-alcoholic steatohepatitis, fatty liver disease, and cholestatic liver disease. Liver transplantation is currently the gold standard for treating severe liver diseases. However, it is limited by a shortage of donor organs and the necessity for lifelong immunosuppressive therapy. Mesenchymal stem cells (MSCs) can differentiate into various liver cells and enhance liver function when transplanted into patients due to their differentiation and proliferation capabilities. Therefore, it can be used as an alternative therapy for treating liver diseases, especially for liver cirrhosis, liver failure, and liver transplant complications. However, due to the potential tumorigenic effects of MSCs, researchers are exploring a new approach to treating liver fibrosis using extracellular vesicles (exosomes) secreted by stem cells. Many studies show that exosomes released by stem cells can promote liver injury repair through various pathways, contributing to the treatment of liver fibrosis. In this review, we focus on the molecular mechanisms by which stem cell exosomes affect liver fibrosis through different pathways and their potential therapeutic targets. Additionally, we discuss the advantages of exosome therapy over stem cell therapy and the possible future directions of exosome research, including the prospects for clinical applications and the challenges to be overcome.

Objective To examine the level of sperm flagellar tubulin glycosylation(Gly-Tubulin)in asthenospermia patients(AP)and discuss its significance.Methods According to the principle of inclusion and exclusion criteria,108 patients treated in the Department of Andrology in Xinjiang Uygur Autonomous Region Maternal and Child Health Hospital from June 2021 to May 2022 were rolled in this study.According to the results of semen examine,they were divided into group AP(n=74),and normal control(NC)group(n=34).Colleced the clinical date of both group,such as the age,the sterility period.The levels of sex hormones were detected by chemiluminescence method.The glycosylated Tubulin levels of the sperm were detected by Western blot and immunofluorescence was used for localization analysis,and the relationship between the Gly-Tubulin of sperm flagellar and asthenospermia was analyzed by Multivariate Logistic regression analysis.Results Compared to NC group,the sterility period of group AP was prolong(3.98±0.30 vs 0.78±0.08),the percent of forward sperm motility was decreased(18.55±0.97 vs 46.24±1.89)and the expression level of Gly-Tubulin in the sperm flagellar was decreased(0.64±0.11 vs 1.00±0.00),the differences with statistical significance(t=62.038,χ2=14.394,3.148,all P＜0.05).There were no significant differences in follicle-stimulating hormone(FSH),luteinizing hormone(LH),prolactin(PRL),estradiol(E2),testosterone,semen volume,sperm concentration and total sperm between the two groups(t/χ2=0.043～1.503,all P>0.05).Multivariate Logistic regression analysis showed that the percent of forward sperm motility and the sperm flagellar Gly-Tubulin expression level were independent risk factors for male asthenospermia(Wald χ2=4.406,7.492,P<0.05).Conclusion Abnormal level of Gly Tubulin in sperm flagella may be closely related to the occurrence and development of asthenospermia.

Objective To explore the differential diagnostic value of three-dimensional CT values in active pulmonary tuberculosis(APTB)and inactive pulmonary tuberculosis(IPTB).Methods A retrospective analysis was conducted on 96 patients with pulmonary tuberculosis.According to whether the pulmonary tuberculosis lesions were active,the patients were divided into APTB group(n=61)and IPTB group(n=35).The baseline data,CT signs,and three-dimensional CT values were compared between two groups.Additionally,the results of three-dimensional CT values and conventional CT reading method in evaluating the activity of pulmonary tuberculosis were compared,and the accuracy,sensitivity and specificity of using three-dimensional CT values and conventional CT reading method to evaluate the activity of pulmonary tuberculosis were further analyzed.Results APTB group showed a higher incidence of bilateral pulmonary lesions than IPTB group(P<0.05).Compared with IPTB group,APTB group had higher proportions of blurred boundaries,parenchymal cavities,ground-glass opacities,and tree-in-bud signs(P<0.05),but lower proportions of parenchymal bronchiectasis,parenchymal calcifications,and fibrous strip shadows(P<0.05).The three-dimensional CT values in APTB group were lower than those in IPTB group(P<0.05).Significant differences were observed between conventional CT reading method and three-dimensional CT values in evaluating the activities of pulmonary parenchymal calcifications and thick-wall cavities(P<0.05).Specifically,three-dimensional CT values correctly identified 92 cases of tuberculosis lesions,including 59 cases of APTB and 33 cases of IPTB,and the remaining 4 misidentified lesions were calcified,consolidated and nodular lesions.Conventional CT reading method correctly identified 68 cases of tuberculosis lesions,including 43 cases of APTB and 25 cases of IPTB.The sensitivity,specificity,and accuracy of three-dimensional CT values were all higher than those of conventional CT reading method(P<0.05).Conclusion Three-dimensional CT values can effectively determine the activity of pulmonary tuberculosis,exhibiting high sensitivity,specificity,and accuracy.

Objective To explore the effect and mechanism of Sechang Zhixie Powder(SCZXS)on mice with acute diarrhea caused by castor oil.Methods The mice were randomly divided into blank control group,model control group,montmorillonite powder group(1.4 g·kg-1),SCZXS-L group(0.9 g·kg-1),SCZXS-M group(1.8 g·kg-1)and SCZXS-H group(3.6 g·kg-1),10 mice in each group.After continuous administration of 7 days,the acute diarrhea model of mice was prepared by oral administration of castor oil(0.01 mL·g-1).The diarrhea of mice was observed within 4 hours of castor oil administration,and the rate of loose stool,degree of loose stool,and diarrhea index were calculated;the levels of DAO,D-LDH,VIP,and SS in the colon were determined by enzyme-linked immunosorbent assay;The morphological changes in the colon tissue of mice were observed after HE staining and the thicknesses of the mucosal and muscular layers of the colon were quantified;AB-PAS staining was performed to observe the effect on mucin in the colon;and the expression of AQP3,Occludin,and ZO-1 in the colon were quantified by immunohistochemistry.Results Compared with the model control group,the rate of loose stool,degree of loose stool,and diarrhea index of the mice in the SCZXS groups tended to decrease,but the difference was not statistically significant.Compared with the model control group,the flat luminal surface of the mice in the SCZXS-M and SCZXS-H group were significantly thickened(P<0.01),and the amount of VIP in the colon was significantly decreased(P<0.05,P<0.01),and that of DAO in the colon was significantly decreased(P<0.01),Occludin and ZO-1 expression were significantly increased(P<0.01),the mucin area ratio was significantly increased(P<0.05)in the SCZXS-M group,and AQP3 expression was significantly increased(P<0.05)in the SCZXS groups.Conclusions SCZXS can improve acute diarrhea induced by castor oil in mice.and its mechanism may be related to the regulation of gastrointestinal hormones and AQP3.In addition,SCZXS improves intestinal damage caused by diarrhea and protects the intestinal barrier.

Japanese encephalitis virus(JEV)belongs to the genus Flavivirus and the family Flavi-viridae,and is classified as a single-stranded,positive-sense RNA virus.The disease known as Japa-nese encephalitis(JE),which results from JEV infection,is a viral zoonosis that is prevalent worldwide and poses a significant public health concern.JEV infection activates a variety of signa-ling pathways,leading to a series of changes that are crucial to the virus's pathogenesis.Among these pathways,Toll-like receptors(TLRs)are particularly significant,and their diverse range and complex signal transduction mechanisms present substantial challenges for the prevention and con-trol of JEV.Currently,there is no specific treatment for JEV.Although some vaccines have been developed to prevent JE,eradicating JEV remains difficult due to its zoonotic transmission cycle and the limited efficacy of the available vaccines.This article reviews the alterations in various TLR signaling pathways induced by JEV infection in the host,aiming to provide insights into the patho-genic mechanisms of JEV and to identify potential new antiviral targets.