Objective To explore common target genes related to aging and osteoporosis using data from public databases and to screen for small molecule compounds with potential therapeutic effects.Methods Osteoporosis datasets GSE56814 and GSE56815 were downloaded and merged from the public gene expression database(Gene Expression Omnibus(GEO)).Senescent genes were selected and merged from the genecard database and the cell age database.Data cleaning and differential gene selection were performed using R software,and a volcano plot was created.Weighted gene co-expression network analysis was performed to screen out key modules and genes,and the machine learning methods were employed to screen target genes.A Venn diagram was drawn using the the Microbioinformatics platform,and cytoscape software was used to visualise protein interactions results.Interaction analysis of differentially encoded proteins was carried out using the STRING database,and prediction of small molecule compounds was carried out using Cmap database.Finally,Receiver operating characteristic(ROC)curves were plotted to find out the most meaningful target genes,followed by the establishment of a logistic regression model and the creation of a nomogram.Results A total of 127 differential genes were screened using the limma package.Weighted gene co-expression network analysis was performed on the differential genes and 103 highly expressed genes were screened.Three machine learning methods,lasso regression,support vector machine and random forest model,were used to finally obtain four target genes:FOXO3,HIRA,CBX5 and RAD1.The nomogram and calibration curves showed good predictive results.Five small molecule compounds with potential therapeutic effects were identified using the Cmap database:sakuraflavin(O-methylated isoflavone),XMD-885,kangaroo hyoscyamine,everolimus and XMD-1150.Conclusion FOXO3 and HIRA genes have now been confirmed to be the common target genes for aging and osteoporosis,and sakuraflavin has potential therapeutic effects on both conditions.

Objective To evaluate the prognostic value of endosomal sorting complex required for transport(ESCRT)-related genes in osteosarcoma(OS)based on bioinformatics.Methods Preprocessing was performed on 88 OS sequencing samples(with 29 death outcomes)downloaded from the TARGET database and 257 patient clinical information.The Cox proportional hazards model was constructed using the survival package to screen ESCRT genes related to the survival.The STRING database was used to construct a protein-protein interaction(PPI)network,and core genes were selected based on PPI.KEGG enrichment analysis was performed on the selected core genes with more than 5 nodes.Lasso regression analysis was applied to identify ESCRT-related genes more closely related to the prognosis of OS patients.Results A total of 1 486 ESCRT-related genes were identified,of which 164 were associated with the survival.CLTC,MYC,INSR,PTPN1,and TNFRSF1A were identified as core genes related to the prognosis of OS patients.OS patients were randomly divided into a training set(n=44)and a validation set(n=44).In the training set,OS patients in the high-risk group had the significantly shorter overall survival than those in the low-risk group(P<0.05),and the similar results were obtained in the validation set(P<0.01).The ROC(receiver operating characteristic)curve showed an AUC of 0.846 in the training set and 0.877 in the validation set.Prognostic survival analysis and differential analysis of core genes revealed no difference in MYC between high-and low-risk groups in the validation set,and no difference in INSR in the training set.In the overall dataset,all prognostic core genes showed significant differences(P<0.05).Survival analysis of core genes using the R package Survival showed significant differences in survival rates for four genes(CLTC,INSR,PTPN1,TNFRSF1A)except MYC(P>0.05).Univariate independent prognostic analysis identified three genes(TNFRSF1A,PTPN1,MYC)associated with OS survival.Multivariate independent prognostic analysis ultimately identified two key genes(TNFRSF1A,PTPN1)as independent factors influencing OS survival prognosis and closely related to OS patient survival.Conclusion A risk scoring model for OS survival prognosis based on the expression of two key genes,TNFRSF1A and PTPN1,was been successfully constructed using bioinformatics and it can provide more options for clinical treatment and survival prognosis assessment of OS.

Objective:To investigate the effect of sleep on physical performance and the correlation between sleep quality and physical performance in the elderly.Methods:In this prospective multicenter case-control study, 472 elderly people aged 60-80 years were recruited from three regions in China, Beijing, Tianjin, and Hainan Province.Basic information of study participants was collected through face-to-face interviews, and physical performance of study participants was assessed by the time up and go(TUG)test on site, with 106 cases(22.5%)in the normal physical performance group and 366 cases(77.5%)in the abnormal group.The Pittsburgh Sleep Quality Index(PSQI)and the Epworth Sleepiness Scale(ESS)were applied to assess sleep quality of study subjects.Correlation analysis was performed to examine factors affecting subjects' physical performance.Results:Age, history of alcohol consumption, BMI, past medical history, the ESS score, daytime sleepiness, and some components of PSQI, such as sleep quality, sleep efficiency, sleep disturbances, use of sleeping drugs and daytime dysfunction, were influencing factors of the TUG score.Two components of PSQI, sleep duration and habitual sleep efficiency, and the ESS score were positively correlated with physical performance.Logistic regression analysis showed that risk factors for decreased physical performance in the elderly included increased age( OR=1.125, 95% CI: 1.083-1.168, P<0.01), history of alcohol consumption( OR=0.482, 95% CI: 0.384-0.605, P<0.001), abnormally high body mass index( OR=1.663, 95% CI: 1.340-2.063, P<0.01), hyperlipemia( OR=0.156, 95% CI: 0.077-0.318, P<0.01), digestive system diseases( OR=0.154, 95% CI: 0.044-0.532, P<0.01), use of sleeping drugs( OR=0.415, 95% CI: 0.202-0.854, P<0.05), daytime sleepiness( OR=4.234, 95% CI: 2.800-6.403, P<0.01), a high habitual sleep efficiency score of PSQI( OR=1.425, 95% CI: 1.214-1.672, P<0.01)and a high sleep disturbances score in PSQI( OR=3.356, 95% CI: 2.337-4.819, P<0.01). Conclusions:The incidence of physical performance decline is high in the elderly.There is a correlation between physical performance and sleep quality.

As the search for effective treatments for COVID-19 continues, the high mortality rate among critically ill patients in Intensive Care Units (ICU) presents a profound challenge. This study explores the potential benefits of traditional Chinese medicine (TCM) as a supplementary treatment for severe COVID-19. A total of 110 critically ill COVID-19 patients at the Intensive Care Unit (ICU) of Vulcan Hill Hospital between Feb., 2020, and April, 2020 (Wuhan, China) participated in this observational study. All patients received standard supportive care protocols, with a subset of 81 also receiving TCM as an adjunct treatment. Clinical characteristics during the treatment period and the clinical outcome of each patient were closely monitored and analysed. Our findings indicated that the TCM group exhibited a significantly lower mortality rate compared with the non-TCM group (16 of 81 vs 24 of 29; 0.3 vs 2.3 person/month). In the adjusted Cox proportional hazards models, TCM treatment was associated with improved survival odds (P < 0.001). Furthermore, the analysis also revealed that TCM treatment could partially mitigate inflammatory responses, as evidenced by the reduced levels of proinflammatory cytokines, and contribute to the recovery of multiple organic functions, thereby potentially increasing the survival rate of critically ill COVID-19 patients.
Humans ; COVID-19 ; Medicine, Chinese Traditional ; SARS-CoV-2 ; Critical Illness ; Treatment Outcome

Abstract The COVID-19 pandemic has posed a series of complex challenges. COVID-19 in children and adolescents is generally less severe than in adults and the elderly; however, some children and adolescents may experience severe complications and adverse health effects even after mild or asymptomatic COVID-19 infections. The article focuses on gathering the epidemic characteristics, health impact, risk factors, prevention and control measures, and vaccination status of children and adolescents with COVID-19 infection to provide recommendations for protecting children and adolescents in the post COVID-19 era.

Emerging research suggests a potential association of progression of Alzheimer's disease(AD)with al-terations in synaptic currents and mitochondrial dynamics.However,the specific associations between these pathological changes remain unclear.In this study,we utilized Aβ42-induced AD rats and primary neural cells as in vivo and in vitro models.The investigations included behavioural tests,brain magnetic resonance imaging(MRI),liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)analysis,Nissl staining,thioflavin-S staining,enzyme-linked immunosorbent assay,Golgi-Cox staining,trans-mission electron microscopy(TEM),immunofluorescence staining,proteomics,adenosine triphosphate(ATP)detection,mitochondrial membrane potential(MMP)and reactive oxygen species(ROS)assess-ment,mitochondrial morphology analysis,electrophysiological studies,Western blotting,and molecular docking.The results revealed changes in synaptic currents,mitophagy,and mitochondrial dynamics in the AD models.Remarkably,intervention with Dengzhan Shengmai(DZSM)capsules emerged as a pivotal element in this investigation.Aβ42-induced synaptic dysfunction was significantly mitigated by DZSM intervention,which notably amplified the frequency and amplitude of synaptic transmission.The cognitive impairment observed in AD rats was ameliorated and accompanied by robust protection against structural damage in key brain regions,including the hippocampal CA3,primary cingular cortex,prelimbic system,and dysgranular insular cortex.DZSM intervention led to increased IDE levels,augmented long-term potential(LTP)amplitude,and enhanced dendritic spine density and length.Moreover,DZSM intervention led to favourable changes in mitochondrial parameters,including ROS expression,MMP and ATP contents,and mitochondrial morphology.In conclusion,our findings delved into the realm of altered synaptic currents,mitophagy,and mitochondrial dynamics in AD,concurrently highlighting the therapeutic potential of DZSM intervention.

Objective:To investigate the effect of 980 nm semiconductor laser preablation of urethra mucosa at the prostatic tip in small volume benign prostatic hyperplasia (BPH).Methods:The case data of 120 patients diagnosed with small volume BPH in the Yan′an University Affiliated Hospital from June 2020 to June 2022 were retrospectively analyzed, and they were divided into improved group and conventional group according to different treatment methods, with 60 cases in each group. Patients in the improved group were treated with 980 nm semiconductor laser preablation of urethra mucosa at the prostatic tip, and patients in the conventional group were treated with 980 nm semiconductor laser vaporization of prostate. The sexual function of the patients was evaluated by the international erectile function index-5(IIEF-5) score, erectile hardness score (EHS) and retrograde ejaculation before surgery and 1, 3, 6, and 12 months after surgery. International prostate symptom scale (IPSS), quality of life (QOL) score, the maximum urine flow rate (Qmax) and postvoid residual urine (PVR) were used to evaluate urinary control function. The incidence of urinary incontinence, bladder neck contracture and other complications were compared between the two groups. Measurement data were expressed as mean±standard deviation ( ± s), and t-test was used for comparison between groups. The count data were expressed as cases and percentage, and Chi-square test was used for comparison between groups. Results:There was no significant difference in PVR, Qmax, IPSS score, QOL score, IIEF-5 score and EHS score between two groups ( P>0.05). In terms of PVR, Qmax, IPSS score, QOL score, IIEF-5 score and EHS score at 1, 3, 6 and 12 months after surgery, all these parameters were significantly improved compared with the preoperative, the differences were statistically significant ( P< 0.05). However, there was no significant difference between the two groups ( P> 0.05). There was no significant difference in IIEF-5 score and EHS score between the two groups during postoperative follow-up and before and after operation ( P> 0.05). The incidence of retrograde ejaculation rate in the improved group was lower than that in the conventional group during the follow-up 1, 3, 6 months after surgery, and the difference was statistically significant ( P<0.05). In the follow-up 1, 3 months after surgery, the incidence of stress urinary incontinence in the improved group was lower than that in the conventional group, the differences were statistically significant ( P< 0.05). At follow-up 6, 12 months after surgery, the rates of stress urinary incontinence were similar between the two groups, and the difference was not statistically significant ( P> 0.05). In the follow-up 12 months after surgery, there were 2 cases (3.33%) of bladder and neck contracture in the improved group, and 8 cases (13.33%) in the conventional group, the difference was statistically significant ( P<0.05). Conclusions:The effect of 980 nm semiconductor laser preablation of urethra mucosa at the prostatic tip in small volume BPH patients is similar to that of conventional vaporization, and the operation time is short. At the same time, the proximal 1 cm tissue of the verticulae and the integrity of the bladder neck are preserved, and the internal and external sphincter of the urethra are protected, thus improving the immediate postoperative urinary control rate and the incidence of retrograde ejaculation in small volume BPH patients.

Parkinson's disease (PD) is one of the hotspots in the research field of neurodegenerative diseases, and its pathogenesis is still controversial. Trace metal elements play an important role in normal growth and development of the human body. Metal ions can cross the blood-brain barrier and enter the brain, leading to α-synapnuclein aggregation, mitochondrial dysfunction, and degeneration of dopaminergic neurons, and then inducing the occurrence of PD. This article mainly reviewed the potential mechanisms of metal elements in PD, discussed the role of metabolic imbalance of common trace metals (copper, iron, manganese, and zinc) in PD, and put forward new insights into the treatment of PD.

Objective:To subdivide clinical classification of refractory atlantoaxial dislocation, and evaluate the reliability of new subdivide clinical classification of refractory atlantoaxial dislocation.Methods:From January 2010 to December 2018, 48 patients with refractory atlantoaxial dislocation were treated, including 19 males and 29 females, aged 16 to 65 years, with an average of 39.2±13.3 years. According to the changes of relative anatomical position of C 1 and C 2 under general anesthesia with heavy traction of 1/6 body weight, subdivide clinical classification of refractory atlantoaxial dislocation were proposed, and refractory atlantoaxial dislocation was divided into traction loosening type (atlantoaxial angle≥5°) and traction stabilization type (atlantoaxial angle<5°). The traction loosening type was directly reduced by posterior atlantoaxial screw-rod fixation and fusion without anterior or posterior soft tissue release. For traction stabilization type, transoral soft tissue release was performed first, and then transoral anterior reduction plate fixation and fusion or posterior atlantoaxial screw-rod fixation and fusion were performed. Atlantodental interval (ADI) and atlantoaxial angle (AAA) were measured and collected before and after surgery to evaluate atlantoaxial reduction. The space available for the spinal cord (SAC) were measured to evaluate spinal cord compression. Visual analogue score (VAS) was used to evaluate the neck pain levels, and Japanese Orthopaedic Association (JOA) scores was used to evaluate the neurological function. American Spinal Cord Injury Association impairment scale (AIS) was used to evaluate the degree of spinal cord injury. One week, 3, 6, 12 months postoperatively and the annual review of the X-ray and CT scan were checked, in order to evaluate the reduction, internal fixation and bone graft fusion. Results:Among all 48 cases, 22 cases were traction loosening type, of which posterior atlantoaxial screw-rod fixation and fusion were performed in 16 cases and occipitocervical fixation and fusion in 6 cases. 26 cases were traction stabilization type, and they all underwent anterior transoral release, and then, anterior TARP fixation and fusion were performed in 24 cases and posterior screw-rod fixation and fusion in the other 2 cases. X-ray, CT and MRI images and of all patients 1 week after surgery showed good atlantoaxial reduction and decompression of spinal cord. In each of the two types, there was one case lost to follow-up. For 46 cases in follow-up, the follow-up time ranged from 6 to 72 months, with an average of 38.0±17.2 months. Among 46 cases, 21 cases of traction loosening type showed that, ADI reduced from preoperative 9.9±2.2 mm to 2.3±0.9 mm at 3 months after surgery and 2.3±1.0 mm at the last follow-up, AAA increased from preoperative 57.9°±12.3° to 91.0°±2.2° at 3 months after surgery and 90.9°±2.2° at the last follow-up, SAC increased from preoperative 9.8±1.3 mm to 15.1±0.7 mm at 3 months after surgery and 14.9±0.7 mm at the last follow-up, VAS score reduced from preoperative 1.5±2.1 to 0.7±1.0 at 3 months after surgery and 0.3±0.6 at the last follow-up, and JOA score increased from preoperative 10.2±1.7 to 13.3±1.3 at 3 months after surgery and 14.9±1.5 at the last follow-up. Twenty-five cases of traction stabilization type presented that, ADI reduced from preoperative 9.7±2.0 mm to 2.1±1.4 mm at 3 months after surgery and 2.1±1.3 mm at the last follow-up, AAA increased from preoperative 55.8°±9.2° to 90.9°±1.4° at 3 months after surgery and 90.9°±1.3° at the last follow-up, SAC increased from preoperative 10.5±1.0 mm to 15.4±0.5 mm at 3 months after surgery and 14.8±2.8 mm at the last follow-up, VAS score reduced from preoperative 1.7±2.1 to 0.7±0.9 at 3 months after surgery and 0.3±0.5 at the last follow-up, and JOA score increased from preoperative 10.1±1.3 to 12.9±1.5 at 3 months after surgery and 14.4±1.3 at the last follow-up. In the traction loosening type, all the 10 grade D patients were improved to grade E at the last follow-up. In the 2 grade C patients of traction stabilization type before surgery, 1 patient was improved to grade E, 1 patient was improved to grade D, and all 11 patients with grade D were improved to grade E at the last follow-up. Bony fusion was obtained in all patients from 3 to 6 months, with an average of 4.4±1.5 months. During follow-up period, no looseness of internal fixation or redislocation happened.Conclusion:Refractory atlantoaxial dislocation can be divided into traction loosening type and traction stabilization type. For traction loosening type, satisfactory reduction can be achieved by using posterior atlantoaxial screw-rod system without soft tissue release. For traction stabilization type, anterior release is preferable, and then anterior TARP or posterior screw-rod can be used to achieve satisfactory reduction.

【Objective】 To analyze the changes of gut microbes in patients with postpartum depression so as to explore the relationship between postpartum depression and gut microbes. 【Methods】 A total of 60 postpartum subjects were recruited to participate in this study. The depression status of the participants was scored using the Edinburgh Postpartum Depression Scale (EPDS). Those with a score ≥13 were included in the postpartum depression group (PPD group), while those with a score less than 13 were included in the postpartum healthy control group (PPHC group). The feces of these 60 subjects were collected, and the fecal whole genome DNA was extracted for 16S rDNA sequencing. The data of changes in the bacterial diversity between the groups were obtained, and the possible correlation between the changes of intestinal microbes and postpartum depression was analyzed. 【Results】 The number of microorganisms in PPD patients was significantly reduced (P<0.001); the Chao1 index (P<0.001) and ACE index (P<0.001) of α diversity decreased significantly. There were also significant differences in β diversity between the two groups. Analysis of the bacteria in the groups showed that Acetanaerobacterium, Adlercreutzia, Allobaculum, Alloprevotella, Bifidobacterium, Christensenella, Escherichia, Eubacterium, Faecalicatena, Fusobacterium, Haemophilus, Intestinimonas, Lactobacillus, Megamonas, Monoglobumus, Muribaculum, Oscillospira, Paraprevotella, Streptococcus, Raoultibacter, Ruminococcus and Stomatobaculum were significantly enriched in PPHC group. In contrast, Kineothrix, Lachnoclostridium, Acinetobacter, Aquisphaera, Enterococcus, and Mucispirillum were enriched in PPD group. RDA/CCA analysis showed that EPDS was positively correlated with Prevotella, Kineothrix, and Alistipes, but negatively correlated with Lachnospira. 【Conclusion】 This study found that the intestinal flora of patients with postpartum depression was significantly disrupted, and there was a correlation between the intestinal flora and postpartum depression symptom score. Therefore, intestinal microbial markers may contribute to the diagnosis and treatment of patients with postpartum depression.