Objective To evaluate the safety and efficacy of valve-in-valve transcatheter mitral valve replacement(ViV-TMVR)in patients with bioprosthetic valve degeneration who are at high surgical risk.Methods This study is a multi-center,retrospective cohort analysis of 20 consecutive patients who underwent transseptal ViV-TMVR using the Edwards SAPIEN 3 transcatheter heart valve(THV).The primary endpoints include technical success and procedural success,both defined according to the Mitral Valve Academic Research Consortium(MVARC)criteria,as well as mortality and functional change assessed based on New York Heart Association(NYHA)classification at 30-days and six months post-procedure.Clinical follow-up assessments are conducted at 30-days and six months.Results From February 2021 to October 2022,a total of 20 patients with symptoms of bioprosthetic valve degeneration were enrolled across nine sites in China.The patients had a mean age of(73.5±5.5)years,with 85.0％being females and 70.0％classified as NYHA class Ⅲ/Ⅳ.The study achieved a 100.0％technical success rate and a 90.0％procedural success rate finally.All patients remained alive during the 30-day follow-up period.However,six months post-intervention,two patients(10.0％)were re-hospitalized due to heart failure,and sadly,one of them(5.0％)died.None of the patients reported any adverse events related to ViV-TMVR during the follow-up period.Notably,there was a significant improvement in NYHA class compared to baseline(P=0.0004)at six-month follow-ups.Conclusions The transseptal ViV-TMVR technique proved to be highly successful and was associated with significant improvement in NYHA class function.These findings strongly suggest that it serves as a safe and efficient treatment alternative for high-risk patients suffering from bioprosthetic valve degeneration.

Objective:To investigate the effects of apixaban on cardiac function,serum levels of soluble suppression of tumorigenicity 2(sST2),fibroblast growth factor-23(FGF-23)and inflammatory factors in patients with atrial fibrillation(AF)and coronary artery disease(CAD).Methods:This randomized controlled study enrolled 120 pa-tients with AF and CAD who admitted Changzhou Wujin Hospital of Traditional Chinese Medicine between July 2022 and December 2023.Patients were randomly divided into control group(n=60,warfarin therapy)and inter-vention group(n=60,apixaban therapy).Each group received corresponding medication based on routine therapy for 8 weeks.Cardiac function indicators,levels of serum sST2,FGF-23,inflammatory factors,myocardial fibrosis indicators,and incidence of adverse reactions were compared between the two groups.Results:Compared to those in the control group,participants in the intervention group had significantly higher left ventricular ejection fraction(LVEF)[(52.22±3.69)％vs.(48.37±4.14)％]and 6-minute walking distance(6MWD)[(456.29±56.47)m vs.(415.25±11.32)m](P＜0.001 all),and significantly lower left ventricular end-diastolic diameter(LVEDd)[(44.98±4.55)mm vs.(50.26±3.61)mm],levels of N-terminal pro B-type natriuretic peptide(NT-proB-NP)[(341.16±29.51)pg/ml vs.(392.33±32.27)pg/ml],cardiac troponin I(cTnI)[(3.76±1.12)ng/ml vs.(5.22±1.36)ng/ml],creatine kinase isoenzyme-MB(CK-MB)[(25.71±6.51)U/L vs.(39.13±6.33)U/L],high sensitive C-reactive protein(hsCRP)[(1.63±0.51)mg/L vs.(1.98±0.46)mg/L],tumor necrosis fac-tor-alpha(TNF-α)[(27.17±5.11)ng/Lvs.(34.19±5.32)ng/L],sST2[(52.11±5.87)μg/L vs.(62.37±5.82)μg/L]and FGF-23[(45.73±4.29)μg/L vs.(56.09±5.25)μg/L](P＜0.001 all).We detected signifi-cant lower incidence of adverse reactions in intervention group compared to control group(6.9％vs.26.3％,P=0.005).Conclusion:Apixaban could alleviate myocardial fibrosis,improve cardiac function,and reduce levels of heart failure biomarkers and inflammatory factors in patients with coronary artery disease and atrial fibrillation.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

Objective:To investigate lymph node metastasis(LNM)in the prostatic anterior fat pad(PAFP)of PCa patients after robot-assisted radical prostatectomy(RARP),and analyze the clinicopathological features and prognosis of LNM in the PAFP.Methods:We retrospectively analyzed the clinicopathological data on 1 003 cases of PCa treated by RARP in the Department of Urolo-gy of PLA General Hospital from January 2017 to December 2022.All the patients underwent routine removal of the PAFP during RARP and pathological examination,with the results of all the specimens examined and reported by pathologists.Based on the pres-ence and locations of LNM,we grouped the patients for statistical analysis,compared the clinicopathological features between different groups using the Student's t,Mann-Whitney U and Chi-square tests,and conducted survival analyses using the Kaplan-Meier and Log-rank methods and survival curves generated by Rstudio.Results:Lymph nodes were detected in 77(7.7％)of the 1 003 PAFP samples,and LNM in 11(14.3％)of the 77 cases,with a positive rate of 1.1％(11/1 003).Of the 11 positive cases,9 were found in the upgraded pathological N stage,and the other 2 complicated by pelvic LNM.The patients with postoperative pathological stage≥T3 constituted a significantly higher proportion in the PAFP LNM than in the non-PAFP LNM group(81.8％[9/11]vs 36.2％[359/992],P=0.005),and so did the cases with Gleason score ≥8(87.5％[7/8]vs 35.5％[279/786],P=0.009).No statisti-cally significant differences were observed in the clinicopathological features and biochemical recurrence-free survival between the pa-tients with PAFP LNM only and those with pelvic LNM only.Conclusion:The PAFP is a potential route to LNM,and patients with LNM in the PAFP are characterized by poor pathological features.There is no statistically significant difference in biochemical recur-rence-free survival between the patients with PAFP LNM only and those with pelvic LNM only.Routine removal of the PAFP and inde-pendent pathological examination of the specimen during RARP is of great clinical significance.

AIM To study the chemical constituents from Inula japonica Thunb.and their anti-asthmatic activity.METHODS Separation and purification were performed using silica gel and Sephadex LH-20,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The effect of compounds on the release rate of β-Hex was evaluated by substrate coloration method.RESULTS Twenty-three compounds were isolated and identified as dehydrodontic acid(1),vitexin(2),alternariol(3),globuxanthone(4),1,3,6,7-tetrahydroxyxanthone(5),hydroxyhydrolapachol(6),isoscopoletin(7),elephanmollen(8),benzoylcholine(9),hoconobiflavone(10),clovandiol(11),hydroxydihydrobovolide(12),5,7-dihydroxycoumarin(13),scopoletin(14),orlichenol glucoside(15),urolignoside(16),9-angeloyloxythymol(17),6,3′,4′-trihydroxyaurone(18),flufuran(19),sweroside(20),guajadial(21),5,7,4′-trimethoxy-4-phenylcoumarin(22),dibutylphthalate(23).After intervention with compounds 9 and 16,the release rates of β-Hex were(56.64±2.37)％and(58.07±2.29)％,respectively.CONCLUSION Compounds 1-23 are isolated from Ⅰ.japonica for the first time.Compounds 9 and 16 have anti-asthmatic activity.

AIM To establish the near-infrared spectroscopy quantitative models for moisture,23-acetylalismol B and 23-acetylalismol C in Alismatis Rhizoma decoction pieces.METHODS The near-infrared spectroscopy(NIRS)data were collected in 95 batches of decoction pieces,after which drying method was adopted in the content determination of moisture,HPLC was applied to determining the contents of 23-acetylalismol B and 23-acetylalismol C,the quantitative models were established by partial least squares method combined with feature extraction algorithms.RESULTS The model training determination coefficients were 0.952 6,0.958 1 and 0.920 8,along with the prediction determination coefficients of 0.930 0,0.905 2 and 0.906 4,the residual prediction deviations(PRD)of 4.00,3.58 and 3.46,and the root mean square error ratios of prediction values to calibration values(RMSEP/RMSEC)of 1.15,1.11 and 1.06,respectively.CONCLUSION The quantitative models based on NIRS exhibit good prediction effects,which can be used for the rapid quality detection of Alismatis Rhizoma decoction pieces.

Objective:To investigate the effects of apixaban on cardiac function,serum levels of soluble suppression of tumorigenicity 2(sST2),fibroblast growth factor-23(FGF-23)and inflammatory factors in patients with atrial fibrillation(AF)and coronary artery disease(CAD).Methods:This randomized controlled study enrolled 120 pa-tients with AF and CAD who admitted Changzhou Wujin Hospital of Traditional Chinese Medicine between July 2022 and December 2023.Patients were randomly divided into control group(n=60,warfarin therapy)and inter-vention group(n=60,apixaban therapy).Each group received corresponding medication based on routine therapy for 8 weeks.Cardiac function indicators,levels of serum sST2,FGF-23,inflammatory factors,myocardial fibrosis indicators,and incidence of adverse reactions were compared between the two groups.Results:Compared to those in the control group,participants in the intervention group had significantly higher left ventricular ejection fraction(LVEF)[(52.22±3.69)％vs.(48.37±4.14)％]and 6-minute walking distance(6MWD)[(456.29±56.47)m vs.(415.25±11.32)m](P＜0.001 all),and significantly lower left ventricular end-diastolic diameter(LVEDd)[(44.98±4.55)mm vs.(50.26±3.61)mm],levels of N-terminal pro B-type natriuretic peptide(NT-proB-NP)[(341.16±29.51)pg/ml vs.(392.33±32.27)pg/ml],cardiac troponin I(cTnI)[(3.76±1.12)ng/ml vs.(5.22±1.36)ng/ml],creatine kinase isoenzyme-MB(CK-MB)[(25.71±6.51)U/L vs.(39.13±6.33)U/L],high sensitive C-reactive protein(hsCRP)[(1.63±0.51)mg/L vs.(1.98±0.46)mg/L],tumor necrosis fac-tor-alpha(TNF-α)[(27.17±5.11)ng/Lvs.(34.19±5.32)ng/L],sST2[(52.11±5.87)μg/L vs.(62.37±5.82)μg/L]and FGF-23[(45.73±4.29)μg/L vs.(56.09±5.25)μg/L](P＜0.001 all).We detected signifi-cant lower incidence of adverse reactions in intervention group compared to control group(6.9％vs.26.3％,P=0.005).Conclusion:Apixaban could alleviate myocardial fibrosis,improve cardiac function,and reduce levels of heart failure biomarkers and inflammatory factors in patients with coronary artery disease and atrial fibrillation.

Schizophrenia (SZ) stands as a severe psychiatric disorder. This study applied diffusion tensor imaging (DTI) data in conjunction with graph neural networks to distinguish SZ patients from normal controls (NCs) and showcases the superior performance of a graph neural network integrating combined fractional anisotropy and fiber number brain network features, achieving an accuracy of 73.79% in distinguishing SZ patients from NCs. Beyond mere discrimination, our study delved deeper into the advantages of utilizing white matter brain network features for identifying SZ patients through interpretable model analysis and gene expression analysis. These analyses uncovered intricate interrelationships between brain imaging markers and genetic biomarkers, providing novel insights into the neuropathological basis of SZ. In summary, our findings underscore the potential of graph neural networks applied to multimodal DTI data for enhancing SZ detection through an integrated analysis of neuroimaging and genetic features.
Humans ; Schizophrenia/pathology* ; Diffusion Tensor Imaging/methods* ; Male ; Female ; Adult ; Brain/metabolism* ; Young Adult ; Middle Aged ; White Matter/pathology* ; Gene Expression ; Nerve Net/diagnostic imaging* ; Graph Neural Networks

Astragalus membranaceus(A. membranaceus), a traditional tonic, contains flavonoids as one of its main bioactive components and key indicators for quality standard detection. These compounds predominantly exist in glycosylated forms after glycosylation modification within the plant. The catalytic products of flavonoid glycosyltransferases in A. membranaceus have been reported to be mostly monoglycosides, and only AmUGT28 catalyzes luteolin to form diglycosides. In this study, we cloned a glycosyltransferase gene, AmGT90, from A. membranaceus, with an ORF length of 1 335 bp, encoding 444 amino acids, and the protein had a relative molecular mass of 50.5 kDa. Phylogenetic tree analysis indicated that AmGT90 belongs to the UGT74 family. In vitro enzymatic reaction showed that AmGT90 had broad substrate specificity and could catalyze the glycosylation of various flavonoids, including isoflavones, flavones, flavanones, and chalcones. AmGT90 not only catalyzed the formation of monoglycosides but also diglycosides. In addition, the mechanism of AmGT90 catalyzing the formation of diglycosides from luteolin was preliminarily explored. The experimental results showed that AmGT90 may preferentially recognize C4'-OH of luteolin and then recognize C7-OH to form diglycosides. This study reported a glycosyltransferase from A. membranaceus capable of converting flavonoids into monoglycosides and diglycosides. This finding not only enhances our understanding of the biosynthetic pathways of flavonoid glycosides in A. membranaceus but also introduces a new component for glycoside production through synthetic biology.
Glycosyltransferases/chemistry* ; Flavonoids/chemistry* ; Astragalus propinquus/classification* ; Phylogeny ; Glycosylation ; Plant Proteins/chemistry* ; Substrate Specificity ; Cloning, Molecular ; Amino Acid Sequence