Objective To explore the effectiveness of the generative large language model MedGo in nursing decision-making for elderly patients with multimorbidity. Methods A quasi-randomized controlled trial study was conducted involving 6 junior nurses, 6 senior nurses and the MedGo model from January 1, 2025 to March 31, 2025 at the Emergency Internal Medicine Ward of Shanghai East Hospital Affiliated to Tongji University. Clinical data of 120 elderly patients with multimorbidity were analyzed to compare the performance of the three groups in four tasks (nursing diagnosis assessment, nursing intervention formulation, complication identification, and complication prevention) from three evaluation dimensions: decision-making time consumption, decision accuracy, and decision-making quality. Results In terms of decision-making time, the senior nurse group completed all four tasks faster than the junior nurse group (P＜0.01), and the MedGo group completed all four tasks faster than the junior nurse group (P＜0.001) and the senior nurse group (P＜0.001). In terms of decision-making accuracy, senior nurse group scored higher than junior nurse group in all four tasks (P＜0.001), while the MedGo group outperformed the senior nurse group only in complication identification (P＜0.001). In terms of decision-making quality, the MedGo group scored higher than junior nurse group (P＜0.001) and senior nurse group (P＜0.001) in all four tasks. Conclusions The MedGo model demonstrates advantages of high efficiency, accuracy, and quality in nursing decision-making for elderly patients with multimorbidity; senior nurses outperform junior nurses in decision-making, providing diverse references for clinical nursing decision-making.

Surface proteins play pivotal roles in physiological processes, including cell recognition, signal transduction, substance transport, and immune responses. However, challenges persist in characterizing abnormal surface proteins in disease states and identifying therapeutic targets, due to the low abundance of these proteins within the total proteome and the frequent presence of their complex glycosylation modifications. Recent years have witnessed the vigorous development of chemical proteomics, leading to the successful creation of various chemical probes for the labeling and characterization of cell surface proteins. These techniques have subsequently been applied to the detection of disease surface proteins and the discovery of corresponding targets. Surface protein characterization techniques based on chemical proteomics are discussed herein, focusing on the principles of amino acid-targeted labeling, proximity labeling, and glycoprotein capture. The novelty, advantages, and limitations of techniques such as targeted lysine labeling, peroxidase and photocatalytic proximity labeling, and chemical glycan capture and metabolic glycan labeling are elaborated, and their applications across various biological models and disease types are described, aiming to provide some reference for target discovery and drug development targeting surface proteins.

PURPOSE: This study aimed to evaluate the accuracy of the ultrasonic jaw tracking system by comparing with the conventional electronic system in recording condylar movements. MATERIALS AND METHODS: Twenty-six subjects with normal occlusion participated in the study. The CADIAX® 4 and Jaw Motion Analyzer (JMA) systems were used to record condylar movement trajectories during mandibular border movements (protrusive/retrusive, lateral, and wide mouth opening), with each movement repeated three times. Both systems used facebows and sensors to locate the condylar axis points and capture movement trajectory data. Paired t-tests were used for normally distributed data, while the Wilcoxon rank-sum test was applied to non-normally distributed data. The level of significance was set at α = .05. RESULTS: The maximum condylar displacement in the sagittal plane during mandibular border movements and the sagittal condylar inclination (SCI) values on both the left and right sides showed no significant difference between the two systems (P > .05). The Bennett angle (BA) values on both the left and right sides measured by the JMA system were significantly higher than those measured by the CADIAX® 4 system (P < .05). The comfort levels of the JMA system were significantly higher than the CADIAX® 4 system (P < .05). CONCLUSION Through this study, it was found that the accuracy of the ultrasonic jaw tracking system was comparable with the conventional electronic system, except for the Bennett angle measurement. In terms of comfort and ease of use, the ultrasonic jaw tracking system is more favored.

Objective Based on 25 indicators including immune factors, cell count classification, and smear results of the knee joint fluid, machine learning models were established to distinguish between osteoarthritis (OA) and rheumatoid arthritis (RA). Methods 100 OA and 40 RA patients scheduled for total knee arthroplasty were enrolled respectively. Each patient's knee joint fluid was collected preoperatively. Nucleated cells were counted and classified. The expression levels of immune factors, including tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1β), IL-6, IL-8, IL-15, matrix metalloproteinase 3 (MMP3), MMP9, MMP13, rheumatoid factor (RF), serum amyloid A (SAA), C-reactive protein (CRP), and others were measured. Smears and microscopic classification of all the immune factors were performed. Independent influencing factors for OA or RA were identified using univariate binary logistic regression, Lasso regression, and multivariate binary logistic regression. Based on the independent influencing factors, three machine learning models were constructed which are logistic regression, random forest, and support vector machine. Receiver operating characteristic curve (ROC), calibration curve and decision curve analysis (DCA) were used to evaluate and compare the models. Results A total of 5 indicators in the knee joint fluid were screened out to distinguish OA and RA, which were IL-1β(odds ratio(OR)=10.512, 95× confidence interval (95×CI) was 1.048-105.42, P=0.045), IL-6 (OR=1.007, 95×CI was 1.001-1.014, P=0.022), MMP9 (OR=3.202, 95×CI was 1.235-8.305, P=0.017), MMP13 (OR=1.002, 95× CI was 1-1.004, P=0.049), and RF (OR=1.091, 95×CI was 1.01-1.179, P=0.026). According to the results of ROC, calibration curve and DCA, the accuracy (0.979), sensitivity (0.98) and area under the curve (AUC, 0.996, 95×CI was 0.991-1) of the random forest model were the highest. It has good validity and feasibility, and its distinguishing ability is better than the other two models. Conclusion The machine learning model based on immune factors in the knee joint fluid holds significant value in distinguishing OA and RA. It provides an important reference for the clinical early differential diagnosis, prevention and treatment of OA and RA.
Humans ; Arthritis, Rheumatoid/metabolism* ; Machine Learning ; Male ; Female ; Middle Aged ; Aged ; Synovial Fluid/immunology* ; Osteoarthritis, Knee/metabolism* ; Knee Joint/metabolism* ; ROC Curve ; Diagnosis, Differential

BACKGROUND: The incidence and mortality rates of lung cancer remain on the rise, creating an urgent need for screening among high-risk populations and early prevention. This study aims to explore the association and interaction between multidimensional lifestyle, socioeconomic status, and the incidence of lung cancer, and to provide scientific evidence for screening high-risk populations and preventing lung cancer. METHODS: Healthy lifestyle score was constructed using information on smoking, alcohol consumption, exercise, diet and sleep obtained through a questionnaire survey. Socioeconomic status was evaluated based on information on education, employment, and family income, and genetic testing data were used to assess the risk of genetic variation. A proportional hazards assumption test was conducted, and the Cox proportional hazards model was applied to analyze the associations between healthy lifestyle scores, socioeconomic status, and lung cancer, as well as the interactions among various factors, after adjusting for the risk of genetic variation, age, gender, diabetes, hypertension and the living environment score. RESULTS: A total of 245,538 samples that entered the cohort from March, 2006 to October, 2010 were included and followed up until December 31, 2022. The participants were divided into the case group (n=1472) and the control group (n=244,066). The analysis results showed that after adjusting for covariates, there was still an association between the healthy lifestyle score, socioeconomic status, and the incidence of lung cancer: compared with participants with a high healthy lifestyle score, the risk of lung cancer in participants with medium and low healthy lifestyle scores was significantly increased, with hazard ratios (HR) of 2.12 (95%CI: 1.86-2.41) and 3.36 (95%CI: 2.82-3.99) respectively; compared with participants with high socioeconomic status, the risk of lung cancer in participants with medium and low socioeconomic status was significantly increased, with HR of 1.29 (95%CI: 1.13-1.48) and 1.67 (95%CI: 1.46-1.90) respectively. Moreover, there were interactions between smoking status and socioeconomic status (Pfor interaction=0.05), as well as the other four lifestyle factors (Pfor interaction=0.02). CONCLUSIONS This study identified the association between multidimensional lifestyle factors and socioeconomic status with the incidence of lung cancer, as well as interactions between smoking and socioeconomic status and four other lifestyle factors, providing a scientific basis for screening and prevention in high-risk populations for lung cancer.
Humans ; Lung Neoplasms/epidemiology* ; Male ; Female ; Middle Aged ; Incidence ; Life Style ; Social Class ; Aged ; Adult ; Risk Factors

Increasing evidence has underscored the significance of post-stroke alterations along gut-brain axis, while its role in pathogenesis and treatment of ischemic stroke (IS) remains largely unexplored. This study aimed to elucidate the therapeutic effects and action targets of Panax notoginseng saponins (PNS) on IS and explore a novel pathogenesis and treatment strategy of IS via profiling the microbial community and metabolic characteristics along gut-brain axis. Our findings revealed for the first time that the therapeutic effect of PNS on IS was microbiota-dependent. Ischemia/reperfusion (I/R) modeling significantly down-regulated Lactobacilli in rats, and PNS markedly recovered Lactobacilli, particularly Lactobacillus reuteri (L.Reu). Metabolomics showed a significant reduction in serum histidine (HIS) in clinical obsolete IS patients and rehabilitation period I/R rats. Meanwhile, the L.Reu colonization in I/R rats exhibited significant neuroprotective activity and greatly increased HIS in serum, gut microbiota, and brain. Moreover, exogenous HIS demonstrated indirect neuroprotective effects through metabolizing to histamine. Notably, vagus nerve severance in I/R rats was performed to investigate HIS's neuroprotective mechanism. The results innovatively revealed that PNS could promote HIS synthesis in gut by enhancing L.Reu proportion, thereby increasing intracerebral HIS through peripheral pathway. Consequently, our data provided novel insights into HIS metabolism mediated by L.Reu in the pathogenesis and treatment of IS.

Stearoyl-coenzyme A desaturase 1 (SCD1) catalyzes the rate-limiting step of de novo lipogenesis and modulates lipid homeostasis. Although numerous SCD1 inhibitors were tested for treating metabolic disorders both in preclinical and clinic studies, the tissue-specific roles of SCD1 in modulating obesity-associated metabolic disorders and determining the pharmacological effect of chemical SCD1 inhibition remain unclear. Here a novel role for intestinal SCD1 in obesity-associated metabolic disorders was uncovered. Intestinal SCD1 was found to be induced during obesity progression both in humans and mice. Intestine-specific, but not liver-specific, SCD1 deficiency reduced obesity and hepatic steatosis. A939572, an SCD1-specific inhibitor, ameliorated obesity and hepatic steatosis dependent on intestinal, but not hepatic, SCD1. Mechanistically, intestinal SCD1 deficiency impeded obesity-induced oxidative stress through its novel function of inducing metallothionein 1 in intestinal epithelial cells. These results suggest that intestinal SCD1 could be a viable target that underlies the pharmacological effect of chemical SCD1 inhibition in the treatment of obesity-associated metabolic disorders.

Osteonecrosis of the femoral head(ONFH)is a disabling orthopedic disease,pathologically characterized by progressive collapse of the femoral head accompanied by destruction of the trabecular and articular cartilage structures,leading to hip joint pain and progressive functional impairment.Bone marrow mesenchymal stem cell-derived extracellular vesicles(BMSC-EVs)show great promise in tissue repair and regeneration,with low immunogenicity and tumorigenicity,and play roles in osteogenesis,angiogenesis,and immunomodulation.This review summarizes the therapeutic effects and underlying mechanisms of BMSC-EVs in ONFH,providing a theoretical basis for its treatment.

Objective: To assess the dynamic changes of microcirculation at acupoints in patients with primary dysmenorrhea and cold congelation and blood stasis syndrome using laser speckle blood flow imaging. Methods: Patients with primary dysmenorrhea and cold coagulation and blood stasis syndrome (primary dysmenorrhea group, n=53) and healthy female college students(control group, n=57) who met the inclusion and exclusion criteria from October 2020 to July 2022 were enrolled at Hebei University of Chinese Medicine. On the premenstrual and first day of menstruation, a laser speckle blood flow imaging system was used to measure the microcirculation blood flow perfusion on the surface of acupoints related to the conception, thoroughfare, and governor vessels, and stomach, spleen, and bladder meridians in the abdomen and lumbosacral regions. The dynamic changes in microcirculation were calculated based on the difference in average blood flow perfusion at each acupoint before and after menstruation. Receiver operating curve (ROC) analysis was used to analyze the diagnostic efficacy of dynamic changes in microcirculation on the surface of each acupoint. The microcirculation sensitization rate of acupoints was calculated. Results: Compared with the control group, the dynamic changes in microcirculation at the following acupoints in the primary dysmenorrhea group were increased (P<0.05): conception vessel (Yinjiao[CV7], Qihai[CV6], Shimen[CV5], Guanyuan[CV4]); left thoroughfare vessel (left Huangshu[KI16], left Zhongzhu[KI15], left Siman[KI14], left Qixue[KI13], left Dahe[KI12], left Henggu[KI11]); left stomach meridian (left Tianshu[ST25], left Wailing[ST26], left Qichong[ST30]); left spleen meridian (left Daheng[SP15], left Fujie[SP14]); right thoroughfare vessel (right Huangshu[KI16], right Zhongzhu[KI15], right Siman[KI14], right Qixue[KI13], right Dahe[KI12], right Henggu[KI11]); right stomach meridian (right Wailing[ST26], right Daju[ST27], right Shuidao[ST28], right Guilai[ST29], right Qichong[ST30]); and right spleen meridian (right Fujie[SP14]). The area under the ROC curve of conception vessel (Yinjiao[CV7], Qihai[CV6], Shimen[CV5], Guanyuan[CV4]), thoroughfare vessel (right Siman[KI14], left Huangshu[KI16], right Qixue[KI13], right Zhongzhu[KI15], right Dahe[KI12], left Zhongzhu[KI15], left Siman[KI14], right Huangshu[KI16], left Qixue[KI13], right Henggu[KI11], left Henggu[KI11], left Dahe[KI12]); stomach meridian (left Tianshu[ST25], right Guilai[ST29], left Wailing[ST26], right Shuidao[ST28], right Daju[ST27], right Wailing[ST26], right Qichong[ST30], left Qichong[ST30]), and spleen meridian (left Daheng[SP15], left Fujie[SP14], right Fujie[SP14]) was 0.610-0.682 (P<0.05). Compared with the control group, the sensitization rate of some acupoints in the primary dysmenorrhea group increased (P<0.05). Conclusion With the onset of menstruation, the blood flow perfusion of some acupoints in the abdomen (thoroughfare, and conception vessels, and stomach and spleen meridians) of patients with primary dysmenorrhea and cold blood coagulation and blood stasis syndrome increased, and the status of acupoints changed from a resting state to an active state. These acupoints are sensitive in patients with primary dysmenorrhea and cold blood coagulation and blood stasis syndrome and have a certain diagnostic efficacy, providing a basis for further analyzing the efficacy and mechanism of acupuncture and moxibustion to treat primary dysmenorrhea with cold blood coagulation and blood stasis syndrome.

PURPOSE: This study aimed to evaluate the accuracy of the ultrasonic jaw tracking system by comparing with the conventional electronic system in recording condylar movements. MATERIALS AND METHODS: Twenty-six subjects with normal occlusion participated in the study. The CADIAX® 4 and Jaw Motion Analyzer (JMA) systems were used to record condylar movement trajectories during mandibular border movements (protrusive/retrusive, lateral, and wide mouth opening), with each movement repeated three times. Both systems used facebows and sensors to locate the condylar axis points and capture movement trajectory data. Paired t-tests were used for normally distributed data, while the Wilcoxon rank-sum test was applied to non-normally distributed data. The level of significance was set at α = .05. RESULTS: The maximum condylar displacement in the sagittal plane during mandibular border movements and the sagittal condylar inclination (SCI) values on both the left and right sides showed no significant difference between the two systems (P > .05). The Bennett angle (BA) values on both the left and right sides measured by the JMA system were significantly higher than those measured by the CADIAX® 4 system (P < .05). The comfort levels of the JMA system were significantly higher than the CADIAX® 4 system (P < .05). CONCLUSION Through this study, it was found that the accuracy of the ultrasonic jaw tracking system was comparable with the conventional electronic system, except for the Bennett angle measurement. In terms of comfort and ease of use, the ultrasonic jaw tracking system is more favored.