Amoenucles A-F (1-6), six previously undescribed nucleoside derivatives, and two known analogs (7 and 8) were isolated from the culture of Aspergillus amoenus TJ507. Their structures were elucidated through spectroscopic analysis, single-crystal X-ray crystallography, and chemical reactions. Notably, 3 and 4 represent the first reported instances of nucleosides with an attached pyrrole moiety. Of particular significance, the absolute configuration of the sugar moiety of 1-4 was determined using nuclear magnetic resonance (NMR), electric circular dichroism (ECD) calculations, and a hydrolysis reaction, presenting a potentially valuable method for confirming nucleoside structures. Furthermore, 1, 2, and 5-8 exhibited potential tumor necrosis factor α (TNF-α) inhibitory activities, which may provide a novel chemical template for the development of agents targeting autoimmune and inflammatory diseases.
Aspergillus/chemistry* ; Tumor Necrosis Factor-alpha/antagonists & inhibitors* ; Molecular Structure ; Nucleosides/isolation & purification* ; Crystallography, X-Ray ; Animals ; Humans ; Mice ; Magnetic Resonance Spectroscopy

Obesity, as a chronic recurrent disease, has become a major public health challenge in China. To implement the requirements of the Healthy China Initiative (2019—2030), under domestic guidelines or consensus statements on overweight and obesity, and in alignment with the latest scientific advances globally, the Quality control protocol for adult overweight and obesity screening in health management (examination) institutions (2025 edition) was developed. This protocol was drafted by the Health Management Center of Shanghai Changzheng Hospital and formulated through multiple rounds of deliberation by experts in China’s health examination quality control field. The protocol establishes unified standards for screening facilities, personnel qualifications, and measurement or testing procedures. It defines specific screening items, outlines a standardized screening pathway, and sets requirements for the final medical review, ensuring the scientific validity, effectiveness, and safety of the screening process. The implementation of this protocol will enhance the consistency of weight management practices for adults across health examination institutions and strengthen the quality control of overweight and obesity screening programs.

ObjectiveTo understand the epidemiological characteristics of syphilis in Ruian City, so as to provide a scientific basis for developing syphilis prevention and control strategies. MethodsDescriptive epidemiological methods were used to investigate the infection status of syphilis cases reported among the permanent resident population in Ruian City from 2014 to 2023, and its epidemiological characteristics were analyzed. ResultsA total of 5 482 syphilis cases were reported in Ruian from 2014 to 2023, with a male-female ratio of 1∶1.47. The average annual incidence rate from 2014 to 2023 was 37.51/100 000, with a declining trend in the incidence rate among females (APC=-4.78%, P<0.05). The incidence of primary and secondary syphilis decreased, while the proportion of latent syphilis cases increased. No cases of congenital syphilis were reported from 2017 to 2023. The majority of cases (60.29%) were reported among individuals aged 20‒<50 years. In terms of occupation, the highest proportion was found among housekeepers and the unemployed, constituting 42.70% the total cases. Dermatology departments reported the most cases in medical institutions, accounting for 33.38% of the total cases. The most likely route of infection was heterosexual transmission, accounting for 85.84%. ConclusionThe incidence of syphilis among females in Ruian City shows a declining trend, but the overall situation remains concerning. Prevention and control efforts should be intensified among key groups and high-risk populations, along with an enhancement on health education to curb the spread of syphilis.

Objective To explore the relationship between symptom burden and disease uncertainty in patients with chronic heart failure(CHF),and verify the moderating effect of health literacy on symptom burden and disease uncertainty.Methods A total of 234 patients with CHF who were hospitalized in the First Affiliated Hospital of Wenzhou Medical University from April 2021 to April 2022 were selected by convenience sampling method.Memorial symptom assessment scale-heart failure,Mishel uncertainty in illness scale for adult,and health literacy management scale were used for questionnaire surveys.Multiple linear regression was used to verify the moderating effect of health literacy on symptom burden and disease uncertainty in CHF patients.Results The symptom burden of CHF patients was positively correlated with disease uncertainty(r=0.497,P＜0.01),and negatively correlated with health literacy(r=-0.252,P＜0.01),health literacy was negatively correlated with disease uncertainty(r=-0.593,P＜0.01).Moderating effect analysis showed that health literacy had a moderating effect between symptom burden and disease uncertainty in CHF patients(β=-0.258,P＜0.05).Simple slope analysis showed that when the health literacy level of CHF patients was high,symptom burden had less positive predictive effect on disease uncertainty(simple slope=6.817,P＜0.05).Conclusion The symptom burden of CHF patients can affect the level of disease uncertainty and is regulated by health literacy.Nursing should pay attention to the effect of symptom burden on the level of disease uncertainty in CHF patients,and formulate interventions to reduce the symptom burden and improve health literacy,so as to reduce the level of disease uncertainty.

Adiponectin is a plasma protein derived from fat cells that regulates a variety of metabolic processes. With the increasing research of adiponectin in nervous system diseases, it is gradually found that adiponectin plays a role in the control of key processes in brain physiology, including neuronal excitability and synaptic plasticity, neuroprotection, neurogenesis and regulation of glial cell activation. This article reviews the research progress of adiponectin in neurodegenerative diseases, convulsive diseases, ischemic brain injury and other neurological diseases.

Objective:To construct and apply the quality sensitive indicator system for eye, ear, nose and throat specialized nursing in Operating Rooms, in order to provide a basis for evaluating the quality of nursing work in specialized Operating Rooms.Methods:Using the three-dimensional quality evaluation model of "structure-process-result", a preliminary framework for quality sensitive indicators of eye, ear, nose, and throat specialty nursing in the Operating Room was developed using literature search and expert interviews. The final indicator system and weight were determined through two rounds of Delphi expert inquiry. In January 2023, targeted training was conducted in the Operating Room of Eye & ENT Hospital of Fudan University based on the established quality indicator system. The difference of outcome indicators in the sensitive index system of nursing quality in Operating Room of our hospital in December 2022 (before training) and February 2023 (after training) were compared.Results:The final version of the quality sensitive indicator system for eye, ear, nose and throat specialty nursing in the Operating Room included three primary indicators, 10 secondary indicators and 36 tertiary indicators. The positive coefficients of the two rounds of consultation with experts were both 100.00%, and the authoritative coefficients were 0.917 and 0.931. After applying the quality indicator system, the failure rate of emergency drills related to difficult airways among nursing staff in the Operating Room of the Eye, Ear, Nose and Throat Department decreased from 4.86% to 0.54% ( P<0.05). The failure rate of specialized theoretical and operational skills assessment decreased from 6.49% to 1.08% ( P<0.01). The number of unqualified nursing quality cases in the two groups decreased to different degrees ( P< 0.05). Among the occurrence of adverse events in the two groups, the incidence of intraoperative counting accidents decreased from 1.85% to 0 ( P<0.05), and the incidence of iatrogenic head and face stress injuries of surgical patients decreased from 2.47% to 0.31% ( P<0.05) . Conclusions:The sensitive indicator system for the quality of eye, ear, nose and throat specialized nursing in the Operating Room constructed in this study is scientifically sound and applicable, which can effectively reduce nursing risks in specialized Operating Rooms and improve the quality of nursing work in specialized Operating Rooms.

Abstract: Objective To analyze the etiological characteristics of Vibrio parahaemolyticus (VP) isolated from food-borne outbreaks in Fuqing City between 2021 and 2023, and to explore its distribution characteristics and epidemic types. 　Methods The serotypes, virulence genes (tlh, tdh, trh), and drug resistance profiles of 23 VP strains isolated from 4 food-borne disease outbreaks were tested by agglutination, multiple real-time PCR, and broth microdilution methods. Pulsed-field gel electrophoresis (PFGE) was used for molecular typing to analyze homology. Results　From 2021 to 2023, four food-borne disease outbreaks occurred in Fuqing City, leading to the isolation and identification of 23 VP strains. Among these, 19 clinical strains were divided into two serotypes: O10:K4 type, comprising 13 strains (68.4%), and O4:KUT type, comprising 6 strains (31.6%); the tdh gene carrying rate was 100.0%, and no trh gene was detected. The serotypes of the four food isolates were O3∶K4, O10:K24, O11∶KUT, and O3∶K37, respectively, all differing from the clinical strains, with two strains coming from the same food item without tdh and trh genes detected. The resistance rate of all isolates to cefazolin was the highest (87.0%), with two strains (8.7%) from different sources showing multidrug resistance. The PFGE genotypes of 19 case isolates were clustered and correlated with their serotypes and drug resistance profiles; strains isolated from the same outbreak event showed high similarity, whereas food strains exhibited polymorphism in PFGE genotypes. Conclusions The predominant serotype causing the four outbreaks was O10:K4, with some strains showing multidrug resistance; all clinical strains carried the tdh gene. The high correlation between strains from the same outbreak event suggests they are homologous. Special attention should be paid to the risk of outbreaks and pandemics caused by the O10:K4 type strain again. Additionally, food safety risk monitoring and assessment should be strengthened to provide an effective basis for epidemic prevention and control and early identification and warning.

ObjectiveTo investigate the intervention effect of Buzhong Yiqitang （BZYQT） on pulmonary inflammation in mice induced by chronic intermittent hypoxia （CIH） and preliminarily elucidate its mechanism. MethodForty healthy male C57BL/6 mice aged 6-8 weeks were randomly divided into the following groups： normoxia group， model group （exposed to CIH）， and low-， medium-， and high-dose BZYQT groups. The normoxia group was exposed to a normoxic environment， while the model group and the low-， medium-， and high-dose BZYQT groups were exposed to intermittent hypoxia. In the BZYQT groups， the BZYQT （8.1， 16.2， 32.4 g·kg^-1·d^-1） was administered orally 30 min before placing the mice in the hypoxic chamber， while the model group and the normoxia group received an equivalent volume of normal saline. After five weeks of modeling， pulmonary function of the mice was measured using an EMKA animal lung function analyzer， and lung tissue samples were collected after the pulmonary function tests. Hematoxylin-eosin （HE） staining was performed to observe the histopathological changes in the lung tissue of each group. Enzyme-linked immunosorbent assay （ELISA） was used to measure the levels of interleukin-6 （IL-6）， interleukin-8 （IL-8）， tumor necrosis factor-α （TNF-α） in the serum， as well as angiotensin Ⅱ （Ang Ⅱ） and angiotensin-（1-7） ［Ang（1-7）］ in lung tissue. Western blot and immunohistochemistry were used to detect the protein expression of IL-6， IL-8， TNF-α， angiotensin-converting enzyme 2 （ACE2）， and mitochondrial assembly receptor （Mas）. ResultCompared with the normoxia group， the model group showed significant abnormalities in lung function （P<0.05， P<0.01）， lung tissue changes， such as thickening of alveolar walls and inflammatory cell infiltration， increased levels of IL-6， IL-8， TNF-α in the serum and Ang Ⅱ in lung tissue （P<0.01）， decreased level of Ang（1-7） （P<0.01）， increased protein expression of IL-6， IL-8， and TNF-α， and decreased protein expression of ACE2 and Mas （P<0.05， P<0.01）. Compared with the model group， the BZYQT groups showed improvement in lung function （P<0.05， P<0.01）， and HE staining of lung tissue showed approximately normal alveolar wall thickness and reduced inflammatory cell infiltration. Immunohistochemistry and Western blot analysis showed a significant decrease in the expression of inflammatory-related proteins （P<0.05， P<0.01）， and a significant increase in ACE2 and Mas protein expression （P<0.05， P<0.01）. ConclusionBZYQT can improve lung injury in mice exposed to CIH by regulating the ACE2-Ang（1-7）-Mas axis to inhibit inflammatory responses.

Objective:To evaluate the relationship between preoperative widespread pain and chronic post-surgical pain (CPSP) following total knee arthroplasty (TKA) in the patients with knee osteoarthritis.Methods:Two hundred American Society of Anesthesiologists physical status Ⅰ-Ⅲ patients with knee osteoarthritis, aged 40-70 yr, undergoing elective the first unilateral primary TKA under general anesthesia, were enrolled.The widespread pain index, visual analogue scale score, Hospital Anxiety and Depression Scale and Central Sensitization Inventory scores were recorded at 1 day before surgery.The patients were divided into CPSP-positive group and CPSP-negative group according to visual analogue scale score at 6 months after surgery.Risk factors for CPSP were analyzed by logistic regression.Results:The results of logistic regression analysis showed that increased preoperative widespread pain index score, Central Sensitization Inventory score and Hospital Anxiety and Depression Scale score and female were risk factors for CPSP after TKA.Conclusions:Preoperative widespread pain is a risk factor for CPSP following TKA in the patients with knee osteoarthritis.

Objective:To assess the effect of intra-aortic balloon pump (IABP) on in-hospital mortality in patients with cardiac arrest undergoing extracorporeal cardiopulmonary resuscitation (ECPR).Methods:A retrospective study was performed on 696 patients with intra-hospital cardiac arrest undergoing ECPR from Samsung Medical Center in Korea between January 2004 and December 2013. According to whether IABP was used, the patients were divided into ECPR group and ECPR+IABP group. Cox regression and propensity score matching (PSM) were used to examine the correlation between IABP usage and in-hospital mortality, and standardized mean difference ( SMD) was used to check the degree of PSM. Survival analysis of in-hospital mortality was performed by the Kaplan-Meier method, and further analyzed by the Log-Rank test. Using the propensity score as weights, multiple regression model and inverse probability weighting (IPW) model were used for sensitivity analysis. In-hospital mortality, extracorporeal membrane oxygenation (ECMO) withdrawal success rate and neurological function prognosis were compared between the two groups. Results:A total of 199 patients with cardiac arrest undergoing ECPR were included, including 120 males and 79 females, and the average age was (60.0±16.8) years. Thirty-one patients (15.6%) were treated with ECPR and IABP, and 168 patients (84.4%) only received ECPR. The total hospitalized mortality was 68.8% (137/199). The 1 : 1 nearest neighbor matching algorithm was performed with the 0.2 caliper value. The following variables were selected to generate propensity scores, including age, gender, race, marital status, insurance, admission type, service unit, heart rate, mean arterial pressure, respiratory rate, pulse oxygen saturation, white blood cell count. After the propensity score matching, 24 pairs of patients were successfully matched, with the average age of (63.0±12.8) years, including 31 males and 17 females. The in-hospital mortality was 72.6% (122/168) and 48.4% (15/31) in the ECPR group and the ECPR+IABP group [hazard ratio ( HR) = 0.48, 95% confidence interval (95% CI) was 0.28-0.82, P = 0.007]. Multiple regression model, adjusted propensity score, PSM and IPW model showed that the in-hospital mortality in the ECPR+IABP group was significantly lower compared with the ECPR group ( HR = 0.44, 0.50, 0.16 and 0.49, respectively, 95% CI were 0.24-0.79, 0.28-0.91, 0.06-0.39 and 0.31-0.77, all P < 0.05). The combined application of IABP could improve the ECMO withdrawal success rate [odds ratio ( OR) = 8.95, 95% CI was 2.72-29.38, P < 0.001] and neurological prognosis ( OR = 4.06, 95% CI was 1.33-12.40, P = 0.014) in adult cardiac arrest patients. Conclusion:In patients with cardiac arrest using ECPR, the combination of IABP was independently associated with lower in-hospital mortality, higher ECMO withdrawal success rate and better neurological prognosis.