Objective: To investigate the efficacy of magnesium-strontium co-doped hydroxyapatite mineralized collagen (MSHA/Col) in improving the bone repair microenvironment and enhancing bone regeneration capacity, providing a strategy to address the insufficient biomimetic composition and limited bioactivity of traditional hydroxyapatite mineralized collagen (HA/Col) scaffolds. Methods: A high-molecular-weight polyacrylic acid-stabilized amorphous calcium magnesium strontium phosphate precursor (HPAA/ACMSP) was prepared. Its morphology and elemental distribution were characterized by high-resolution transmission electron microscopy (TEM) and energy-dispersive spectroscopy. Recombinant collagen sponge blocks were immersed in the HPAA/ACMSP mineralization solution. Magnesium-strontium co-doped hydroxyapatite was induced to deposit within collagen fibers (experimental group: MSHA/Col; control group: HA/Col). The morphological characteristics of MSHA/Col were observed using scanning electron microscopy (SEM). Its crystal structure and chemical composition were analyzed by X-ray diffraction and Fourier transform infrared spectroscopy, respectively. The mineral phase content was evaluated by thermogravimetric analysis. The scaffold's porosity, ion release, and in vitro degradation performance were also determined. For cytological experiments, CCK-8 assay, live/dead cell staining, alkaline phosphatase staining, alizarin red S staining, RT-qPCR, and western blotting were used to evaluate the effects of the MSHA/Col scaffold on the proliferation, viability, early osteogenic differentiation activity, late mineralization capacity, and gene and protein expression levels of key osteogenic markers [runt-related transcription factor 2 (Runx2), collagen type Ⅰ (Col-Ⅰ), osteopontin (Opn), and osteocalcin (Ocn)] in mouse embryonic osteoblast precursor cells (MC3T3-E1). Results: HPAA/ACMSP appeared as amorphous spherical nanoparticles under TEM, with energy spectrum analysis showing uniform distribution of carbon, oxygen, calcium, phosphorus, magnesium, and strontium elements. SEM results of MSHA/Col indicated successful complete intrafibrillar mineralization. Elemental analysis showed the mass fractions of magnesium and strontium were 0.72% (matching the magnesium content in natural bone) and 2.89%, respectively. X-ray diffraction revealed characteristic peaks of hydroxyapatite crystals (25.86°, 31°-34°). Infrared spectroscopy results showed characteristic absorption peaks for both collagen and hydroxyapatite. Thermogravimetric analysis indicated a mineral phase content of 78.29% in the material. The scaffold porosity was 91.6% ± 1.1%, close to the level of natural bone tissue. Ion release curves demonstrated sustained release behavior for both magnesium and strontium ions. The in vitro degradation rate matched the ingrowth rate of new bone tissue. Cytological experiments showed that MSHA/Col significantly promoted MC3T3-E1 cell proliferation (130% increase in activity at 72 h, P < 0.001). MSHA/Col exhibited excellent efficacy in promoting osteogenic differentiation, significantly upregulating the expression of osteogenesis-related genes and proteins (Runx2, Col-Ⅰ, Opn, Ocn) (P < 0.01). Conclusion The MSHA/Col scaffold achieves dual biomimicry of natural bone in both composition and structure, and effectively promotes osteogenic differentiation at the genetic and protein levels, breaking through the functional limitations of pure hydroxyapatite mineralized collagen. This provides a new strategy for the development of functional bone repair materials

ObjectiveThis study aims to compare the modeling effects of submaxillary gland antigen and salivary gland antigen in the establishment of Sjögren syndrome (SS) mouse models, and to characterize the phenotypic and immunological features of these models in comparison with spontaneous SS-prone non-obese diabetic (NOD)/LtJ mice. MethodsAdult C57BL/6J mice (equal numbers of males and females) were immunized with submaxillary gland antigen or salivary gland antigen, respectively, combined with Freund's adjuvant to induce SS models. Mice immunized with phosphate-buffered saline (PBS) combined with Freund's adjuvant served as the control group. Immunization was induced via multiple subcutaneous injections in the back with antigen combined with Freund's complete adjuvant (FCA) on Days 1 and 7. A booster immunization was administered via multiple subcutaneous injections in the back with antigen combined with Freund's incomplete adjuvant (FIA) on Day 14. Female NOD/LtJ mice were used as the spontaneous SS model group, with ICR mice as the corresponding control strain for comparative analysis. Body weight, water intake, and salivary flow rate of mice were dynamically monitored for 4 weeks. At the end of the experiment, tissue and serum samples were collected, the weights of submaxillary glands, thymus, and spleen were measured, and organ indices (organ-to-body weight ratios) were calculated. Pathological morphological analysis of the submaxillary gland and spleen was performed with hematoxylin and eosin (HE) staining. Serum interleukin-17 (IL-17) level was detected using enzyme-linked immunosorbent assay (ELISA). Real-time quantitative polymerase chain reaction was used to detect the mRNA expression levels of SS type A (SSA) and SS type B (SSB) in submaxillary gland tissues. ResultsFemale mice in the submaxillary gland antigen group exhibited significantly increased water intake (P<0.05) and reduced salivary flow rate (P<0.05) compared with the female control group. No statistically significant differences were observed in the submaxillary gland index, thymus index and spleen index (P>0.05). Focal lymphocytic infiltration was observed in the submaxillary glands, and the splenic marginal zone was enlarged. Serum IL-17 levels were significantly increased (P<0.05). There was no significant difference in submaxillary gland SSA/SSB expression levels (P>0.05). Compared with the female control group, female mice in the salivary gland antigen group showed no statistically significant differences in water intake, salivary flow rate, submaxillary gland index, and spleen index (P>0.05), whereas the thymus index was significantly reduced (P<0.01). Mild inflammatory cell infiltration and glandular atrophy were observed in the submaxillary glands, and the splenic white pulp and marginal zone were slightly enlarged. Serum IL-17 levels and submaxillary gland SSB mRNA expression levels were significantly increased (P<0.01), whereas no significant change was observed in submaxillary gland SSA expression levels (P>0.05). Compared with the male control group, mild submaxillary gland atrophy was observed in male mice in the submaxillary gland antigen group, whereas no obvious changes were found in other modeling-related indicators (P>0.05). Compared with the ICR control group, NOD/LtJ model mice exhibited elevated water intake (P<0.05), significantly reduced salivary flow rate (P<0.01), no significant differences in the submaxillary gland index or spleen index (P>0.05), but a significantly increased thymus index (P<0.05). Marked focal infiltration was observed in the submaxillary glands, the splenic marginal zone was obviously enlarged, and serum IL-17 concentrations as well as submaxillary gland SSA/SSB expression levels were significantly increased (P<0.05). ConclusionSubmaxillary gland antigen and salivary gland antigen can induce SS-related features in female C57BL/6J mice. The SS-related phenotype is more pronounced in the submaxillary gland antigen group than in the salivary gland antigen group, but weaker than that in spontaneously SS-prone female NOD/LtJ mice. Immunization of male C57BL/6J mice with submaxillary or salivary gland antigens fails to induce an obvious SS phenotype.

Objective:To explore the application of nursing intervention based on the capability, opportunity, motivation-behavior model (COM-B) in stroke patients during the rehabilitation period.Methods:Using the convenience sampling method, 146 stroke patients admitted to the First Affiliated Hospital of Zhengzhou University from February 2021 to February 2024 were selected as the research objects. According to the admission time sequence, they were divided into the COM-B group and the routine group, with 73 cases in each group. The routine group received routine nursing measures, and the COM-B group was intervened with the COM-B intervention, both for 3 months. The scores of the Health Education Self-Management Scale for Stroke Patients (HES-SP), the Exercise of Self-Care Agency Scale (ESCA), the Fugl-Meyer Assessment (FMA), and the Barthel Index of the two groups before and after the intervention were compared.Results:Finally, 72 patients in the COM-B group and 71 patients in the routine group completed the study. After 3 months of intervention, the scores of ESCA, HES-SP, FMA, and the Barthel Index of the two groups were all higher than those before the intervention, and the scores of COM-B group were all higher than those of the routine group, and the differences were statistically significant ( P<0.05) . Conclusions:The application of the COM-B intervention in stroke patients can improve patients' healthy behaviors and self-care abilities, and enhance their limb motor function and activities of daily living abilities, with a good application effect.

Objective To investigate the clinical features,etiological features and prognosis of patients with hematologic diseases complicated with candidemia for improving clinical diagnosis and treatment.Methods A retrospective analysis was conducted for 107 hematological patients complicated with candidemia who were treated in the First Affiliated Hospital of Zhengzhou University,Henan Cancer Hospital,Henan Provincial People's Hospital,or Zhengzhou People's Hospital from June 2022 to May 2024.The clinical data and pathogenic bacteria were analyzed by univariate and multivariate analyses.Results The Candida pathogen of the 107 cases of candidemia were mostly Candida tropicalis(73.8％),followed by Candida parapsilosis,Candida glabrata,and Candida albicans.Antifungal susceptibility testing showed that 43.9％,47.7％,and 48.6％of the Candida strains were resistant voriconazole,fluconazole and itraconazole,respectively.Logistic regression analysis found that disease not in remission(OR=7.795,95％CI:2.274-26.723),septic shock(OR=10.376,95％CI:1.129-95.388),multiple organ dysfunction syndrome(MODS)(OR=9.107,95％CI:1.789-46.361),and inappropriate antifungal treatment(OR=3.422,95％CI:1.153-10.153)were risk factors for 30-day mortality in hematological patients with candidemia.Conclusions Candidemia in patients with hematological diseases is associated with high mortality rate,the major pathogen of which is Candida tropicalis.The Candida isolates showed high resistance rates to azoles.Disease not in remission,septic shock,MODS,and inappropriate antifungal treatment are the risk factors for mortality.

Objective To investigate the clinical features,etiological features and prognosis of patients with hematologic diseases complicated with candidemia for improving clinical diagnosis and treatment.Methods A retrospective analysis was conducted for 107 hematological patients complicated with candidemia who were treated in the First Affiliated Hospital of Zhengzhou University,Henan Cancer Hospital,Henan Provincial People's Hospital,or Zhengzhou People's Hospital from June 2022 to May 2024.The clinical data and pathogenic bacteria were analyzed by univariate and multivariate analyses.Results The Candida pathogen of the 107 cases of candidemia were mostly Candida tropicalis(73.8％),followed by Candida parapsilosis,Candida glabrata,and Candida albicans.Antifungal susceptibility testing showed that 43.9％,47.7％,and 48.6％of the Candida strains were resistant voriconazole,fluconazole and itraconazole,respectively.Logistic regression analysis found that disease not in remission(OR=7.795,95％CI:2.274-26.723),septic shock(OR=10.376,95％CI:1.129-95.388),multiple organ dysfunction syndrome(MODS)(OR=9.107,95％CI:1.789-46.361),and inappropriate antifungal treatment(OR=3.422,95％CI:1.153-10.153)were risk factors for 30-day mortality in hematological patients with candidemia.Conclusions Candidemia in patients with hematological diseases is associated with high mortality rate,the major pathogen of which is Candida tropicalis.The Candida isolates showed high resistance rates to azoles.Disease not in remission,septic shock,MODS,and inappropriate antifungal treatment are the risk factors for mortality.

Myocardial infarction(MI)is the leading cause of mortality worldwide,with heart failure(HF)af-ter MI being the main driver of this high mortality rate.Currently,no method can effectively halt the progression from MI to HF.In recent years,research on myocardial regeneration has shown promise for the treatment of HF after MI.Studies have confirmed that the regulation of myocardial amino acid metabolism can achieve myocardial regeneration,and branched-chain amino acid(BCAA)metabolism is crucial for this process.BCAA can regulate the branched-chain keto acid level through the BCAA aminotransferase(BCAT)-branched-chain keto acid dehydrogenase(BCKDH),BCKDH ki-nase(BCKDK)-BCKDH,and mitochondrial protein phosphatase 2C(PP2Cm)-BCKDH axes,thereby activating the mam-malian target of rapamycin to promote myocardial regeneration.BCAA also participates in the crosstalk between glucose and lipid metabolism,reprogramming fatty acid oxidation towards glucose metabolism and inducing cardiomyocyte prolifer-ation.However,the effects of BCAA on myocardial regeneration have not been systematically reviewed.In this review,the relationship and underlying mechanism between BCAA and myocardial regeneration are discussed extensively from the perspective of amino acid metabolic reprogramming,providing a reference for the study and treatment of post-MI HF.

Objective:To evaluate the clinical utility of an intelligent endoscope transportation system in the digestive endoscopy center.Methods:A parallel-group controlled trial was conducted at Digestive Endoscopy Center of Qilu Hospital of Shandong University from June 1st to December 31st 2024, comparing robotic intelligent endoscope transport (experimental group) versus manual transport (control group). Performance metrics, including response time, transportation speed, labor efficiency, contamination prevention, closed-loop traceability, and nursing staff satisfaction, were statistically analyzed. Full-time equivalent (FTE) was introduced to quantify the operational efficiency of the experimental group.Results:The study included a total of 60 206 instances of intelligent endoscope transportation and 60 485 instances of manual transportation data. The robotic group demonstrated significantly shorter response times versus manual group for initial dispatch (51.08±14.97 seconds VS 54.44±13.61 seconds, t=35.8, P<0.001) and recovery response time (32.52±11.26 seconds VS 40.20±11.40 seconds, t=103.93, P<0.001). During the 148 days operational period, the success rate was 99.83% (60 104/60 206) and the failure rate was 0.17% (102/60 206) for robotic transports. Primary failure causes were wireless disconnection, pathfinding errors, and mechanical faults, averaging 1.05 malfunctions/month with no adverse events. The success and failure rate was 99.26% (60 043/60 485) and 0.74% (442/60 485) respectively for manual transports. Staff satisfaction was significantly higher for robotic transport in endoscopic transportation (4.65±0.55 scores VS 3.97±0.98 scores, t=96.5, P<0.001) and delivery process (4.71±0.59 scores VS 3.90±1.04 scores, t=210.3, P<0.001). and workload intensity was significantly lower (4.06±0.77 scores VS 4.48±0.63 scores, t=59.9, P=0.025). The system reduced labor requirements by 3.68 FTE, yielding annual savings of ￥657 000. Conclusion:The robotic intelligent endoscope transport system improves work efficiency, reduces nursing labor costs and physical workload, enhances job experience and satisfaction, and enables full-process smart traceability, providing a validated solution for endoscopy center logistics.

Objective:To establish a high-performance liquid chromatography method for the determination of related substances in panamivir injection.Methods:The Waters Xbridge Peptide BEH C18(250 mm×4.6 mm,3.5 μm).Phosphate buffer-acetonitrile was used as mobile phase,gradient elution,flow rate 0.8 mL·min-1,column temperature 35℃,detection wavelength 210 nm.Results:Peramivir could be effectively separated from all known impurities,with a limit of quantification of 5.29-18.02 ng and a limit of detection of 1.59-5.41 ng,with a good linear relationship(r＞0.999 0)in the range of 200%of the limit of quantification to the limit concen-tration,and the average recovery rate of each impurity was 99.6%-106.8%(n=12).The results of three batches of peramivir injection samples showed that the known impurities and other largest single impurities were less than 0.2%,and the total impurities were less than 1.0%.Conclusion:Verified by analytical methodology,the method is convenient,fast,specific,sensitive,and accurate,and can be used for the determination of peramivir injection-related substances.

Objective:This study aimed to construct a prediction model for diagnosis of proliferative lupus nephritis based on a machine learning algorithm. Additionally, a user-friendly platform was developed to propose a non-invasive method to assist the pathologic classification of lupus nephritis.Methods:A retrospective analysis was conducted on clinical and pathological data of lupus nephritis patients confirmed by renal biopsy at Zhengzhou University People′s Hospital from January 2017 to August 2023. The study population was randomly divided into training and testing sets in a 7∶3 ratio. Utilizing six machine learning algorithms, classification models were developed. The predictive performance of each model was assessed using metrics such as accuracy, sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC). The optimal model, once identified, was deployed as a web-based calculator for convenient model application. SPSS 25.0 and R 4.2.2 were used to analyze the data.Results:The study included a total of 212 patients, with 138 cases with proliferative lupus nephritis and 74 cases with non-proliferative lupus nephritis. The AUC values for the six models, namely logistic regression, decision tree, random forest, support vector machine, extreme gradient boosting, and light gradient boosting machine, were 0.79, 0.62, 0.79, 0.88, 0.81, and 0.77, respectively; the accuracy rates were 82.54%, 65.08%, 74.60%, 85.71%, 69.84%, 71.43%, respectively. Among them, the support vector machine model demonstrated the optimal performance. This model had deployed as a web-based calculator. Based on feature importance scores, the top 10 influencing factors were identified, including anti URNP antibody, immunoglobulin G, serum globulin, estimated glomerular filtration rate, anti Smith antibody, BMI index, anti dsDNA antibody, uric acid, anti-Rib.p antibody, and gender.Conclusion:A prediction model based on machine learning algorithms was successfully established, and a web calculator was developed to offer a simple and non-invasive method for diagnosing proliferative lupus nephritis. This can assist clinicians in evaluating the risk-benefit ratio of kidney biopsy in patients with lupus nephritis.