ObjectiveThe malaria parasites remodel the host erythrocyte structure by exporting parasite proteins that interact with the membrane skeleton proteins of red blood cells (RBCs), facilitating their intracellular survival and pathogenicity. Skeleton-binding protein 1 (SBP1) is a conserved exported protein across Plasmodium species. In Plasmodium falciparum, SBP1 has been reported to interact with erythrocyte membrane skeleton proteins 4.1R and spectrin, while its contribution to erythrocyte remodeling and parasite virulence in Plasmodium berghei (Pb) remains unclear. This study aims to determine whether PbSBP1 associates with the host cytoskeletal protein 4.1R and to investigate its role in the remodeling of host RBCs and the pathogenicity of Plasmodium berghei. MethodsIn Plasmodium berghei, the relationship between PbSBP1 and the erythrocyte cytoskeletal protein 4.1R was examined using co-immunoprecipitation. A Pbsbp1 gene knockout mutant of Plasmodium berghei (Pbsbp1∆) was generated based on the principle of double crossover homologous recombination. The deformability of erythrocytes infected with Pbsbp1∆ parasites was assessed using microfluidic methods. Microchannels with an array of cylindrical pillars were used to detect modifications in infected RBC deformability. The infected RBCs were squashed between the rows and recovered between the columns and the transit velocity (μm/s) of infected RBCs travelling through the microchannel was recorded. The component of the erythrocyte membrane skeleton junctional complex, tropomodulin (TMOD), was fluorescently labeled, and the cytoskeletal network of infected erythrocytes was imaged using super-resolution stochastic optical reconstruction microscopy (STORM) to analyze ultrastructural changes in the cytoskeleton of wild-type (WT) and Pbsbp1∆-infected erythrocytes. Actin-based junctional complexes were displayed as individual clusters by the labeled TMOD in the STORM images, and the cluster densities and distances between adjacent clusters of infected RBCs were calculated. Additionally, rodent malaria models (BALB/c mice) and experimental cerebral malaria models (C57BL/6 mice) were employed to monitor the growth of Pbsbp1∆ and WT parasites during the intraerythrocytic stage and their capacity to induce cerebral malaria in mice. ResultsPbSBP1 may participate in the remodeling of infected erythrocytes through direct or indirect interaction with the erythrocyte cytoskeletal protein 4.1R. Microfluidic assays revealed that the deformability of erythrocytes infected with Pbsbp1∆ parasites was significantly enhanced compared to those infected with WT parasites. STORM imaging further demonstrated that the ultrastructure of the erythrocyte cytoskeleton in Pbsbp1∆-infected cells was altered relative to that in WT-infected erythrocytes. The distances between nearest neighbors of clusters had a tendency to increase while the cluster densities were decreased in Pbsbp1∆-infected RBCs compared to WT-infected RBCs. Subsequent phenotypic analysis indicated that the growth rate of Pbsbp1∆ parasites during the intraerythrocytic stage was significantly slower than that of WT parasites, and their ability to induce cerebral malaria in mice was also attenuated. These findings suggest that PbSBP1 is involved in the remodeling of the erythrocyte membrane skeleton, likely through its direct or indirect interaction with protein 4.1R, thereby regulating the deformability of infected erythrocytes and influencing the pathogenicity of the blood-stage parasites. ConclusionThis study establishes a role for PbSBP1 in host erythrocyte remodeling and parasite virulence, providing new research strategies for the prevention and treatment of malaria.

BACKGROUND:Arthroscopic anchor repair has become the main treatment method for rotator cuff tears at present.Among them,the insertion status of the anchor is a key factor in the success or failure of the operation.However,currently,the impact of the insertion depth of the anchor on the stress of the bone tunnel and the anchor under different bone density conditions remains unclear.OBJECTIVE:To explore the stress distribution of the bone tunnel and the anchor when the insertion depth of the anchor varies under different bone density conditions by using three-dimensional finite element analysis technology.METHODS:The CT image data of the humerus of volunteers were collected,and the models of the humerus and the anchor were constructed by using Mimics,3-Matic,and Solidworks software.In 3-Matic,holes with distances of 0,2,4,6,and 8 mm from the surface of the humerus were respectively created at the same position of the humerus and assembled with the anchor.In Mimics,values were assigned based on the CT gray value to obtain a model with normal bone mass(T value ≥-1.0).The parameters were changed to construct models with reduced bone mass(-2.5＜T value＜-1.0)and osteoporosis(T value＜-2.5).In each model,a 70 N pulling force was applied to the anchor along the direction tangent to the inner edge of the bone tunnel.The stress distribution and magnitude of the bone tunnel and the anchor when inserted at different depths under different bone density conditions were observed.RESULTS AND CONCLUSION:(1)When the insertion depth was the same,as the bone density decreased,the maximum equivalent stress of the anchor increased,while the maximum equivalent stress of the bone tunnel decreased.(2)When the bone density was the same,as the insertion depth of the anchor increased,the maximum equivalent stress of the anchor decreased.When the insertion depth was 4 mm,the stress of the bone tunnel was the smallest and the distribution was relatively uniform.The stress of the anchor was mainly distributed around the lower anchor hole and the proximal thread,and the stress of the bone tunnel was mainly at the part in contact with the proximal thread.The increase in the insertion depth would change the uniformity and pattern of the stress distribution,while the bone density had a relatively small impact on the stress distribution pattern.(3)It is concluded that the bone density of the humerus is crucial for the anchor repair of rotator cuff tears.It is recommended that clinicians measure the bone density of the greater tuberosity of the humerus before the operation.Excessive insertion depth of the anchor does not significantly increase its stability.Clinicians can conduct personalized preoperative assessments by using the finite element analysis method in combination with the actual situation of patients to achieve the best surgical results.

BACKGROUND:Due to the complex movement of the scapula,which is a six-degree-of-freedom activity in three-dimensional space,it is difficult to measure it accurately using traditional methods.The image and model matching technology based on dual-plane X-ray is a three-dimensional measurement method that has gradually developed and matured in recent years.Two high-speed cameras are used to project and shoot from orthogonal directions.Compared with a single perspective,this method has advantages in observation range and reduction of out-of-plane errors,and is suitable for the study of scapula kinematics.OBJECTIVE:X-ray biplane and image-model registration technology were used to explore the differences in scapular kinematics between normal individuals and patients with rotator cuff tears,providing a basis for the treatment and rehabilitation of rotator cuff tear patients.METHODS:From April 2023 to January 2024,10 patients with normal shoulders and 10 patients with rotator cuff tears who met the inclusion criteria were enrolled from Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.The subjects underwent a shoulder CT scan to create a 3D model and a local scapular coordinate system.X-ray biplane images were taken during shoulder abduction with two C-arm machines.The 2D and 3D images were registered to compare scapular kinematic differences between the two groups at 0°,15°,30°,45°,60°,75°,and 90° of abduction,including scapular rotation angle and displacement distance.RESULTS AND CONCLUSION:(1)During shoulder abduction,the scapula of both groups showed upward rotation,but the upward rotation of the rotator cuff tear group was greater than that of the control group,and the difference was significant when the abduction was 30°-90°(P＜0.01).At the same time,the scapula internal rotation of both groups gradually increased,but the rotator cuff tear group was significantly greater than the control group when the abduction was 45°-90°(P＜0.01).In addition,the anteroposterior tilt of the scapula of the two groups was significantly different when the abduction was 15°-90°(P＜0.01).The scapula posterior tilt of the control group gradually increased during abduction,while the scapula of the rotator cuff tear group tilted forward except for a slight posterior tilt at 15°-30° abduction.(2)In terms of displacement,the upward displacement of the rotator cuff tear group was less than that of the control group during abduction,and the difference was significant at 15°-90°(P＜0.05),but there was no significant difference in lateral and anterior-posterior displacement between the two groups(P＞0.05).(3)Rotator cuff tear can cause scapular dyskinesis,characterized by increased upward rotation,internal rotation,and abnormal forward tilt during shoulder abduction.Identifying and addressing scapular dyskinesis is crucial for treating rotator cuff tear.

BACKGROUND:Arthroscopic anchor repair has become the main treatment method for rotator cuff tears at present.Among them,the insertion status of the anchor is a key factor in the success or failure of the operation.However,currently,the impact of the insertion depth of the anchor on the stress of the bone tunnel and the anchor under different bone density conditions remains unclear.OBJECTIVE:To explore the stress distribution of the bone tunnel and the anchor when the insertion depth of the anchor varies under different bone density conditions by using three-dimensional finite element analysis technology.METHODS:The CT image data of the humerus of volunteers were collected,and the models of the humerus and the anchor were constructed by using Mimics,3-Matic,and Solidworks software.In 3-Matic,holes with distances of 0,2,4,6,and 8 mm from the surface of the humerus were respectively created at the same position of the humerus and assembled with the anchor.In Mimics,values were assigned based on the CT gray value to obtain a model with normal bone mass(T value ≥-1.0).The parameters were changed to construct models with reduced bone mass(-2.5＜T value＜-1.0)and osteoporosis(T value＜-2.5).In each model,a 70 N pulling force was applied to the anchor along the direction tangent to the inner edge of the bone tunnel.The stress distribution and magnitude of the bone tunnel and the anchor when inserted at different depths under different bone density conditions were observed.RESULTS AND CONCLUSION:(1)When the insertion depth was the same,as the bone density decreased,the maximum equivalent stress of the anchor increased,while the maximum equivalent stress of the bone tunnel decreased.(2)When the bone density was the same,as the insertion depth of the anchor increased,the maximum equivalent stress of the anchor decreased.When the insertion depth was 4 mm,the stress of the bone tunnel was the smallest and the distribution was relatively uniform.The stress of the anchor was mainly distributed around the lower anchor hole and the proximal thread,and the stress of the bone tunnel was mainly at the part in contact with the proximal thread.The increase in the insertion depth would change the uniformity and pattern of the stress distribution,while the bone density had a relatively small impact on the stress distribution pattern.(3)It is concluded that the bone density of the humerus is crucial for the anchor repair of rotator cuff tears.It is recommended that clinicians measure the bone density of the greater tuberosity of the humerus before the operation.Excessive insertion depth of the anchor does not significantly increase its stability.Clinicians can conduct personalized preoperative assessments by using the finite element analysis method in combination with the actual situation of patients to achieve the best surgical results.

BACKGROUND:Due to the complex movement of the scapula,which is a six-degree-of-freedom activity in three-dimensional space,it is difficult to measure it accurately using traditional methods.The image and model matching technology based on dual-plane X-ray is a three-dimensional measurement method that has gradually developed and matured in recent years.Two high-speed cameras are used to project and shoot from orthogonal directions.Compared with a single perspective,this method has advantages in observation range and reduction of out-of-plane errors,and is suitable for the study of scapula kinematics.OBJECTIVE:X-ray biplane and image-model registration technology were used to explore the differences in scapular kinematics between normal individuals and patients with rotator cuff tears,providing a basis for the treatment and rehabilitation of rotator cuff tear patients.METHODS:From April 2023 to January 2024,10 patients with normal shoulders and 10 patients with rotator cuff tears who met the inclusion criteria were enrolled from Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.The subjects underwent a shoulder CT scan to create a 3D model and a local scapular coordinate system.X-ray biplane images were taken during shoulder abduction with two C-arm machines.The 2D and 3D images were registered to compare scapular kinematic differences between the two groups at 0°,15°,30°,45°,60°,75°,and 90° of abduction,including scapular rotation angle and displacement distance.RESULTS AND CONCLUSION:(1)During shoulder abduction,the scapula of both groups showed upward rotation,but the upward rotation of the rotator cuff tear group was greater than that of the control group,and the difference was significant when the abduction was 30°-90°(P＜0.01).At the same time,the scapula internal rotation of both groups gradually increased,but the rotator cuff tear group was significantly greater than the control group when the abduction was 45°-90°(P＜0.01).In addition,the anteroposterior tilt of the scapula of the two groups was significantly different when the abduction was 15°-90°(P＜0.01).The scapula posterior tilt of the control group gradually increased during abduction,while the scapula of the rotator cuff tear group tilted forward except for a slight posterior tilt at 15°-30° abduction.(2)In terms of displacement,the upward displacement of the rotator cuff tear group was less than that of the control group during abduction,and the difference was significant at 15°-90°(P＜0.05),but there was no significant difference in lateral and anterior-posterior displacement between the two groups(P＞0.05).(3)Rotator cuff tear can cause scapular dyskinesis,characterized by increased upward rotation,internal rotation,and abnormal forward tilt during shoulder abduction.Identifying and addressing scapular dyskinesis is crucial for treating rotator cuff tear.

Objective This study reports on the obligatory parasitism of water mites Arrenurus sp. on Anopheles messeae at the Manzhouli Port, Inner Mongolia, China. Methods Duing July 2024, a survey on the mosquito diversity was conducted at the Manzhouli Port. Captured mosquitoes and their ectoparasites were identified to species level. Results A total of 1840 adult mosquitoes were collected, representing species from three genera: Culex(Cx. modestus, Cx. pipiens pallens), Aedes(Ae. dorsalis, Ae. flavidorsalis, Ae. flavescens), and Anopheles (An. messeae). Among all the mosqutioes specimens,3 out of 150 captured An. messeae were found to carry ectoparasitic mites, with number of 2,4,27 mites separately. Morphological and molecular identification reached the same result as water mites(Hydrachnidiae, Hydracrina). COI gene sequence showed 94% similarity with the closest species Arrenurus truncatellus. Conlusions Literature review suggests water mites are host-specific parasitism of mosquito species and herein with the first record of Arrenurus sp. parasiting on An. Messeae in the most high-latitude region globally.

This paper reports the diagnosis and treatment process of a patient with severe anemia caused by hookworm and Ascaris lumbricoides co-infections, so as to provide insights into clinical diagnosis and treatment and avoid misdiagnosis and under-diagnosis of parasitic infections. Living parasites were found by endoscopy, which were morphologically identified as hookworm and A. lumbricoides, and routine stool examinations detected hookworm and A. lumbricoides eggs. The patient was diagnosed with severe anemia caused by hookworm and A. lumbricoides co-infections by means of clinical symptoms, epidemiological history, endoscopic findings, and laboratory tests. Following blood transfusion, hemostasis, oral administration with albendazole, and symptomatic treatments, the patient showed remarkable symptomatic improvement and had a good prognosis.

Objective: To analyze the demographic evolution of China over the forthcoming decade (2026-2035) and to systematically evaluate its potential implications for voluntary blood donation practices and the equilibrium of clinical blood supply and demand. Methods: Leveraging comprehensive blood collection and utilization data from 2021 to 2025 at the national, provincial (Shandong), and municipal (Zibo) levels, we identified and examined critical determinants influencing blood management systems. The DeepSeek-V3.2 large language model was deployed to project future population age structures, and to generate quantitative estimates for hospitalization volumes, clinical blood requirements, available blood supply, and donation frequencies for the target years 2030 and 2035, thereby furnishing an evidence base for strategic planning and priority-setting. Results: DeepSeek-derived projections indicate that the proportion of China's population aged 60 years and above will surpass 27% (370 million/1 380 million) by 2030 and exceed 30% (400 million/1 350 million) by 2035, signaling a marked acceleration in population aging. This demographic shift is projected to reduce the proportion of the national population eligible to donate blood from 59.2% (835 million out of 1.41 billion) to 52% (710 million out of 1.36 billion), while the demand for blood is expected to increase by 87.8% relative to 2024, rising from 26.927 million units to 50.56 million units. Sustaining blood supply-demand balance will necessitate progressive annual increases in donation rates. Under prevailing policy frameworks, the required blood donation rate among the eligible population in Shandong Province would need to rise by 122.57% by 2035 [from 20.07‰ (1.1641 million person-times/58 million people) to 44.67‰ (2.189 million person-times/49 million people)] to potentially satisfy projected clinical requirements. Conclusion: By integrating DeepSeek-V3.2, AI predictive models, and blood donation incentive measures, it is possible to monitor population demographics, forecast clinical blood demand, manage blood supplies, and ensure the long-term sustainability of clinical blood availability. It must be acknowledged, however, that the present analysis is constrained by a limited data foundation (comprising only five annual observation points); accordingly, the projections should be interpreted as directional trend indicators or methodological illustrations rather than definitive quantitative forecasts.

Objective: To examine the association of sleep duration, physical activity, and their joint effects on depressive and anxiety symptoms among college students, and to provide evidence for the prevention and intervention of emotional symptoms in the population. Methods: From October to December 2023, a total of 7 684 college students aged 18-22 years, who were selected from nine universities in Hubei, Jiangxi, and Anhui provinces by using convenience sampling, underwent questionnaire surveys and physical examinations. Chi-square test and Logistic regression model were used to analyze the associations of meeting sleep duration and moderate to vigorous physical activity (MVPA) recommendations, as well as their joint effects, with depressive and anxiety symptoms. Results: The prevalence rates of depressive and anxiety symptoms were 25.78% and 35.59%, respectively. The prevalence rates of both depressive and anxiety symptoms differed significantly across sleep duration and physical activity groups ( χ 2= 9.32 -127.01, all P <0.01). Logistic regression analyses showed that insufficient sleep duration and failure to meet the physical activity recommendation were associated with higher odds of depressive symptoms ( OR =1.67, 1.20) and anxiety symptoms ( OR = 1.74 , 1.21 ) (all P <0.01). Further joint effects analyses showed that the combination of insufficient sleep and insufficient MVPA and that of insufficient sleep and sufficient MVPA were associated with higher odds of depressive symptoms ( OR =1.94, 1.38 ) and anxiety symptoms ( OR =2.09, 1.59) (all P <0.05). The combination of sufficient sleep and insufficient MVPA was also associated with higher odds of anxiety symptoms ( OR =1.16, P <0.05). Conclusions Sleep duration, physical activity, and their joint effects are associated with depressive and anxiety symptoms among college students. Joint interventions targeting both sleep and physical activity should be emphasized to reduce the risk of emotional symptoms.

ObjectiveTo investigate the trends in the disease burden of falls among Chinese children and adolescents from 1990 to 2021, and to inform the development of targeted prevention and control strategies. MethodsData on age-standardized incidence rate, age-standardized mortality rate and age-standardized disability-adjusted life years (DALYs) rate for falls among Chinese children and adolescents under 20 years of age from 1990 to 2021 were systematically extracted from the Global Burden of Disease Study (GBD) 2021 database. The annual percent change (APC) and average annual percent change (AAPC) were calculated to evaluate temporal trends in fall-related disease burden across different age groups and sexes. ResultsFrom 1990 to 2021, the age-standardized incidence rate of falls among Chinese children and adolescents showed a non-linear fluctuation (AAPC=0.08%, P=0.040), while both the age-standardized mortality rate and age-standardized DALYs rate declined (AAPC=-3.66% and -3.09%, both P<0.001). The crude incidence rate decreased in the <5 years old and 5 ‒ <10 years old groups (AAPC=-1.38% and -0.29%, both P<0.001), but increased annually in the 10 ‒ <15 years old and 15 ‒ <20 years old groups (AAPC=0.27% and 0.81%, both P<0.001). The crude mortality rate and crude DALYs rate declined across all four age groups, with the most significant reduction observed in the <5 years old group (AAPC=-5.21%, 95%CI:-5.55%‒ -5.00%; AAPC=-4.98%, 95%CI: -5.20%‒ -4.79%, both P<0.001). For both males and females, the age-standardized incidence rate of falls showed a V-shaped trend (initial decline followed by a subsequent rise). In contrast, the age-standardized mortality rate and age-standardized DALY rate declined in both sexes, with an AAPC of -3.40% and -2.94% for males, and -4.50% and -3.49% for females, respectively (all P<0.001). ConclusionThe overall disease burden of falls among Chinese children and adolescents has been substantially improved; however, the incidence burden remains considerable. Future prevention efforts should be tailored to age- and sex-specific characteristics, with the family as the fundamental care unit in conjunction with high-quality nursing extension services, to establish a closed-loop management model encompassing “early identification, immediate intervention, and continuous follow-up.”