Objective: To evaluate the diagnostic performance of magnetic resonance spectroscopy (MRS) in discriminating fumarate hydratase-deficient (FH-d) uterine leiomyomas (ULs) from FH-preserved ULs. Materials and Methods: This study consisted of three stages, with independent cohorts recruited for each stage: 1) sample-size estimation was retrospectively performed on UL specimens (diameter ≥3 cm; age, 20–40 years) from our database with immunohistochemistry (IHC) for 2-succinocysteine (2-SC) as the reference, without genetic testing, 2) MRS sequence optimization in confirmed FH germline mutation participants with ultrasound-detected ULs (diameter ≥3 cm), without IHC analysis, and 3) prospective diagnostic test accuracy was evaluated in consecutive participants with ultrasound-detected ULs (diameter ≥3 cm;age, 20–40 years), using IHC for 2-SC for determining the FH status and subsequent genetic testing in those with positive 2-SC results to identify whether FH mutations were germline or somatic in origin. The choline and fumarate peaks in MRS were classified as positive, negative, or technical failure (TF). TFs were analyzed separately and excluded from the primary diagnostic accuracy calculations. T1-, T2-, and diffusion-weighted images were interpreted as hyperintense or hypointense. The enhancement rate and apparent diffusion coefficient were also acquired. Diagnostic performance was compared between MRS and various magnetic resonance imaging (MRI) features. Results: The optimal MRS parameters for the fumarate peak were echo time (TE) = 140 ms and an average of 256. Among the 360 prospective participants, 37 were confirmed to have FH-dULs. MRS showed positive fumarate peaks in 35 of 37 FH-dULs.After excluding six TFs, the positive fumarate peak on MRS showed 94.6% (35/37) sensitivity, 99.7% (316/317) specificity, and 99.2% (351/354) accuracy, all of which were significantly superior to those of other MRI features (P ≤ 0.002). Conclusion A positive fumarate peak on MRS may be a useful imaging biomarker for diagnosing FH-dULs.

Objective: To assess the association of family food environment with dietary and nutrition literacy among junior and senior high school students, providing a basis for nutritional health education and adolescent nutritional improvement. Methods: From January 9 to February 10, 2025, a total of 1 473 junior and senior high school students aged 12-20 were recruited by using a cluster random sampling method combined with convenient sampling from 15 provinces (municipalities and autonomous regions) across China. Data on basic demographic characteristics, home food environment, and dietary and nutrition literacy were collected by using the Food and Nutritional Literacy Questionnaire for Chinese School age Children. Multiple linear regression and Logistic regression models were employed to analyze the association of the home food environment on adolescent dietary and nutrition literacy. Results: The total score of dietary and nutrition literacy among junior and senior high school students was (65.28±9.03). The score in the cognitive domain (67.59±10.56) was higher than that in the skill domain (60.74±9.15), and the score for food preparation skills (56.60±14.28) was the lowest. Students aged 16-20, senior high school students, those for only children, non boarding students, those with urban household registration, those from wealthier families, those whose primary caregivers were parents with higher education levels, and those who previously received nutrition and health education had significantly higher dietary and nutrition literacy scores compared to their respective counterpart groups ( t/F =-8.32, -8.14, 4.76, -2.70, 7.15, 18.29, 10.68, 11.66 , all P <0.05). Multiple linear regression analysis revealed that family food environment was associated with dietary and nutrition literacy, and the model was statistically significant ( R 2=0.20, F=20.54, P <0.05). Lower availability of fruits at home in the past month and lower frequency of family communication regarding dietary and nutrition were associated with lower dietary nutrition literacy scores among junior and senior high school students ( β =-1.35, -1.67, both P <0.01). Among junior and senior high school students, lower frequency of dining out with the family, watching videos during family meals, and being urged by parents to eat more food in the past month were associated with higher scores on dietary nutrition literacy ( β =1.35, 1.13, 0.71, all P <0.01). Logistic regression model results indicated that watching videos during family meals ( OR =1.70) and family communication regarding dietary and nutrition ( OR =0.51) were significantly associated with dietary and nutrition literacy levels (both P <0.05). Conclusions The score of dietary and nutrition literacy among junior and senior high school students is relatively low, and the family food environment is a key factor. It is recommended that nutrition education and improvement initiatives for junior and senior high school students prioritize attention on children and adolescents from households with less favorable food environments.

Objective:To investigate the diagnostic value of D-dimer (D-D) testing combined with multi-slice spiral CT pulmonary angiography (MSCTPA) in patients with pulmonary embolism (PE) based on the modified Geneva score.Methods:This study adopted a prospective design. Ninety-six patients with suspected pulmonary embolism (PE) who received treatment at Jinhua Hospital of Traditional Chinese Medicine, Zhejiang Chinese Medical University, from January to December 2024, were included in this study. The modified Geneva score was used to assess the clinical probability and severity of PE in these patients. Based on their modified Geneva scores, the patients were divided into high-risk, moderate-risk, and low-risk groups. All patients underwent both MSCTPA and D-D testing. The diagnostic value of D-D testing and MSCTPA, both individually and in combination, for PE among patients with different modified Geneva scores was evaluated.Results:Clinical diagnosis confirmed PE in 55 of the 96 suspected cases, with a positivity rate of 57.29% (55/96). According to the revised Geneva score, the high-risk group had the highest PE positivity rate (91.67%, 11/12), followed by the moderate-risk group (59.70%, 40/67) and the low-risk group (23.53%, 4/17). In the moderate-risk group, MSCTPA showed a significantly higher positive confirmation rate than negative confirmation rate ( χ2 = 12.32, P < 0.001), with a positive predictive value of 73.91% (34/46), a negative predictive value of 71.43% (15/21), specificity of 55.56% (15/27), sensitivity of 85.00% (34/40), and accuracy of 73.13% (49/67). D-D testing in the moderate-risk group also demonstrated a higher positive confirmation rate ( χ2 = 9.04, P < 0.05), with a positive predictive value of 72.73% (32/44), negative predictive value of 65.22% (15/23), specificity of 55.56% (15/27), sensitivity of 80.00% (32/40), and accuracy of 70.15% (47/67). The combination of D-D testing and MSCTPA significantly increased the positive confirmation rate for patients in the moderate-risk group compared with the negative confirmation rate ( χ2 = 28.78, P < 0.001). D-D testing combined with MSCTPA showed a positive predictive value of 83.72% (36/43), a negative predictive value of 83.33% (20/24), specificity of 74.07% (20/27), sensitivity of 90.00% (36/40), and accuracy of 83.58% (56/67) for patients in the moderate-risk group. Conclusions:D-D testing combined with MSCTPA demonstrates high diagnostic value for PE in patients assessed by the revised Geneva score, particularly for patients who are at moderate risk for PE.

Objective To investigate the role and mechanism of RNA-Specific adenosine deaminase 3 (Adar3) in regulating macrophage polarization during Coxsackievirus B3(CVB3)-induced viral myocarditis (VM). Methods Bone marrow-derived macrophages (BMDM) from mice were cultured in vitro and induced into M1/M2 macrophages using interferon-gamma (IFN-γ)/lipopolysaccharide (LPS) or interleukin 4 (IL-4), respectively. The mRNA expression levels of Adar1, Adar2, and Adar3 in each group of cells were assessed by real-time quantitative PCR (qRT-PCR). Specific siRNAs targeting the Adar3 gene were designed, synthesized, and transiently transfected into M2 macrophages. The mRNA levels of M2 polarization-related marker genes-including arginase 1 (Arg1), chitinase 3-like molecule 3 (YM1/Chi3l3), and resistin-like molecule alpha (RELMα/FIZZ1)-were detected by qRT-PCR. RNA sequencing was performed to analyze the signaling pathways affected by Adar3. The expression levels of Wnt/β-catenin signaling pathway were further validated using qRT-PCR and Western blot. The adeno-associated virus overexpressing Adar3 was designed, synthesized, and injected into mice via tail vein. Three weeks later, a myocarditis mouse model was established. After an additional week, the phenotype and function of cardiac macrophages, as well as multiple indicators of VM (including echocardiography, body weight, histopathology and serology) were examined. Additionally, the protein levels of the Wnt/β-catenin signaling pathway were assessed. Results Compared to M0-type macrophages, the expression level of Adar3 was significantly increased in M2-type macrophages. After transfection of Adar3 siRNA, the mRNA levels of Arg1, YM1 and FIZZ1 in M2 macrophages were downregulated. RNA sequencing revealed 149 upregulated genes and 349 downregulated genes. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis and subsequent validation experiments indicated that Adar3 modulated the Wnt/β-catenin signaling pathway. In vivo experiments demonstrated that Adar3 overexpression alleviated the cardiac dysfunction of VM mice. The proportion of M1 macrophages in the heart decreased, while the proportion of M2 macrophages increased. At the same time, the Adar3 overexpression activated the Wnt/β-catenin signaling pathway. Conclusion Adar3 promotes macrophage polarization toward the M2 phenotype by activating the Wnt/β-catenin signaling pathway, thereby alleviating VM.
Animals ; Adenosine Deaminase/metabolism* ; Macrophages/immunology* ; Wnt Signaling Pathway/genetics* ; Myocarditis/immunology* ; Mice ; Coxsackievirus Infections/metabolism* ; Male ; Mice, Inbred BALB C ; Enterovirus B, Human/physiology* ; beta Catenin/genetics*

Objective:To explore the relationship between acute leukemia and blood lipid level.Methods:The Chinese and English literature on the relationship between acute leukemia and blood lipid level published in PubMed, Web of Science, Cochrane library, CNKI, Wanfang, and VIP databases from the establishment of the database to December 2023 was searched, the literature that met the evaluation criteria was screened, and the quality of the literature was evaluated by using the Newcastle-Ottawa scale. Basic clinical characteristics and blood lipid-related data were obtained from the acute leukemia patients (acute leukemia group) and the healthy individuals who underwent physical examination or patients with non-hematological disorders that did not lead to abnormal blood lipid metabolism and who did not take medications that affected blood lipid during the same period (control group). Meta-analysis of the differences in peripheral blood levels of total cholesterol (TC), triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c) between the two groups was carried out by using Stata 14.0 software to make forest plots and to calculate the combined weighted mean difference (WMD) or standardised mean difference (SMD) and 95% CI. Results:Six articles were finally included, published between 2005 and 2023, all of which were of moderate quality. Finally, 558 patients with acute leukemia and 323 controls were included in the analysis. By Meta-analysis, TG level in the acute leukemia group was higher than that in the control group (WMD = 0.30, 95% CI: 0.07-0.54, P = 0.012), HDL-c (SMD = -1.54, 95% CI: -2.11--0.97, P < 0.001) and LDL-c (WMD = -0.57, 95% CI: -0.72 - -0.41, P < 0.001) levels were lower than those in the control group, and the differences were all statistically significant; the difference in TC between the acute leukemia group and the control group was not statistically significant (WMD = -0.34, 95% CI: -0.82-0.13, P = 0.157). Conclusions:Compared with normal subjects, patients with acute leukemia have high TG level and low LDL-c and HDL-c levels.

Plant-derived bioactive peptides have become a research hotspot in the fields of food and medicine due to their high source safety,easy absorption and utilization by the human body,and potential edible and medicinal value.Bioactive peptides can be classified into antihypertensive,hypoglycemic,hypolipidemic,anticancer,antioxidant,antimicrobial,and anti-inflammatory peptides according to their functions.Among these,antihypertensive,hypoglycemic,and hypolipidemic peptides are collectively referred to as cardiovascular active peptides,which can be used for the treatment and prevention of cardiovascular diseases and have an important role in the development of modem biomedicine.This review focused on the preparation methods,separation,purification,and identification techniques of bioactive peptides,as well as their mechanisms of action and applications in regulating cardiovascular diseases,aiming to provide a reference for further development and application of plant-derived cardiovascular peptides.

Objective:To investigate the diagnostic value of D-dimer (D-D) testing combined with multi-slice spiral CT pulmonary angiography (MSCTPA) in patients with pulmonary embolism (PE) based on the modified Geneva score.Methods:This study adopted a prospective design. Ninety-six patients with suspected pulmonary embolism (PE) who received treatment at Jinhua Hospital of Traditional Chinese Medicine, Zhejiang Chinese Medical University, from January to December 2024, were included in this study. The modified Geneva score was used to assess the clinical probability and severity of PE in these patients. Based on their modified Geneva scores, the patients were divided into high-risk, moderate-risk, and low-risk groups. All patients underwent both MSCTPA and D-D testing. The diagnostic value of D-D testing and MSCTPA, both individually and in combination, for PE among patients with different modified Geneva scores was evaluated.Results:Clinical diagnosis confirmed PE in 55 of the 96 suspected cases, with a positivity rate of 57.29% (55/96). According to the revised Geneva score, the high-risk group had the highest PE positivity rate (91.67%, 11/12), followed by the moderate-risk group (59.70%, 40/67) and the low-risk group (23.53%, 4/17). In the moderate-risk group, MSCTPA showed a significantly higher positive confirmation rate than negative confirmation rate ( χ2 = 12.32, P < 0.001), with a positive predictive value of 73.91% (34/46), a negative predictive value of 71.43% (15/21), specificity of 55.56% (15/27), sensitivity of 85.00% (34/40), and accuracy of 73.13% (49/67). D-D testing in the moderate-risk group also demonstrated a higher positive confirmation rate ( χ2 = 9.04, P < 0.05), with a positive predictive value of 72.73% (32/44), negative predictive value of 65.22% (15/23), specificity of 55.56% (15/27), sensitivity of 80.00% (32/40), and accuracy of 70.15% (47/67). The combination of D-D testing and MSCTPA significantly increased the positive confirmation rate for patients in the moderate-risk group compared with the negative confirmation rate ( χ2 = 28.78, P < 0.001). D-D testing combined with MSCTPA showed a positive predictive value of 83.72% (36/43), a negative predictive value of 83.33% (20/24), specificity of 74.07% (20/27), sensitivity of 90.00% (36/40), and accuracy of 83.58% (56/67) for patients in the moderate-risk group. Conclusions:D-D testing combined with MSCTPA demonstrates high diagnostic value for PE in patients assessed by the revised Geneva score, particularly for patients who are at moderate risk for PE.

Plant-derived bioactive peptides have become a research hotspot in the fields of food and medicine due to their high source safety,easy absorption and utilization by the human body,and potential edible and medicinal value.Bioactive peptides can be classified into antihypertensive,hypoglycemic,hypolipidemic,anticancer,antioxidant,antimicrobial,and anti-inflammatory peptides according to their functions.Among these,antihypertensive,hypoglycemic,and hypolipidemic peptides are collectively referred to as cardiovascular active peptides,which can be used for the treatment and prevention of cardiovascular diseases and have an important role in the development of modem biomedicine.This review focused on the preparation methods,separation,purification,and identification techniques of bioactive peptides,as well as their mechanisms of action and applications in regulating cardiovascular diseases,aiming to provide a reference for further development and application of plant-derived cardiovascular peptides.

Objective:To explore the association between polymorphisms of transforming growth factor-β(TGF-β)signaling pathway and non-syndromic cleft lip with or without cleft palate(NSCL/P)among Asian populations,while considering gene-gene interaction and gene-environment interaction.Methods:A total of 1 038 Asian NSCL/P case-parent trios were ascertained from an international consortium,which conducted a genome-wide association study using a case-parent trio design to investigate the genes affec-ting risk to NSCL/P.After stringent quality control measures,343 single nucleotide polymorphism(SNP)spanning across 10 pivotal genes in the TGF-β signaling pathway were selected from the original genome-wide association study(GWAS)dataset for further analysis.The transmission disequilibrium test(TDT)was used to test for SNP effects.The conditional Logistic regression models were used to test for gene-gene interaction and gene-environment interaction.Environmental factors collected for the study in-cluded smoking during pregnancy,passive smoking during pregnancy,alcohol intake during pregnancy,and vitamin use during pregnancy.Due to the low rates of exposure to smoking during pregnancy and al-cohol consumption during pregnancy(＜3％),only the interaction between maternal smoking during pregnancy and multivitamin supplementation during pregnancy was analyzed.The threshold for statistical significance was rigorously set at P=1.46 × 10-4,applying Bonferroni correction to account for multiple testing.Results:A total of 23 SNPs in 4 genes yielded nominal association with NSCL/P(P＜0.05),but none of these associations was statistically significant after Bonferroni's multiple test correction.How-ever,there were 6 pairs of SNPs rs4939874(SMAD2)and rs1864615(TGFBR2),rs2796813(TGFB2)and rs2132298(TGFBR2),rs4147358(SMAD3)and rs1346907(TGFBR2),rs4939874(SMAD2)and rs1019855(TGFBR2),rs4939874(SMAD2)and rs12490466(TGFBR2),rs2009112(TGFB2)and rs4075748(TGFBR2)showed statistically significant SNP-SNP interaction(P＜1.46 × 10-4).In contrast,the analysis of gene-environment interactions did not yield any significant results after being cor-rected by multiple testing.Conclusion:The comprehensive evaluation of SNP associations and interac-tions within the TGF-β signaling pathway did not yield any direct associations with NSCL/P risk in Asian populations.However,the significant gene-gene interactions identified suggest that the genetic architec-ture influencing NSCL/P risk may involve interactions between genes within the TGF-β signaling path-way.These findings underscore the necessity for further investigations to unravel these results and further explore the underlying biological mechanisms.

Objective:To delve into the intricate relationship between common genetic variations across the entire genome and the risk of non-syndromic cleft lip with or without cleft palate(NSCL/P).Methods:Utilizing summary statistics data from genome-wide association studies(GW AS),a thorough investigation to evaluate the impact of common variations on the genome were undertook.This involved assessing single nucleotide polymorphism(SNP)heritability across the entire genome,as well as within specific genomic regions.To ensure the robustness of our analysis,stringent quality control measures were applied to the GWAS summary statistics data.Criteria for inclusion encompassed the absence of missing values,a minor allele frequency≥1％,P-values falling within the range of 0 to 1,and clear SNP strand orientation.SNP meeting these stringent criteria were then meticulously included in our analy-sis.The SNP heritability of NSCL/P was calculated using linkage disequilibrium score regression.Addi-tionally,hierarchical linkage disequilibrium score regression to partition SNP heritability within coding re-gions,promoters,introns,enhancers,and super enhancers were employed,and the enrichment levels within different genomic regions using LDSC(v1.0.1)software were further elucidated.Results:Our study drew upon GWAS summary statistics data obtained from 806 NSCL/P trios,comprising a total of 2 418 individuals from the Chinese population.Following rigorous quality control procedures,490 593 out of 492 993 SNP were deemed suitable for inclusion in SNP heritability calculations.The observed SNP heritability of NSCL/P was 0.55(95％CI:0.28-0.82).Adjusting for the elevated disease pre-valence within our sample,the SNP heritability scaled down to 0.37(95％CI:0.19-0.55)based on the prevalence observed in the general Chinese population.Notably,our enrichment analysis unveiled significant enrichment of SNP heritability within enhancer regions(15.70,P=0.04)and super enhan-cer regions(3.18,P=0.03).Conclusion:Our study sheds light on the intricate interplay between common genetic variations and the risk of NSCL/P in the Chinese population.By elucidating the SNP heritability landscape across different genomic regions,we contribute valuable insights into the genetic basis of NSCL/P.The significant enrichment of SNP heritability within enhancer and super enhancer re-gions underscores the potential role of these regulatory elements in shaping the genetic susceptibility to NSCL/P.This paves the way for further research aimed at uncovering novel genetic pathogenic factors un-derlying NSCL/P pathogenesis.