OBJECTIVE To explore the influencing factors for secondary heart failure in the children with severe pneumonia and establish the nomogram prediction model.METHODS A total of 767 children with severe pneumo-nia who were treated in Children's Hospital of Nanjing Medical University from Mar.2018 to Mar.2024 were en-rolled in the study and were divided into the modeling group with 537 cases and the validation group with 230 ca-ses in a 7∶3 ratio.Meanwhile,127 children with severe pneumonia who were treated from Apr.2024 to Dec.2024 were chosen as the external validation group.The children of the modeling group were divided into the heart failure group with 56 cases and the non-heart failure group with 481 cases according to the status of secondary heart fail-ure.The clinical data were collected from the children.Multivariate logistic regression analysis was performed for the influencing factors for the secondary heart failure in the children with severe pneumonia,the prediction model for secondary heart failure in the severe pneumonia children was established with the use of R software.The effica-cy of the model in prediction of secondary heart failure in the children with severe pneumonia was analyzed by means of receiver operating characteristic(ROC)curves and Hosmer-Lemeshow(H-L)fitting test.RESULTS The critically ill case score(OR=8.847,95％CI:3.806 to 20.566),persistent pulmonary arterial hypertension(OR=5.557,95％CI:2.450 to 12.604),respiratory failure(OR=2.646,95％CI:1.066 to 6.567),coagulation dysfunction(OR=13.444,95％CI:5.790 to 31.219)and procalcitonin(PCT)(OR=8.103,95％CI:3.466 to 18.943)were the influencing factors for the secondary heart failure in the children with severe pneumonia(P＜0.05).The area under the ROC curve of the validation group was 0.962,the external validation group 0.973;the H-L test showed that the prediction model had high consistency and discrimination for the secondary heart fail-ure in the children with severe pneumonia.CONCLUSIONS The critically ill case score,persistent pulmonary arte-rial hypertension,respiratory failure,coagulation dysfunction and PCT level are the influencing factors for the sec-ondary heart failure in the children with severe pneumonia.The prediction model that is established based on the influencing factors shows high efficiency.

Objective To investigate the diagnostic value of peripheral blood trimethylamine N-oxide(TMAO)combined with neutrophil-to-lymphocyte ratio(NLR)in patients with acute ische-mic stroke(AIS).Methods A total of 100 AIS patients were selected as study group,and 100 non-stroke study objects who underwent physical examinations during the same period were selected as con-trol group.Blood samples were collected from all participants,and plasma TMAO levels were meas-ured using high-performance liquid chromatography-tandem mass spectrometry.TMAO levels and NLR were compared between two groups,and Spearman correlation analysis,multivariate logistic regression analysis,and receiver operating characteristic(ROC)curve were applied to evaluate the diagnostic val-ue of TMAO and NLR in AIS.Results Compared with the control group,the AIS group had signifi-cantly higher TMAO levels and NLR(P＜0.05).Spearman correlation analysis indicated that TMAO and NLR were positively correlated with the occurrence of AIS(P＜0.05).Multivariate Logistic re-gression analysis revealed that age,TMAO,NLR,and hypertension were independent influencing fac-tors for the occurrence of AIS(P＜0.05).The ROC curve showed that the optimal cut-off values for TMAO and NLR in predicting AIS were 3.749 μmol/L and 2.210,respectively.The area under the curve for TMAO combined with NLR in predicting AIS was 0.902,which was higher than that of TMAO or NLR alone(0.808 and 0.801,respectively),and the Youden index for combined prediction was greater.Conclusion Peripheral blood TMAO and NLR are positively correlated with the occurrence of AIS,and the combination of TMAO and NLR can significantly improve the diagnostic efficacy of AIS,providing a basis for early clinical identification of AIS.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

OBJECTIVE To explore the influencing factors for secondary heart failure in the children with severe pneumonia and establish the nomogram prediction model.METHODS A total of 767 children with severe pneumo-nia who were treated in Children's Hospital of Nanjing Medical University from Mar.2018 to Mar.2024 were en-rolled in the study and were divided into the modeling group with 537 cases and the validation group with 230 ca-ses in a 7∶3 ratio.Meanwhile,127 children with severe pneumonia who were treated from Apr.2024 to Dec.2024 were chosen as the external validation group.The children of the modeling group were divided into the heart failure group with 56 cases and the non-heart failure group with 481 cases according to the status of secondary heart fail-ure.The clinical data were collected from the children.Multivariate logistic regression analysis was performed for the influencing factors for the secondary heart failure in the children with severe pneumonia,the prediction model for secondary heart failure in the severe pneumonia children was established with the use of R software.The effica-cy of the model in prediction of secondary heart failure in the children with severe pneumonia was analyzed by means of receiver operating characteristic(ROC)curves and Hosmer-Lemeshow(H-L)fitting test.RESULTS The critically ill case score(OR=8.847,95％CI:3.806 to 20.566),persistent pulmonary arterial hypertension(OR=5.557,95％CI:2.450 to 12.604),respiratory failure(OR=2.646,95％CI:1.066 to 6.567),coagulation dysfunction(OR=13.444,95％CI:5.790 to 31.219)and procalcitonin(PCT)(OR=8.103,95％CI:3.466 to 18.943)were the influencing factors for the secondary heart failure in the children with severe pneumonia(P＜0.05).The area under the ROC curve of the validation group was 0.962,the external validation group 0.973;the H-L test showed that the prediction model had high consistency and discrimination for the secondary heart fail-ure in the children with severe pneumonia.CONCLUSIONS The critically ill case score,persistent pulmonary arte-rial hypertension,respiratory failure,coagulation dysfunction and PCT level are the influencing factors for the sec-ondary heart failure in the children with severe pneumonia.The prediction model that is established based on the influencing factors shows high efficiency.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Polygonum cuspidatum polyketide synthase 1 (PcPKS1) has the catalytic activity of chalcone synthase (CHS) and benzylidene acetone synthase (BAS), which can catalyze the production of polyketides naringenin chalcone and benzylidene acetone, and then catalyze the synthesis of flavonoids or benzylidene acetone. In this study, three amino acid sites (Thr133, Ser134, Ser33) that may affect the function of PcPKS1 were identified by analyzing the sequences of PcPKS1, the BAS from Rheum palmatum and the CHS from Arabidopsis thaliana, as well as the conformation of the catalytic site of the enzyme. Molecular modification of PcPKS1 was carried out by site-directed mutagenesis, and two mutants were successfully obtained. The in vitro enzymatic reactions were carried out, and the differences in activity were detected by high performance liquid chromatography (HPLC). Finally, mutants T133LS134A and S339V with bifunctional activity were obtained. In addition to bifunctional activities of BAS and CHS, the modified PcPKS1 had much higher BAS activity than that of the wild type PcPKS1 under the conditions of pH 7.0 and pH 9.0, respectively. It provides a theoretical basis for future use of PcPKS1 in genetic engineering to regulate the biosynthesis of flavonoids and raspberry ketones.
Amino Acid Sequence ; Fallopia japonica/metabolism* ; Polyketide Synthases/chemistry* ; Acetone ; Mutagenesis, Site-Directed ; Flavonoids/metabolism* ; Acyltransferases/metabolism*

{L-End}Objective To analyze the correlation between occupational burnout and sleep quality among steelworkers. {L-End}Methods A total of 11 491 steelworkers from a large steel enterprise in Gansu Province were selected as the research subjects using convenient sampling method. The Burnout Questionnaire and the Pittsburgh Sleep Quality Index Scale were used to investigate their occupational burnout and sleep quality. Hierarchical regression analysis was used to analyze the effects of occupational burnout on the sleep quality. {L-End}Results The detection rate of occupational burnout and sleep disorder were 50.4% and 39.0%, respectively. There was a positive correlation between the level of occupational burnout and the total score of sleep quality (Spearman correlation coefficient=0.454, P<0.05). The results of hierarchical regression analysis, adjusting for confounding factors such as gender, age, marital status, education level, alcohol consumption, exercise, weekly working hours, seniority, work shift, noise exposure, dust exposure, and high-temperature work, showed that the score of occupational burnout was positively related to the score of sleep quality(P<0.01), explaining 16.0% of the variance in the score of sleep quality among these steelworkers. {L-End}Conclusion The detection rate of occupational burnout and sleep disorders are relatively high among the steelworkers in this enterprise. Higher levels of occupational burnout are associated with poorer sleep quality. Alleviating occupational burnout among steelworkers may contribute to improving their sleep quality.

Reynoutria japonica Houtt., belonging to Polygoneae of Polygonaceae, is a Chinese medicinal herb with the functions of draining dampness and relieving jaundice, clearing heat and detoxifying, dispersing blood stasis and relieving pain, and relieving cough and resolving phlegm. In this study, we carried out high-throughput sequencing for the chloroplast genome sequences of five cultivars of R. japonica and analyzed the genome structure and variations. The chloroplast genomes of the five R. japonica cultivars had two sizes (163 376 bp and 163 371 bp) and a typical circular tetrad structure composed of a large single-copy (LSC) region of 85 784 bp, a small single-copy (SSC) region of 18 616 bp, and a pair of inverted repeat (IR) regions (IRa/IRb) which are spaced apart. A total of 161 genes were obtained by annotation, which consisted of 106 protein-coding genes, 10 rRNA-coding genes, and 45 tRNA-coding genes. The total GC content was 36.7%. Specifically, the GC content in the LSC, SSC, and IR regions were 34.8%, 30.7%, and 42.7%, respectively. Comparison of the whole chloroplast genome among the five cultivars showed that trnk-UUU, rpoC1, petD, rpl16, ndhA, and rpl12 in coding regions had sequence variations. In the phylogenetic tree constructed for the 11 samples of Polygoneae, the five cultivars of R. japonica clustered into one clade near the root and was a sister group of Fallopia multiflora (Thunb.).
Base Composition ; Genome, Chloroplast/genetics* ; Open Reading Frames ; Phylogeny ; Reynoutria