Objective Under the guidance of the Social Ecosystems Theory(SET)framework,this study explores the experience of social isolation among patients with chronic obstructive pulmonary disease(COPD),providing a basis for the development of targeted clinical interventions.Methods This study employed purposeful sampling methods.Semi-structured interviews were conducted from April to July 2024 with patients diagnosed with COPD at a tertiary hospital in Shanxi Province,China,who met the inclusion and exclusion criteria.Data were analyzed using Colaizzi's seven-step analysis method and NVivo 12.0 software.Results This study involved in-depth interviews with 15 patients suffering from COPD,totaling approximately 405 minutes of interview time and yielding over 40,000 words in transcribed text.Totally 3 main themes and 9 sub-themes were distilled,among which the microsystem level reflects the intricate interplay of individual experiences(physical functional limitations,severe negative emotions,heightened emotional imbalance,and weakened social roles);the mesosystem level pertains to the support and challenges from family and social networks(intense need for familial emotional support,widening social gaps in interactions with friends and relatives,and pronounced interpersonal communication barriers);the macrosystem level involves the integrated influence of societal and policy environments(restricted living conditions and urgent demands for policy support and service accessibility).Conclusion The social isolation experienced by patients with COPD manifests in multiple dimensions of experience.It is necessary to develop interdisciplinary and multi-level comprehensive intervention strategies for the future,to create more social opportunities and emotional connections for patients,thereby improving their quality of life.

Objective To investigate the biomechanical effects of implant-anchored retraction and intrusion of maxillary anterior teeth under different force systems using three-dimensional finite element analysis(3D-FEA),by constructing models simulating both normal periodontium and mild alveolar bone resorption.Methods Cone-beam computed tomography(CBCT)data from a patient with skeletal protrusion and gummy smile was utilized.3D finite element models integrating micro-implants anchorage(MIA)and a straight-wire ap-pliance for en-mass retraction of maxillary anterior teeth were established using Mimics,Geomagic,SolidWorks,and Ansys software.Six experimental groups were designed based on alveolar bone height and vertical positioning of posterior MIA.Groups A1,A2,A3:Normal alveolar bone height.Groups B1,B2,B3:Mild alveolar bone resorption.Posterior MIA were placed between the first molar and second premolar at vertical heights of 4,6,and 8 mm(relative to the cementoenamel junction),respectively,each loaded with 200 g retraction force.Anterior MIA between the central and lateral incisors delivered 50 g intrusion force.Stress distribution,anterior tooth displacement patterns,and torque changes were analyzed and compared across all groups.Results Under varying force conditions,greater torque loss was observed in the anterior teeth of the mild alveolar bone resorption group compared to the periodontally healthy group.Differential displacement patterns emerged among central incisors,lateral incisors,and canines when posterior MIA were placed at different vertical heights.The center of resistance in the resorption group shifted apically,resulting in undesirable extrusion and com-promised torque control during intrusion-retraction of maxillary anterior teeth.Conclusion Anterior torque control is more challenging in the alveolar bone resorption group than in the periodontally normal group.Elevating posterior MIA height promotes bodily movement of central incisors,thereby mitigating the ＂bowing effect＂ to a clinically relevant extent.

Objective Under the guidance of the Social Ecosystems Theory(SET)framework,this study explores the experience of social isolation among patients with chronic obstructive pulmonary disease(COPD),providing a basis for the development of targeted clinical interventions.Methods This study employed purposeful sampling methods.Semi-structured interviews were conducted from April to July 2024 with patients diagnosed with COPD at a tertiary hospital in Shanxi Province,China,who met the inclusion and exclusion criteria.Data were analyzed using Colaizzi's seven-step analysis method and NVivo 12.0 software.Results This study involved in-depth interviews with 15 patients suffering from COPD,totaling approximately 405 minutes of interview time and yielding over 40,000 words in transcribed text.Totally 3 main themes and 9 sub-themes were distilled,among which the microsystem level reflects the intricate interplay of individual experiences(physical functional limitations,severe negative emotions,heightened emotional imbalance,and weakened social roles);the mesosystem level pertains to the support and challenges from family and social networks(intense need for familial emotional support,widening social gaps in interactions with friends and relatives,and pronounced interpersonal communication barriers);the macrosystem level involves the integrated influence of societal and policy environments(restricted living conditions and urgent demands for policy support and service accessibility).Conclusion The social isolation experienced by patients with COPD manifests in multiple dimensions of experience.It is necessary to develop interdisciplinary and multi-level comprehensive intervention strategies for the future,to create more social opportunities and emotional connections for patients,thereby improving their quality of life.

Objective:To investigate the incidence of hearing loss among helicopter flying personnel, and to analyze the contributing factors.Methods:Basic data of 443 male helicopter flying personnel who received physical examinations at Beidaihe Rehabilitation and Recuperation Center of PLA between March and June 2024 was collected. The hearing threshold levels were measured at 8 frequencies: 250, 500, 1 000, 2 000, 3 000, 4 000, 6 000 and 8 000 Hz. Routine blood tests and blood biochemical tests were performed. Based on the results of pure-tone audiometry, the participants were divided into 2 groups: the hearing loss group (hearing threshold ≤20 dB HL) and the normal hearing group (hearing threshold >20 dB HL). The basic data, routine blood results, and blood biochemical indicators were compared between the 2 groups before the contributors to hearing loss were analyzed.Results:A total of 443 helicopter flying personnel were included in the study, with 82 cases (18.51%) in the hearing loss group and 361 cases (81.49%) in the normal hearing group. There were significant differences in age and pulse between the flying personnel in the 2 groups ( t=2.13, 2.78, P=0.034, 0.006). Among the blood routine indicators, only the mean platelet volume (MPV) was significantly different ( t=2.26, P=0.025). Among the blood biochemical indicators, only homocysteine (HCY) revealed statistically significant difference ( Z=2.30, P=0.021). The determinants of hearing loss in helicopter flying personnel were age ( OR=1.046, 95% CI: 1.060-1.361), pulse ( OR=1.201, 95% CI: 1.060-1.361), MPV ( OR=1.365, 95% CI: 1.016-1.834) and HCY ( OR=1.065, 95% CI: 1.033-1.097). Conclusions:Age, pulse, the MPV and HCY levels can all contribute to hearing loss, and the MPV and HCY can serve as potential biomarkers for hearing loss in helicopter flying personnel. Potential hearing loss should be detected early and personalized interventions should be implemented. Noise exposure should be monitored more rigorously to reduce the risk of occupational hearing loss for helicopter flying personnel and ensure flight safety.

Objective To explore the prognostic value of serum growth hormone releasing peptide(Ghre-lin),angiopoietin like protein 4(ANGPTL4)combined with Geriatric Nutritional Risk Index(GNRI)in eld-erly patients with chronic pulmonary heart disease(CPHD).Methods From January 2019 to January 2022,a total of 98 elderly patients with CPHD admitted to the Hai'an People's Hospital were selected as the CPHD group,and another 98 healthy individuals who underwent physical examinations were selected as the control group.Enzyme linked immunosorbent assay(ELISA)was applied to determine the levels of serum Ghrelin and ANGPTL4.Multivariate Logistic regression was applied to analyze the influencing factors of prognosis in elderly patients with CPHD.Receiver operating characteristic(ROC)curve was plotted to analyze the predic-tive value of serum Ghrelin,ANGPTL4 combined with GNRI in the prognosis of CPHD.Results Compared with the control group,the level of serum Ghrelin and GNRI in the CPHD group were obviously reduced(P＜0.05),while the level of ANGPTL4 was obviously increased(P＜0.05).Compared with the survival group,the GNRI and Ghrelin level in the death group were obviously reduced(P＜0.05),while the level of AN-GPTL4 was obviously increased(P＜0.05).Multivariate Logistic regression results showed that ANGPTL4 was a risk factor affecting the prognosis of elderly CPHD patients(P＜0.05),while Ghrelin and GNRI were protective factors affecting the prognosis of elderly CPHD patients(P＜0.05).ROC curve results showed that the combination of serum Ghrelin,ANGPTL4,and GNRI had the largest area under the curve(AUC)in predicting the prognosis of elderly CPHD patients,which was better than that of the individual predictions of serum Ghrelin,ANGPTL4,and GNRI(P＜0.05).Conclusion The level of serum Ghrelin decreases and the level of ANGPTL4 increases in elderly patients with CPHD.The combination of the two with GNRI could better predict the prognosis of CPHD patients and has high predictive value.

Objective To investigate the biomechanical effects of implant-anchored retraction and intrusion of maxillary anterior teeth under different force systems using three-dimensional finite element analysis(3D-FEA),by constructing models simulating both normal periodontium and mild alveolar bone resorption.Methods Cone-beam computed tomography(CBCT)data from a patient with skeletal protrusion and gummy smile was utilized.3D finite element models integrating micro-implants anchorage(MIA)and a straight-wire ap-pliance for en-mass retraction of maxillary anterior teeth were established using Mimics,Geomagic,SolidWorks,and Ansys software.Six experimental groups were designed based on alveolar bone height and vertical positioning of posterior MIA.Groups A1,A2,A3:Normal alveolar bone height.Groups B1,B2,B3:Mild alveolar bone resorption.Posterior MIA were placed between the first molar and second premolar at vertical heights of 4,6,and 8 mm(relative to the cementoenamel junction),respectively,each loaded with 200 g retraction force.Anterior MIA between the central and lateral incisors delivered 50 g intrusion force.Stress distribution,anterior tooth displacement patterns,and torque changes were analyzed and compared across all groups.Results Under varying force conditions,greater torque loss was observed in the anterior teeth of the mild alveolar bone resorption group compared to the periodontally healthy group.Differential displacement patterns emerged among central incisors,lateral incisors,and canines when posterior MIA were placed at different vertical heights.The center of resistance in the resorption group shifted apically,resulting in undesirable extrusion and com-promised torque control during intrusion-retraction of maxillary anterior teeth.Conclusion Anterior torque control is more challenging in the alveolar bone resorption group than in the periodontally normal group.Elevating posterior MIA height promotes bodily movement of central incisors,thereby mitigating the ＂bowing effect＂ to a clinically relevant extent.

Objective:To investigate the incidence of hearing loss among helicopter flying personnel, and to analyze the contributing factors.Methods:Basic data of 443 male helicopter flying personnel who received physical examinations at Beidaihe Rehabilitation and Recuperation Center of PLA between March and June 2024 was collected. The hearing threshold levels were measured at 8 frequencies: 250, 500, 1 000, 2 000, 3 000, 4 000, 6 000 and 8 000 Hz. Routine blood tests and blood biochemical tests were performed. Based on the results of pure-tone audiometry, the participants were divided into 2 groups: the hearing loss group (hearing threshold ≤20 dB HL) and the normal hearing group (hearing threshold >20 dB HL). The basic data, routine blood results, and blood biochemical indicators were compared between the 2 groups before the contributors to hearing loss were analyzed.Results:A total of 443 helicopter flying personnel were included in the study, with 82 cases (18.51%) in the hearing loss group and 361 cases (81.49%) in the normal hearing group. There were significant differences in age and pulse between the flying personnel in the 2 groups ( t=2.13, 2.78, P=0.034, 0.006). Among the blood routine indicators, only the mean platelet volume (MPV) was significantly different ( t=2.26, P=0.025). Among the blood biochemical indicators, only homocysteine (HCY) revealed statistically significant difference ( Z=2.30, P=0.021). The determinants of hearing loss in helicopter flying personnel were age ( OR=1.046, 95% CI: 1.060-1.361), pulse ( OR=1.201, 95% CI: 1.060-1.361), MPV ( OR=1.365, 95% CI: 1.016-1.834) and HCY ( OR=1.065, 95% CI: 1.033-1.097). Conclusions:Age, pulse, the MPV and HCY levels can all contribute to hearing loss, and the MPV and HCY can serve as potential biomarkers for hearing loss in helicopter flying personnel. Potential hearing loss should be detected early and personalized interventions should be implemented. Noise exposure should be monitored more rigorously to reduce the risk of occupational hearing loss for helicopter flying personnel and ensure flight safety.

Objective:To investigate the molecular genetic and clinical characteristics of MEF2D-BCL9 fusion gene-positive acute B-cell lymphoblastic leukemia (B-ALL), and to provide the reference for the diagnosis and treatment of the disease.Methods:The medical record and experimental examination data of a 18-year-old female MEF2D-BCL9 fusion gene-positive B-ALL patient were retrospectively analyzed. The clinical manifestations and biological characteristics of MEF2D-BCL9 fusion gene-positive B-ALL were summarized.Results:This 18-year-old female patient was treated in a local hospital in December 2018 and was diagnosed as B-ALL. She achieved complete remission after chemotherapy and recurred at 6 months after the initial onset, and then she was admitted to Hebei Yanda Ludaopei Hospital in the 9 months after the initial onset.MEF2D-BCL9 fusion gene was detected through RNA-sequencing (RNA-seq) and verified by using polymerase chain reaction and Sanger sequencing. Bone marrow cell morphology was similar to mature B cells with vacuoles but without characteristic chromosome karyotype abnormalities. The patient achieved remission after VLD regimen chemotherapy, chimeric antigen receptor T-cell (CAR-T) therapy and bridged to allogeneic hematopoietic stem cell transplantation (allo-HSCT). She has maintained complete remission for 2 years at the last follow-up in February 2022.Conclusions:MEF2D-BCL9 fusion gene-positive B-ALL is characterized with high risk, early relapse and poor prognosis. These patients may benefit from CAR-T and allo-HSCT. It further emphasizes the importance of taking MEF2D-BCL9 fusion gene into the detection or identification by using RNA-seq, particularly for those newly diagnosed B-ALL patients in children and adolescents with specific bone marrow morphology.

Whether Fanconi anemia (FA) heterozygotes are predisposed to bone marrow failure and hematologic neoplasm is a crucial but unsettled issue in cancer prevention and family consulting. We retrospectively analyzed rare possibly significant variations (PSVs) in the five most obligated FA genes, BRCA2, FANCA, FANCC, FANCD2, and FANCG, in 788 patients with aplastic anemia (AA) and hematologic malignancy. Sixty-eight variants were identified in 66 patients (8.38%). FANCA was the most frequently mutated gene (n = 29), followed by BRCA2 (n = 20). Compared with that of the ExAC East Asian dataset, the overall frequency of rare PSVs was higher in our cohort (P = 0.016). BRCA2 PSVs showed higher frequency in acute lymphocytic leukemia (P = 0.038), and FANCA PSVs were significantly enriched in AA and AML subgroups (P = 0.020; P = 0.008). FA-PSV-positive MDS/AML patients had a higher tumor mutation burden, higher rate of cytogenetic abnormalities, less epigenetic regulation, and fewer spliceosome gene mutations than those of FA-PSV-negative MDS/AML patients (P = 0.024, P = 0.029, P = 0.024, and P = 0.013). The overall PSV enrichment in our cohort suggests that heterozygous mutations of FA genes contribute to hematopoietic failure and leukemogenesis.
Anemia, Aplastic/genetics* ; Epigenesis, Genetic ; Fanconi Anemia/genetics* ; Germ Cells ; Hematologic Neoplasms/genetics* ; Humans ; Leukemia, Myeloid, Acute/genetics* ; Retrospective Studies

Ulcerative colitis(UC)is a chronic inflammatory bowel disease caused by many factors including colonic inflammation and microbiota dysbiosis.Previous studies have indicated that celastrol(CSR)has strong anti-inflammatory and immune-inhibitory effects.Here,we investigated the effects of CSR on colonic inflammation and mucosal immunity in an experimental colitis model,and addressed the mechanism by which CSR exerts the protective effects.We characterized the ther-apeutic effects and the potential mechanism of CSR on treating UC using histological staining,intestinal permeability assay,cytokine assay,flow cytometry,fecal microbiota transplantation(FMT),16S rRNA sequencing,untargeted metabolomics,and cell differentiation.CSR administra-tion significantly ameliorated the dextran sodium sulfate(DSS)-induced colitis in mice,which was evidenced by the recovered body weight and colon length as well as the decreased disease activity index(DAI)score and intestinal permeability.Meanwhile,CSR down-regulated the production of pro-inflammatory cytokines and up-regulated the amount of anti-inflammatory mediators at both mRNA and protein levels,and improved the balances of Treg/Thl and Treg/Th1 7 to maintain the colonic immune homeostasis.Notably,all the therapeutic effects were exerted in a gut microbiota-dependent manner.Furthermore,CSR treatment increased the gut microbiota diversity and changed the compositions of the gut microbiota and metabolites,which is probably associated with the gut microbiota-mediated protective effects.In conclusion,this study provides the strong evidence that CSR may be a promising therapeutic drug for UC.