ObjectiveTo investigate the mechanism by which activation of α7nicotinic acetylcholine receptors （α7nAChR） optimizes brown adipose tissue （BAT） thermogenesis in obese mice. MethodsObesity was induced in C57BL/6J mice via a high-fat diet. Fifty 8-week-old mice were randomly assigned to five groups： low-fat diet （Control）， high-fat diet （HFD）， high-fat diet plus a β3-adrenergic receptor agonist （HFD+β3）， high-fat diet plus a β3-adrenergic receptor agonist and an α7nAChR selective agonist （HFD+β3+GTS-21）， and high-fat diet plus a β3-adrenergic receptor agonist and an α7nAChR selective antagonist （HFD+β3+α-BGT）. Haematoxylin and eosin （HE） staining was used to evaluate BAT morphology. Transmission electron microscopy was performed to assess mitochondrial number and lipid droplet morphology in adipocytes. ELISA was used to measure levels of tumour necrosis factor-α （TNF-α）， interleukin（IL）-1β，IL-10， transforming growth factor-β （TGF-β）， cyclic adenosine monophosphate （cAMP）， and norepinephrine （NE）. RT-qPCR was conducted to determine mRNA expression levels of vascular endothelial growth factor A （VEGF-A）， nitric oxide synthase 2 （NOS2）， arginase 1 （Arg1）， uncoupling protein 1 （UCP1）， PR domain-containing protein 16 （PRDM16）， and peroxisome proliferator-activated receptor γ coactivator-1α （PGC-1α） in BAT. Immunohistochemistry was used to detect macrophage markers （CD31， CD86， and CD206）. Protein expression levels of UCP1， α7nAChR， nuclear factor-κB p65（NF-κB p65）， phosphorylated Janus kinase 2 （p-JAK2）， and phosphorylated signal transducer and activator of transcription 3 （p-STAT3） were analyzed by Western blot. ResultsCompared with the Control group， the HFD group showed enlarged lipid droplets and reduced mitochondrial numbers in adipocytes， accompanied by increased TNF-α and IL-1β and decreased IL-10， TGF-β， Arg1， and VEGF-A （all P<0.01）. Compared with the HFD+β3 group， the HFD+β3+GTS-21 group showed a smaller lipid droplet area and a higher mitochondrial number， along with reduced levels of pro-inflammatory factors， NOS2， and NF-κB p65， and increased levels of anti-inflammatory factors， Arg1， and phosphorylation of JAK2 and STAT3 （all P<0.01）. ConclusionActivation of α7nAChR in combination with a β3-adrenergic receptor agonist effectively enhances thermogenesis， alleviates local adipose tissue hypoxia， and shifts the local inflammatory phenotype toward an M2-like state， thereby reducing inflammation in brown adipose tissue and improving its thermogenic capacity.

BackgroundBoth modified Suanzaoren Decoction and estazolam serve as effective treatments for chronic insomnia disorder （CID）. Default mode network （DMN） dysfunction is recognized as the primary pathophysiological mechanism underlying CID. However， it remains unclear whether the two treatments exert their therapeutic effects via convergent modulation of DMN functional connectivity. ObjectiveTo investigate the convergent remodeling characteristics of bidirectional effective connectivity （EC） of core DMN nodes with both the intra-network and the remaining whole-brain regions in CID patients with Yin-deficiency and fire-hyperactivity syndrome following the treatment with modified Suanzaoren Decoction or estazolam， so as to provide neuroimaging evidence for the convergent neural mechanisms underlying the therapeutic effects of both therapies in treating CID. MethodsEighty-two patients diagnosed with CID according to the International Classification of Sleep Disorder， third edition （ICSD-3） were consecutively recruited from the outpatient clinic of the Inner Mongolia Autonomous Region Mental Health Center from October 2020 to September 2023. Based on treatment preference， patients were assigned to receive a 6-week intervention in either the modified Suanzaoren Decoction group （n=52） or the estazolam group （n=30）. Ultimately， 66 patients completed follow-up assessments （modified Suanzaoren Decoction group， n=41； estazolam group， n=25）. All CID patients underwent resting-state functional magnetic resonance imaging scanning before and after treatment. Core DMN nodes including medial prefrontal cortex （mPFC）， bilateral inferior parietal lobule （IPL）， and precuneus （PCUN） were selected as seed regions. Granger causality analysis （GCA） was employed to assess bidirectional EC between the seed regions and both the other intra-DMN nodes and the remaining whole-brain regions. Hepatic and renal function indices were detected pre- and post-treatment to evaluate the safety profiles of both treatments. ResultsAt baseline， significant between-group differences were identified in EC from the left IPL to the left middle fronto-orbital gyrus/gyrus rectus （t=5.24， Z=4.84， voxel-level P<0.001， cluster-level P<0.05， GRF-corrected）， with the modified Suanzaoren Decoction group exhibiting stronger EC than the estazolam group. No significant between-group differences were observed in EC between other core DMN nodes and remaining whole-brain regions （P>0.05）. Within-group pre- to post-treatment comparisons demonstrated consistent connectivity alterations in both groups. Specifically， EC from the left IPL to the supplementary motor area （SMA） decreased after treatment （modified Suanzaoren Decoction group： t=-6.28， Z=5.208； estazolam group： t=-5.58， Z=4.425）. Conversely， EC from the SMA to the left IPL increased （modified Suanzaoren Decoction group： t=5.89， Z=4.968； estazolam group： t=6.15， Z=4.720）. Furthermore， both groups demonstrated reduced EC from the PCUN to the left IPL （modified Suanzaoren Decoction group： t=-5.85， Z=4.94； estazolam group： t=-5.75， Z=4.515）， and elevated EC from the left IPL to the PCUN （modified Suanzaoren Decoction group： t=5.29， Z=4.579； estazolam group： t=4.55， Z=3.826） （voxel-level P<0.001， cluster-level P<0.05， GRF-corrected）. No significant pre- to post-treatment differences were observed in hepatic or renal function indices in either group （P>0.05）. ConclusionIn CID patients with Yin-deficiency and fire-hyperactivity syndrome， both modified Suanzaoren Decoction and estazolam induce convergent bidirectional remodeling of EC between the left IPL and the SMA and the PCUN. ［Funded by Natural Science Fund Project of Inner Mongolia Autonomous Region （number， 2019MS08099）； ClinicalTrials.gov number， NCT06452953］

ObjectiveTo investigate the relationship between mitochondrial DNA copy number (mtDNAcn) and cognitive dysfunction, and its mediating role between type 2 diabetes mellitus (T2DM) and cognitive dysfunction. MethodsA case-control study was conducted from May 2019 to April 2021 at the Shanghai Yangpu District Central Hospital, China. A total of 193 subjects were recruited and divided into two groups based on the Montreal Cognitive Assessment (MoCA): normal control (NC) group (n=95) and cognitive impairment group (n=98). The prevalence of T2DM was determined on the basis of medical history, while mtDNAcn in peripheral blood samples was quantified using realtime fluorescent quantitative polymerase chain reaction. ResultsUnivariate analyses revealed that the mean mtDNAcn in the cognitive impairment group was 0.76±0.37, significantly lower than that in the NC group (1.06±0.45) (P<0.05). Logistic regression analyses showed that higher mtDNAcn was associated with a reduced risk of cognitive impairment (OR=0.315, 95%CI: 0.125‒0.795). Additionaly, a statistically significant positive correlation was observed between mtDNAcn and the total MoCA score (r=0.381, P<0.01). Morever, T2DM history (OR=2.741, 95%CI: 1.002‒7.497) and elevated glycosylated hemoglobin (HbA1c) levels (OR=1.796, 95%CI: 1.190‒2.711) were identified as risk factors for cognitive impairment. Mediation analyses indicated that mtDNAcn served as a mediator between T2DM/HbA1c and the risk of cognitive impairment, with proportions of mediating effect of 9.04% and 9.18%, respectively. ConclusionPatients with mild and moderate cognitive impairment have significantly lower mtDNAcn than those with normal cognitive function. Reduced mtDNAcn is an influencing factor for cognitive dysfunction and may play a mediating role in the association between T2DM and mild to moderate cognitive impairment.

Objective: To develop a simple digital chylous plasma device and validate its ability to accurately, standardly, and non-destructively determine chylous plasma in blood banks and clinical transfusions in hospitals. Methods: A digital chylous plasma assessment device was designed and manufactured. This device was used to measure the chylous degrees of chylous plasma samples before freezing, after freeze-thawing, before viral inactivation, and after viral inactivation. The measured chylosity index values were categorized according to the requirements specified in Appendix A of the Chinese national standard GB 18469-2001 "Quality Requirements for Whole Blood and Blood Components". This process established a digital standard for chylous plasma, enabling the identification of severe, moderate and mild chylous plasma, and non-chylous plasma. Results: The initial simple product of the digital chylous assessment device was successfully designed and manufactured. There was no significant difference in the degree of chylous plasma between pre-freezing 468.11±217.73 lux and post-thawing 538.91±273.39 lux of chylous plasma (P>0.05), or between pre-viral inactivation 858.33±387.79 lux and post-viral inactivation 928.33±166.51 lux of chylous plasma (P>0.05). The median of chylous degree values for plasma chylous index grades 0 to 6 were 45 lux, 250 lux, 620 lux, 835 lux, 1 130 lux, 1 390 lux, and 1 700 lux, respectively. The defined cutoff values/ranges for the chylous degree values corresponding to plasma chylous index grade 0 to 6 were ≤125 lux, 126-465 lux, 466-740 lux, 741-1 000 lux, 1 001-1 233 lux, 1 234-1 560 lux, and ≥1 561 lux. Conclusion: This study successfully developed the initial product of the digital chylous device and established digital standards for classifying chylous plasma. The device demonstrates the potential to meet the needs for assessment of chylous plasma in both blood banks and clinical transfusions in hospitals, thereby promoting the development and application of standardized, non-destructive chylous plasma assessment technology.

Objective To construct a predictive model for high-grade pathological components of early invasive lung adenocarcinoma(ILAC)based on radiomics.Methods Collecting information on total 495 patients who underwent radical operation and were pathologically diagnosed as stage Ⅰ in the cardiothoracic surgery of Zhoushan Hospital from January 2015 to December 2019,including gender,age,pathological findings,tumor markers and preoperative chest CT images.The micropapillary and solid components in postoperative pathology were defined as"high-grade pathological components",while those without high-grade pathological components were classified into the low-grade group and those with high-grade pathological components were classified into the high-grade group.And patients were randomly divided into the training set(343 cases)and the validation set(152 cases)with a ratio of 7∶3 using the simple randomization grouping method.The region of interest of nodules on CT images were delineated layer by layer by scientific research platform and 1950 radiomics features were extracted.And then those features were filtrated by F-test,Pearson correlation coefficient,and L1 based feature selection.A model was built by using Logistic regression machine learning classifier,named mod 2,and radscore was also obtained.Differences between general information and CT features were analyzed.Binary Logistic regression analysis was used to construct a model for statistically significant variables,named mod 1.At the same time,Radscore was added to build the mod and named comb mod.The area under the curve(AUC),sensitivity and specificity of the three models were calculated.A nomogram was also drawn.Results A total of 495 patients were divided into the training set(n=343)and the validation set(n=152).Gender,carcinoma embryonic antigen(CEA),nodule,and maximum diameter were screened out in clinical features and involved in constructing the mod 1.Twelve features were selected from the radiomics features to build mod 2.Comb mod performed best,training set AUC:0.887,validation set AUC:0.875,and had good clinical practicability.Conclusion The model composed of general feature,CT feature and radiomics features could accurately predict high-grade pathological components in early ILAC,and provide references for clinicians to choose surgical method for patients.

Objective To develop the application technology of finger length ratios in the selection of Muay Thai athletes,and to provide practical guidance for improving the competitive level of Muay Thai.Methods By using the method of snowball sampling and simple random sampling,413 subjects were selected in Bangkok,Thailand,including 84 male Muay Thai professional players,62 female Muay Thai professional players,137 ordinary male college students and 130 female college students.The finger length of the subjects was measured and their finger length ratios was calculated.SPSS 20.0 statistical software was used for discriminant analysis.Results The 2D∶3D,2D∶4D,2D∶5D,3D∶4D and 3D∶5D of male Muay Thai professional players were significantly lower than that in the general male Thai population,and the 2D∶4D,3D∶4D and 3D∶5D of female Muay Thai players were significantly lower than that in the general female Thai population,and the above differences were statistically significant(P＜0.05).Discriminant functions developed using both the full model and stepwise method were statistically significant,demonstrating high accuracy and stability.The correct discrimination rates were higher in the male population than that in the female population.When distinguishing between Muay Thai professional fighters and the general Thai population,the optimal 2D∶4D threshold for males is 0.951,and for females,it was 0.960.Conclusion The discriminant model of Muay Thai professional players and ordinary people based on the ratios of finger length can provide important reference for the selection of Muay Thai athletes.

Facing of mounting resource constraints and rising demands for personalization in medical education,regional anatomy teaching urgently requires transformation.In this paper,we focus on the regional anatomy of the thoracic wall,in order to explore a novel AI-driven teaching paradigm.Anchored in the core principle of"virtual-real integration with cadaveric dissection as the cornerstone,"the paradigm redefines educational objective and constructs an intelligent,closed-loop teaching model integrating students,computers,and instructors.Leveraging the robust support of digital intelligence(e.g.,DeepSeek),this paradigm incorporates interactive method including group collaboration,branching instruction,and gamified assessments.It achieves a comprehensive intelligent transformation of the entire teaching process-from goal setting and plan customization to activity implementation,task completion,outcome exchange,multidimensional evaluation,and reflective iteration.This new paradigm centers on medical students and leverages digital intelligence to activate deep personalized learning potential.It seamlessly integrates fundamental anatomical knowledge with clinical scenarios(e.g.,key anatomy in breast cancer surgery,flap design in breast reconstruction),and significantly enhances clinical decision-making abilities,scientific research and innovative thinking,as well as medical humanistic literacy,paving a new path for intelligent medical education.

Objective To explore the integration value of mobile virtual reality devices in the classroom teaching of human anatomy,and to evaluate their potential impact on the in-depth construction of human anatomy knowledge,the cultivation of spatial cognitive ability,and the transformation of teaching paradigms from the perspectives of cognitive load theory and situated learning.Methods The undergraduate students majoring in clinical medicine in Peking University were selected as the research objects.Among them,students in grade 2019 were the control group,and students in grade 2022 were the experimental group,introducing movable virtual anatomy equipment and other teaching auxiliary method in theory and practice courses.The final exam scores of the two groups of students were compared,and a questionnaire survey was conducted for the experimental group after the course,and the survey result were statistically analyzed.Results The final examination result showed that the average score of the experimental group was 82.47±10.19,and the average score of the control group was 74.82±16.56,which was significantly higher in the experimental group than in the control group,with statistical significance(P＜0.05).The questionnaire survey result showed that compared with traditional classroom teaching,94.62％of students preferred the new auxiliary teaching mode such as VR,96.77％of students believed that VR assisted teaching could achieve the traditional teaching effect or better,95.7％of them think that it improved students' interest in learning human anatomy,and 98.92％thought that it improved students' knowledge of anatomy.Conclusion The application of mobile virtual reality devices in anatomy classroom teaching provides immersive and interactive 3D visualization teaching scenarios,effectively reducing students' cognitive load on abstract and complex anatomical structures,promoting spatial understanding and knowledge internalization,significantly improving teaching effectiveness and self-learning ability,thus changing the traditional anatomy teaching mode and laying a solid foundation for the development of future medical education and the cultivation of medical talents.

Objective To construct a perioperative nursing intervention scheme for patients undergoing hepatic arterial infusion chemotherapy(HAIC)via brachial artery access and to discuss its clinical application.Methods By using systematic literature search method,a perioperative nursing intervention scheme was constructed.A total of 90 patients with confirmed hepatic malignancy,who were admitted to hospital to receive HAIC from February 2022 to August 2023,were collected to validate this perioperative nursing intervention scheme,and its clinical application effect was evaluated.Results Through two rounds of expert letter inquiry,a nursing intervention scheme containing five primary indicators and 16 secondary indicators was finally formulated.The clinical validation was conducted.After the implementation of this nursing intervention scheme,the incidences of phlebitis and limb swelling in the intervention group decreased from previous 17.78％ to post-intervention 2.22％ and from previous 33.33％ to post-intervention 8.89％,respectively.The patient's anxiety level and depressed mood were significantly improved;the HADS scores decreased by 35.2％and 36.6％,respectively;the EORTC QLQ-C30 scores in the dimensions of somatic,role,emotional,and social functioning were obviously improved and the quality of life was strikingly improved(all P＜0.05).Besides,in the patients of the intervention group the clinical symptoms(e.g.pain,nausea,etc.)were significant alleviated,and the severity of the symptoms as well as the degree of distress to the patients were significantly reduced,indicating that the nursing intervention plays an important role in relieving the symptoms,anxiety and depression of the patients.Conclusion The perioperative nursing intervention scheme constructed in this study for patients undergoing AIC via brachial artery access is scientific and practical,it provides an important reference basis for the therapeutic nursing care of patients with hepatic malignancy.

ObjectiveTo assess the efficiency of a Sophora flavescens Ait (S. flavescens, Ku Shen)-soluble microneedle (SFA-MN) for improving skin lesion symptoms in mice with psoriasis.MethodsSFA-MNs were prepared using a two-mold molding process with 20% w/v polyvinylpyrrolidone and 15% w/v polyvinyl alcohol. The SFA-MNs were assessed for morphology, mechanical properties, in vitro dissolution, identification of components, and skin lesion improvement in imiquimod-induced psoriasis mice.ResultsThe SFA-MNs demonstrated good mechanical properties for efficiently penetrating the dermis, facilitating efficient drug delivery. Furthermore, they effectively inhibited mast cell levels in the dorsal lesion area of psoriasis mice and reduced the expression of the T-lymphocyte factor cluster of differentiation 3 and tumor necrosis factor-α. In addition, this system alleviated skin inflammation, splenic swelling, and thymic atrophy in the psoriasis-like mouse model. Seven major components were detected from SFA-MNs by comparison of the mass-to-nucleus ratios (m/z) of the secondary fragments N-methylcytisine, 5α, 9α-dihydroxymatrine, sophoramine, matrine, oxysophocarpine, oxymatrine, and kushenol O.ConclusionThe drug delivery strategy combining traditional herbal S. flavescens with soluble microneedle technology provides more targeted and effective immune regulation for treating psoriasis-like mice models, enabling enhanced therapeutic effects compared with the control group.