Objective To systematically analyze the disease burden, long-term trends, and age-sex distribution of major valvular heart disease (VHD) subtypes—rheumatic heart disease (RHD), non-rheumatic valvular disease (NRVD), and non-rheumatic calcific aortic valve disease (CAVD)—in global, Chinese, and US populations from 1990 to 2021, providing evidence for public health strategies and clinical resource allocation. Methods Based on publicly available data from the Global Burden of Disease (GBD) Study 2021, we extracted incidence, mortality, and disability-adjusted life years (DALYs) for VHD from 1990 to 2021. Age-standardized rates (ASRs) were calculated using the GBD 2021 global standard population, and the estimated annual percentage change (EAPC) with its 95% uncertainty interval (UI) was computed for the period. Data from the Agency for Healthcare Research and Quality (AHRQ), the European Society of Cardiology (ESC)/Eurostat surveys, and Chinese national registries were used for trend triangulation and contextual background. Results From 1990 to 2021, the ASR and disease burden of RHD significantly decreased globally and in China (EAPC for DALYs in China: −4.8%, 95%UI: −5.0% to −4.6%). In contrast, the burden of NRVD and CAVD steadily increased in aging populations like those in China and the US, with a higher burden observed in older adults and males. In 2021, the incidence of NRVD and CAVD peaked in individuals aged ≥65 years, with rates being significantly higher in men than in women. RHD burden was concentrated in low socio-demographic index (SDI) regions, whereas NRVD/CAVD burden was strongly associated with high-SDI regions. Conclusion The global VHD epidemiological landscape is transitioning from an RHD-dominant to an NRVD/CAVD-dominant pattern. China faces a dual challenge of a residual RHD burden and a rapidly growing burden of degenerative valvular diseases. Developing tailored screening, prevention, and treatment strategies for different disease subtypes and populations is crucial.

Maximizing the value of data element resources is inseparable from the compliant and safe cross-border flow of health and medical data， yet it is constrained by value conflicts with privacy rights protection and its relevant legal issues. These include， first， the current legal system exhibits fragmented characteristics， lacking consistency and structured overall regulation. Second， the specific implementation rules of privacy rights protection in the cross-border flow of health and medical data remain incomplete， and the applicability norms are insufficient. Furthermore， a mutual trust mechanism for the cross-border flow of health and medical data is still lacking. In this regard， China should achieve the following aspects based on the theory of interest balance. From the perspective of balance， China should clarify the value orientation for cross-border flow of health and medical data and privacy rights protection through data classification and graded protection， as well as through purpose identification and filtering mechanisms. At the systemic level， it is necessary to promote separate legislation for the cross-border flow of health and medical data， adopting an overseas equivalent model to delineate the concurrence issue in the extraterritorial application of the Personal Information Protection Law. In terms of applicability level， by reducing the stringency of domestic rules and clarifying the rules of proactive notification and explicit consent， it is vital to adjust and improve the specific legal regulations for privacy rights protection in the cross-border flow of health and medical data. From the collaborative dimension， through signing bilateral or multilateral international treaties and other forms of joint cooperation， it is essential to promote the coordinated sharing of data governance experiences and technologies， thereby establishing international mutual trust mechanisms for the cross-border flow of health and medical data.

Viral pneumonia in the Lancang-Mekong River Basin exhibits distinct regional epidemiological characteristics and pathogenic mechanisms. Filthy dampness constitutes the core pathogenic factor of the disease here， and the core pathogenesis lies in the yang failing to be stored in the you （酉） position. Clinically， the fundamental therapeutic principle is established as boosting qi to expel filth and guiding yang qi to descend and converge into the you position. In the early stage， the pathogenesis is characterized by the pervasive diffusion of filthy dampness， yang qi floating externally and failing to be stored， and the lung failing to diffuse qi. The treatment focuses on invigorating yang qi to dispel filth and dredging the you pathways， primarily using modified Ganlu Xiaodu Decoction （甘露消毒丹）. In the progressive stage， the pathogenesis involves the tenacious stagnation of filthy dampness， yang constraint transforming into heat， and the rampant spread of heat-toxins. The therapeutic approach shifts to acrid medicinals for opening and bitter medicinals for promoting descent， rectifying healthy qi to expel filth， utilizing modified Dayuan Beverage （达原饮）. In the recovery stage， filthy dampness gradually recedes， accompanied by the depletion of qi and yin， and insufficient kidney yang. The treatment emphasizes supplementing qi and nourishing yin， accompanied by warming yang， with modified Yunv Decoction （玉女煎）.

Peri-implant keratinized mucosa (PIKM) augmentation refers to surgical procedures aimed at increasing the width of PIKM. Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health. Currently, several surgical techniques have been validated for their effectiveness in increasing PIKM. However, the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques, variations in clinical scenarios, and anatomical differences. Therefore, clear guidelines and considerations for PIKM augmentation are needed. This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery. It aims to establish a standardized framework for assessing, planning, and executing PIKM augmentation procedures, with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.
Humans ; Consensus ; Dental Implants ; Mouth Mucosa/surgery* ; Keratins

OBJECTIVE: To characterize a glycosyltransferase (RpUGT1) from Rheum palmatum and investigate its specificity toward flavonoid compounds. METHODS: The RpUGT1 was expressed in Escherichia coli and screened for catalytic activity against a range of flavonoid substrates using a high-throughput HPLC assay method. Mass spectrometry (MS) and nuclear magnetic resonance (NMR) were used to determine the structure of the product. Homology modeling, molecular docking analyses and site-directed mutagenesis studies were conducted to identify key residues responsible for its function. RESULTS: The recombinant RpUGT1 protein exhibited catalytic activity towards various flavonoids. Notably, RpUGT1 catalyzed the glycosylation of isorhamnetin to form 3-O-glucoside and kaempferol to form 7-O-glucoside, utilizing uridine diphosphate (UDP) glucose as the sugar donor. The homology modeling and molecular docking analyses identified key residues responsible for its activity. Subsequent site-directed mutagenesis studies highlighted the crucial role of K307 in catalysis. CONCLUSION These discoveries offer valuable perspectives on the role of the UGT family and establish a groundwork for forthcoming research on the synthesis of flavonoids in plants.

Objective To explore the value of combined ultrasound parameters, including the hepatorenal index (HRI) and renal resistance index (RRI), with cystatin C (CysC) in monitoring early acute kidney injury (AKI) after liver transplantation. Methods Perioperative data from 121 liver transplant recipients who received organs from donation after brain death were collected. The HRI and RRI of the recipients were measured on postoperative days 1-7 and at 1 month, and the CysC levels were measured on postoperative day 1. The recipients were divided into the AKI group (n=53) and the non-AKI group (n=68) based on whether AKI occurred within 7 days after operation. The data of the two groups were compared, and the ultrasound parameters before and after recovery in the AKI group were analyzed. The value of combined HRI, RRI and CysC in monitoring AKI was also analyzed. Results AKI occurred in 53 recipients, with an incidence rate of 43.8%, including 30 cases of stage 1, 18 cases of stage 2, and 5 cases of stage 3. Among them, 49 cases occurred on postoperative day 1, and 4 cases occurred on postoperative day 2. Of these, 43 cases recovered within 7 days after surgery, 8 cases recovered within 2 months after surgery, 1 case was lost to follow-up, and 1 case received renal replacement therapy. The body mass index and preoperative CysC levels were higher in the AKI group than in the non-AKI group, and the operative time was longer in the AKI group than in the non-AKI group (all P < 0.05). The HRI on postoperative day 1 was lower in the AKI group than in the non-AKI group, while the RRI and CysC levels were higher (all P < 0.05). When AKI occurred, the HRI was lower than the baseline level, and the RRI was higher than the baseline level. As AKI recovered, the HRI gradually increased, and the RRI gradually decreased. The receiver operating characteristic curve analysis showed that the sensitivity and specificity of HRI ≤ 1.12 for predicting AKI were 0.623 and 0.878, respectively, with an area under the curve (AUC) of 0.801. The sensitivity and specificity of RRI ≥ 0.65 for predicting AKI were 0.878 and 0.676, respectively, with an AUC of 0.825. The sensitivity and specificity of CysC ≥ 1.38 mg/L for predicting AKI were 0.736 and 0.882, respectively, with an AUC of 0.851 (all P<0.01). The combination of HRI and CysC (AUC=0.897, P<0.01), RRI and CysC (AUC=0.910, P<0.01), and all three parameters combined (AUC=0.934, P<0.01) were more effective than using each parameter alone. Conclusions HRI and RRI may be used to monitor the occurrence and recovery of early AKI after liver transplantation. The combination of these two parameters with CysC has a high application value in monitoring early AKI after liver transplantation.

Objective:To establish a protocol for virus isolation using the mixed method, and evaluate the efficacy of the suspended method and the mixed method in isolating herpes simplex virus (HSV).Methods:Simulated HSV-infected clinical samples were prepared using HSV-1 F strain and CDC-P1 strain. Both the suspended method and the mixed method were used to isolate HSV-1 from these samples. The virus isolation efficiency of the mixed method under various conditions was assessed. These conditions included different multiplicity of infection (MOI), cell seeding densities, and virus adsorption times.The 50% tissue culture infective dose (TCID 50) assay was used for the assessment. The positive rates of virus detection under low viral load conditions were compared between the two methods. Results:Under the conditions of a MOI of 0.005, a virus adsorption time of 15 min, and a cell seeding density of 1×10 6 cell/ml, the mixed method achieved effective isolation of HSV-1. When the virus titer of the sample was 100 TCID 50/ml, the positivity rate of the mixed method reached 100.0%, while the positivity rates of the suspended method were 50.7% (38/75) and 52.0% (39/75) after cultured for 72 h and 96 h, respectively. When the virus titer of the sample was 10 TCID 50/ml, the positivity rate of the mixed method was 100.0%, while the positivity rate of the suspension method was 0. Conclusions:The mixed method exhibits significantly higher efficiency in HSV isolation compared with the suspended method. Under the conditions of high viral load, both the suspended method and the mixed method can be effective in isolating HSV-1. For clinical samples with low viral loads, the mixed method has greater applicability.

In response to the demand for portable and rapid measurement in normalized nutritional metabolism monitoring,a low-power and multifunctional measurement method and system scheme based on indirect calorimetry is proposed. Firstly,a combination of Kalman and the 5th order Bessel filtering algorithm is used to preprocess the real-time data of oxygen,carbon dioxide,flow rate and electrocardiogram,and the cumulative amount of gas per unit time is obtained. Secondly,a rapid nutrient metabolism measurement method that considers resting analyses of electrocardiogram and respiratory waves is designed,and a calculation model for energy metabolism parameters is constructed. Then,a dedicated collection and analysis circuit system is developed to transmit data to the upper computer or cloud through wireless networks,achieving intelligent and networked design. Finally,the resting state of the subjects is determined by analyzing electrocardiogram and respiratory parameters,and the test of monitoring nutrient metabolism is completed. The results show that the system can effectively detect metabolism related physiological signals with high precision,and achieve accurate measurement of human fat and sugar consumptions on metabolism,providing an effective means for measuring human metabolic energy.

Objective:To investigate the dynamic changes of cellular miRNA expression profiles in EBV latently infected Raji cells upon reactivation with Phorbol ester (TPA).Methods:Total RNA was extracted using TRIzol reagent from Raji cells treated with TPA at different time points (0 h, 24 h, 48 h). Small RNA libraries were constructed and sequenced on an Illumina SE50 platform. Differentially expressed miRNAs were identified, and their target genes were predicted and functionally annotated. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were carried out through online tools. Additionally, miRanda and RNAhybrid software were used to predict cellular miRNAs targeting the EBV genome. Real-time RT-qPCR was employed to validate the expression levels of differentially expressed novel miRNAs.Results:High-throughput sequencing identified 1 301 celluar miRNAs, comprising 1 189 known and 112 novel miRNAs. A total of 264 known differentially expressed cellular miRNAs and 13 novel miRNAs were identified through high-throughput miRNA sequencing. Secondary structure prediction revealed that the novel miRNAs exhibited typical pre-miRNA hairpin structures. Stem-loop quantitative real-time PCR (RT-qPCR) validation of Novel_miR_183 and Novel_miR_242 did not exhibit a statistically significant difference ( F=1.407, P=0.370 7 for Novel_miR_183; F=1.277, P=0.397 0 for Novel_miR_242) between the TPA-stimulated and untreated groups. Target gene prediction analysis revealed that the differentially expressed cellular miRNAs were involved in various important biological processes and signaling pathways. Furthermore, 1 189 known cellular miRNAs and 108 novel miRNAs were predicted to target the EBV genome. Conclusions:Treatment of Raji cells with TPA stimulation successfully reactivated Raji cells and significantly altered their miRNA expression patterns. Differentially expressed miRNAs were identified, suggesting that these miRNAs probably play crucial roles in regulating EBV infection and replication by directly targeting the EBV genome.

Objective:To investigate the effect of nuclear factor erythroid-2 related factor (Nrf2) overexpression on high-risk human papillomavirus type 16 (HPV16) E6 protein.Methods:The pRK5-FLAG-NFE2L2 plasmid was constructed, and pRK5-FLAG-NFE2L2 and pRK5-HA-HPV16E6 plasmids were co-transfected in HEK293T cells, and the expression of the two proteins was detected by Western blotting (WB). Next, pRK5-HA-HPV16E6 and pRK5-FLAG-Nrf2 plasmids were expressed using an in vitro transcription system to observe the expression of both. Finally, pEGFP-HPV16E6 and pLVX-mCherry-Nrf2 plasmids were co-transfected in HEK293T cells, and the cellular localization of the E6 protein and the Nrf2 protein was observed using fluorescence microscopy.Results:Nrf2 protein was successfully overexpressed in HEK293T cells, and the WB result showed that Nrf2 inhibited HPV16 E6 protein expression in a significant dose-dependent manner. The expression of HPV16 E6 protein in the TNT Quick Coupled Transcription/Translation Systems was affected by Nrf2, while the expression of HPV16 E6 in TnT SP6 High-Yield Wheat Germ Protein Expression System was no longer inhibited by Nrf2. Fluorescence imaging further showed no intracellular co-localization of Nrf2 and HPV16 E6.Conclusions:Overexpression of the nuclear transcription factor Nrf2 reduces HPV16 E6 protein expression, but there is no intracellular co-localization of them.