Background Frailty serves as a significant precursor to falls, disability, and mortality. Epidemiological evidence examining the impact of working hours on frailty remains scarce. Objective To explore the prevalence of frailty and the relationship between frailty and working hours among full-time middle-aged and older workers in China. Methods Data were derived from the 2020 China Health and Retirement Longitudinal Study (CHARLS). The study included full-time workers aged 45 years and above with a weekly working duration exceeding 35 h. Frailty was assessed using the Frailty Index (FI). First, the dose-response relationship between working hours and FI was explored using a generalized additive model (GAM). Second, univariate analyses were performed using t-tests, χ² tests, and the Jonckheere–Terpstra trend test. Restricted cubic splines (RCS) were introduced for modeling. Based on ordinal logistic regression models, covariates were adjusted sequentially to examine whether differences in frailty prevalence existed across different weekly working hour categories. Finally, subgroup analyses were performed. Results Among the 5504 included participants, the mean age was (56.41±7.30) years, with 2304 being female (41.86%). A total of 807 participants (14.66%) were identified as frail, and 2 686 participants (48.80%) were pre-frail. After standardization for gender and age according to the seventh national census data, the standardized prevalence of frailty and prefrailty were 18.89% and 47.25%, respectively. Significant higher proportions of frail individuals were found among those in non-managerial (73.73%), agricultural (64.06%), and non-employed (65.68%) occupations. Long working hours were prevalent: 2596 (47.17%) workers worked 41–60 h per week, 1649 (29.96%) worked >60 h per week, and only 1259 (22.87%) worked 35–40 h per week. GAM analysis showed a non-linear relationship between weekly working hours and FI. Restricted cubic spline analysis showed a statistically significant association between weekly working hours and frailty status (P=0.022). Logistic regression analysis revealed that individuals working more than 60 h per week had a 23% higher odds of frailty compared to those working 41–60 h (OR=1.23, 95%CI: 1.09, 1.38, P<0.01), while those working 35–40 h per week showed a 15% higher odds of frailty (OR=1.15, 95%CI: 1.01, 1.31, P=0.034). The subgroup analysis revealed that the positive association between working more than 60 h per week and frailty remained generally consistent across sex, age, urban/rural residence, occupational attributes, industry, or employment type, although the association did not reach statistical significance among non-rural residents and individuals aged 60 years and older. Conclusion The prevalence of frailty among full-time middle-aged and older labor force in China is relatively high, and the odds of frailty increases significantly among those who work more than 60 h per week. It is recommended to implement frailty prevention and management strategies targeting long-working-hour workers and to prioritize the impact of working duration on frailty.

Background: and Purpose To investigate the association between derivatives of reactive oxygen metabolites (d-ROMs), biological antioxidant potential (BAP) and the risk of stroke by subtype, and ischemic heart disease (IHD). Methods: We employed a case cohort design consisting of cardiovascular disease cases (n=1,521; stroke, n=1,271; IHD, n=265) and a random sub-cohort (n=4,761) in a large Japanese population-based study. d-ROMs and BAP were measured in plasma samples collected between 1995 and 1999. Hazard ratios (HRs) were estimated using weighted Cox proportional hazards methods according to d-ROMs and BAP quartiles, adjusted for age, sex, area, and potential confounding factors. Results: Analysis revealed a positive association between d-ROMs and the risk of total stroke, ischemic stroke, IHD, and the composite outcome of ischemic stroke and IHD. The multivariable HRs and 95% confidence intervals (CIs) for the highest versus lowest quartiles for d-ROMs were 1.34 (95% CI: 1.11–1.63) for total stroke (P for trend<0.001), 1.47 (1.16–1.86) for ischemic stroke (P for trend<0.001), 1.47 (1.02–2.11) for IHD (P for trend=0.072), 1.47 (0.87–2.49) for subarachnoid hemorrhage (P for trend=0.101), and 1.01 (0.72–1.41) for intraparenchymal hemorrhage (P for trend=0.618). In contrast, no significant association was detected between BAP levels and the risk of cardiovascular disease. Conclusions Analysis revealed that d-ROMs levels were positively associated with the risk of ischemic stroke and heart disease but not with hemorrhagic stroke.

Thymocyte selection-associated high mobility group box (TOX), a member of the high mobility group protein super-family, plays an important role in T cell development, functional maintenance, and exhaustion. It has been recently found that TOX exerts critical immunoregulatory functions during pathogen infections, and TOX expression is strongly associated with the intensity and tolerance of host immune responses. This review systematically summarizes the structural and functional features of TOX and focuses on its expression dynamics, mechanisms of action, and immunomodulatory effects during viral, bacterial, and parasitic infections, which provides a theoretical support to better understanding of the role of TOX in infectious diseases and provides new insights into development of potential immunotherapeutic strategies targeting TOX.

Objective To analyze the relationship between the visceral adiposity index(VAI)and nocturia in the US adult population.Methods A cross-sectional study was performed.Data from subjects aged≥20 years in the National Health and Nutrition Examination Survey(NHANES)database from 2007 to 2020 were collected,including waist circumference,triglyceride,body mass index(BMI),high-density lipoprotein,age,gender,race,poverty income ratio,education level,marital status,smoking,alcohol consumption,sleep disorders,depression,occupation,hypertension,diabetes,congestive heart failure,cancer,and nocturnal urination frequency.Weighted analysis,multivariate logistic regression,generalized additive model(GAM),and curve fitting were employed to evaluate the association between VAI and nocturia,adjusting for age,gender,race,poverty income ratio,education level,marital status,smoking,alcohol consumption,sleep disorders,depression,occupation,hypertension,diabetes,congestive heart failure,and cancer.Subgroup analyses were conducted based on age,gender,race,hypertension and diabetes to further evaluate the relationship between VAI and the risk of nocturia.Results A total of 29,196 American adults were included.All subjects were divided into 4 groups based on VAI quartiles:Q1 group(0.32≤VAI<1.01),Q2 group(1.01≤VAI<1.70),Q3 group(1.70≤VAI<2.95),and Q4 group(2.95≤VAI<13.59),with nocturia prevalence rates of 28.5%,31.4%,33.3%,and 34.9%,respectively.In subgroup analyses,the risk of nocturia significantly increased with higher VAI in the 20-40 age group,females and other Hispanics(OR=1.04,95%CI 1.01-1.08,P=0.006;OR=1.02,95%CI 1.00-1.04,P=0.035;OR=1.05,95%CI 1.01-1.09,P=0.026).GAM analysis results showed a nonlinear relationship between VAI and nocturia.Conclusion VAI is positively associated with the risk of nocturia,and may be an effective indicator for predicting the risk of nocturia occurrence.

Objective To investigate the effect of Gd-hydroxyapatite(Gd-HA)stents with adipose mesenchymal cells(ADSCs)on the repair of knee articular cartilage defects.Methods To isolate,culture,and identify rabbit ADSCs by establishing a rabbit knee joint full-thickness cartilage defect model,a total of 18 rabbits were randomly divided into blank control group,Gd-HA scaffold group,and ADSCs+Gd-HA scaffold group.At week 12 and 24 after surgery,International Curtilage Repair Society(ICRS)score,HE,toluidine blue,modified red O bright green and ColⅡ were detected by immunohistochemical staining,then ColⅡand GAG mRNA expression levels were detected by O'Driscoll and Real-time PCR.ColⅡ protein expression was detected by Western blotting,GAG content was detected by DMMB,biomechanical strength was detected by indentation test,and PKH26 labeled ADSCs was used to trace the tissue engineering scaffold with Gd-HA composite ADSCs to evaluate the repair effect of rabbit knee cartilage defects.Results The ADSCs isolated and cultured in vitro showed good growth,stable phenotype and good directional differentiation through macroscopic observation and histological staining,it could be seen that the repair degree and effect of the knee joint full-thickness cartilage defect model implanted with Gd-HA scaffold group were better than those of the blank control group,while the cartilage repair situation of the ADSCs+Gd-HA scaffold group was better than that of the Gd-HA scaffold group(P＜0.05);The ICRS and improved O'Driscoll scores were higher than the other two groups(P＜0.05).Compared with the Gd-HA group,the ADSCs+Gd-HA group could produce ColⅡ and GAG during the process of cartilage repair,with stronger mechanical strength of the repaired tissue(P＜0.05);PKH26 labeled ADSCs were found in the repaired tissues of the ADSCs+Gd-HA group,and they were involved in the composition of newly formed tissues.Conclusion Gd-HA scaffold material combined with ADSCs has a good repair effect on full-thickness cartilage defects in the knee joint as a new type of biological material for repairing joint cartilage defects.

Objective To analyze the etiological characteristics of pediatric bacterial meningitis(BM)and change of biochemical indicators in cerebrospinal fluid,and establish a diagnostic model for pathogen differentiation based on biochemical indicators in cerebrospinal fluid.Methods Eighty children with BM in the Children's Hospital Affiliated to Zhengzhou University from May 2021 to May 2023 were selected as BM group,and their pathogen distribution as well as cytological and biochemi-cal indicators in cerebrospinal fluid were analyzed.Forty non-central nervous system infections chil-dren with cytological and biochemical testing in cerebrospinal fluid in the same period were included as control group.The relationships between indicators in cerebrospinal fluid and pathogen types in BM children were analyzed,and a diagnostic model was constructed.Results A total of 85 pathogens were detected in 80 BM children,including 48 Gram-negative bacteria(56.47％)and 37 Gram-pos-itive bacteria(43.53％).The BM group showed significantly higher white blood cell count and lym-phocyte percentages,lower neutrophil and monocyte percentages,lower glucose and chloride levels in cerebrospinal fluid,and higher protein levels in cerebrospinal fluid when compared to the control group(P＜0.05).Among BM children,those infected with Gram-negative bacteria had significantly higher white blood cell count and lymphocyte percentages,as well as lower glucose and chloride levels in cerebrospinal fluid when compared to those with Gram-positive bacterial infections(P＜0.05).Multivariate Logistic analysis revealed that white blood cell count,lymphocyte percentage,glucose,and chloride levels in cerebrospinal fluid were significantly associated with pathogen types(P＜0.05).A diagnostic model based on these factors demonstrated an area under the receiver operating characteristic(ROC)curve of 0.925 for distinguishing Gram-positive and Gram-negative infections,with a cutoff value of 0.754,asensitivity of 76.25％,and aspecificity of 98.33％.Conclusion The primary pathogens of pediatric BM include Acinetobacter baumannii,Escherichia coli,Klebsiella pneumoniae,coagulase-negative Staphylococcus,Staphylococcus aureus,and Streptococcus pneumoni-a,accompanied by elevated white blood cell count and lymphocyte percentages as well as reduced glucose and chloride levels in cerebrospinal fluid,which is helpful in differentiating Gram-positive from Gram-negative infections and guiding antibiotic therapy.

Operation management is an important tool to promote the high-quality development of public hospitals in China.Since the founding of New China,based on China's economic and social development and medical and health system reform,the evolution of operation management of public hospitals in China can be divided into four stages,the system building stage(1949-1978),the liberalization and revitalization stage(1979-1996),the operation mechanism reform stage(1997-2020),and the new stage of high-quality development(2021 present).The development trend of public hospital operation management in future should deepen the public welfare-oriented public hospital operation management,explore the value-oriented medical operation management model based on high-quality development and the refined operation and management model of public hospitals,so as to promote the high-quality development of public hospitals in China.

The symptoms of allergic diseases are complex and changeable, and the pathogenesis is complex and difficult to distinguish, and the prevalence of allergic diseases has gradually increased in recent years. Due to the relative limitations of Western medical treatment, in order to further meet the clinical treatment goals, the "lung being responsible for regulating visceral activities" is now used as the theoretical basis, combined with modern medicine, to explore the pathogenesis and etiological mechanism of this disease. Based on the classics, it is proposed that allergic diseases have four characteristics: "onset of allergies, seasonality of disease onset, diversity of symptoms, and recurrence of recovery", and summarized the etiology and pathogenesis as "stagnation of incubative pathogenic factors and disharmony between the nutritive and defensive levels, imbalance of waterways and obstruction of phlegm and dampness, a dysfunction in the pivotal qi flow leading to malnourishment of the skin and hair, the intermingling of cold and heat leads to the dysfunction of the orifices, a disorder of the blood-governing organs leads to extravasation of blood", and advocated that the treatment should take into account the symptoms, syndromes, viscera, and seasons, and clarify the syndromes, which would provide a new research idea for the exploration of the TCM connotation of this disease.

BACKGROUND:Transcranial magneto-acoustic-electrical stimulation is a novel non-invasive neural regulation technique that utilizes the induced electric field generated by the coupling effect of ultrasound and static magnetic field to regulate the discharge activity of the nervous system.However,the mechanism by which it affects synaptic plasticity in the brain is still not enough. OBJECTIVE:To explore the effect of transcranial magneto-acoustic-electrical stimulation intensity on synaptic plasticity of the prefrontal cortex neural network in mice. METHODS:(1)Animal experiment:Twenty-four C57 mice were equally and randomly divided into four groups:the control group receiving pseudo-stimulation,the 6.35 W/cm2 stimulation group receiving coupled stimulation of 0.3 T,6.35 W/cm2,the 17.36 W/cm2 stimulation group receiving coupled stimulation of 0.3 T,17.36 W/cm2,and the 56.25 W/cm2 stimulation group receiving coupled stimulation of 0.3 T,56.25 W/cm2.The local field potential signals and behavioral correctness were recorded during the execution of T-maze in mice.(2)Modeling and simulation experiments:A neural network model of the prefrontal cortex in mice stimulated by transcranial magneto-acoustic-electrical stimulation was constructed to compare the structural connectivity characteristics of the neural network under different stimulation intensities. RESULTS AND CONCLUSION:Transcranial magneto-acoustic-electrical stimulation could effectively shorten the behavior learning time,improve the working memory ability of mice(P＜0.05),and continue to stimulate the frontal lobe of mice after learning behavior.There was no significant difference in the accuracy of the T-maze behavioral experiment among the experimental groups(P＞0.1).Analysis of local field potential signals in the frontal lobe of mice revealed that transcranial magneto-acoustic-electrical stimulation promoted energy enhancement of β and γ rhythms.As the stimulation intensity increased,there was an asynchronous decrease in β and γ rhythms.Through β-γ phase amplitude coupling,it was found that stimuli could enhance the neural network's ability to adapt to new information and task requirements.Modeling and simulation experiments found that stimulation could enhance the discharge level of the neural network,increase the long-term synaptic weight level,and decrease the short-term synaptic weight level only when the stimulation intensity was high.To conclude,there is a complex nonlinear relationship between different stimulus intensities and the functional structure of neural networks.This neural regulation technique may provide new possibilities for the treatment of related neurological diseases such as synaptic dysfunction and neural network abnormalities.

Distinct from the complementary inhibition mechanism through binding to the target with three-dimensional conformation of small molecule inhibitors, targeted protein degradation technology takes tremendous advantage of endogenous protein degradation pathway inside cells to degrade plenty of “undruggable” target proteins, which provides a novel route for the treatment of many serious diseases, mainly including proteolysis-targeting chimeras, lysosome-targeting chimeras, autophagy-targeting chimeras, antibody-based proteolysis-targeting chimeras, etc. Unlike proteolysis-targeting chimeras first found in 2001, which rely on ubiquitin-proteasome system to mainly degrade intracellular proteins of interest, lysosome-targeting chimeras identified in 2020, which was act as the fastly developing technology, utilize cellular lysosomal pathway through endocytosis mediated by lysosome-targeting receptor to degrade both extracellular and membrane proteins. As an emerging biomedical technology, nucleic acid-driven lysosome-targeting chimeras utilize nucleic acids as certain components of chimera molecule to replace with ligand to lysosome-targeting receptor or protein of interest, exhibiting broad application prospects and potential clinical value in disease treatment and drug development. This review mainly introduced present progress of nucleic acid-driven lysosome-targeting chimeras technology, including its basic composition, its advantages compared with antibody or glycopeptide-based lysosome-targeting chimeras, and focused on its chief application, in terms of the type of lysosome-targeting receptors. Most research about the development of nucleic acid-driven lysosome-targeting chimeras focused on those which utilized cation-independent mannose-6-phosphonate receptor as the lysosome-targeting receptor. Both mannose-6-phosphonate-modified glycopeptide and nucleic aptamer targeting cation-independent mannose-6-phosphonate receptor, even double-stranded DNA molecule moiety can be taken advantage as the ligand to lysosome-targeting receptor. The same as classical lysosome-targeting chimeras, asialoglycoprotein receptor can also be used for advance of nucleic acid-driven lysosome-targeting chimeras. Another new-found lysosome-targeting receptor, scavenger receptor, can bind dendritic DNA molecules to mediate cellular internalization of complex and lysosomal degradation of target protein, suggesting the successful application of scavenger receptor-mediated nucleic acid-driven lysosome-targeting chimeras. In addition, this review briefly overviewed the history of lysosome-targeting chimeras, including first-generation and second-generation lysosome-targeting chimeras through cation-independent mannose-6-phosphonate receptor-mediated and asialoglycoprotein receptor-mediated endocytosis respectively, so that a clear timeline can be presented for the advance of chimera technique. Meantime, current deficiency and challenge of lysosome-targeting chimeras was also mentioned to give some direction for deep progress of lysosome-targeting chimeras. Finally, according to faulty lysosomal degradation efficiency, more cellular mechanism where lysosome-targeting chimeras perform degradation of protein of interest need to be deeply explored. In view of current progress and direction of nucleic acid-driven lysosome-targeting chimeras, we discussed its current challenges and development direction in the future. Stability of natural nucleic acid molecule and optimized chimera construction have a great influence on the biological function of lysosome-targeting chimeras. Discovery of novel lysosome-targeting receptors and nucleic aptamer with higher affinity to the target will greatly facilitate profound advance of chimera technique. In summary, nucleic acid-driven lysosome-targeting chimeras have many superiorities, such as lower immunogenicity, expedient synthesis of chimera molecules and so on, in contrast to classical lysosome-targeting chimeras, making it more valuable. Also, the chimera technology provides new ideas and methods for biomedical research, drug development and clinical treatment, and can be used more widely through further research and optimization.