Objective: To investigate the trend in disease burden of interstitial lung disease (ILD) in China from 1990 to 2021, so as to provide a reference for formulating prevention and control strategies for chronic respiratory diseases. Methods: Based on the Global Burden of Disease 2021 database, data on the number of incident cases, incidence, standardized incidence, number of deaths, mortality, standardized mortality, number of disability-adjusted life years (DALY), DALY rate, and standardized DALY rate of ILD in China were collected. The incidence, mortality, and DALY rate were used to analyze the disease burden of ILD. The estimated annual percentage change (EAPC) was employed to assess the trend in standardized incidence, standardized mortality, and standardized DALY rate of ILD from 1990 to 2021. Rate decomposition analysis was applied to identify the main contributing factors affecting the trend in disease burden. Results: In 2021, China reported 48 514 cases, 7 674 deaths, and 222 288 person-years of DALY due to ILD, representing increases of 155.43%, 159.70%, and 97.34%, respectively, compared with 1990. From 1990 to 2021, the standardized incidence and standardized mortality of ILD in China showed upward trends (EAPC=1.106% and 0.239%, both P<0.05), while the standardized DALY rate showed a downward trend (EAPC=-0.230%, P<0.05). From 1990 to 2021, the standardized incidence and standardized mortality among males showed upward trends (EAPC=1.199% and 0.520%, both P<0.05), while the trend in the standardized DALY rate was not statistically significant (P>0.05). Among females, the standardized incidence of ILD showed an upward trend (EAPC=0.966%, P<0.05), while the standardized mortality and standardized DALY rate showed downward trends (EAPC=-0.306% and -0.760%, both P<0.05). In 2021, the incidence, mortality, and DALY rate of ILD in China increased with age, peaking in the group aged ≥95 years at 14.84/105, 13.90/105, and 124.71/105, respectively. Across all age groups aged ≥55 years, the incidence, mortality, and DALY rate of ILD were consistently higher in males than in females. The increase in the number of incident cases, deaths, and DALY due to ILD in China from 1990 to 2021 was primarily influenced by population aging, with contribution rates of 42.65%, 68.25%, and 69.79%, respectively. Conclusions From 1990 to 2021, the incidence and mortality risk of ILD in China showed upward trends, while the disability risk demonstrated a downward trend. Males bore a heavier disease burden of ILD, and aging was identified as the primary factor contributing to the increased burden of ILD in China.

Objective:To study and screen the differential expression of inflammatory proteins in diabetes skin ulcers and common skin ulcers, so as to provide experimental basis for further research on anti-inflammatory and healing drug targets of diabetes skin ulcers.Methods:The tissues of 11 patients with diabetes skin ulcer, 12 patients with common skin ulcer and 11 patients with normal skin were collected from the First Hospital of Hunan University of Chinese Medicine. The levels of inflammatory protein Toll like receptor 4 (TLR4), nuclear factor κB (NF-κB), pro-inflammatory factor interferon -γ (IFN -γ), tumor necrosis factor - α (TNF -α), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-1β (IL-1β), macrophage chemotactic protein-1 (MCP-1), anti-inflammatory factors epidermal growth factor (EGF), interleukin-4 (IL-4), and interleukin-10 (IL-10) were detected in three groups of tissues using enzyme-linked immunosorbent assay (ELISA).Results:Compared with normal tissues, the concentrations of TLR4, NF-κB, IFN -γ, TNF -α, IL-1β, IL-6, IL-8, MCP-1 and EGF in common ulcer skin tissues and diabetes ulcer tissues were higher, and the concentrations of IL-10 were lower, with statistically significant differences (all P<0.05); Compared with the normal tissue, the concentration of IL-4 in diabetes ulcer tissue was lower, the difference was statistically significant ( P<0.05); Compared with ordinary ulcer skin tissue, the concentrations of TLR4, NF-κB and MCP-1 in diabetes ulcer tissue were higher, and the concentrations of IL-4 were lower, with statistically significant differences (all P<0.05). Conclusions:The skin ulcer in diabetes patients will have inflammatory reaction, and high glucose promotes the inflammatory reaction of skin ulcer, which may be related to the abnormal expression of TLR4, NF-κB, MCP-1 and IL-4. TLR4/NF-κB signal pathway and inflammatory factors MCP-1 and IL-4 may be the target of the inflammation regulation of diabetes skin ulcer.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has a clinical manifestation of hypoxic respiratory failure and acute respiratory distress syndrome. However, COVID-19 still lacks of effective clinical treatments so far. As a promising potential treatment against COVID-19, stem cell therapy raised recently and had attracted much attention. Here we review the mechanisms of mesenchymal stem cell-based treatments against COVID-19, and provide potential cues for the effective control of COVID-19 in the future. METHODS: Literature is obtained from databases PubMed and Web of Science. Key words were chosen for COVID- 19, acute respiratory syndrome coronavirus 2, mesenchymal stem cells, stem cell therapy, and therapeutic mechanism. Then we summarize and critically analyze the relevant articles retrieved. RESULTS: Mesenchymal stem cell therapy is a potential effective treatment against COVID-19. Its therapeutic efficacy is mainly reflected in reducing severe pulmonary inflammation, reducing lung injury, improving pulmonary function, protecting and repairing lung tissue of the patients. Possible therapeutic mechanisms might include immunoregulation, antiinflammatory effect, tissue regeneration, anti-apoptosis effect, antiviral, and antibacterial effect, MSC - EVs, and so on. CONCLUSION Mesenchymal stem cells can effectively treat COVID-19 through immunoregulation, anti-inflammatory, tissue regeneration, anti-apoptosis, anti-virus and antibacterial, MSC - EVs, and other ways. Systematically elucidating the mechanisms of mesenchymal stem cell-based treatments for COVID-19 will provide novel insights into the follow-up research and development of new therapeutic strategies in next step.

ObjectiveTo investigate the effect of exogenous H₂O₂ on secondary metabolism in Atractylodes chinensis and its mechanism. MethodFresh rhizomes of A. chinensis were treated with 5.0， 1.0， 0.2， 0.04 mmol·L^-1 H₂O₂ solution and clean water， and the relationships between the contents of reactive oxygen species， activities of antioxidant enzymes， activities of key enzymes of secondary metabolites， and contents of secondary metabolites in A. chinensis were compared. ResultUnder treatment with exogenous H₂O₂， the content of reactive oxygen species and malondialdehyde （MDA） in the fresh rhizomes of A. chinensis were significantly elevated on the 4th day， and returned to normal level on the 6th-8th day. The activities of superoxide dismutase （SOD）， catalase （CAT） and peroxidase （POD） were all increased first and then decreased， and reached the peak on the 4th， 4^th-6^th and 2^th-4^th day， respectively. The activities of 3-hydroxy-3-methyl glutaryl coenzyme A reductase （HMGR） and acetyl CoA carboxylase （ACC）， key enzymes of the secondary metabolites， were remarkably enhanced， and under treatments with different concentrations of H₂O₂， the activities of key synthetic enzymes of the secondary metabolites in 0.2 mmol·L^-1 H₂O₂ group were increased most， with the highest biosynthesis of secondary metabolites. The contents of atractylodin， β-eudesmol， atractylone， atractylenolide Ⅱ， and atractylenolide Ⅲ on the 6th day of 0.2 mmol·L^-1 H₂O₂ treatment were 89.5%， 108.7%， 308.8%， 64.7% and 9.3%， respectively higher than those in the control. ConclusionThe antioxidant enzymes and secondary metabolites in A. chinensis synergistically maintain the balance of reactive oxygen species， and exogenous H₂O₂ can improve the medicinal quality of A. chinensis remarkably.

ObjectiveTo explore the correlation between gross motor function and spinal range of motion (ROM) in children with bilateral spastic cerebral palsy. MethodsA total of 33 children with bilateral spastic cerebral palsy in Beijing Bo'ai Hospital from December, 2019 to March, 2022 were selected and divided into group 1 (grade Ⅰ, n = 12), group 2 (grade Ⅱ, n = 11) and group 3 (grade Ⅲ, n = 10) according to Gross Motor Function Classification System (GMFCS). SpinalMouse (spine morphometric machine) was used to measure the ROM of forward and backward flexion, and left and right lateral flexion of trunk, respectively, in sitting. Their gross motor ability was then further tested using the Gross Motor Function Measure (GMFM) 88 item. ResultsThe ROM of backward flexion, the left and right lateral flexion, and the total ROM of sagittal and coronal plane were positively correlated with the scores of GMFM88 (r > 0.424, P < 0.05), and were negatively correlated with the grade of GMFCS (|r| > 0.424, P < 0.05). ConclusionSpinal ROM correlates with gross motor function in children with bilateral spastic cerebral palsy.

ObjectiveTo develop a professional occupational stress scale for medical staff （CSSM） and test its reliability and validity， so as to provide a technical tool for the evaluation and management of medical staff occupational stress. MethodsThe initial index item pool was formed by literature retrieval， in-depth interview and expert evaluation. Pre-survey questionnaires were distributed in April 2021， stratified sampling was used to randomly select 1 tertiary hospital， 2 secondary hospitals and 1 community health service center in Shanghai. Sampling was performed according to the number of medical staff in all level hospitals and the proportion of doctors， nurses and medical technicians. 848 valid questionnaires were collected. Item differentiation method， correlation analysis and exploratory factor analysis were used to filter the pre-survey item pool and form a formal scale. From June to July 2021， stratified sampling method was used to carry out formal survey with formal scale， and the reliability and validity of the scale were verified. A total of 5 510 valid questionnaires were collected. Confirmatory factor analysis was used to test the construct validity of the scale. Job burnout， sleep disorder and job demand-autonomy （-support） model occupational stress scales were used as calibration scales， respectively. Pearson correlation analysis was used to test the scale's calibration validity and aggregate validity， and Cronbach's α coefficient was used to evaluate the scale's reliability. ResultsThrough project differentiation method， correlation analysis， exploratory factor analysis on the preliminary survey item pool， we produced the formal scale of7 dimensions and 32 items， respectively， including "career development"， "interpersonal relationship"， "working overtime and work-life imbalance"， "physical environment"， "the doctor-patient relationship"， "social environment"， "work load". The cumulative variance contribution rate of common factors in exploratory factor analysis was 65.937%， and the factor loading value of each item ranged from 0.513 to 0.880. The scale was used for formal investigation to verify the reliability and validity of the scale. The goodness of fit index （GFI）， comparative fit index （CFI） and root mean square error of approximation （RMSEA） were 0.913， 0.909 and 0.064， respectively. The scores of the scale and all dimensions were positively correlated with the scores of occupational stress in the mode of job burnout， sleep disorder symptoms and job demand-autonomy （r=0.235‒0.754， P<0.05）. The Cronbach's α coefficients of the total amount table and each dimension ranged from 0.743 to 0.937， showing good reliability and validity. ConclusionCSSM has good reliability and validity， which provides a measurement and assessment tool for the targeted prevention of occupational stress in medical staff. The popularization and use of this scale in other regions need further verification.

Phenylalaninammo-nialyase (PAL) is a key enzyme in the synthesis of methyl benzoate - a plant aroma compound. In order to understand the function of this enzyme in the formation of fragrance in the scented Rhododendron species-Rhododendron fortunei, we cloned a gene encoding this enzyme and subsequently examined the gene expression patterns and the profile of enzyme activity during development in various tissues. The full length of RhPAL gene was cloned by reverse transcription-PCR (RT-PCR) and rapid amplification of cDNA ends (RACE) techniques. The expression levels of RhPAL gene were measured by real-time quantitative reverse transcription PCR (qRT-PCR) and the amount of phenylalanine and cinnamic acid were assayed with LC-MS. The results showed that the ORF sequence of RhPAL gene amplified from the cDNA templates of flower buds had 2 145 bp, encoding 715 amino acids, and shared 90% homology to the PAL amino acid sequences from other species. qRT-PCR analysis showed that the expression of RhPAL in petals during flowering kept in rising even until the flowers wilted. The expression of RhPAL in pistil was much higher than that in stamen, while the expression in the younger leaves was higher than in old leaves. However, the expression level was relatively lower in petal and stamen compared to that in leaves. We also measured the PAL activity by Enzyme-linked immuno sorbent assay in the petals of flowers at different flowering stages. The results showed that PAL activity reached the highest at the bud stage and then decreased gradually to the lowest when the flowers wilted, which followed a similar trend in the emission of the flower fragrance. The phenylalanine and cinnamic acid contents measured by LC-MS were highly correlated to the expression level of RhPAL in various tissues and at different flowering stages, implying that RhPAL plays an important role in the formation of the flower fragrance. This work may facilitate the breeding and improvement of new fragrant Rhododendron cultivars.
Amino Acid Sequence ; Cloning, Molecular ; DNA, Complementary ; Flowers/genetics* ; Rhododendron/genetics*

Terpene synthase (TPS) plays important roles in the synthesis of terpenoids which are the main fragrances in Rhododendron flowers. To understand the function of TPS genes in terpenoid metabolism in relation to flower aroma formation, we identified all TPS gene family members in Rhododendron by analyzing its genome database. We then used a transcriptomic approach to analyze the differential gene expression patterns of TPS gene family members in the scented flower Rhododendron fortunei compared to the non-scented flower Rhododendron 'Nova Zembla'. The contents of terpenoid compounds in petals of the above two Rhododendron species at different developmental stages were also measured by using qRT-PCR and head space-solid phase micro-extraction combined with gas chromatography-mass spectrometry. Our results showed that a total of 47 RsTPS members, with individual lengths ranged from 591 to 2 634 bp, were identified in the Rhododendron genome. The number of exons in RsTPS gene ranged from 3 to 12, while the length of each protein encoded ranged from 196 to 877 amino acids. Members of the RsTPS family are mainly distributed in the chloroplast and cytoplasm. Phylogenetic analysis showed that RsTPS genes can be clustered into 5 subgroups. Seven gene family members can be functionally annotated as TPS gene family since they were temporally and spatially expressed as shown in the transcriptome data. Notably, TPS1, TPS10, TPS12 and TPS13 in Rhododendron fortunei were expressed highly in flower buds reached the peak in the full blossoming. Correlation analysis between gene expression levels and terpenoid content indicates that the expression levels of TPS1, TPS4, TPS9, TPS10, TPS12 and TPS13 were positively correlated with the content of terpenoids in the petals of R. fortunei at all flower developmental stages, suggesting that these six genes might be involved in the aroma formation in R. fortunei.
Rhododendron/metabolism* ; Phylogeny ; Terpenes/metabolism* ; Family ; Gene Expression Regulation, Plant

Objective To detect the radiation of ¹³¹I in treatment site of a grade A tertiary hospital. Methods A total of 25 patients with thyroid cancer were administrated ¹³¹I at a total dose of 82880 MBq. After administration, the ambient dose equivalent rate of the ward was detected with X- and γ-ray detectors. After patient discharge, surface contamination of the ward was detected with α/β surface contamination meter. During patient hospitalization and on the day of discharge, air samples were collected from ¹³¹I treatment site and office area. The air samples were measured using a HPGe γ-ray spectrometer and the concentration of ¹³¹I in air was calculated. Results The ambient dose equivalent rate in the ward ranged from 0.15 to 0.46 μSv/h. Before ward cleaning, surface contamination ranged from 0.53 to 40.1 Bq/cm² and the highest value was recorded on the toilet. Within 4 h after administration, the concentrations of ¹³¹I in air in treatment site and the corridor of the office area were 1.74 Bq/m³ and 0.66 Bq/m³, respectively. The ventilation air flow rate in the treatment site was 0.50 m/s. Ventilation decreased the concentration of ¹³¹I in air by 29.7%, 79.7%, and 53.3% compared with the previous day during hospitalization and on the day of discharge. Conclusion The radiation of external exposure of ¹³¹I in the treatment site is low and the shielding is effective. Before ward cleaning, the surface contamination is lower than the required limits except for the toilet. Ventilation is the primary way to reduce the concentration of ¹³¹I in air.

Purpose: We aimed to investigate whether obtaining a higher level of education was causally associated with lower breast cancer risk and to identify the causal mechanism linking them. Methods: The main data analysis used publicly available summary-level data from 2 large genome-wide association study consortia. Mendelian randomization (MR) analysis used 65 genetic variants derived from the Social Science Genetic Association Consortium as instrumental variables for years of schooling. The outcomes from the Breast Cancer Association Consortium (BCAC) were the overall breast cancer risk (122,977 cases/105,974 controls in women) and the two subtypes: estrogen receptor (ER)-positive breast cancer and ER-negative breast cancer. Fixed and random effects inverse variance weighted methods were used to estimate the causal effects, along with other additional MR methods for sensitivity analyses. Results: Results showed that each additional standard deviation of 4.2 years of education was causally associated with a 27% lower risk of ER-negative breast cancer (odds ratio, 0.73; 95% confidence interval, 0.64–0.84; p-value < 0.001). This finding was consistent with the results of the sensitivity analyses. Physical activities can help improve the protective effect of education against breast cancer, with relatively large mediation proportions. Education increases the risk of ER-positive breast cancer due to alterations in high-density lipoprotein level, triglyceride level, height, waist-to-hip ratio, body mass index, and smoking status, with relative medium mediation proportions. Other mediators including low-density lipoprotein, hip circumference, number of cigarettes smoked per day, time spent performing light physical activity, and performing vigorous physical activity for > 10 minutes explain a small part of the causal effect of education on the risk of developing breast cancer, and their mediation proportion is approximately 1%. Conclusion A low level of education is a causal risk factor in the development of breast cancer as it is associated with poor lipid profile, obesity, smoking, and types of physical activity.