Objective: To explore the relationship of physical activity (PA) and sedentary behavior (SB) with cardiorespiratory fitness (CRF) among middle schoold students in Tibet, so as to provide empirical references for improving the cardiorespiratory fitness and health levels of adolescents in Tibet. Methods: From August to December 2020, 1 225 junior and senior high school students were selected from 2 middle schools in Lhasa, Tibet Autonomous Region, using the stratified cluster random sampling method. Triaxial accelerometers were used to evaluate PA and SB behaviors, and the 20 meter shuttle run was employed to assess CRF among the middle school students. Isochronous substitution modeling was used to analyze the associations of SB, low intensity physical activity (LPA), and moderate vigorous physical activity (MVPA) with CRF, and the saturation threshold effect in the dose response relationship between MVPA and CRF was analyzed through restricted cubic spline and two stage linear regression. Results: After adjusting for covariates such as gender, body mass index and sleep quality score, isotemporal substitution analysis showed that among junior high school students aged 13-15, replacing 30 minutes of SB ( B =1.73) or LPA ( B =2.38) with MVPA were positively associated with CRF (both P <0.05). Among senior high school students aged 16-18, replacing SB ( B =0.99) or LPA ( B =1.38) with MVPA were also positively associated with CRF (both P <0.05). Restricted cubic spline and two piecewise linear regression analyses indicated that only middle school girls aged 13-18 exhibited a saturation threshold effect between MVPA and CRF (logarithmic likelihood ratio test=0.03), with the optimal CRF improvement observed at 60 minutes of MVPA per day ( B=0.13, P ＜ 0.01). Conclusions Reducing SB and LPA while increasing MVPA can improve CRF in Tibetan middle school students. To maximize CRF improvement, middle school girls should engage in at least 60 minutes of MVPA daily.

Mycophenolic acid (MPA), the active moiety of both mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (EC-MPS), serves as a primary immunosuppressant for maintaining solid organ transplants. Therapeutic drug monitoring (TDM) enhances treatment outcomes through tailored approaches. This study aimed to develop an evidence-based guideline for MPA TDM, facilitating its rational application in clinical settings. The guideline plan was drawn from the Institute of Medicine and World Health Organization (WHO) guidelines. Using the Delphi method, clinical questions and outcome indicators were generated. Systematic reviews, Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence quality evaluations, expert opinions, and patient values guided evidence-based suggestions for the guideline. External reviews further refined the recommendations. The guideline for the TDM of MPA (IPGRP-2020CN099) consists of four sections and 16 recommendations encompassing target populations, monitoring strategies, dosage regimens, and influencing factors. High-risk populations, timing of TDM, area under the curve (AUC) versus trough concentration (C₀), target concentration ranges, monitoring frequency, and analytical methods are addressed. Formulation-specific recommendations, initial dosage regimens, populations with unique considerations, pharmacokinetic-informed dosing, body weight factors, pharmacogenetics, and drug‍-‍drug interactions are covered. The evidence-based guideline offers a comprehensive recommendation for solid organ transplant recipients undergoing MPA therapy, promoting standardization of MPA TDM, and enhancing treatment efficacy and safety.
Mycophenolic Acid/administration & dosage* ; Drug Monitoring/methods* ; Humans ; Organ Transplantation ; Immunosuppressive Agents/administration & dosage* ; Delphi Technique

Magnesium-doped calcium silicate(CS)bioceramic scaffolds have unique advantages in mandibular defect repair;however,they lack antibacterial properties to cope with the complex oral microbiome.Herein,for the first time,the CS scaffold was functionally modified with a novel copper-containing polydopamine(PDA(Cu2+))rapid deposition method,to construct internally modified(*P),externally modified(@PDA),and dually modified(*P@PDA)scaffolds.The morphology,degradation behavior,and mechanical properties of the obtained scaffolds were evaluated in vitro.The results showed that the CS*P@PDA had a unique micro-/nano-structural surface and appreciable mechanical resistance.During the prolonged immersion stage,the release of copper ions from the CS*P@PDA scaffolds was rapid in the early stage and exhibited long-term sustained release.The in vitro evaluation revealed that the release behavior of copper ions ascribed an excellent antibacterial effect to the CS*P@PDA,while the scaffolds retained good cytocompatibility with improved osteogenesis and angiogenesis effects.Finally,the PDA(Cu2+)-modified scaffolds showed effective early bone regeneration in a critical-size rabbit mandibular defect model.Overall,it was indicated that considerable antibacterial property along with the enhancement of alveolar bone regeneration can be imparted to the scaffold by the two-step PDA(Cu2+)modification,and the convenience and wide applicability of this technique make it a promising strategy to avoid bacterial infections on implants.

Objective:To investigate the strategy of using tissue flaps for repairing scalp defects with exposed skull wounds.Methods:This study was a retrospective observational study. From January 2019 to December 2023, 18 patients (13 males and 5 females, aged 17-59 years) with different scalp defect combined with skull exposure area (hereafter referred to as scalp defect area) who met the inclusion criteria were admitted to Guangzhou Red Cross Hospital of Jinan University. After debridement, the scalp defect area was 1 cm×1 cm to 25 cm×25 cm. For patients with scalp defect area < 9 cm 2 and good local conditions of the surrounding scalp, local flaps with area of 2 cm×2 cm-5 cm×5 cm were used for wound repair. The wound in the donor site of the flap was pulled together and sutured. If the suture tension was large, the skin graft from the head was taken and transplanted for wound repair. For patients with scalp defect area > 9 cm 2 and ≤1/4 of the total scalp area, expanded flaps with area of 5 cm×3 cm-12 cm×12 cm were used for wound repair. The wound in the donor site of the flap was pulled together and sutured directly. For patients with scalp defect area >1/4 and ≤1/2 of the total scalp area, free transplantation of anterolateral thigh flaps with area of 9 cm×7 cm-29 cm×14 cm were used for wound repair. The wound in the donor site of the flap was sutured in layers, and the skin graft from the ipsilateral thigh was transplanted for repair if the tension was large. For patients with scalp defect area >1/2 of the total scalp area, free greater omental flap (28 cm×23 cm-29 cm×26 cm in area) transplantation and thigh skin graft were used for wound repair. The abdominal incision caused by cutting the greater omental flap was sutured directly. The types of tissue flaps were recorded during operation. After operation, the survival of tissue flaps and skin graft in the recipient sites was observed, and the wound healing of flap donor sites/abdominal incision caused by cutting the greater omental flap was observed. During follow up, the survival of tissue flaps and the scar hyperplasia of flap donor site/abdominal incision caused by cutting the greater omental flap were observed. At the last follow-up, the skull necrosis was evaluated by computed tomography scan. Results:For the scalp defect with exposed skull wounds in this group of cases, 4 cases were repaired with local flaps, of which 2 cases were repaired with V-Y advancement flaps, and 2 cases were repaired with local double-pedicle vault stone flaps. The flaps survived completely after operation. Five cases were repaired with expanded flaps, of which 1 patient was implanted with 2 skin and soft tissue expanders, and 4 patients were implanted with 1 skin and soft tissue expander. The expanded flaps survived completely after operation. Seven cases were repaired with free transplantation of anterolateral thigh flaps. After operation, the flap in 6 cases survived, and the distal end of the flap was necrotic in 1 case, and the wound healed well after debridement and suture. Two cases were repaired with free transplantation of greater omental flaps and thigh skin graft, and the greater omental flap and skin graft in the recipient site survived well after operation. After operation, the wound of flap donor site/abdominal incision caused by cutting the greater omental flap healed well. During follow-up, all tissue flaps survived well without skull exposure; the scar hyperplasia of flap donor site/abdominal incision caused by cutting the greater omental flap was not obvious. At the last follow-up, computed tomography scan showed that all patients had no skull necrosis.Conclusions:According to the size of scalp defect, local flap, expanded flap, free anterolateral thigh flap, and free greater omental flap+skin graft are selected successively from small to large to repair the wounds, and the effect is good, which is worthy of clinical promotion.

Background/Aims: The aim of this study was to analyze the chronological changes in postoperative complications in surgical ulcerative colitis patients over the past decade in China and to investigate the potential parameters that contributed to the changes. Methods: Ulcerative colitis patients who underwent surgery during 2008–2017 were retrospectively enrolled from 13 hospitals in China. Postoperative complications were compared among different operation years. Risk factors for complications were identified by logistic regression analysis. Results: A total of 446 surgical ulcerative colitis patients were analyzed. Fewer short-term complications (24.8% vs. 41.0%, P=0.001) and more laparoscopic surgeries (66.4% vs. 25.0%, P<0.001) were found among patients who received surgery during 2014–2017 than 2008–2013. Logistic regression suggested that independent protective factors against short-term complications were a higher preoperative body mass index (odds ratio [OR], 0.870; 95% confidence interval [CI], 0.785–0.964; P=0.008), laparoscopic surgery (OR, 0.391; 95% CI, 0.217–0.705; P=0.002) and elective surgery (OR, 0.213; 95% CI, 0.067–0.675; P=0.009). The chronological decrease in short-term complications was associated with an increase in laparoscopic surgery. Conclusions Our data revealed a downward trend of short-term postoperative complications among surgical ulcerative colitis patients in China during the past decade, which may be due to the promotion of minimally invasive techniques among Chinese surgeons.

The Ly-6 and uPAR (LU) domain-containing proteins represent a large family of cell-surface markers. In particular, mouse Ly-6A/Sca-1 is a widely used marker for various stem cells; however, its human ortholog is missing. In this study, based on a systematic survey and comparative genomic study of mouse and human LU domain-containing proteins, we identified a previously unannotated human gene encoding the candidate ortholog of mouse Ly-6A/Sca-1. This gene, hereby named LY6A, reversely overlaps with a lncRNA gene in the majority of exonic sequences. We found that LY6A is aberrantly expressed in pituitary tumors, but not in normal pituitary tissues, and may contribute to tumorigenesis. Similar to mouse Ly-6A/Sca-1, human LY6A is also upregulated by interferon, suggesting a conserved transcriptional regulatory mechanism between humans and mice. We cloned the full-length LY6A cDNA, whose encoded protein sequence, domain architecture, and exon-intron structures are all well conserved with mouse Ly-6A/Sca-1. Ectopic expression of the LY6A protein in cells demonstrates that it acts the same as mouse Ly-6A/Sca-1 in their processing and glycosylphosphatidylinositol anchoring to the cell membrane. Collectively, these studies unveil a novel human gene encoding a candidate biomarker and provide an interesting model gene for studying gene regulatory and evolutionary mechanisms.
Humans ; Membrane Proteins/genetics* ; Pituitary Neoplasms/genetics* ; Biomarkers

OBJECTIVE To establish a quantitative analysis method for the quality control components in Tenghuang jiangu capsules， and predict the possible action mechanism of the quality control components. METHODS Seven key quality control components in Tenghuang jiangu capsules were quantitatively analyzed by UHPLC-Q-Orbitrap HRMS. The “component-target” network was constructed based on network pharmacology， and the Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis and gene ontology （GO） function enrichment analysis were further conducted to find the key signaling pathways. RESULTS The average contents of succinic acid， hyperoside， gallic acid， kaempferol， naringin， naringenin and protocatechuic acid in 20 batches of Tenghuang jiangu capsules were 520.92， 67.67， 129.48， 4.74， 397.45， 5.66 and 376.62 μg/g， respectively. The results of network pharmacology showed that the 62 key target genes of the quality control components of the drug included AKT1， TNF， VEGFA， MMP9， PTGS2， etc. They were mainly enriched in cytokine receptor interaction， nuclear factor， tumor necrosis factor， interleukin 17， rheumatoid arthritis， Toll-like receptor and other signal pathways， involving inflammatory reaction， signal transduction， protein phosphorylation and other biological processes， kytoplasm， cell membrane and other cell components， as well as enzyme activity， energy activity and other molecular functions. CONCLUSIONS The established UHPLC- Q-Orbitrap HRMS method can be used for the quantitative analysis of the quality control components of Tenghuang jiangu capsule. Its quality control components may be mapped to inflammatory pathways related to bone diseases such as rheumatoid arthritis and Toll-like receptors through AKT1， TNF， VEGFA and other key targets， so as to play a therapeutic role.

Objective:To retrospectively analyze the clinical and serological characteristics in rehabilitated patients with common novel coronavirus pneumonia(COVID-19).Methods:A total of 165 patients with common COVID-19 were enrolled in this retrospective study, in which clinical data was collected from February 23 to March 15, 2020 in Leishenshan Hospital(Wuhan, China). The patients with COVID-19 were divided into elderly group and non-elderly group according to their age, and the differences in the clinical and serological metabolic characteristics between these two groups were analyzed.Results:49.7% patients were over 60 years old. The most common clinical symptoms were fever, cough, and fatigue, followed by muscle soreness. Expectoration and digestive tract symptoms were rare. Dyspnea occurred more frequently in the elderly group than in non-elderly group(47.56% vs 25.30%, P<0.01). Hypertension was the most common concomitant disease(accounting for 29.1%)followed by diabetes. Hypertension was more common in the elderly group than in non-elderly group(41.46% vs 16.86%, P<0.01), but without significant difference in diabetes between the two groups. The counts of leukocytes and lymphocytes in all patients were in the normal range, and no difference was observed between the groups. The comparison of serological indicators showed that serum creatinine in the elderly group was higher than that in the non-elderly group( P<0.01)while serum albumin, glomerular filtration rate, and serum calcium were lower in the elderly group. After serum albumin correction, the levels of albumin corrected calcium in all patients were in the normal range, without significant difference between these two groups. There was no significant difference between the two groups when the length of hospital stay was taken as the index of outcome [(34.01±10.24) vs(30.97±10.51)d, P>0.05]. Conclusion:Fever, cough, and fatigue are the most common clinical symptoms in patients with ordinary COVID-19. The elderly are more likely to develop dyspnea. The blood routine and metabolic characteristics in patients with common COVID-19 are normal, but serum albumin level is more likely to decrease in elderly patients with COVID-19.

Since the outset of the coronavirus disease 2019(COVID-19)pandemic,the gut micro-biome in COVID-19 has garnered substantial interest,given its significant roles in human health and pathophysiology.Accumulating evidence is unveiling that the gut microbiome is broadly altered in COVID-19,including the bacterial microbiome,mycobiome,and virome.Overall,the gut microbial ecological network is significantly weakened and becomes sparse in patients with COVID-19,together with a decrease in gut microbiome diversity.Beyond the existence of severe acute respiratory syndrome coronavirus type 2(SARS-CoV-2),the gut microbiome of patients with COVID-19 is also characterized by enrichment of opportunistic bacteria,fungi,and eukaryotic viruses,which are also associated with disease severity and presentation.Meanwhile,a multitude of symbiotic bacteria and bacteriophages are decreased in abundance in patients with COVID-19.Such gut microbiome features persist in a significant subset of patients with COVID-19 even after disease resolution,coinciding with'long CO VID'(also known as post-acute sequelae of COVID-19).The broadly-altered gut microbiome is largely a consequence of SARS-CoV-2 infection and its downstream detrimental effects on the systemic host immunity and the gut milieu.The impaired host immunity and distorted gut microbial ecology,particularly loss of low-abundance beneficial bacteria and blooms of opportunistic fungi including Candida,may hinder the reassembly of the gut microbiome post COVID-19.Future investigation is necessary to fully understand the role of the gut microbiome in host immunity against SARS-CoV-2 infection,as well as the long-term effect of COVID-19 on the gut microbiome in relation to the host health after the pandemic.

Objective To evaluate the effect of percutaneous coronary intervention (PCI) on anxiety and depression among patients with coronary heart disease (CHD). Methods A total of 600 CHD patients were divided into the stent group (n = 400) and the non-stent group (n = 200) according to stent implantation during coronary angiography, and 400 cases in the stent group were further divided into the intervention group (n = 200) and the non-intervention group (n = 200) according to post-stenting psychological interventions. The anxiety and depression were scored using self-rating anxiety and depression scales 1 day after admission, 1 day after PCI and at discharge from hospital, and the anxiety and depression scores were compared at different time points. Results The mean age, sex ratio, hemoglobin, total cholesterol, triglyceride, high-density lipoprotein cholesteroland low-density lipoprotein cholesterol levels were comparable among the three groups (P > 0.05). There were no significant differences among the three groups in terms of anxiety or depression scores one day after admission (P > 0.05). One day after PCI, the anxiety and depression scores were significantly higher among CHD patients in the intervention and non-intervention groups than in the non-stent group (P < 0.05), and the anxiety (t = 11.21, P < 0.01; t = 9.96, P < 0.01) and depression scores (t = 8.56, P < 0.01; t = 6.73, P < 0.01) were significantly higher in the intervention and non-intervention groups one day after PCI than one day after admission. At discharge from hospital, there were significant differences among the three groups in terms of anxiety and depression scores (P < 0.05), and the anxiety (t = 21.57, P < 0.01; t = 15.77, P < 0.01) and depression scores (t = 24.33, P < 0.01; t = 15.01, P < 0.01) were significantly higher in the intervention and non-intervention groups at discharge from hospital than one day after PCI, while the anxiety and depression scores were significantly lower among CHD patients in the intervention group than in the non-intervention group (P < 0.05). Conclusion The anxiety and depression are aggravated among CHD patients after PCI, and psychological interventions may alleviate the anxiety and depression.