Objective:This study used data-independent acquisition (DIA) proteomics to analyze plasma protein expression in sepsis-induced coagulopathy (SIC), identify key biomarkers, and develop a diagnostic model.Methods:This prospective study included 46 adult sepsis patients from the intensive care unit. Patients were categorized into a general sepsis group ( n=26) and an SIC group ( n=20) based on established SIC criteria. Plasma samples underwent proteomic and bioinformatics analyses to identify differentially expressed protein (DEP) using LASSO regression and Random Forest. A diagnostic model was constructed and assessed via receiver operating characteristic (ROC) curve analysis. Results:The baseline data revealed that SIC patients exhibited longer prothrombin times, lower platelet counts, and higher D-dimer, fibrin degradation products, blood lactate, SOFA scores, and APACHE Ⅱ scores compared with general sepsis patients ( P<0.05). DIA proteomics identified 2 637 proteins, with 240 DEP meeting the criteria (fold change >1.5, P<0.05), including 81 upregulated and 159 downregulated DEP. Subcellular localization analysis revealed that DEPs were predominantly extracellular and nuclear. Gene ontology (GO) annotation showed that DEP were mainly involved in cellular physiology, biological regulation, and stress response processes in biological processes. Domain annotation revealed a predominance of immunoglobulin V regions in DEP, which are crucial for antigen recognition and binding. KEGG enrichment analysis showed significant enrichment of DEP in pathways related to natural killer cell-mediated cytotoxicity, glycosylphosphatidylinositol anchor biosynthesis, tumor necrosis factor signaling, and NF-κB signaling. LASSO regression identified angiogenin and C-type lectin domain family 10 member A as key DEP. The SIC diagnostic nomogram showed an area under the curve of 0.896, with 0.731 specificity and 0.900 sensitivity. Conclusion:The nomogram incorporating angiogenin and C-type lectin domain family 10 member A provides an accurate tool for SIC diagnosis.

Objective:This study used data-independent acquisition (DIA) proteomics to analyze plasma protein expression in sepsis-induced coagulopathy (SIC), identify key biomarkers, and develop a diagnostic model.Methods:This prospective study included 46 adult sepsis patients from the intensive care unit. Patients were categorized into a general sepsis group ( n=26) and an SIC group ( n=20) based on established SIC criteria. Plasma samples underwent proteomic and bioinformatics analyses to identify differentially expressed protein (DEP) using LASSO regression and Random Forest. A diagnostic model was constructed and assessed via receiver operating characteristic (ROC) curve analysis. Results:The baseline data revealed that SIC patients exhibited longer prothrombin times, lower platelet counts, and higher D-dimer, fibrin degradation products, blood lactate, SOFA scores, and APACHE Ⅱ scores compared with general sepsis patients ( P<0.05). DIA proteomics identified 2 637 proteins, with 240 DEP meeting the criteria (fold change >1.5, P<0.05), including 81 upregulated and 159 downregulated DEP. Subcellular localization analysis revealed that DEPs were predominantly extracellular and nuclear. Gene ontology (GO) annotation showed that DEP were mainly involved in cellular physiology, biological regulation, and stress response processes in biological processes. Domain annotation revealed a predominance of immunoglobulin V regions in DEP, which are crucial for antigen recognition and binding. KEGG enrichment analysis showed significant enrichment of DEP in pathways related to natural killer cell-mediated cytotoxicity, glycosylphosphatidylinositol anchor biosynthesis, tumor necrosis factor signaling, and NF-κB signaling. LASSO regression identified angiogenin and C-type lectin domain family 10 member A as key DEP. The SIC diagnostic nomogram showed an area under the curve of 0.896, with 0.731 specificity and 0.900 sensitivity. Conclusion:The nomogram incorporating angiogenin and C-type lectin domain family 10 member A provides an accurate tool for SIC diagnosis.

Trichinella spiralis zinc metalloproteinase NAS-36 gene(TsNas36)is a member of the zinc metalloproteinase family found in excretory secretory products(ESP)of T.spiralis.In this study,TsNas36 gene was cloned and expressed,and its biological characteristics and temporal and spatial characteristics were identified.These results provide a theoretical and material basis for ex-ploring the biological function of TsNas36 gene.Bioinformatics analysis showed that TsNas36 was 470 amino acids(AA)in length with a molecular weight of about 54.69 kDa,no transmembrane region,and contained a signal peptide(1-20 AA),an Astacins domain(116-320 AA)and a CUB domain(355-470 AA).There were five active site residues located at amino acids 216(His),217(Glu),220(His),226(His)and 275(Tyr).The expression plasmid pET-28a(+)/TsNas36 was constructed and induced to express in E.coli BL21(DE3)to obtain the recombinant protein rTs-Nas36.The recombinant protein was used to immunize rabbits to obtain anti-rTsNas36 polyclonal antibody serum.Indirect ELISA results showed that the antibody titer reached 1∶105.qRT-PCR and Western blot results showed that the transcription levels of TsNas36 were significantly higher in newborn larvae(NBL)than in adult worm(AW)and muscle larva(ML)stages.Immunofluo-rescence results showed that TsNas36 was only localized in the epidermis of NBL.In summary,this study characterized the biological characteristics of the TsNas36 gene and found that this gene is highly period-specific and may be involved in the unique developmental process of NBL.

Objective Accurate speed perception is crucial for tasks such as man-controlled rendezvous and docking,and teleoperation of space manipulator.Therefore,it is necessary to conduct in-orbit experiments to explore the influence of long-term spaceflight on human speed perception characteristics.Methods The Time-to-Collision(TTC)paradigm was selected to develop experimental software,using a tablet computer for stimulus presentation.Human speed perception characteristics were evaluated based on the subjects'keystroke response data on the keyboard.Through ground-based experiments,the usability and reliability of the paradigm were explored,and the gravity internal model effect was quantitatively analyzed.Through in-orbit experiments on space station tasks,the influence of long-term spaceflight on human speed perception characteristics was further investigated.Results Under the 1G environment on the ground,the TTC paradigm has a high test-retest reliability(r>0.8),and indicators such as average deviation rate and absolute value of average deviation rate show no practice effect.In addition,ground experiments found that compared to vertical upward movement,vertical downward movement is estimated to be faster(i.e.,keystroke time is advanced),showing the existence of the gravity internal model effect.In the microgravity environment of spaceflight,there are no significant differences in average deviation rate and absolute value of average deviation rate among three stages(pre-flight,in-flight,post-flight)and seven tests,indicating that no obvious changes in astronauts'speed perception ability were found at the existing test time points and paradigms.However,the gravity internal model effect(difference between vertical downward and vertical upward)showed a trend of fading in the early stage of astronauts entering orbit.Conclusion Based on the computer screen TTC estimation paradigm,no significant changes in human speed perception ability were found during long-term spaceflight,but microgravity may weaken the human brain's gravity internal model.

Objective To investigate clinical efficacy of endoscopic transforaminal lumbar interbody fusion(Endo-TLIF)combined with huge-large cage insertion technique in the treatment of lumbar instability.Methods A retrospective analysis was made on 18 cases of lumbar instability from May 2022 to August 2022.Endo-TLIF was performed to complete neural decompression,Kambin's triangle exposure,and endplate preparation.A huge-large cage was inserted in the intervertebral space through the Kambin's triangle with full-visualization endoscopy.Results The operation time was(180.3±24.4)min,and the intraoperative blood loss was(72.2±25.6)ml.Symptoms of numbness and weakness in the front thigh were gradually relieved after symptomatic treatment in 1 case.The hospital stay was(7.9±1.8)d.The 18 cases were followed up for 19-22 months(mean,19.9±1.1 months).As compared to pre-operation,Visual Analogue Scale[(2.3±1.4)points vs.(7.7±1.0)points,P=0.000;(1.1±0.4)points vs.(7.7±1.0)points,P=0.000]and Oswestry Disability Index[(18.61±4.79)％ vs.(52.78±8.08)％,P=0.000;(9.28±4.03)％ vs.(52.78±8.08)％,P=0.000]were significantly improved at 3 months after surgery and at final follow-up.As compared to pre-operation,the intervertebral height[(12.56±1.62)mm vs.(8.28±1.27)mm,P=0.000;(12.11±1.45)mm vs.(8.28±1.27)mm,P=0.000]and intervertebral foramen heigh[(22.89±2.00)mm vs.(17.17±1.69)mm,P=0.000;(22.61±1.86)mm vs.(17.17±1.69)mm,P=0.000]were significantly improved at 3 months after surgery and at the final follow-up.All the patients had a good bone fusion,and the excellent and good rate of the modified Macnab criteria was 94.4％(17/18).Conclusion Endo-TLIF combined with huge-large cage insertion can acquire a significantly good clinical outcomes in patients with lumbar instability,with advantages of safe and simple performance,good recovery of intervertebral height,and minimal damage to paraspinal soft tissue.

Objective: Randomized controlled trials (RCTs) of Chinese patent medicines and classic traditional Chinese medicine prescriptions were systematically reviewed from both Chinese and English journals published in 2023. A preliminary summary and evaluation were conducted on the generation and translation of clinical evidence for these treatments. This analysis aims to inform future research on clinical efficacy evaluation and guide the rational application of evidence. Methods: RCTs of Chinese patent medicines and classic traditional Chinese prescriptions published in 2023 were comprehensively retrieved from the Artificial Intelligence Clinical Evidence Database for Chinese Patent Medicine (AICED-CPM), with supplementary searches conducted in China National Knowledge Infrastructure (CNKI), Wanfang Data, Chinese Science and Technology Journal Database (VIP), Chinese Biomedical Literature Database (SinoMed), Cochrane Library, PubMed, Embase, and Web of Science. The study characteristics and methodological quality of these RCTs were systematically analyzed and evaluated. Results: A total of 1 443 RCTs of Chinese patent medicines were included, comprising 1 399 Chinese articles and 44 English articles. Additionally, 334 RCTs of classic traditional Chinese medicine prescriptions were found, with 331 published in Chinese and 3 in English. 196 567 participants were included, covering 585 types of Chinese patent medicines (487 oral, 61 injectable, and 37 topical) and 179 classic traditional Chinese medicine prescriptions. The involved studies encompassed 22 types of diseases, with research primarily focusing on diseases of the circulatory system, the respiratory system, and the genitourinary system. The sample sizes ranged from 18 to 3 777 participants, and most studies were conducted at a single center. Methodologically, the implementation of allocation concealment and blinding remained insufficiently emphasized. Conclusion Overall, compared with 2022, both the number of RCT publications and their methodological quality have improved in 2023, with heightened attention to research on diseases of the genitourinary system. However, quality control and standardized management in the design and implementation processes still require enhancement to produce more high-quality clinical evidence and accelerate the translation and application of this evidence.

Trichinella spiralis zinc metalloproteinase NAS-36 gene(TsNas36)is a member of the zinc metalloproteinase family found in excretory secretory products(ESP)of T.spiralis.In this study,TsNas36 gene was cloned and expressed,and its biological characteristics and temporal and spatial characteristics were identified.These results provide a theoretical and material basis for ex-ploring the biological function of TsNas36 gene.Bioinformatics analysis showed that TsNas36 was 470 amino acids(AA)in length with a molecular weight of about 54.69 kDa,no transmembrane region,and contained a signal peptide(1-20 AA),an Astacins domain(116-320 AA)and a CUB domain(355-470 AA).There were five active site residues located at amino acids 216(His),217(Glu),220(His),226(His)and 275(Tyr).The expression plasmid pET-28a(+)/TsNas36 was constructed and induced to express in E.coli BL21(DE3)to obtain the recombinant protein rTs-Nas36.The recombinant protein was used to immunize rabbits to obtain anti-rTsNas36 polyclonal antibody serum.Indirect ELISA results showed that the antibody titer reached 1∶105.qRT-PCR and Western blot results showed that the transcription levels of TsNas36 were significantly higher in newborn larvae(NBL)than in adult worm(AW)and muscle larva(ML)stages.Immunofluo-rescence results showed that TsNas36 was only localized in the epidermis of NBL.In summary,this study characterized the biological characteristics of the TsNas36 gene and found that this gene is highly period-specific and may be involved in the unique developmental process of NBL.

Objective To investigate clinical efficacy of endoscopic transforaminal lumbar interbody fusion(Endo-TLIF)combined with huge-large cage insertion technique in the treatment of lumbar instability.Methods A retrospective analysis was made on 18 cases of lumbar instability from May 2022 to August 2022.Endo-TLIF was performed to complete neural decompression,Kambin's triangle exposure,and endplate preparation.A huge-large cage was inserted in the intervertebral space through the Kambin's triangle with full-visualization endoscopy.Results The operation time was(180.3±24.4)min,and the intraoperative blood loss was(72.2±25.6)ml.Symptoms of numbness and weakness in the front thigh were gradually relieved after symptomatic treatment in 1 case.The hospital stay was(7.9±1.8)d.The 18 cases were followed up for 19-22 months(mean,19.9±1.1 months).As compared to pre-operation,Visual Analogue Scale[(2.3±1.4)points vs.(7.7±1.0)points,P=0.000;(1.1±0.4)points vs.(7.7±1.0)points,P=0.000]and Oswestry Disability Index[(18.61±4.79)％ vs.(52.78±8.08)％,P=0.000;(9.28±4.03)％ vs.(52.78±8.08)％,P=0.000]were significantly improved at 3 months after surgery and at final follow-up.As compared to pre-operation,the intervertebral height[(12.56±1.62)mm vs.(8.28±1.27)mm,P=0.000;(12.11±1.45)mm vs.(8.28±1.27)mm,P=0.000]and intervertebral foramen heigh[(22.89±2.00)mm vs.(17.17±1.69)mm,P=0.000;(22.61±1.86)mm vs.(17.17±1.69)mm,P=0.000]were significantly improved at 3 months after surgery and at the final follow-up.All the patients had a good bone fusion,and the excellent and good rate of the modified Macnab criteria was 94.4％(17/18).Conclusion Endo-TLIF combined with huge-large cage insertion can acquire a significantly good clinical outcomes in patients with lumbar instability,with advantages of safe and simple performance,good recovery of intervertebral height,and minimal damage to paraspinal soft tissue.

Background::Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) can profoundly affect the mental health of the people living with HIV (PLWH), with higher rates of anxiety, depression, and sleep disturbances. The disparities in neuropsychological problems evaluated by physicians and self-assessed by patients are still unknown.Methods::A total of 5000 PLWH and 500 physicians from 167 hospitals were enrolled in this cross-sectional study from September 2022 to February 2023. 4-Item Patient Health Questionnaire (PHQ-4) was used for the evaluation of depressive issues and anxiety issues by PLWH. Each physician assessed 10 PLWH under their care for the presence of depressive or anxiety issues. The primary outcomes of this study are the concordance rates on the depressive issues and anxiety issues evaluation between physicians and PLWH. The Cohen’s kappa test was used to assess the agreement between physicians and PLWH.Results::The concordance rate for the evaluation of depressive issues is 73.84% (95% confidence interval [CI]: 72.60-75.04%), and it is significantly different from the expected rate of 80% ( P <0.001). Similarly, the concordance rate for the evaluation of anxiety issues is 71.74% (95% CI: 70.47-72.97%), which is significantly different from the expected rate of 80% as per the null hypothesis ( P <0.001). The overestimation rate by physicians on depressive issues is 12.20% (95% CI: 11.32-13.14%), and for anxiety issues is 12.76% (95% CI: 11.86-13.71%). The mismatch rate for depressive issues is 26.16% (95% CI: 24.96-27.40%), and for anxiety issues is 28.26% (95% CI: 27.02-29.53%). The underestimation rate by physicians on depressive issues is 13.96% (95% CI: 13.03-14.95%), and for anxiety issues is 15.50% (95% CI: 14.52-16.53%). For the treatment regiments, PLWH sustained on innovative treatment regimen (IR) related to a lower prevalence of depressive issues (odds ratio [OR] = 0.71, 95% CI: 0.59-0.87, P = 0.003) and a lower prevalence of anxiety issues (OR = 0.63, 95% CI: 0.52-0.76, P <0.001). PLWH switch from conventional treatment regimen (CR) to IR also related to a lower prevalence of depressive issues (OR = 0.79, 95% CI: 0.64-0.98) and a lower prevalence of anxiety issues (OR = 0.81, 95% CI: 0.67-0.99). Conclusion::Nearly one in three PLWH had their condition misjudged by their physicians. The findings underscore the need for improved communication and standardized assessment protocols in the care of PLWH, especially during the acute phase of HIV infection.

Objective To explore the application value of percutaneous coronary intervention (PCI) in the treatment of elderly patients with sarcopenia and ischemic cardiomyopathy (ICM). Methods A total of 129 elderly patients with sarcopenia and ICM were selected as study subjects and randomly divided into conventional group (64 patients) and combined group (65 patients) using a random number table method. After screening based on exclusion criteria, 55 patients were ultimately included in each group. The conventional group received conventional drug therapy, while the combined group received PCI in addition to conventional therapy. Subjective symptoms, blood pressure [systolic blood pressure (SBP), diastolic blood pressure (DBP)], New York Heart Association (NYHA) functional class, Canadian Cardiovascular Society (CCS) angina class, left ventricular function indicators [left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESD)], serological indicators [N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac troponin T (cTnT), creatine kinase-MB (CK-MB)], and 6-minute walk distance (6MWD) were compared between the two groups at admission and 1-, 3-, and 6-month after discharge. Additionally, the incidence of major adverse cardiovascular events (MACE) was observed in both groups. Results All 55 patients in the combined group underwent PCI with implantation of 1 stent to 3 stents, with an average of (1.78±0.36) stents implanted per patient, and the surgical success rate was 100.00%. At 1-, 3-, and 6-month after discharge, the scores for chest pain, palpitations, chest distress, and fatigue, as well as SBP, DBP, NYHA functional class, and CCS angina class, were lower in both groups compared to admission. Furthermore, these indicators were lower in the combined group than in the conventional group at 3 and 6 months after discharge (P < 0.05). At 1-, 3-, and 6-month after discharge, LVEDD and LVESD were smaller, LVEF was higher, and serum levels of NT-proBNP, cTnT, and CK-MB were lower in both groups compared to admission. Additionally, LVEDD, LVESD, and serum levels of NT-proBNP, cTnT, and CK-MB were lower, and LVEF values were higher in the combined group than those in the conventional group at 3 and 6 months after discharge (P < 0.05). The 6MWD was longer in both groups at 1-, 3-, and 6-month after discharge compared to admission, and the combined group was longer than that in the conventional group at 3 and 6 months after discharge (P < 0.05). At 6 months after discharge, the incidence of MACE was lower in the combined group than in the conventional group (P < 0.05). Conclusion The application of PCI in the treatment of elderly patients with sarcopenia and ICM can significantly improve subjective symptoms and objective cardiac function indicators, and reduce the incidence of MACE.