Traditional development of small protein scaffolds has relied on display technologies and mutation-based engineering, which limit sequence and functional diversity, thereby constraining their therapeutic and application potential. Protein design tools have significantly advanced the creation of novel protein sequences, structures, and functions. However, further improvements in design strategies are still needed to more efficiently optimize the functional performance of protein-based drugs and enhance their druggability. Here, we extended an evolution-based design protocol to create a novel minibinder, BindHer, against the human epidermal growth factor receptor 2 (HER2). It not only exhibits super stability and binding selectivity but also demonstrates remarkable properties in tissue specificity. Radiolabeling experiments with ^99mTc, ⁶⁸Ga, and ¹⁸F revealed that BindHer efficiently targets tumors in HER2-positive breast cancer mouse models, with minimal nonspecific liver absorption, outperforming scaffolds designed through traditional engineering. These findings highlight a new rational approach to automated protein design, offering significant potential for large-scale applications in therapeutic mini-protein development.

Sensorineural hearing loss (SNHL), the most commonly-occurring form of hearing loss, is caused mainly by injury to or the loss of hair cells and spiral ganglion neurons in the cochlea. Numerous environmental and physiological factors have been shown to cause acquired SNHL, such as ototoxic drugs, noise exposure, aging, infections, and diseases. Several programmed cell death (PCD) pathways have been reported to be involved in SNHL, especially some novel PCD pathways that have only recently been reported, such as ferroptosis, necroptosis, and pyroptosis. Here we summarize these PCD pathways and their roles and mechanisms in SNHL, aiming to provide new insights and potential therapeutic strategies for SNHL by targeting these PCD pathways.
Humans ; Hearing Loss, Sensorineural/metabolism* ; Necroptosis/drug effects* ; Pyroptosis/drug effects* ; Ferroptosis/drug effects* ; Animals

Objective To explore the work experiences and needs of nutrition specialist nurses,so as to provide a basis in career development and management practices among the nutrition specialist nurses.Methods A method of descriptive phenomenological research was adopted in this study.Purposive sampling was used to select 12 nutrition specialist nurses who came from different regions across the country with over one year of clinical working experiences as well as had completed the specialist training and been qualified by the Nutrition Committee of Guangdong Nursing Association between January and February 2024.Semi-structured on-line interviews were conducted among the participants and the data acquired from the interviews were analysed and summarised.Themes were extracted using NVivo12 and Colaizzi's seven-step analysis from the data from interview.Results Three main themes and eight sub-themes were identified regarding the work experience of nutrition specialist nurses:growth and gains(continuously learning in nutrition therapy-related knowledge to enhance professional skills;actively practice in nutrition therapy to achieve the self-worth);sense of responsibility and mission(increased awareness of responsibility and proactive services;sense of mission to cultivate talents and promotion of the development of nutrition nursing discipline);challenges(lack of an established role in nutrition nursing,conflict in responsibilities;insufficient communication in a medical team regarding nutrition therapy;limited resource to support the development of nutrition nursing;and the professional knowledge and skills unable to fully meet the job demands).Conclusion Hospitals managers should strengthen the support and training for nutrition specialist nurses,clarify their roles,leverage their professional value and promote the career development.

Objective:To investigate the clinical effects of radiofrequency microneedling versus fire needle therapy on facial acne. Methods:Ninety patients with facial acne treated at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2022 to December 2023 were included in this study. Each patient's facial areas were divided into a radiofrequency microneedling group and a fire needle group, with treatments conducted every 2 weeks for a total of two sessions. The improvement of skin lesions on both sides was assessed using the Global Acne Grading System (GAGS), while the Visual Analog Scale (VAS) was used to evaluate the severity of pain experienced by patients. The incidence of adverse reactions, recurrence rates, and patient satisfaction were statistically analyzed. Additionally, a reflective confocal microscope was used to observe the imaging characteristics of the lesions before and after treatment.Results:At 2 and 4 weeks post-treatment, GAGS results showed that the improvement rates for skin lesions in the radiofrequency microneedling group were 83.33% (75/90) and 90.00% (81/90), respectively, both of which were significantly higher than those in the fire needle group [70.00% (63/90), 78.89% (71/90), χ2 = 4.47, 4.22, P = 0.034, 0.040]. The incidence of pigmentation in the radiofrequency microneedling group was 4.44% (4/90), which was slightly higher than that in the fire needle group [2.22% (2/90)]. However, there was no significant difference in overall incidence of adverse reactions between the radiofrequency microneedling and fire needle groups [15.56% (14/90) vs. 20.00% (18/90), χ2 = 0.60, P = 0.436]. The recurrence rate was lower in the radiofrequency microneedling group [10.00% (9/90)] compared with the fire needle group [22.22% (20/90), χ2 = 4.97, P = 0.026]. The VAS score for the radiofrequency microneedling group was (4.12 ± 1.33) during the first treatment and (3.30 ± 1.05) during the second treatment, both of which were significantly higher than those in the fire needle group [(3.67 ± 1.12), (2.88 ± 0.86), t = 2.45, 2.93, P = 0.015, 0.004]. Patient satisfaction with treatment outcomes did not significantly differ between the radiofrequency microneedling and fire needle groups [92.22% (83/90) vs. 87.78% (79/90), χ2 = 0.98, P = 0.320]. Results from the reflective confocal microscope indicated that after treatment, the hair follicles in both the radiofrequency microneedling and fire needle groups exhibited a distinct funnel shape and oval appearance, along with a noticeable reduction in funnel diameter compared with pre-treatment observations. Additionally, there was a decrease in the central amorphous material, a reduction in the size of the bright edge zone, and a decline in the infiltration of inflammatory cells, with no significant differences observed between the two groups. Conclusions:For facial inflammatory acne lesions (such as papules and pustules), both radiofrequency microneedling and fire needle treatments have shown good effectiveness. The fire needle treatment leads to less pain, while radiofrequency microneedling has a lower recurrence rate, but it carries a slightly higher risk of hyperpigmentation.

Objective:To investigate the clinical effects of radiofrequency microneedling versus fire needle therapy on facial acne. Methods:Ninety patients with facial acne treated at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2022 to December 2023 were included in this study. Each patient's facial areas were divided into a radiofrequency microneedling group and a fire needle group, with treatments conducted every 2 weeks for a total of two sessions. The improvement of skin lesions on both sides was assessed using the Global Acne Grading System (GAGS), while the Visual Analog Scale (VAS) was used to evaluate the severity of pain experienced by patients. The incidence of adverse reactions, recurrence rates, and patient satisfaction were statistically analyzed. Additionally, a reflective confocal microscope was used to observe the imaging characteristics of the lesions before and after treatment.Results:At 2 and 4 weeks post-treatment, GAGS results showed that the improvement rates for skin lesions in the radiofrequency microneedling group were 83.33% (75/90) and 90.00% (81/90), respectively, both of which were significantly higher than those in the fire needle group [70.00% (63/90), 78.89% (71/90), χ2 = 4.47, 4.22, P = 0.034, 0.040]. The incidence of pigmentation in the radiofrequency microneedling group was 4.44% (4/90), which was slightly higher than that in the fire needle group [2.22% (2/90)]. However, there was no significant difference in overall incidence of adverse reactions between the radiofrequency microneedling and fire needle groups [15.56% (14/90) vs. 20.00% (18/90), χ2 = 0.60, P = 0.436]. The recurrence rate was lower in the radiofrequency microneedling group [10.00% (9/90)] compared with the fire needle group [22.22% (20/90), χ2 = 4.97, P = 0.026]. The VAS score for the radiofrequency microneedling group was (4.12 ± 1.33) during the first treatment and (3.30 ± 1.05) during the second treatment, both of which were significantly higher than those in the fire needle group [(3.67 ± 1.12), (2.88 ± 0.86), t = 2.45, 2.93, P = 0.015, 0.004]. Patient satisfaction with treatment outcomes did not significantly differ between the radiofrequency microneedling and fire needle groups [92.22% (83/90) vs. 87.78% (79/90), χ2 = 0.98, P = 0.320]. Results from the reflective confocal microscope indicated that after treatment, the hair follicles in both the radiofrequency microneedling and fire needle groups exhibited a distinct funnel shape and oval appearance, along with a noticeable reduction in funnel diameter compared with pre-treatment observations. Additionally, there was a decrease in the central amorphous material, a reduction in the size of the bright edge zone, and a decline in the infiltration of inflammatory cells, with no significant differences observed between the two groups. Conclusions:For facial inflammatory acne lesions (such as papules and pustules), both radiofrequency microneedling and fire needle treatments have shown good effectiveness. The fire needle treatment leads to less pain, while radiofrequency microneedling has a lower recurrence rate, but it carries a slightly higher risk of hyperpigmentation.

Objective To explore the work experiences and needs of nutrition specialist nurses,so as to provide a basis in career development and management practices among the nutrition specialist nurses.Methods A method of descriptive phenomenological research was adopted in this study.Purposive sampling was used to select 12 nutrition specialist nurses who came from different regions across the country with over one year of clinical working experiences as well as had completed the specialist training and been qualified by the Nutrition Committee of Guangdong Nursing Association between January and February 2024.Semi-structured on-line interviews were conducted among the participants and the data acquired from the interviews were analysed and summarised.Themes were extracted using NVivo12 and Colaizzi's seven-step analysis from the data from interview.Results Three main themes and eight sub-themes were identified regarding the work experience of nutrition specialist nurses:growth and gains(continuously learning in nutrition therapy-related knowledge to enhance professional skills;actively practice in nutrition therapy to achieve the self-worth);sense of responsibility and mission(increased awareness of responsibility and proactive services;sense of mission to cultivate talents and promotion of the development of nutrition nursing discipline);challenges(lack of an established role in nutrition nursing,conflict in responsibilities;insufficient communication in a medical team regarding nutrition therapy;limited resource to support the development of nutrition nursing;and the professional knowledge and skills unable to fully meet the job demands).Conclusion Hospitals managers should strengthen the support and training for nutrition specialist nurses,clarify their roles,leverage their professional value and promote the career development.

The Spt-Ada-Gcn5-acetyltransferase (SAGA) is an ancillary transcription initiation complex which is highly conserved. The ADA1 (alteration/deficiency in activation 1, also called histone H2A functional interactor 1, HFI1) is a subunit in the core module of the SAGA protein complex. ADA1 plays an important role in plant growth and development as well as stress resistance. In this paper, we performed genome-wide identification of banana ADA1 gene family members based on banana genomic data, and analyzed the basic physicochemical properties, evolutionary relationships, selection pressure, promoter cis-acting elements, and its expression profiles under biotic and abiotic stresses. The results showed that there were 10, 6, and 7 family members in Musa acuminata, Musa balbisiana and Musa itinerans. The members were all unstable and hydrophilic proteins, and only contained the conservative SAGA-Tad1 domain. Both MaADA1 and MbADA1 have interactive relationship with Sgf11 (SAGA-associated factor 11) of core module in SAGA. Phylogenetic analysis revealed that banana ADA1 gene family members could be divided into 3 classes. The evolution of ADA1 gene family members was mostly influenced by purifying selection. There were large differences among the gene structure of banana ADA1 gene family members. ADA1 gene family members contained plenty of hormonal elements. MaADA1-1 may play a prominent role in the resistance of banana to cold stress, while MaADA1 may respond to the Panama disease of banana. In conclusion, this study suggested ADA1 gene family members are highly conserved in banana, and may respond to biotic and abiotic stress.
Musa/genetics* ; Phylogeny ; Fungal Proteins ; Cell Nucleus ; Histones ; Stress, Physiological/genetics*

Objective To compare the effects of visual rigid laryngoscope and visual laryngoscope in nasotracheal intubation(NTI)for patients with cervical spine immobilization simulated difficult airway.Methods Ninety patients scheduled for selective surgery under general anesthesia requiring NTI,52 males and 38 females,aged 18-64 years,BMI 18.5-25.0 kg/m2,ASA physical status Ⅰ or Ⅱ,were scheduled for selective surgery under general anesthesia requiring NTI.Before anesthesia induction,the spinal surgeon selected an appropriate cervical collar and adjusted it to fix patient's neck to establishing difficult airway sim-ulation model.All patients were randomly assigned into two groups:visual rigid laryngoscope(group R)and common visual laryngoscope(group C),45 patients in each group.NTI was performed using either visual rigid laryngoscope or visual laryngoscope in groups R and C,respectively.The nasal passage time,glottic exposure time,intubation time,number of successful first intubation attempts,and intubation attempts were recorded.Glottic exposure was assessed using the Cormack-Lehane(C-L)grading system,and the intuba-tion condition was quantitatively evaluated using the modified nasal intubation difficulty scale(NIDS).The blood pressure and heart rate were measured at baseline(T1),immediately after intubation(T2),and at 1 minute(T3)and 3 minutes(T4)after intubation.The occurrence of intubation-related complications(nasal bleeding,sore throat,hoarseness)was recorded.Results Compared with group C,the nasal passage time and proportion of successful intubations without difficulty were significantly increased in group R,and the glottic exposure time and intubation time were significantly decreased in group R(P<0.05).Compared with group C,the HR and MAP at T2 and T3 were significantly decreased in group R(P<0.05).Com-pared with group C,group R had significantly lower incidence rates of nasal bleeding,sore throat,and hoarseness(P<0.05).There were no statistically significant differences in the first intubation success rate,number of intubation attempts,or C-L grade between the two groups.Conclusion Patients with cer-vical spine immobilization simulated difficult airway,both visual rigid laryngoscope and visual laryngoscope can be performed safely and effectively in NTI.Compared with visual laryngoscope,visual rigid laryngoscope can provide faster glottic exposure,shorter intubation time,lower intubation difficulty,less hemodynamic impact,and lower incidence of complications.

At the time of the reform and adjustment of discipline transformation,the Institute of Respiratory and Critical Care Medicine,the 8th Medical Center of Chinese PLA General Hospital,relies on Beijing Key Laboratory of Organ Transplantation and Immunology Regulatory,to build a multidisciplinary postgraduate joint training mode based on immunology.From the aspects of indi-vidualized postgraduate training background,teaching mode,ability training,etc.,the practice mode of joint training of postgraduates in multiple clinical disciplines is explored.In order to cultivate medical thinking talents with systematic and holistic theory,and pre-pare for future clinical work.

Objective To evaluate the therapeutic effect of botulinum toxin type A(BTX-A)in patients with rosacea erythema telangiectasia and analyze the characteristics of dermoscopy.Methods Thirty patients with erythema telangiectasia rosacea treated in our hospital from January 2021 to August 2023 were collected as the observation targets.All of them received oral drugs(doxycycline hydrochloride combined with hydroxychloroquine sulfate),and were randomized,double-blind,face-divided.The patients with rosacea were injected with botulinum toxin type A(treatment side)and normal saline(control side)respectively,and the skin physiological indexes(transepidermal water loss,oil content,cuticle water content,erythema index)of the patients before and after treatment were compared.The vascular changes before and after dermoscopic treatment were analyzed,and the incidence of adverse reactions of the patients were calculated.Results After treatment,compared with the control side,the water loss,erythema index and oil content in the epidermis of the treatment side were decreased,and the water content in the stratum corneum was increased after treatment,with statistical significance(P<0.05).There was no difference before and after treatment on the control side(P>0.05).On the treatment side,the therapeutic effect was the best at 4 weeks after treatment,and the effect lasted until the 8th week,with no statistical significance(P>0.05),and the therapeutic effect was weakened at 8 weeks to 12 weeks,with statistical significance(P<0.05).The results of dermoscopy showed that after 4 weeks of treatment,compared with before treatment,the distribution proportion of dark red background,red background and polygonal blood vessels decreased,while the distribution proportion of light red background,linear blood vessels,branched blood vessels and punctured blood vessels increased,with statistical significance(P<0.05).There were no significant differences in yellow and red background and blood vessel distribution(P>0.05).The incidence of adverse reactions was 6.67%in the control group and 10.00%in the treatment group,with no statistical difference between the two groups(P>0.05).Conclusion BTX-A has a significant improvement effect on the symptoms of erythematous telangiectatic rosacea with high safety.