Sarcopenia is a progressive and systemic skeletal muscle disease and an important extrapulmo-nary complication of chronic obstructive pulmonary disease(COPD).Multiple studies have confirmed that COPD patients with sarcopenia have more severe airflow obstruction and emphysema,higher dyspnea index scores,reduced quality of life and exercise capacity,frequent acute exacerbations,and increased mortality.Although sarcopenia has been mentioned as a complication of COPD for many years,current clinical practice has received insufficient attention and insufficient intervention.The main reason is that its pathogenesis is unknown and drug treatment regi-mens are ineffective.As more and more research has been done on COPD combined with sarcopenia in recent years,this article reviews the current research progress to pay attention to further research and early intervention,including new mechanisms,diagnostic criteria,and drug treatment progress.

Objective:To investigate the prospective association of sleep duration with the development of chronic obstructive pulmonary disease (COPD) in adults in Suzhou.Methods:The study used the data of 53 269 participants aged 30-79 years recruited in the baseline survey from 2004 to 2008 and the follow-up until December 31, 2017 of China Kadoorie Biobank (CKB) conducted in Wuzhong District, Suzhou. After excluding participants with airflow limitation, self-reported chronic bronchitis/emphysema/coronary heart disease history at the baseline survey and abnormal or incomplete data, a total of 45 336 participants were included in the final analysis. The association between daily sleep duration and the risk for developing COPD was analyzed by using a Cox proportional hazard regression model, and the hazard ratio ( HR) values and their 95% CI were calculated. The analysis was stratified by age, gender and lifestyle factors, and cross-analysis was conducted according to smoking status and daily sleep duration. Results:The median follow-up time was 11.12 years, with a total of 515 COPD diagnoses in the follow-up. After adjusting for potential confounders, multifactorial Cox proportional hazard regression analysis showed that daily sleep duration ≥10 hours was associated with higher risk for developing COPD ( HR=1.42, 95% CI: 1.03-1.97). The cross analysis showed that excessive daily sleep duration increased the risk for COPD in smokers ( HR=2.49, 95% CI: 1.35-4.59, interaction P<0.001). Conclusion:Longer daily sleep duration (≥10 hours) might increase the risk for COPD in adults in Suzhou, especially in smokers.

Objective To evaluate the status quo of organizational commitment and job burnout of male nurses in Nanjing Municipal hospitals,and to analyze the effect of organizational commitment on job burnout.Methods A total of 349 male nurses working in the hospitals of various districts in Nanjing city from March to August 2022 were selected.The general demographic data questionnaire,Chinese version of nurses'job burnout questionnaire and organizational commitment scale of Chinese workers were used to conduct a ques-tionnaire survey.The Pearson correlation was used to analyze the relationship between organizational commit-ment and job burnout.Results The scores of three dimensions of job burnout in the Chinese version of Maslach job burnout scale were at a high level,which was significantly higher than that in the norm(P＜0.05);the score of various dimensions in the organizational commitment of Chinese workers scale also were in the higher level.The emotional exhaustion and depersonalization of male nurses were negatively correlated with the total scores of emotional commitment,normative commitment,ideal commitment and organizational commitment(P＜0.001),and significantly positively correlated with the opportunity commitment(P＜0.05).The low personal accomplishment sense of male nurses was negatively correlated with emotional com-mitment and opportunity commitment(P＜0.001),and positively correlated with the total scores of norma-tive commitment,ideal commitment and organizational commitment(P＜0.001).Conclusion The job burn-out of male nurses in Nanjing area is at a high level,and the organizational commitment is at a high level.It is necessary to give special attention to male nurses with professional identity and low job satisfaction in order to reduce the occurrence of job burnout.

OBJECTIVE To investigate the potential of low-frequency, low-power ultrasound to enhance the transdermal absorption and efficacy of ketoprofen gel. METHODS Ketoprofen gel was used as a model drug to compare the in vitro transdermal permeation of ultrasound treated group and untreated group. Additionally, a rat model of collagen-induced inflammation provided a basis for evaluating pharmacodynamic differences. Pharmacokinetic studies further elucidated the effects of ultrasound on ketoprofen gel's penetration process. RESULTS Ultrasound treatment enhanced the cumulative transdermal permeation of ketoprofen gel by 3.5-fold over 24 hours compared to untreated. Significant pharmacokinetic improvements in AUC0-t from (4289.02±763.58)ng·h·mL−1 to (11301.10±3386.30)ng·h·mL−1 and a reduction in Tmax from (6.0±1.4)h to (3.0±2.0)h. Ultrasound notably improved the gel's anti-inflammatory effects in the rat model, effectively and rapidly reducing inflammation-induced swelling. CONCLUSION Low-frequency, low-power ultrasound can significantly improve the amount and rate of transdermal absorption of ketoprofen gel and enhance its pharmacological potency, from the aspects of skin permeation tests, pharmacodynamic evaluation, and pharmacokinetic studies, which is an effective penetration enhancer for transdermal administration of ketoprofen gel.

This paper reported a case of severe COVID-19 in the recovery stage with acute lymphoblastic leukemia treated by integrated traditional Chinese and western medicine， with the intention of shedding light on the clinical diagnosis and treatment of similar conditions. The patient， who had acute lymphoblastic leukemia， developed COVID-19 infection during the bone marrow suppression period after chemotherapy. Treatment with western medicine was mainly anti-infection， symptomatic management， and supportive care. During the recovery stage， considering the patient's chemotherapy history and disease progression， the overall syndrome was identified as deficiency of both qi and yin and binding of phlegm and blood. Based on the “state-target” combined treatment strategy， herbal prescriptions were selected and modified to address the “deficiency state”， “disease target”， and “symptom target”. In addition to western medicine， the patient was administered with Shengmai Powder （生脉散） and Compound Zhebei Granules （复方浙贝颗粒） in its modifications to boost qi， nourish yin， and reinforce healthy qi， nourish and cool the blood， ultimately achieving satisfactory therapeutic effects.

Objective To explore the expression pattern of Micall2a gene during the early development of zebrafish embryos and the effect of this gene on zebrafish vascular development.MethodsWhole embryo in situ hybridization was used to detect Micall2a expression levels at different stages of early embryo development of Tg (fli:GFP) transgenic (labeled with green fluorescent protein) and wild type zebrafish (AB). Micall2a gene expression was downregulated by microinjection of a morpholine antisense oligonucleotide, and real-time fluorescent quantitative PCR was used to detect mRNA expression of the gene at different developmental stages of zebrafish embryos. Laser confocal microscopy was used to observe and analyze vascular phenotypic changes in zebrafish after the downregulation of Micall2a. ResultsMicall2a was expressed in the brain, heart, and vascular system of zebrafish embryos at the 24th, 36th, and 48th hours post fertilization. The mRNA level of Micall2a increased after microinjection of morpholine antisense oligonucleotides, inhibiting vascular development in zebrafish embryos, resulting in internode angiogenesis defects in zebrafish. ConclusionDownregulation of Micall2a expression inhibits the development of blood vessels in zebrafish.

OBJECTIVE To obtain mitochondria targeting compounds from Gastrodia elata， and to study the neuroprotective activities of these compounds. METHODS The mitochondria was extracted from cerebral tissue of rats. The purity of mitochondria was evaluated with Janus green staining and neutral red staining. The activity of purified mitochondria was evaluated. The purified mitochondria was included in the control group，and the inactivated mitochondria was included in the experimental group. The ratio of the difference between the peak areas of the control group and the experimental group to the peak areas of control group（ΔP） was determined and calculated to verify the feasibility of the method for obtaining the mitochondria targeting compounds. The mitochondria targeting compounds from G. elata were obtained by ultrafiltration centrifugation-high performance liquid chromatography （HPLC） and identified， and the effects of the compounds on the acitivities of mitochondria were also detected. The neuroprotective activities of the compounds with better activities were studied with hypoxia glucose deprivation/reoxygenation （OGD/R） damaged HT22 cells. RESULTS The extracted mitochondria possessed high purity and activity. Results of feasibility validation showed that ultrafiltration centrifugation-HPLC method had recognition and separation function， and could be used to obtain compounds with mitochondria targeting function. Two mitochondria targeting compounds （p-hydroxybenzyl alcohol and p- hydroxybenzaldehyde） were obtained from G. elata； these 2 compounds could improve the activities of mitochondria in vitro， and p-hydroxybenzyl alcohol had higher activity. Results of cell experiment showed that pretreatment with p-hydroxybenzyl alcohol （25， 50， 100 μmol/L） had little effect on the survival rate of HT22 cells. Compared with the model group， p-hydroxybenzyl alcohol could reduce cell mortality of OGD/R damaged cells， improve cell morphology， increase the levels of ATP and MMP， and reduced LDH and ROS levels and MPTP openness；most of the differences were statistically significant （P＜0.05）. CONCLUSIONS Two brain mitochondria targeting compounds （p-hydroxybenzyl alcohol and p-hydroxybenzaldehyde） are obtained from G. elata，among E-mail：1047896527@qq.com which p-hydroxybenzyl alcohol has a significant protective effect against OGD/R-induced neuronal injury， possibly through mitochondria targeting therapy.

ObjectiveTo investigate the distribution characteristics of hepatitis C virus (HCV) genotypes in patients with hepatitis C in Guizhou, China, and to provide a basis for the prevention and individualized treatment of HCV infection. MethodsA total of 1211 HCV RNA-positive patients with hepatitis C who were treated in Guiyang Public Health Clinical Center from September 2011 to October 2018 were enrolled. PCR direct sequencing was performed to obtain HCV sequences, which were then compared with the known HCV sequences in GenBank to obtain HCV genotypes and subgenotypes. The association of genotype distribution with sex, age, ethnic group, region, and route of infection was analyzed. The chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. ResultsA total of 4 genotypes and 11 subgenotypes were detected among the 1211 individuals with HCV infection, with the main genotypes of 1b (26.84%), 3b (27.17%), and 6a (24.28%). There was a significant difference in the distribution of HCV genotypes between the male and female individuals (χ2=15.428, P=0.009); 29.34% of the male individuals had genotype 3b, and 32.21% of the female individuals had genotype 1b. There was a significant difference in the distribution of HCV genotypes between different age groups (χ2=67.439, P＜0.001); genotype 1b was the main genotype in the individuals aged ≤18 years (66.67%) or ≥60 years (58.93%), genotypes 3b and 6 were the main genotypes in the individuals aged 19-39 years (28.93% and 29.29%, respectively), and genotypes 1b, 3b, and 6 were the main genotypes in the individuals aged 40-59 years (29.54%, 27.33%, and 24.28%, respectively). There was a significant difference in the distribution of HCV genotypes between the individuals with different routes of infection (χ2=153.916, P＜0001); the most common route of infection was intravenous drug addiction (57.97%), followed by sexual contact (8.42%) and invasive cosmetic surgery (8.42%); genotype 3b was the main genotype in the individuals with intravenous drug addiction (31.48%) or invasive cosmetic surgery (32.35%), and genotype 6 was the main genotype in the individuals with sexual contact (36.27%). There was no significant difference in the distribution of HCV genotypes between the individuals in different ethnic groups or from different regions of Guizhou (both P＞0.05). ConclusionThe distribution of HCV genotypes is diverse in Guizhou, and HCV strains with genotypes 3b, 1b, and 6a are the main epidemic strains. Several rare subgenotypes of HCV genotype 6 are observed. There is a significant difference in the distribution of HCV genotypes between the individuals with different ages, sexes, or routes of infection.

Objective To investigate the effect of neuromuscular electrical stimulation(NMES) on muscle atrophy and muscle fiber type conversion in quadriceps muscles of rats with chronic obstructive pulmonary disease(COPD).Methods Forty-eight male SPF Wistar rats were randomly divided into three groups:the healthy control group,COPD model group and NMES treatment group,with sixteen rats in each group.Rats in the NMES treatment group were given alternating electrical stimulation at 100 Hz and 2 Hz,with each stimulation time of 30 min,7 days per week,for 4 weeks.The control group and the COPD model group were only treated with electrode sheets.After the intervention,the endurance running distance measurement,the pathological changes of rat quadriceps muscle detected by HE staining,the mRNA and protein content of MSTN,MyHC(Myosin Heavy Chain)-Ⅰ,MyHC-Ⅱ a and MyHC-Ⅱ x in quadriceps muscles determined by Realtime PCR and Western Blot were performed.Results Compared with the healthy control group,the cross-sectional area,endurance running distance and MyHC-Ⅰ mRNA and protein expressions in the quadriceps muscles were decreased[(654.7±53.7) μm2 vs.(1079.8±117.2) μm2,(396.7±42.4) m vs.(607.4 ±56.3) m,0.407 ± 0.054 vs.0.997 ± 0.069,0.884 ± 0.102 vs.1.723 ± 0.156,t =4.642,3.785,24.723 and 18.640,P =0.008,0.033,0.000 and 0.000,respectively],while MSTN,MyHC-Ⅱ a and MyHC-Ⅱx mRNA and protein expressions were increased in the COPD model group (all P ＜ 0.01)Compared with COPD model,the cross-sectional area (997.5 ± 92.4 μm2),endurance running distance(597.2±65.8 m)and the expression levels of MyHC-Ⅰ mRNA(0.884±0.097)and protein (1.534±0.182)in the quadriceps muscles were increased(t =3.734,3.602,19.988 and 13.666,P =0.035,0.043,0.000,0.000),and the mRNA and protein expression levels of MSTN,MyHC-Ⅱ a and MyHC-Ⅱ x were decreased in the NMES treatment group(all P ＜0.01).Further correlation analysis found that the protein expression of MSTN in the quadriceps muscles was negatively correlated with muscle cross-sectional area,MyHC-Ⅰ protein levels and endurance running distance(r =-0.724,0.426 and-0.536,P =0.002,0.036 and 0.007,respectively),and positively correlated with the protein expressions of MyHC-Ⅱ a and MyHC-Ⅱ x(r=0.408 and 0.392,P =0.042 and 0.048).Conclusions The expression of MSTN is increased in quadriceps muscle of COPD rats,and NMES can inhibit the expression of MSTN in quadriceps muscles.MSTN is associated with muscle atrophy and muscle fiber conversion in COPD.Inhibition of MSTN expression can improve muscle atrophy and reverse muscle fiber transformation.

Fever and abdominal pain are common symptoms and could be main manifestations in patients with autoinflammatory diseases.A 48-year-old female patient was admitted with recurrent fever and abdominal pain for 9 years.Serum level of inflammatory markers synchronously fluctuated with fever,and returned to normal when fever subsided.The periodic episodes of fever occurred every 1 to 4 months and failed to respond to empirical antibiotics.Whole exome sequencing showed heterozygous mutation of NOD2 gene q902k,leading to the final diagnosis of autoinflammatory disease.Corticosteroid and tripterygiumglycosides were effective for the disease remission.