BACKGROUND:Lumbar disc degeneration is a common disease that causes lower back pain and lower limb neurological symptoms.The balance of collagen metabolism plays an important role in maintaining the stability of the intervertebral discs.OBJECTIVE:To review the research progress in the imbalance of collagen metabolism in intervertebral disc degeneration.METHODS:The first author searched for relevant literature published before May 2024 in CNKI,PubMed and Web of Science databases.Search terms were"degenerative disc disease,""collagen metabolism,""collagenase family,""collagen synthesis related factors,"and"collagen breakdown related factors"in Chinese and English.Seventy-six articles were finally included for review.RESULTS AND CONCLUSION:In the process of intervertebral disc degeneration,the balance of collagen metabolism plays a crucial role in maintaining the stability of the normal intervertebral disc.When intervertebral disc degeneration occurs,a large amount of pro-inflammatory factors,collagenase,and oxidative stress reactions occur in the intervertebral disc,which increases the breakdown of collagen in the intervertebral disc.At the same time,it inhibits the generation of growth factors,collagen synthase,and collagen synthesis-related factors,resulting in a decrease in collagen synthesis in the intervertebral disc.The combined effect of the above two conditions disrupts the balance of collagen metabolism in the intervertebral disc,further exacerbating the process of intervertebral disc degeneration.

Objective To investigate the neuroprotective effect of Dendrobium nobile Lindl(DNL)extract in a Caenorhabditis elegans(C.elegans)model of Parkinson's disease(PD).Methods C.elegans NL5901 and 6-hydroxydopamine(6-OHDA)induced N2,BZ555,PD4521,and CB7272 C.elegans strains were treated with DNL 7.5,15,and 30 mg/L.The survival rate,basal slowing response rate,α-synuclein(α-syn)aggregation,dopaminergic neurons(DNs),mitochondrial distribution density of body wall muscle cells,and protein levels in the membrane were observed.In addition,reactive oxygen species(ROS),superoxide dismutase(SOD)and glutathione(GSH)in 6-OHDA induced N2 was detected to explore the effect of DNL on the antioxidative stress ability of PD C.elegans models.Results Compared with that in the model group,the DN fluorescence intensity was significantly increased in nematodes treated with DNL and levodopa(L-DOPA)(P＜0.05,P＜0.0001),α-syn aggregation was significantly decreased(P＜0.05,P＜0.001,P＜0.0001),the basal slowing rate(P＜0.05,P＜0.01,P＜0.001),mitochondrial density(P＜0.05,P＜0.01,P＜0.001),mitochondrial intima protein content(P＜0.05,P＜0.001,P＜0.0001),SOD content(P＜0.05),and GSH content were all increased.The ROS content was reduced in nematodes(P＜0.01).The lifespans of N2 wild-type and PD C.elegans models were prolonged after DNL treatment(P＜0.05,P＜0.01,P＜0.001).Conclusions DNL can effectively improve motor paralysis in a C.elegans PD model,improve DN degradation,inhibit α-syn aggregation and neuronal damage,increase the antioxidative stress ability,and slow the aging process in C.elegans.

Objective To investigate the association between birth weight and dementia risk and the mediating roles of chronic diseases,and to assess potential biological pathways underlying the birth weight-associated dementia risk based on large-scale proteomics.Methods We used data from 279 743 participants aged 40 to 69 years enrolled in the UK Biobank.Birth weight was categorized into low birth weight(≤2 500 g),normal birth weight(2 500-3 999 g),and macrosomia(≥4 000 g).Multivariable Cox proportional hazards regression models were used to assess the associations between birth weight categories and all-cause dementia and its subtypes(Alzheimer's disease and vascular dementia).Proteomics analyses were conducted to identify proteins and the potential pathways involved.Results Low birth weight was associated with higher risks for all-cause dementia and its subtypes.The hazard ratios were 1.18(95%CI,1.08-1.30)for all-cause dementia,1.14(95%CI,1.00-1.31)for Alzheimer's disease,and 1.22(95%CI,1.01-1.48)for vascular dementia.A non-linear relationship was observed between birth weight and dementia risk(P for nonlinearity<0.001).Certain cardiometabolic diseases in middle-aged adults,such as diabetes,stroke,hypertension,and dyslipidemia,played a significant mediating role in the relationship between low birth weight and dementia risk,with the mediation proportion being 6.3%to 15.8%.Proteomic analyses identified 21 proteins linked to both low birth weight and all-cause dementia risk,which were significantly enriched in the pathways for viral protein interaction with cytokines and cytokine receptors,adipocytokine signaling,and cytokine-cytokine receptor interaction.Conclusion Low birth weight is positively associated with dementia risk.Cardiometabolic diseases in middle-aged adults may mediate the relationship between low birth weight and dementia risk.A number of proteins and the associated pathways underscore the relationship between low birth weight and dementia risk.

Objective To explore potential association between sedentary time and the risk of all-cause mortality and cardiovascular disease(CVD)in Chinese population using data from the Prospective Urban Rural Epidemiology(PURE-China)cohort study.Methods Baseline data were collected,from 2022 standardized questionnaires and physical examinations,with follow-up until August 31,2022.The primary endpoints were all-cause mortality and cardiovascular events(non-fatal myocardial infarction,stroke or heart failure).Multivariable Cox shared frailty model was used to analyze the association between sedentary time and the risks of all-cause mortality and CVD in the target population,and to compare differences across subgroups based on gender,age and geographic location.Results A total of 47 931 participants were recruited,and 43 367 were included in the final analysis.Over a me-dian follow-up of 11.9±3.0 years,2 277 participants experienced all-cause mortality,3 551 experienced cardiovas-cular events.The Cox model indicated that,compared to individuals with less than 4 h of sedentary time per day,those with 6-8 h had a 23％increased in risk of all-cause mortality(HR=1.23,95％CI:1.06-1.44)and an 18％increased risk of CVD(HR=1.18,95％CI:1.04-1.33).For individuals with more than 8 h of sedentary time,the risk increased by 50％for all-cause mortality(HR=1.50,95％CI:1.16-1.94)and 44％for CVD(HR=1.44,95％CI:1.16-1.79).These associations were more pronounced in men and individuals aged 50 years and older.Conclusions Sedentary behavior is associated with an increased risk of all-cause mortality and cardiovascular disease in Chinese population,especially in the population with sedentary time of 6 hrs or more per day.Reducing sedentary time and increasing physical activity is an important strategy to mitigate the disease burden of cardiovascular disease and premature death.

Objective To investigate the epidemiological trends,temporal and spatial distribution characteristics of pulmonary tuberculosis in Lanping County.Methods Based on tuberculosis management data and basic information systems from the"China Disease Prevention and Control Information System,"pulmonary tuberculosis data from Lanping County for 2018-2023 were obtained.Descriptive epidemiology,concentration method,circular distribution method,and spatial autocorrelation analysis were used to conduct epidemiological and spatial analyses of the pulmonary tuberculosis data.Results A total of 2836 TB cases were reported in Lanping County from 2018 to 2023,with an average annual incidence rate of 233.26 per 100000,showing a declining trend.The male-to-female ratio was 1.95∶1,with the highest incidence among individuals aged 60 and above(932 cases,32.86%).Cases were predominantly among farmers(91.01%)and the Lisu ethnic group(52.68%).TB incidence showed weak seasonality with a bimodal distribution,with primary peak occurring from October to March and secondary peak from June to August.Tu'e Township(324.74 per 100,000),Shideng Township(307.42 per 100000),and Jinding Town(260.98 per 100,000)had the highest incidence rates,accounting for 1,284 cases or 45.28%of the county's total cases.In 2020,the incidence of pulmonary tuberculosis in Lanping County showed a spatial clustering distribution(global Morans's I value<0,P value<0.05),with Shideng Township consistently showing high-low aggregation characteristics.Conclusion Between 2018-2023,while the tuberculosis incidence rate in Lanping County has declined,it still falls short of Yunnan Province's tuberculosis prevention and control targets,and the prevention and control work continues to face significant challenges.Strengthening screening of high-risk populations and providing medical support to remote areas will be key measures for future prevention and treatment.

Objective: To investigate the value of metagene next⁃generation sequencing ( mNGS) in the detection of pathogens in patients with pulmonary infection. Methods: A retrospective analysis was performed on clinical data from 434 patients with pulmonary infections admitted over the past four years. Based on the presence of underlying comorbidities , patients were divided into underlying disease group (n = 262) and non⁃underlying disease group (n = 172) . Pathogen detection was conducted using both mNGS and conventional tests. Clinical and laboratory parameters , radiographic findings , and pathogen detection results were systematically analyzed. The diagnostic performance of the two methods in identifying causative pathogens of pulmonary infections was compared. Results: The positive rate of mNGS in 434 patients was higher than that of conventional tests , and the difference was statisti⁃cally significant (P < 0. 05) . The efficacy of mNGS in detecting bacteria and viruses was significantly higher than that of conventional tests , and the difference was statistically significant (P < 0. 05) . Although the fungal detection rate of mNGS was higher than that of conventional tests , the difference was not statistically significant. Among them , the detection rates of Mycobacterium tuberculosis , Mycoplasma pneumoniae , Haemophilus influenzae , Strepto⁃ coccus pneumoniae , Streptococcus constellation , Staphylococcus aureus and Aspergillus fumigatus were significantly higher than those of conventional tests , and the difference was statistically significant (P < 0. 05) . Subgroup analy- sis showed that the proportion of males , hospital stay , smoking prevalence and average age in the underlying dis- ease group were higher than those in the non-underlying disease group , and the difference was statistically signifi- cant (P < 0. 05) , while there were no significant differences in antibiotic use and endotracheal intubation rate be- tween the two groups. The most common pathogens detected by mNGS in the underlying disease group were Myco⁃ bacterium tuberculosis , Haemophilus influenzae , Streptococcus pneumoniae , Pseudomonas aeruginosa , human herpes⁃ virus type 4 and Aspergillus fumigatus , while the most common pathogens in the non-underlying disease group were Mycobacterium tuberculosis , Haemophilus influenzae , Streptococcus pneumoniae , Mycoplasma pneumoniae and Kleb⁃ siella pneumoniae. The positive rate of mNGS in the two groups was significantly higher than that of conventional tests , and the difference was statistically significant (P < 0. 05) , while the difference in the positive rate of mNGS between the two groups was not statistically significant. Conclusion mNGS has significant advantages over con- ventional tests of pathogen in lung infection , and is less affected by underlying diseases , which can provide an etio- logical basis for lung infection.

Objective:To construct the training course content for gastrointestinal endoscopy nurses based on job competency model.Methods:Based on the job competency model, the training course content for gastrointestinal endoscopy nurses was constructed on the basis of systematic literature search and semi-structured interviews combined with the Delphi expert consultation.Results:A total of 21 experts from nine regions including Beijing City, Hebei Province, Inner Mongolia Autonomous Region, Shanxi Province, Hubei Province, Tianjin City, Guangdong Province, Jilin Province, and Zhejiang Province were selected for consultation. There were two rounds of expert consultation. In the first round of expert consultation, 21 questionnaires were issued and 21 valid questionnaires were recovered, with an effective recovery rate of 100.00%, of which nine experts proposed a total of 38 amendments. In the second round of expert consultation, 21 questionnaires were issued and 17 valid questionnaires were recovered, with an effective recovery rate of 80.95%, of which two experts proposed modifications. For the two rounds of consultation, the expert authority coefficients were 0.871 and 0.882 respectively, and the coefficients of variation for each entry were 0 to 0.16 and 0 to 0.20, and the Kendall's harmony coefficients were 0.272 and 0.217 ( P<0.01). The finalized training course content for gastrointestinal endoscopy nurse based on job competency model consisted of four first-level indicators, 19 second-level indicators, and 53 third-level indicators. Conclusions:The training course content for the gastrointestinal endoscopy nurses constructed based on the job competency model is scientific, generalizable, and practical, and can provide reference and guidance for the training of endoscopic specialty nursing personnel.

Objective To investigate the impact of different application methods of tissue compensators(bolus)on the skin dose delivered to the chest wall following radical mastectomy for breast cancer.Methods A retrospective analysis was conducted on 60 female patients who underwent radical mastectomy and required chest wall radiotherapy at the hospital between January 2023 and March 2025.The Pinnacle3 9.10 radiotherapy planning system(TPS)was utilized to design two VMAT dual semi-arc radiotherapy plans for each patient,with a prescribed target dose of 50 Gy delivered in 2 Gy fractions over 25 sessions.In Plan 1,a Bolus was applied and optimized during the first 15 fractions,and subsequently removed for the remaining 10 fractions without re-optimization.The sub-field configuration and dose weighting from the initial optimization were retained,and only dose recalculations were performed.The final treatment plan combined both the Bolus-included and Bolus-excluded phases.In contrast,Plan 2 involved the application and optimization of Bolus during the first 15 fractions,followed by its removal and re-optimization of the plan for the last 10 fractions.The two optimized plans were then combined for the overall treatment delivery.Data from the two plan groups were analyzed using a paired sample t-test with SPSS 29.0 software.Results There was a statistically significant difference(P＜0.05)in skin Dmean,V52.5,and V55;heart Dmean,V5,V30,and V40;affected lung Dmean,V5,and V20;PRVcord Dmean and Dmax;healthy breast Dmean,V5,and V10;affected humeral head Dmean and V30;as well as PTV Dmean,V50,V55,D2％,D98％,CI,and MU.Moreover,the dose distribution on the target layer and the DVH curves showed marked differences.However,no statistically significant difference was observed in PTV HI(P=0.125).Conclusion The combination of the two optimized plans,consisting of 15 fractions with bolus and 10 fractions without bolus,more accurately reflects the dose distri-bution within the planned target area and organs at risk,thereby providing enhanced protection for the patient's chest wall skin.

This study was aimed at analyzing the epidemiological and drug resistance characteristics of tuberculosis at a desig-nated tuberculosis hospital in Hunan Province in 2024.Patients diagnosed with TB at the hospital between April and October 2024 were included in the study.Demographic data,clinical information,and drug sensitivity test results were collected from the hospital′s electronic medical record system.Descriptive statistics,the chi-square test,and logistic regression were used to analyze the epidemic characteristics,drug resistance characteristics,and factors influencing tuberculosis.Whole genome sequencing of isolates was per-formed,and lineage classification and drug resistance gene mutations were detected with TB-Profiler.The male-to-female ratio was 2.72∶1,and the median age was 56(IQR:43-66)years.Among the 391 patients,most were farmers(46.8%,183/391)and were pri-marily from Changsha(41.1%,162/391).Significant differences were observed in sex and occupation between pulmonary tuberculosis(PTB)and extrapulmonary tuberculosis(EPTB).The overall prevalence of any type of drug resistance of tuberculosis was 33.25%,and the multidrug resistance TB(MDR-TB)and poly-drug resistance(PR-TB)rates were 14.23%and 4.35%,respectively.The re-sistance rates to rifampicin(RIF),isoniazid(INH),ethambutol(EMB),and streptomycin(SM)were 17.90%,22.25%,6.39%,and 20.20%,respectively.Multivariable logistic regression analysis indicated that both diabetes(OR:2.295,95%CI:1.082-4.866)and retreatment(OR:17.822,95%CI:8.343-38.072)were risk factors for developing MDR-TB.Lineage 2(L2)strains accounted for 64.40%(136/191),whereas lineage 4(L4)accounted for 28.80%(55/191).The most common drug resistance mutations were katG Ser315Thr(62.50%,20/32)for INH,rpoB Ser450Leu(50.00%,12/24)for RIF,embB Met306Val(55.56%,5/9)for EMB,and rpsL Lys43Arg(80.95%,34/42)for SM.In conclusion,TB drug resistance was found to be a serious problem at a designated tu-berculosis hospital in Hunan in 2024.Strengthening the treatment and management of patients infected with L2 strains,those with co-morbid diabetes,and retreatment cases is crucial for preventing and controlling the emergence of drug-resistant TB.

OBJECTIVES: As early as the Apollo 11 mission, astronauts experienced ocular, skin, and upper airway irritation after lunar dust (LD) was brought into the return cabin, drawing attention to its potential biological toxicity. However, the biological effects of LD exposure through the digestive system remain poorly understood. This study aimed to evaluate the impact of digestive exposure to lunar dust simulant (LDS) on gut microbiota and on the intestine, liver, kidney, lung, and bone in mice. METHODS: Eight-week-old female C57BL/6J mice were used. LDS was used as a substitute for lunar dust, and Shaanxi loess was used as Earth dust (ED). Mice were randomly divided into a phosphate buffered saline (PBS) group, an ED group (500 mg/kg), and a LDS group (500 mg/kg), with assessments at days 7, 14, and 28. Mice were gavaged once every 3 days, with body weight recorded before each gavage. At sacrifice, fecal samples were analyzed by 16S ribosomal RNA (rRNA) sequencing; inflammatory cytokine expression [interleukin (IL)-1β, IL-6, and tumor necrosis factor alpha (TNF-α)] in intestinal, liver, and lung tissues was measured by real-time reverse transcription PCR (real-time RT-PCR); hematoxylin and eosin (HE) staining was performed on lung, liver, and intestinal tissues; Periodic acid-Schiff (PAS) staining was used to assess the integrity of the intestinal mucus barrier, and immunohistochemical staining was performed to evaluate the expression of mucin-2 (MUC2). Serum biochemical tests assessed hepatic and renal function. Femoral bone mass was analyzed by micro-computed tomography (micro-CT); osteoblasts and osteoclasts were assessed by osteocalcin (OCN) and tartrate-resistant acid phosphatase (TRAP) staining. Bone marrow immune cell subsets were analyzed by flow cytometry. RESULTS: At day 10, weight gain was slowed in ED and LDS groups. At days 22 and 28, body weight in both ED and LDS groups was significantly lower than controls (both P<0.05). LDS exposure increased microbial species richness and diversity at day 7. Compared with the PBS and ED groups, mice in the LDS group showed increased relative abundance of Deferribacterota, Desulfobacterota, and Campylobacterota, and decreased Firmicutes, with increased Helicobacter typhlonius and reduced Lactobacillus johnsonii and Lactobacillusmurinus. HE and PAS staining of the colon showed that mucosal structural disruption and goblet cell loss were more severe in the LDS group. In addition, immunohistochemistry revealed a significant downregulation of MUC2 expression in this group (P<0.05). No obvious pathological alterations were observed in liver HE staining among the 3 groups, and none of the groups exhibited notable hepatic or renal dysfunction. HE staining of the lungs in the ED and LDS groups showed increased perivascular inflammatory cell infiltration (both P<0.05). CONCLUSIONS LDS exposure via the digestive route induces gut dysbiosis, intestinal barrier disruption, pulmonary inflammation, bone loss, and bone marrow immune imbalance. These findings indicate that LD exposure poses potential health risks during future lunar missions. Targeted restoration of beneficial gut microbiota may represent a promising strategy to mitigate LD-related health hazards.
Animals ; Dust ; Mice ; Mice, Inbred C57BL ; Dysbiosis/etiology* ; Female ; Gastrointestinal Microbiome/drug effects* ; Moon ; Liver/metabolism* ; Digestive System/microbiology* ; Lung/metabolism* ; Kidney