Objective: To investigate the prevalence and influencing factors of menopausal syndrome among postmenopausal women in Pan'an County, Zhejiang Province, so as to provide the basis for guiding the health management of postmenopausal women. Methods: From May 2023 to April 2024, the postmenopausal women aged 40 to 69 years in Pan'an County were selected using the random cluster sampling method. Demographic information, lifestyle and prevalence of gynecological diseases were collected through questionnaire surveys. The prevalence of menopausal syndrome was assessed by modified Kupperman Score Scale. Factors affecting menopausal syndrome were analyzed by a multivariable logistic regression model. Results: A total of 816 postmenopausal women were surveyed, with an mean age of (57.63±2.92) years and a mean natural menopause age of (49.85±2.13) years. There were 574 cases with menopausal syndrome, with a prevalence of 70.34%. Flashes and sweating, insomnia and irritability were common symptoms, accounting for 62.87%, 47.43% and 41.18%, respectively. Multivariable logistic regression analysis showed that monthly personal income of ≤5 000 yuan (<3 000 yuan, OR=3.124, 95%CI: 1.829-5.335; 3 000-5 000 yuan, OR=2.399, 95%CI: 1.370-4.201) and having gynecological diseases (OR=1.970, 95%CI: 1.292-3.004) were associated with a higher risk of menopausal syndrome, while average (OR=0.141, 95%CI: 0.072-0.276) or sufficient sleep quality (OR=0.095, 95%CI: 0.049-0.185) were associated with a lower risk of menopausal syndrome. Conclusion The prevalence of menopausal syndrome among postmenopausal women in Pan'an County is relatively high, and is mainly influenced by personal economic status, sleep quality and the presence of gynecological diseases.

ObjectiveTo investigate the mechanism by which 2，3，5，4'-tetrahydroxyldiphenylethylene-2-O-glucoside （THSG） mitigates cerebral ischemia/reperfusion （CI/R） injury by regulating mitochondrial calcium overload and promoting mitophagy. MethodsSixty male SD rats were randomized into sham， model， SAS （40 mg·kg^-1）， and low-， medium- and high-dose （10， 20， 40 mg·kg^-1， respectively） THSG groups， with 10 rats in each group. The middle cerebral artery occlusion/reperfusion （MCAO/R） model was established by the modified Longa suture method. An oxygen-glucose deprivation/reoxygenation （OGD/R） model was constructed in PC12 cells. Neurological deficits were assessed via Zea Longa scoring， and cerebral infarct volume was measured by 2，3，5-triphenyltetrazolium chloride （TTC） staining. Structural and functional changes of cortical neurons in MCAO/R rats were assessed by hematoxylin-eosin and Nissl staining. PC12 cell viability was detected by cell counting kit-8 （CCK-8） assay， and mitochondrial calcium levels were quantified by Rhod-2 AM. Immunofluorescence was used to detect co-localization of PTEN-induced kinase 1 （PINK1） and leucine zipper/EF-hand-containing transmembrane protein 1 （LETM1） in neurons. Transmission electron microscopy （TEM） was employed to observe mitochondrial morphology in neurons. Western blot was employed to analyze the expression of translocase of outer mitochondrial membrane 20 （TOMM20）， autophagy-associated protein p62， microtubule-associated protein light chain 3 （LC3）， cysteinyl aspartate-specific proteinase-9 （Caspase-9）， B-cell lymphoma 2-associated protein X （Bax）， and cytochrome C （Cyt C）. ResultsCompared with the sham group， the model group exhibited increased infarct volume （P<0.01） and neurological deficit scores （P<0.01）， neuronal structure was disrupted with reduced Nissl bodies. （P<0.01）， mitochondrial swelling/fragmentation， decreased PINK1/LETM1 co-localization （P<0.01）， upregulated protein levels of LC3Ⅱ/LC3Ⅰ， TOMM20， Caspase-9， Bax， and Cyt C （P<0.01）， downregulated protein level of p62 （P<0.05）， weakened PC12 viability （P<0.01）， and elevated mitochondrial calcium level （P<0.01）. Compared with the model group， THSG and SAS groups showed reduced infarct volumes （P<0.05，P<0.01） and neurological deficit scores （P<0.05，P<0.01）， mitigated mitochondrial damage， and increased PINK1/LETM1 co-localization （P<0.01）. Medium/high-dose THSG and SAS alleviated the neurological damage， increased Nissl bodies （P<0.05，P<0.01）， downregulated the protein levels of p62， TOMM20， Caspase-9， Bax， and Cyt C （P<0.05，P<0.01）， and elevated the LC3Ⅱ/LC3Ⅰ level （P<0.05，P<0.01）. High-dose THSG enhanced PC12 cell viability （P<0.01）， increased PINK1/LETM1 co-localization （P<0.01）， and reduced mitochondrial calcium （P<0.01）. ConclusionTHSG may exert the neuroprotective effect on CI/R injury by activating the PINK1-LETM1 signaling pathway， reducing the mitochondrial calcium overload， and promoting mitophagy.

ObjectiveTo investigate the mechanism by which 2，3，5，4'-tetrahydroxyldiphenylethylene-2-O-glucoside （THSG） mitigates cerebral ischemia/reperfusion （CI/R） injury by regulating mitochondrial calcium overload and promoting mitophagy. MethodsSixty male SD rats were randomized into sham， model， SAS （40 mg·kg^-1）， and low-， medium- and high-dose （10， 20， 40 mg·kg^-1， respectively） THSG groups， with 10 rats in each group. The middle cerebral artery occlusion/reperfusion （MCAO/R） model was established by the modified Longa suture method. An oxygen-glucose deprivation/reoxygenation （OGD/R） model was constructed in PC12 cells. Neurological deficits were assessed via Zea Longa scoring， and cerebral infarct volume was measured by 2，3，5-triphenyltetrazolium chloride （TTC） staining. Structural and functional changes of cortical neurons in MCAO/R rats were assessed by hematoxylin-eosin and Nissl staining. PC12 cell viability was detected by cell counting kit-8 （CCK-8） assay， and mitochondrial calcium levels were quantified by Rhod-2 AM. Immunofluorescence was used to detect co-localization of PTEN-induced kinase 1 （PINK1） and leucine zipper/EF-hand-containing transmembrane protein 1 （LETM1） in neurons. Transmission electron microscopy （TEM） was employed to observe mitochondrial morphology in neurons. Western blot was employed to analyze the expression of translocase of outer mitochondrial membrane 20 （TOMM20）， autophagy-associated protein p62， microtubule-associated protein light chain 3 （LC3）， cysteinyl aspartate-specific proteinase-9 （Caspase-9）， B-cell lymphoma 2-associated protein X （Bax）， and cytochrome C （Cyt C）. ResultsCompared with the sham group， the model group exhibited increased infarct volume （P<0.01） and neurological deficit scores （P<0.01）， neuronal structure was disrupted with reduced Nissl bodies. （P<0.01）， mitochondrial swelling/fragmentation， decreased PINK1/LETM1 co-localization （P<0.01）， upregulated protein levels of LC3Ⅱ/LC3Ⅰ， TOMM20， Caspase-9， Bax， and Cyt C （P<0.01）， downregulated protein level of p62 （P<0.05）， weakened PC12 viability （P<0.01）， and elevated mitochondrial calcium level （P<0.01）. Compared with the model group， THSG and SAS groups showed reduced infarct volumes （P<0.05，P<0.01） and neurological deficit scores （P<0.05，P<0.01）， mitigated mitochondrial damage， and increased PINK1/LETM1 co-localization （P<0.01）. Medium/high-dose THSG and SAS alleviated the neurological damage， increased Nissl bodies （P<0.05，P<0.01）， downregulated the protein levels of p62， TOMM20， Caspase-9， Bax， and Cyt C （P<0.05，P<0.01）， and elevated the LC3Ⅱ/LC3Ⅰ level （P<0.05，P<0.01）. High-dose THSG enhanced PC12 cell viability （P<0.01）， increased PINK1/LETM1 co-localization （P<0.01）， and reduced mitochondrial calcium （P<0.01）. ConclusionTHSG may exert the neuroprotective effect on CI/R injury by activating the PINK1-LETM1 signaling pathway， reducing the mitochondrial calcium overload， and promoting mitophagy.

BACKGROUND: Regulatory dendritic cell (DCreg) subset exhibits a unique capacity for inducing immune tolerance among the variety subsets of dendritic cells (DCs) within gut-associated lymphoid tissues (GALTs). Fms-like tyrosine kinase 3 ligand (FLT3L) is involved in the differentiation of DCregs and the subsequent expansion of regulatory T-cells (Tregs) mediated by DCregs, though the precise mechanism remains poorly understood. This study aimed to explore the expansion mechanism of Treg induced by DCreg and the role of FLT3L in this process. METHODS: DCregs were distinguished from other DC subsets isolated from GALTs of BALB/c mice through a mixed lymphocyte reaction assay. The functions and mechanisms by which FLT3L promoted Treg expansion via DCregs were investigated in vitro through co-culture experiments involving DCregs and either CD4 + CD25 - T-cells or CD4 + CD25 + T-cells. Additionally, an in vivo experiment was conducted using a dextran sulfate sodium (DSS)-induced colitis model in mice. RESULTS: CD103 + CD11b + DC exhibited DCreg-like functionality and was identified as DCreg for subsequent investigation. Analysis of Foxp3 + Treg percentages within a co-culture system of CD4 + CD25 - T-cells and DCregs, with or without FLT3L, demonstrated the involvement of the FLT3/FLT3L axis in driving the differentiation of precursor T-cells into Foxp3 + Tregs induced by DCregs. Cell migration and co-culture assays revealed that the FLT3/FLT3L axis enhanced DCreg migration toward Tregs via the Rho pathway. Additionally, it was observed that DCregs could promote Treg proliferation through the Notch pathway, as inhibition of Notch signaling by DAPT (N-[N-(3,5-difluorophenacetyl)-l-alanyl]-S-phenylglycine t-butyl ester) suppressed Treg expansion within the co-culture system of DCregs and CD4 + T-cells or CD4 + CD25 + T-cells. Furthermore, the FLT3/FLT3L axis influenced JAG1 expression in DCregs, indirectly modulating Treg expansion. In vivo experiments further established that FLT3L promoted DCreg expansion and restored Treg balance in DSS-induced colitis models, thereby ameliorating colitis symptoms in mice. CONCLUSION The FLT3/FLT3L axis is integral to the maintenance of DCreg function in Treg expansion.
Animals ; T-Lymphocytes, Regulatory/immunology* ; Dendritic Cells/immunology* ; Mice ; Mice, Inbred BALB C ; Membrane Proteins/metabolism* ; Receptors, Notch/metabolism* ; Lymphoid Tissue/metabolism* ; Signal Transduction/physiology* ; Coculture Techniques ; Flow Cytometry

BACKGROUND: The effect of the interval between previous Helicobacter pylori (H. pylori) eradication and rescue treatment on therapeutic outcomes remains unknown. The aim of this study was to investigate the association between eradication rates and treatment interval durations in H. pylori infections. METHODS: This prospective observational study was conducted from December 2021 to February 2023 at six tertiary hospitals in Shandong, China. We recruited patients who were positive for H. pylori infection and required rescue treatment. Demographic information, previous times of eradication therapy, last eradication therapy date, and history of antibiotic use data were collected. The patients were divided into four groups based on the rescue treatment interval length: Group A, ≥4 weeks and ≤3 months; Group B, >3 and ≤6 months; Group C, >6 and ≤12 months; and Group D, >12 months. The primary outcome was the eradication rate of H. pylori . Drug compliance and adverse events (AEs) were also assessed. Pearson's χ2 test or Fisher's exact test was used to compare eradication rates between groups. RESULTS: A total of 670 patients were enrolled in this study. The intention-to-treat (ITT) eradication rates were 88.3% (158/179) in Group A, 89.6% (120/134) in Group B, 89.1% (123/138) in Group C, and 87.7% (192/219) in Group D. The per-protocol (PP) eradication rates were 92.9% (156/168) in Group A, 94.5% (120/127) in Group B, 94.5% (121/128) in Group C, and 93.6% (190/203) in Group D. There was no statistically significant difference in the eradication rates between groups in either the ITT ( P = 0.949) or PP analysis ( P = 0.921). No significant differences were observed in the incidence of AEs ( P = 0.934) or drug compliance ( P = 0.849) between groups. CONCLUSION: The interval duration of rescue treatment had no significant effect on H. pylori eradication rates or the incidence of AEs. REGISTRATION ClinicalTrials.gov , NCT05173493.
Humans ; Helicobacter Infections/drug therapy* ; Helicobacter pylori/pathogenicity* ; Male ; Female ; Prospective Studies ; Middle Aged ; Anti-Bacterial Agents/adverse effects* ; Adult ; Aged ; Treatment Outcome ; Proton Pump Inhibitors/therapeutic use*

[This corrects the article DOI: 10.1016/j.apsb.2022.03.002.].

An ideal dermal filler should integrate filling, repair, and anti-aging effects, with immediate tissue augmentation, slow degradation, and progressive stimulation of collagen regeneration. However, commonly used hyaluronic acid (HA) hydrogels, while effective for rapid filling, suffer from limited duration of support, weak cell adhesion, and an inability to promote collagen regeneration. Silk fibroin (SF), a natural protein from silkworm cocoons, is known for its excellent cell adhesion and collagen-stimulating abilities. However, its limited gelation capability restricts its potential application as a standalone injectable hydrogel. Based on a complementary strategy, this study combines the rapid gelling properties of HA with the collagen regenerative properties of SF to create a co-crosslinked HA-SF hydrogel. The composite hydrogel merges HA's rapid filling effect with SF's strong tissue adhesion and collagen-stimulating abilities. The formulation, physicochemical properties, degradation, biocompatibility, and filling effects of the HA-SF hydrogel were systematically investigated. HA-SF hydrogel exhibits excellent mechanical properties and ensures long-term support while maintaining injectability. Interestingly, after intradermal injection in the UVB-induced photoaging model, HA-SF hydrogel not only enhances hydrogel-cell interaction but also continues to stimulate collagen regeneration, especially type III collagen. This dual action achieves the biological effects of repair and anti-aging while maintaining the filling effect. Proteomic analysis confirms that repair and anti-aging effects are enhanced by the regulation of skin fibroblasts and modulation of amino acid and lipid metabolism. This composite hydrogel holds strong promise for clinical applications, offering a safer, long-lasting, and more natural injectable filler that combines filling, repair, and anti-aging into one system.

Objective:To explore the current status of decision conflict in breast cancer patients with immediate breast reconstruction, and analysis the relationship with personality traits, which can provides new ideas for understanding decision-making behavior and promotes effective decision-making.Methods:A cross-sectional survey was conducted to select 175 breast cancer patients who met the inclusion and exclusion criteria for immediate breast reconstruction in Cancer Hospital of Tianjin Medical University from May to December 2022 by convenient sampling method. A questionnaire was conducted using the general information questionnaire, Revised NEO Personality Inventory, Decisional Conflict Scale, and the Control Preference Scale. Single factor analysis and multiple linear regression were used to analyze the current situation and influencing factors of decision-making conflict.Results:The 175 patients with immediate breast reconstruction were all female, aged 24-67(45.26 ± 8.01) years. The decision conflict score of 175 breast cancer patients with immediate breast reconstruction was (25.05 ± 7.05), the standardized decision conflict score was (39.14 ± 10.04), the dimension score of factors affecting decision making was(7.18 ± 2.58), the score of decision uncertainty dimension was (7.34 ± 2.28). 37 patients (21.14%) had no decision conflict, 64 patients (36.57%) had moderate decision conflict, and 74 patients (42.29%) had high level decision conflict. The scores of altruism, neuroticism, openness, sociality and moral sense of patients in this survey were (15.16 ± 3.43), (18.14 ± 4.95), (13.71 ± 3.71), (18.12 ± 4.40) and (17.46 ± 4.03) respectively. The decision conflict was negatively correlated with altruism, sociality and moral sense ( r=-0.355, -0.543, -0.331, all P<0.05), and positively correlated with neuroticism( r=0.208, P<0.05). Multivariate regression analysis showed that age, decision type, neuroticism and sociality were the influencing factors of decision conflict ( F=16.39, P<0.05), accounted for 47.1% of the variation. The variance inflation factor of the above variables was less than 10, indicating no collinearity. Conclusions:The decision conflict of breast cancer patients with immediate breast reconstruction needs to be improved urgently. Based on the influencing factors (age, decision-making type and personality traits) of decision conflict, medical staff should implement personalized decision-making aid process to meet decision-making information needs, reduce decision-making conflict and optimize decision-making quality.

Objective To investigate the effect of different doses of esketamine combined with hydromorphone postoperative patient-controlled intravenous analgesia(PCIA)on depression in elderly pa-tients undergoing total knee arthroplasty.Methods A total of 180 elderly patients,44 males and 136 fe-males,aged 65-80 years,BMI 18.5-35.0 kg/m2,ASA physical status Ⅱ or Ⅲ,undergoing total knee arthroplasty(TKA)under elective general anesthesia combined with adductor block from J uly 2023 to Sep-tember 2023.Patients were divided into three groups by random number table method;control group(group C),esketamine 0.5 mg/kg group(group E1),and esketamine 1.0 mg/kg group(group E2),60 patients in each group.After operation,groups C,E1 and E2 were given hydromorphone 0.2 mg/kg,esketamine 0.5 mg/kg combined with hydromorphone 0.2 mg/kg,and esketamine 1.0 mg/kg combined with hydromor-phone 0.2 mg/kg to receive PCIA,respectively,and the three groups were diluted to 100 ml with normal saline.Parameters were set as follows.The background infusion rate was 1.5 ml/h,and the single press dose was 1.5 ml,and the locking time was 15 minutes.If the VAS pain score at rest was greater than or equal to 4 points and the analgesic effect of pressing the PCIA pump was not effective,then intramuscular injection of tramadol 0.1 g was used for remedial analgesia.Hamilton depression scale(HAMD)score was performed 1 day,3 and 7 days after surgery.Depressive state was classified as having HAMD score ≥ 8 points.VAS pain scores at rest were performed 1 day,3 and 7 days after surgery.The number of depression within 7 days after surgery,the number of effective(D1)and total(D2)pump compressions and D1/D2 within 3 days after surgery,the number of rescue analgesia,the occurrence of adverse reactions such as tra-madol dosage,dizziness,headache,multiple dreams,hallucinations,nausea and vomiting were recorded.Results Twenty-one patients(35％)in group C experienced depression,7 patients(12％)in group E1,and 8 patients(13％)in group E2 during 3 days after surgery.Eight patients(13％)in group C experi-enced depression,1 patients(2％)in group E1,and 2 patients(3％)in group E2 during 7 days after sur-gery.Compared with group C,the incidence of depression 3 and 7 days after surgery,rescue analgesia rate in group E1 were significantly decreased,the incidence of depression 3 and 7 days after surgery,dizziness,headache,and dreaminess within 3 days after surgery in group E2 were significantly decreased(P＜0.05).There were no significant differences in the incidence of depression and VAS pain scores between group El and group E2 at 1,3,and 7 days after surgery.Conclusion Esketamine 0.5 and 1.0 mg/kg for PCIA in elderly patients after TKA can improve postoperative depression,while esketamine 1.0 mg/kg can reduce the incidence of postoperative dizziness,headache,and multiple dreams.

Objective To translate the fear-avoidance components scale(FACS)into Chinese and test its reliability and validity.Methods In September 2023,the Chinese version of the Fear-avoidance component scale(FACS)was translated from the English version with translation,back-translation,cultural adjustment and pre-experiment according to Brislin's translation-back-translation model,after having been granted the rights by the author of FACS in August 2023.In October 2023,with the convenience sampling method,402 patients with chronic musculoskeletal pain in a Grade IIIA hospital were selected as the trial subjects to test the reliability and validity of the Chinese version of FACS.Results A total of 376 patients with chronic musculoskeletal pain had completed the study.The Chinese version of FACS encompassed 2 dimensions with 18 items:fear-avoidance psychology(12 items)and fear-avoidance behaviour(6 items).The total Cronbach α coefficient of the scale was 0.907 with the split-half reliability at 0.836 and test-retest reliability at 0.895.The Cronbach α coefficients of the two dimensions were at 0.884 and 0.812,split-half reliability at 0.871 and 0.896 and the test-retest reliability at 0.808 and 0.921,respectively.The content validity index of the scale level was 0.935,with a range from 0.870 to 1.000 at the item level.The KMO value for exploratory factor analysis was at 0.909,the spherical test value at 3134.208(P<0.01)and the cumulative variance contribution rate at 66.514%.Confirmatory factor analysis indicated that the model fitted the data well.Conclusion The Chinese version of FACS exhibits good reliability and validity.It can serve as an effective tool in the assessment of fear-avoidance in the patients with chronic pain in China.