Oligodendrocyte lineage cells, including oligodendrocyte precursor cells (OPCs) and oligodendrocytes (OLs), are essential in establishing and maintaining brain circuits. Autophagy is a conserved process that keeps the quality of organelles and proteostasis. The role of autophagy in oligodendrocyte lineage cells remains unclear. The present study shows that autophagy is required to maintain the number of OPCs/OLs and myelin integrity during brain aging. Inactivation of autophagy in oligodendrocyte lineage cells increases the number of OPCs/OLs in the developing brain while exaggerating the loss of OPCs/OLs with brain aging. Inactivation of autophagy in oligodendrocyte lineage cells impairs the turnover of myelin basic protein (MBP). It causes MBP to accumulate in the cytoplasm as multimeric aggregates and fails to be incorporated into integral myelin, which is associated with attenuated endocytic recycling. Inactivation of autophagy in oligodendrocyte lineage cells impairs myelin integrity and causes demyelination. Thus, this study shows autophagy is required to maintain myelin quality during aging by controlling the turnover of myelin components.
Animals ; Autophagy/physiology* ; Oligodendroglia/metabolism* ; Myelin Sheath/physiology* ; Aging/pathology* ; Myelin Basic Protein/metabolism* ; Cell Lineage/physiology* ; Mice ; Oligodendrocyte Precursor Cells ; Mice, Inbred C57BL ; Brain/cytology* ; Cells, Cultured ; Cell Count

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OBJECTIVE: This study aimed to explore the association between body mass index (BMI) and mortality based on the 10-year population-based multicenter prospective study. METHODS: A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023. Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality. Stratified analyses were performed based on the individual characteristics of the participants. RESULTS: Overall, 19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died. The underweight (< 18.5 kg/m ²) presented an increase in all-cause mortality (adjusted hazards ratio [ aHR] = 2.00, 95% confidence interval [ CI]: 1.66-2.41), while overweight (≥ 24.0 to < 28.0 kg/m ²) and obesity (≥ 28.0 kg/m ²) presented a decrease with an aHR of 0.61 (95% CI: 0.52-0.73) and 0.51 (95% CI: 0.37-0.70), respectively. Overweight ( aHR = 0.76, 95% CI: 0.67-0.86) and mild obesity ( aHR = 0.72, 95% CI: 0.59-0.87) had a positive impact on mortality in people older than 60 years. All-cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m ² ( aHR = 0.95, 95% CI: 0.92-0.98) and increased slightly above that value, indicating a U-shaped association. The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses. CONCLUSION This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years. Therefore, it is essential to consider age differences when formulating health and weight management strategies.
Humans ; Body Mass Index ; China/epidemiology* ; Male ; Female ; Middle Aged ; Prospective Studies ; Rural Population/statistics & numerical data* ; Aged ; Follow-Up Studies ; Adult ; Mortality ; Cause of Death ; Obesity/mortality* ; Overweight/mortality*

Objective To track and evaluate the scientificity, applicability, and operability of the current implementation of the Radiation Shielding Specifications for Radiotherapy Treatment Rooms—Part 2: Radiotherapy Room of Electron Linear Accelerators (GBZ/T 201.2—2011) among personnel in medical radiation technology service institutions, and to provide scientific evidence for further improvement of the standard. Methods Following the Guidelines for Health Standards Tracking Evaluation Work (WS/T 536—2017) and the project implementation plan, a survey was conducted among 140 personnel engaged in shielding testing and evaluation of electron linear accelerator rooms in medical radiation technology service institutions from 24 provinces in China. The methods of pre-investigation, on-site research, mailing, and email were used to collect data for analysis. Results Questionnaires were completed by 140 respondents from 98 medical radiation service institutions, including 63 public institutions and 77 private institutions. Of the surveyed individuals, 86.68% claimed to have a good or very good understanding of the standard, while only 64.3% had participated in training related to the standard. The survey indicated a low level of mastery of the standard content among the personnel and insufficient efforts in training and dissemination. Although only 3.57% of the respondents considered the existing standard to be inapplicable in the context of new radiotherapy equipment and technological advancements, 95.71%, 93.57%, and 96.43% believed that shielding calculation examples should be added for tomotherapy devices, CyberKnife systems, and ring accelerators with self-shielding bodies. Furthermore, 65% of the respondents felt that neutron shielding should be considered for 10 MV X-ray accelerator rooms. Conclusion The GBZ/T 201.2—2011 has been widely used for radiation protection in radiotherapy. However, it is imperative to update this standard. Additionally, due to the technical complexity of the standard, it can be challenging for professionals to fully understand and implement it. Therefore, publicity goals should be tailored to different groups and the training of key personnel should be strengthened. A nationwide communication and cooperation mechanism should be established to ensure uniform implementation of the standard.

OBJECTIVE To study the anti-ulcerative colitis(UC) effect of Sargentodoxae Caulis and explore its mechanism. METHODS The UC mice model induced by dextran sodium sulfate was used to evaluate the anti-UC effect of Sargentodoxae Caulis. The ingredients of Sargentodoxae Caulis were obtained according to the CNKI and PubMed website, component targets were screened by SwissTargetPrediction database, GEO gene chip was used to extract UC differential genes, then a network of "ingredients-targets-disease" of the Sargentodoxae Caulis was constructed. After screening the core targets, protein interaction and cluster analysis, biological process and pathway enrichment analysis were performed, and the reliability of network analysis was preliminarily verified by molecular docking and literatures. RESULTS Sargentodoxae Caulis could significantly improve the disease activity index score, colon shortening and colonic histopathological changes of UC mice, and had a good anti-UC effect. The network analysis found that the core components of the anti-UC of Sargentodoxae Caulis include (+)-Dihydroxyurearetic acid, Isorhaponigenin and Pinosylvin, and 63 core targets, such as EGFR, STAT1 and LCK, regulating PI3K-Akt signal pathway and cancer proteoglycan and other related signal pathways of immune anti-inflammatory and anti-cancer, and it could affect the biological processes such as amino acid modification, kinase activity regulation, cell reaction and oxidative stress to treat UC. Molecular docking and literature showed that the constructed network had high reliability. CONCLUSION Sargentodoxae Caulis has a good anti-UC effect, and its mechanism may be closely related to the regulation of intestinal immune inflammation and cell proliferation, differentiation and migration. It has the characteristics of multi-component, multi-target and multi-way.

BACKGROUND:Ankylosing spondylitis is a chronic inflammatory disease with chronic rheumatic immunity.Soft tissue ossification and fusion and spinal stiffness can cause biomechanical changes. OBJECTIVE:To reconstruct the lumbar-sacral intervertebral disc in ankylosing spondylitis patients with lumbar kyphosis by finite element analysis,and to study the range of motion of each segment of T11-S1 and the biomechanical characteristics of annulus fibrosus and nucleus pulposus. METHODS:The imaging data were obtained from an ankylosing spondylitis patient with lumbar kyphosis.The original CT image data of continuously scanned spine were imported into Mimics 21.0 in DICOM format,and T11-S1 was reconstructed respectively.The established model was imported into 3-Matic software in the format of"Stl"to reconstruct the intervertebral disc,and the fibrous intervertebral disc model was obtained.The improved model was further imported into Hypermesh software,and the vertebra,nucleus pulposus,annulus fibrosus and ligament were mesh-divided.After the material properties were given,the model was imported into ABAQUS software to observe the range of motion of each vertebral body in seven different working conditions of T11-S1,and analyze the biomechanical characteristics of each segment of annulus fibrosus and nucleus pulposus. RESULTS AND CONCLUSION:(1)The range of motion of L1 vertebrae was higher than that of other vertebrae under six different working conditions:extension,forward flexion,rotation(left and right),and lateral flexion(left and right).The maximum range of motion was 2.18° during L1 vertebral flexion,and the minimum range of motion was 0.12° during L5 vertebral extension.(2)The annular fiber flexion at L2-L3 segments was greater than the extension(P<0.05),and the annular fiber flexion at L3-L4 and L4-L5 segments was less than the extension(P<0.05).The left rotation of L1-L2 annular fibers was greater than the right rotation(P<0.05).The left flexion of the annulus was greater than the right flexion in L1-L2,L2-L3,L3-L4,L4-L5 and L5-S1 segments(P<0.05).(3)The nucleus pulposus stresses of T11-L12,L1-L2,L2-L3,L3-L4 and L4-L5 segments in forward flexion were greater than in extension(P<0.05).The left rotation of T12-L1 and L3-L4 segments was smaller than the right rotation(P<0.05),and that of T11-T12,L1-L2,and L2-L3 segments was larger than the right rotation(P<0.05).The left flexion was larger than the right flexion in the T11-S1 segment.(4)It is concluded that in ankylosing spondylitis patients with lumbar kyphosis,the minimum range of motion of the vertebral body is located at the L5 vertebral body in extension.To prevent fractures,it is recommended to avoid exercise in the extension position.During the onset of lumbar kyphosis in patients with ankylosing spondylitis,the maximum stress of the annulus fibrosus and nucleus pulposus is located in the L1-L2 segment,which is fixed and will not alter with the change of body position.The late surgical treatment and correction of deformity should focus on releasing the pressure of the annulus fibrosus and nucleus pulposus in this segment to avoid the rupture of the annulus fibrosus and the injury of the nucleus pulposus.

Background::The goal of the assisted reproductive treatment is to transfer one euploid blastocyst and to help infertile women giving birth one healthy neonate. Some algorithms have been used to assess the ploidy status of embryos derived from couples with normal chromosome, who subjected to preimplantation genetic testing for aneuploidy (PGT-A) treatment. However, it is currently unknown whether artificial intelligence model can be used to assess the euploidy status of blastocyst derived from populations with chromosomal rearrangement.Methods::From February 2020 to May 2021, we collected the whole raw time-lapse videos at multiple focal planes from in vitro cultured embryos, the clinical information of couples, and the comprehensive chromosome screening results of those blastocysts that had received PGT treatment. Initially, we developed a novel deep learning model called the Attentive Multi-Focus Selection Network (AMSNet) to analyze time-lapse videos in real time and predict blastocyst formation. Building upon AMSNet, we integrated additional clinically predictive variables and created a second deep learning model, the Attentive Multi-Focus Video and Clinical Information Fusion Network (AMCFNet), to assess the euploidy status of embryos. The efficacy of the AMCFNet was further tested in embryos with parental chromosomal rearrangements. The receiver operating characteristic curve (ROC) was used to evaluate the superiority of the model. Results::A total of 4112 embryos with complete time-lapse videos were enrolled for the blastocyst formation prediction task, and 1422 qualified blastocysts received PGT-A ( n = 589) or PGT for chromosomal structural rearrangement (PGT-SR, n = 833) were enrolled for the euploidy assessment task in this study. The AMSNet model using seven focal raw time-lapse videos has the best real-time accuracy. The real-time accuracy for AMSNet to predict blastocyst formation reached above 70% on the day 2 of embryo culture, and then increased to 80% on the day 4 of embryo culture. Combing with 4 clinical features of couples, the AUC of AMCFNet with 7 focal points increased to 0.729 in blastocysts derived from couples with chromosomal rearrangement. Conclusion::Integrating seven focal raw time-lapse images of embryos and parental clinical information, AMCFNet model have the capability of assessing euploidy status in blastocysts derived from couples with chromosomal rearrangement.

OBJECTIVE To explore the clinical characteristics,diagnosis and treatment of primary hyperparathyroidism(PHPT),and to improve the diagnosis and treatment ability of this disease.METHODS The clinical data of 27 patients with PHPT admitted to Southeast University Affiliated Zhongda Hospital from January 2016 to June 2023 were retrospectively analyzed,and the clinical characteristics,preoperative diagnosis,surgical treatment and postoperative follow-up were summarized.RESULTS All patients had elevated serum calcium and parathyroid hormone before operation,and were diagnosed before operation.All patients underwent parathyroidectomy with low neck incision,19 underwent unilateral parathyroidectomy and 8 underwent bilateral parathyroidectomy.PTH was rapidly detected 10 min after resection of the diseased gland,all 27 cases terminated surgery after PTH decreased by more than 50%.All patients experienced no postoperative complications such as hoarseness and coughing due to diet.There were 20 cases diagnosed pathologically as parathyroid adenoma and 7 cases diagnosed as parathyroid hyperplasia after operation.After operation,15 patients had short-term hypocalcemia,the hypocalcemia patients were treated with calcitriol and calcium for 2-4 weeks and their blood calcium returned to normal.and one patient was slightly higher than normal value,the hypercalcemia returned to normal about one week after operation.The remaining patients had normal serum calcium after operation.The parathyroid hormone returned to normal in 27 patients within 6 months.All patients were followed up for 6 months to 6 years,and no one recurred.CONCLUSION Parathyroidectomy is the best treatment for PHPT.Preoperative imaging location and intraoperative PTH measurement are helpful to narrow the exploration range,shorten the operation time and reduce the complications.

Objective:To systematically observe the location and severity of perineal lacerations during childbirth and explore the relationship between the length/depth and the degrees of perineal lacerations.Methods:This prospective study recruited full-term singleton cephalic pregnant women planning vaginal delivery at the Fourth Hospital of Shijiazhuang from March 2023 to July 2023. Before the second stage of labor, the perineal body length (PBL) was measured. After delivery, the locations of all birth canal lacerations, the perineal skin lacerations length (PSLL), and the perineal lacerations depth (PLD) were measured and recorded. A magnifying glass was used to identify the layers of the skin and photographs were taken if necessary. Statistical methods such as t-test, rank-sum test, and Chi-square test (or Fisher's exact test) were used to compare the basic conditions and birth canal lacerations between primiparous and multiparous women. The receiver operating characteristic (ROC) curve was used to analyze the sensitivity and specificity of PSLL, PLD, and the PSLL/PBL ratio. Results:During the study period, 200 women were included, of which 189 had vaginal deliveries (173 primiparous and 16 multiparous) and 11 had emergency cesarean sections (10 primiparous and one multiparous). Among the 173 primiparous women with vaginal deliveries, 33 (19.1%) underwent episiotomy, and the other 140 (80.9%) had perineal lacerations. Among these cases of perineal lacerations, nine were complicated by vaginal wall lacerations, 20 by labial lacerations, and four by clitoral and urethral lacerations. There were 32 (22.9%) primiparous women with first-degree perineal lacerations and 108 (77.1%) with second-degree perineal lacerations. Among the 16 multiparous women who delivered vaginally, two had intact birth canals without lacerations, and 14 had perineal lacerations (eight with first-degree and six with second-degree perineal lacerations). Besides, none of them underwent episiotomy or assisted vaginal delivery. The rates of episiotomy and second-degree perineal lacerations were higher in primiparous women than in multiparous women [19.1% (33/173) vs. 0/16, 77.1% (108/173) vs. 6/14, Fisher's exact test, both P<0.05). The PSLL, PLD, and PSLL/PBL ratio were significantly lower in the primiparous women with first-degree perineal lacerations than in the primiparous women with second-degree perineal lacerations [0.0 mm (0.0-10.0 mm) vs. 30.0 mm (25.5-40.0 mm), 5.0 mm (1.5-10.0 mm) vs. 14.0 mm (10.0-15.0 mm), 0.0 mm (0.0-21.1 mm) vs. 63.6 mm (50.0-77.3 mm); Z values were－8.04,－6.46, and－7.75, respectively, all P<0.05]. The optimal cut-off values of PSLL, PLD, and PSLL/PBL ratio for differentiating between first-degree and second-degree perineal lacerations were 15 mm, 9 mm, and 33.33%, with the area under the ROC curve (AUC) of 0.965, 0.869, and 0.951 and the sensitivity of 91.67%, 91.67%, and 89.81%, respectively. The AUC of PSLL was significantly greater than that of PLD ( Z=2.55, P=0.011), but the AUC of PSLL/PBL ratio showed no significant difference with that of PSLL or PLD ( Z=1.18 and 1.89, both P>0.05). Conclusions:It is difficult for full-term primiparas to maintain perineal integrity during vaginal delivery. Measuring the PSLL, PLD, and PSLL/PBL ratio of primiparous women will be useful for distinction between first- and second-degree perineal lacerations.