ObjectiveGastrodia elata has evolved ecological types with shortened rhizome internodes and diversified flower and fruit coloration in response to different altitudes. Studying the genetic mechanisms of different ecotype germplasm is significant for guiding variety breeding in different cultivation areas. MethodsThe bHLH gene family was identified based on the whole-genome datasets of G. elata f. elata and G. elata f. glauca. Subsequently， the gene family members were subject to analysis， including gene structure， chromosomal localization， cis-acting elements， gene synteny， and phylogeny. Combined with transcriptome data and quantitative Real-time PCR， the expression patterns of bHLH genes in the stems of the different G. elata ecotype germplasm were analyzed. Finally， correlation analysis was conducted between gene expression patterns and color to obtain the key bHLH genes regulating the color formation of stem. ResultsA total of 63 bHLH genes were identified in both G elata f. elata and G. elata f. glauca， unevenly distributed across 17 chromosomes and clustered into 16 subfamilies， with significant expansion in some family members. Obvious inversions of bHLH genes on the same chromosome and interchromosomal translocations were detected in the two ecotype germplasm. Among these genes， 12 bHLH genes （such as bHLH62-3 and bHLH74） were associated with the bright yellow color of G elata f. elata stem， while 9 bHLH genes （such as PIL13， UNE12， and bHLH130） were correlated with the red color of G. elata f. glauca stem. Compared to G. elata f. glauca， the bHLH48 expression level was significantly higher in flowers and scale leaves of G elata f. elata， and the bHLH62-3 expression level was significantly higher in all organs of G elata f. elata. ConclusionsFunctional pathway divergence of the bHLH family members has occurred across different chromosomes in G elata f. elata and G. elata f. glauca. Through synergism or antagonism with other genes， 21 bHLH genes participate in the coloration metabolic pathway regulation of stems， flowers， and fruits. Specifically， bHLH62-3 is involved in regulating stem color differentiation in the anthocyanin biosynthesis pathway of G. elata， thus relevant to the color formation of stem. Additionally， GebHLH48 positively regulates flowering-related pathways to promote the early-flowering phenotype of G. elata f. elata. These findings have laid the foundation for analyzing the genetic regulatory mechanisms underlying the color formation of the G. elata stem.

ObjectiveGastrodia elata has evolved ecological types with shortened rhizome internodes and diversified flower and fruit coloration in response to different altitudes. Studying the genetic mechanisms of different ecotype germplasm is significant for guiding variety breeding in different cultivation areas. MethodsThe bHLH gene family was identified based on the whole-genome datasets of G. elata f. elata and G. elata f. glauca. Subsequently， the gene family members were subject to analysis， including gene structure， chromosomal localization， cis-acting elements， gene synteny， and phylogeny. Combined with transcriptome data and quantitative Real-time PCR， the expression patterns of bHLH genes in the stems of the different G. elata ecotype germplasm were analyzed. Finally， correlation analysis was conducted between gene expression patterns and color to obtain the key bHLH genes regulating the color formation of stem. ResultsA total of 63 bHLH genes were identified in both G elata f. elata and G. elata f. glauca， unevenly distributed across 17 chromosomes and clustered into 16 subfamilies， with significant expansion in some family members. Obvious inversions of bHLH genes on the same chromosome and interchromosomal translocations were detected in the two ecotype germplasm. Among these genes， 12 bHLH genes （such as bHLH62-3 and bHLH74） were associated with the bright yellow color of G elata f. elata stem， while 9 bHLH genes （such as PIL13， UNE12， and bHLH130） were correlated with the red color of G. elata f. glauca stem. Compared to G. elata f. glauca， the bHLH48 expression level was significantly higher in flowers and scale leaves of G elata f. elata， and the bHLH62-3 expression level was significantly higher in all organs of G elata f. elata. ConclusionsFunctional pathway divergence of the bHLH family members has occurred across different chromosomes in G elata f. elata and G. elata f. glauca. Through synergism or antagonism with other genes， 21 bHLH genes participate in the coloration metabolic pathway regulation of stems， flowers， and fruits. Specifically， bHLH62-3 is involved in regulating stem color differentiation in the anthocyanin biosynthesis pathway of G. elata， thus relevant to the color formation of stem. Additionally， GebHLH48 positively regulates flowering-related pathways to promote the early-flowering phenotype of G. elata f. elata. These findings have laid the foundation for analyzing the genetic regulatory mechanisms underlying the color formation of the G. elata stem.

[Objective] To conduct a retrospective statistical comparison of alanine aminotransferase (ALT) test values in blood donors prior to blood collection, aiming to analyze the objective characteristics of the population with elevated ALT levels (ALT>50 U/L) and provide reference data for adjusting the screening eligibility threshold for ALT. [Methods] The preliminary ALT screening data of 30 341 blood donor samples collected prior to blood donation from three smart blood donation sites at the Shenzhen Blood Center between 2022 and 2023 were extracted and compared with data from a health examination department of a tertiary hospital in Shenzhen (representing the general population, n=24 906). Both datasets were categorized and statistically described. A retrospective analysis was conducted to examine the associations between ALT test results and factors such as donors' gender, age, ethnicity, donation site, donation season, and frequency of blood donation. [Results] The ALT levels in both blood donors and the general population were non-normally distributed. The 95th percentile of ALT values was calculated as 61.4 U/L (male: 67.8 U/L, female: 39.3 U/L) for blood donors and 58.1 U/L (male: 63.7 U/L, female: 51.2 U/L) for the general population. The non-compliance rates (ALT>50 U/L) were 7.65% (2 321/30 341) in blood donors and 7.08% (1 763/24 906) in the general population. There were significant differences (P<0.05) in the ALT failure rate among blood donors based on gender, age, and donation site, but no significant differences (P>0.05) during the blood donation season. There was no statistically significant difference (P>0.05) in the positive rates of four serological markers (HBsAg, anti HCV, HIV Ag/Ab, anti TP) for blood screening pathogens between ALT unqualified and qualified individuals (2.05% vs 1.5%). If the ALT qualification threshold was raised from 50 U/L to 90 U/L, the non qualification rates of male and female blood donors would decrease from 9.82% (2 074/21 125) to 2.23% (471/21 125) and from 2.70% (249/9 216) to 0.75% (69/9 216), respectively. Among the 154 blood donors who donated blood more than 3 times, 88.31% of the 248 ALT test results were in the range of 50-90 U/L. Among them, 9 cases had ALT>130 U/L, and ALT was converted to qualified in subsequent blood donations. [Conclusion] There are differences in the ALT failure rate among blood donors of different genders and ages, and different blood donation sites and operators can also affect the ALT detection values of blood donors. The vast majority of blood donors with ALT failure are caused by transient and non pathological factors. With the widespread use of blood virus nucleic acid testing, appropriately increasing the ALT qualification threshold for blood donors can expand the qualified population and alleviate the shortage of blood sources, and the risk of blood safety will not increase.

Objective To investigate the expression and prognostic value of uncoupling protein 2(UCP2)and ubiquitin associated protein 2-like(UBAP2L)in non-small cell lung cancer(NSCLC).Methods A total of 94 patients with NSCLC who received surgical treatment in a hospital from March 2019 to March 2021 were selected as the study objects.The expressions of UCP2 protein,UBAP2L protein,UCP2 mRNA and UBAP2L mRNA in cancer tissues and adjacent tissues of NSCLC patients were detected by real-time fluorescence quan-titative polymerase chain reaction and immunohistochemistry.The correlation between UCP2 mRNA and UBAP2L mRNA in NSCLC was analyzed by Pearson correlation.Kaplan-Meier curve was used to analyze the differences in survival rates of NSCLC patients with different UCP2 mRNA and UBAP2L mRNA expres-sions,and multivariate Cox regression was used to analyze the prognostic factors of NSCLC patients.Results The positive rate of UCP2 protein and UBAP2L protein in cancer tissues of NSCLC patients was higher than that in adjacent tissues,and the difference was statistically significant(P＜0.05).The expressions of UCP2 mRNA and UBAP2L mRNA in cancer tissues of NSCLC patients were significantly higher than those in adjacent tissues,and the differences were statistically significant(P＜0.05).There was a positive cor-relation between UCP2 mRNA and UBAP2L mRNA expression in NSCLC patients(r=0.721,P＜0.001).The expression of UCP2 mRNA and UBAP2L mRNA in cancer tissues of NSCLC patients was related to TNM stage and lymph node metastasis.There was significant difference in 3-year survival rate between UCP2 mRNA high expression group and UCP2 mRNA low expression group(P＜0.05).There was significant difference in 3-year survival rate between UBAP2L mRNA high expression group and UBAP2L mRNA low expression group(P＜0.05).TNM stage Ⅲ A,lymph node metastasis,UCP2 mRNA high expression and UBAP2L mRNA high expression were risk factors for prognosis of NSCLC patients(P＜0.05).Conclusion UCP2 protein,UBAP2L protein,UCP2 mRNA and UBAP2L mRNA are up-regulated in NSCLC patients,and UCP2 mRNA and UBAP2L mRNA are helpful to evaluate the survival prognosis of NSCLC patients.

Objective:To investigate the current situation of nursing information ability of head nurses in different grades of hospitals in Jiaozuo City, and analyze its influencing variables based on the random forest model, so as to provide evidence-based basis for the construction of nursing information ability improvement strategies and training programs for head nurses.Methods:From August to September 2024, the head nurses of 20 hospitals of different grades were selected by cluster sampling method in Jiaozuo City as the research subjects. General Data Questionnaire and Nursing Information Ability Scale of Head Nurses were used to conduct a cross-sectional survey. Random forest model was used to evaluate the importance of variables, lasso regression analysis was applied to complete the variable screening, and the influencing factors of nursing information ability of head nurses were explored through stepwise multiple linear regression analysis.Results:A total of 305 questionnaires were ultimately collected, of which 297 were valid, the effective rate was 97.38%. Out of 297 head nurses, 6 were male and 291 were female; 49 individuals aged 20-29 years old, 127 individuals aged 30-39 years old, 92 individuals aged 40-49 years old, and 29 individuals aged ≥ 50 years old. The total score of nursing information ability was (139.06 ± 24.62). Random forest model and lasso regression analysis showed that the top 6 variables in terms of importance were the number of years serving as head nurses, participation in information function development, number of academic conferences in the past three years, hospital grade, participating in information training, and chairing or participating in scientific research in the past three years. Stepwise multiple linear regression analysis showed that the number of years serving as head nurses, participating in information training, participating in information function development and number of academic conferences in the past three years had significant effects on nursing information ability of head nurses (t values were -4.66 to 3.81, all P<0.05). Conclusions:The nursing information ability of head nurses in Jiaozuo city is in the middle level, and the nursing information ability of head nurses in different grades of hospitals is different. It is suggested to construct a stepped information ability continuing education framework and a research-information ability coupling development mechanism, and incorporate nursing information ability into the necessary conditions for the appointment of nursing management posts, so as to realize the balanced development of nursing information management ability and the continuous iteration of nursing manager information ability.

Objective:To culturally adapt the eHealth Literacy Questionnaire (eHLQ) into Chinese and validate its reliability and validity in stroke patients, so as to provide a basis for comprehensive evaluation of electronic health literacy in stroke patients.Methods:From May to September 2024, the Brislin translation model was adopted for translation, and the expert consultation was used for cultural adaptation. Followed by preliminary testing to finalize the Chinese version of eHLQ. A convenience sample of the stroke patients was recruited from Beijing Tiantan Hospital, Capital Medical University and Tianjin Huanhu Hospital between October 2024 to February 2025 to conduct a cross-sectional study and evaluate the scale's reliability and validity.Results:Finally, 415 stroke patients were included, with 284 males and 131 females, aged (61.26 ± 9.75) years. The Chinese eHLQ comprised 7 dimensions and 35 items. The item-level content validity index ranged from 0.875 to 1.000, and the scale-level content validity index of universal agreement was 0.857. Exploratory factor analysis revealed KMO value of 0.922, with a cumulative variance contribution rate of 68.90% and factor loading ranging from 0.515 to 0.803. Confirmatory factor analysis demonstrated satisfactory model fit indices: χ2/ df was 1.639, incremental fit index was 0.913, Tucker-Lewis index was 0.902, comparative fit index was 0.912, goodness-of-fit index was 0.812, and root mean square error of approximation was 0.056. The overall Cronbach α coefficient was 0.941, with subscale Cronbach α ranging from 0.825 to 0.894. The test-retest reliability was 0.954. Conclusions:The Chinese version of the eHLQ exhibits excellent reliability and validity, serving as an effective tool for assessing eHealth literacy among stroke patients in China.

Objective:To establish and validate a multimodal model based on radiomics and deep learning for predicting acute pancreatitis (AP) complicated with acute respiratory distress syndrome (ARDS).Methods:Patients diagnosed with AP from The First Affiliated Hospital of Soochow University, Donghai County People's Hospital and Jintan Affiliated Hospital of Jiangsu University between January 2017 and December 2023 were enrolled. Based on the diagnosis of ARDS within 1 week after admission, the patients were classified into the ARDS group and the non-ARDS group. Patients in the First Affiliated Hospital of Soochow University ( n=406) was used as the training set (non-ARDS group n=212 vs ARDS group n=194), while Donghai and Jintan hospitals served as the test set ( n=175; non-ARDS group n=104 vs ARDS group n=71). Clinical data, laboratory tests and the occurrence of systemic inflammatory response syndrome (SIRS) within 24 hours after admission were collected. Scoring systems such as bedside index for severity in acute pancreatitis (BISAP), Ranson score and modified CT severity index (MCTSI) were calculated. Radiomics features were extracted from three-dimensional CT images to develop a radiomics model based on XGBoost algorithm. At the same time, a deep learning model was constructed using deep convolutional networks to extract deep features. Finally, clinical features and the predictions from the aforementioned models were integrated to establish a multimodal model based on XGBoost algorithm. To enhance model visualization, variable importance ranking and local interpretable visualization were used. The receiver operating characteristic (ROC) curves of the three models and the three scores including BISAP, Ranson and MCTSI were plotted and the area under the curves (AUCs) were calculated to evaluate the prediction performance for ARDS in AP patients, as well as sensitivity and specificity. Results:In the multimodal model for predicting ARDS in AP patients, predictions of the deep learning model and the radiomics model were the most important variables, followed by SIRS, C-reactive protein, procalcitonin, albumin, glucose, creatinine, neutrophil, and Ca 2+. In the training set, the multimodal model achieved an AUC of 0.933 for predicting ARDS in AP patients, higher than the radiomics model (0.727), the deep learning model (0.877), MCTSI (0.870), Ranson (0.620) and BISAP (0.898). In the test set, the model's AUC was 0.916 for predicting ARDS in AP patients, higher than the radiomics model (0.660), the deep learning model (0.864), MCTSI (0.851), Ranson (0.609), and BISAP (0.860). Conclusions:Based on clinical structured data, radiomics and deep learning features, the multimodal model could predict the risk of ARDS in AP patients at an early stage, whose performance is better than the single-modal models and the traditional scoring systems.

OBJECTIVE: To analyze the clinical features of acute myeloid leukemia patients with DEK-NUP214 fusion gene positive. METHODS: The DEK-NUP214 fusion gene was amplified by multi-nested PCR in 26 patients admitted to the First Affiliated Hospital of Soochow University from January 2018 to October 2023, and the disease course and post-transplant survival data were obtained by searching outpatient and inpatient medical records and telephone follow-up. RESULTS: The median follow-up time of pateints was 21.25（0.9-60.2） months. Among 26 patients with DEK-NUP214 fusion gene positive AML, 15 patients had FLT3-ITD gene mutation positive. One patient died after abandoning treatment due to non-remission of induction chemotherapy, one died due to infection, and 23 patients received allo-HSCT after achieving CR, of which one patient died within one month after transplantation due to multiple infections and one died due to severe pulmonary infection that did not respond to treatment. One patient received allo-HSCT in non-remission state and later died due to recurrence. CONCLUSION DEK-NUP214 fusion gene positive AML is a type of acute leukemia subtype with high risk and poor prognosis. Allo-HSCT treatment at the early stage of disease remission is the most effective way to improve the prognosis of patients.
Humans ; Leukemia, Myeloid, Acute/genetics* ; Poly-ADP-Ribose Binding Proteins ; Oncogene Proteins, Fusion/genetics* ; Nuclear Pore Complex Proteins/genetics* ; Oncogene Proteins/genetics* ; Chromosomal Proteins, Non-Histone/genetics* ; Male ; Female ; Adult ; Mutation ; Hematopoietic Stem Cell Transplantation ; Middle Aged

BACKGROUND: Prolonged occupational noise exposure poses potential health risks, but its impact on mitochondrial DNA (mtDNA) damage and methylation patterns remains unclear. METHOD: We recruited 306 factory workers, using average binaural high-frequency hearing thresholds from pure-tone audiometry to assess noise exposure. MtDNA damage was evaluated through mitochondrial DNA copy number (mtDNAcn) and lesion rate, and mtDNA methylation changes were identified via pyrophosphate sequencing. RESULTS: There was a reduction in MT-RNR1 methylation of 4.52% (95% CI: -7.43% to -1.62%) among workers with abnormal hearing, whereas changes in the D-loop region were not statistically significant (β = -2.06%, 95% CI: -4.44% to 0.31%). MtDNAcn showed a negative association with MT-RNR1 methylation (β = -0.95, 95% CI: -1.23 to -0.66), while no significant link was found with D-loop methylation (β = -0.05, 95% CI: -0.58 to 0.48). Mediation analysis indicated a significant increase in mtDNAcn by 10.75 units (95% CI: 3.00 to 21.26) in those with abnormal hearing, with MT-RNR1 methylation mediating 35.9% of this effect. CONCLUSIONS These findings suggest that occupational noise exposure may influence compensatory increases in mtDNA content through altered MT-RNR1 methylation.
Humans ; DNA, Mitochondrial ; DNA Methylation ; Male ; Adult ; Noise, Occupational/adverse effects* ; Middle Aged ; Occupational Exposure/adverse effects* ; Biomarkers/blood* ; Female

OBJECTIVE: Varied acupoint selections represent a potential cause of the uncertainty surrounding the efficacy of acupuncture for knee osteoarthritis (OA). Skin temperature, a guiding factor for acupoint selection, may help to address this issue. This study explored thermal sensitization of acupoints used for the treatment of knee OA. METHODS: This cross-sectional case-control study enrolled cases aged 45-75 years with symptomatic knee OA and age- and gender-matched non-knee OA controls in a 1:1 ratio. All participants underwent infrared thermographic imaging. The primary outcome was the relative skin temperature of acupoint (STA), and the secondary outcome was the absolute STA of 11 acupoints. The Z test was used to compare the relative and absolute STAs between the groups. Principal component analysis was used to extract the common factors (CFs, acupoint cluster) in the STAs. A general linear model was used to identify factors affecting the STA in the knee OA cases. For the group comparisons of relative STA, P < 0.0045 (adjusted for 11 acupoints through Bonferroni correction) was considered to indicate statistical significance. For other analyses, P < 0.05 was used as the threshold for statistical significance. RESULTS: The analysis included 308 participants, consisting of 151 cases (mean age: [64.58 ± 6.67] years; male: 25.83%; mean body mass index: [25.70 ± 3.16] kg/m²) and 157 controls (mean age: [63.37 ± 5.96] years; male: 26.11%; mean body mass index: [24.47 ± 2.84] kg/m²). The relative STAs of ST34 (P = 0.0001), EX-LE2 (P < 0.0001), EX-LE5 (P = 0.0006), SP10 (P < 0.0001), BL40 (P = 0.0012) and GB39 (P = 0.0037) were higher in the knee OA group. No difference was found in the STAs of ST35, ST36, SP9, GB33 and GB34. Four CFs were identified for relative STA in both groups. The acupoints within each CF were consistent between the groups. The mean values of the relative STAs across each CF were higher in the knee OA group. In the knee OA cases, no factors were observed to affect the relative STA, while age and gender were found to affect the absolute STA. CONCLUSION Among patients with knee OA, thermal sensitization occurs in the acupoints of the lower extremity, exhibiting localized and regional thermal consistencies. The thermally sensitized acupoints that we identified in this study, ST34, SP10, EX-LE2, EX-LE5, GB39 and BL40, may be good choices for the acupuncture treatment of knee OA. Please cite this article as: Tu JF, Wang XZ, Yan SY, Wang YR, Yang JW, Shi GX, Zhang WZ, Jing LN, Yang LS, Liu DH, Wang LQ, Mi BH. Thermal sensitization of acupoints in patients with knee osteoarthritis: A cross-sectional case-control study. J Integr Med. 2025; 23(3): 289-296.
Humans ; Osteoarthritis, Knee/physiopathology* ; Male ; Cross-Sectional Studies ; Middle Aged ; Female ; Acupuncture Points ; Case-Control Studies ; Aged ; Skin Temperature ; Acupuncture Therapy