Objective To investigate the features of non-motor symptoms and transcranial substantia nigra ultrasound in essential tremor （ET）. Methods General data were collected from 50 patients with ET and 50 healthy controls，and non-motor symptom scales and transcranial nigra sonography （TCS） were used for assessment. The t-test，the non-parametric test，and the chi-square test were used for comparison of general data，scale assessment results，and TCS findings between the two groups. Results There were significant differences between the ET group and the healthy control group in the total scores of NMSS，MoCA，HAMA，HAMD，PSQI，ESS，and FSS and the incidence rates of cognitive impairment，moderate or severe anxiety，poor sleep，and daytime sleepiness，while there were no significant differences in the incidence rates of moderate or severe depression and fatigue between the two groups. There were no significant differences between the two groups in terms of “hyperechoic area of the left side” “hyperechoic area of the right side” “hyperechoic area of both sides” “S/M value” “the number of cases with a hyperechoic area of >0.2 cm2 for at least one side” “the number of cases with an S/M ratio of >7%” and “the number of cases with positive TCS results”. Conclusion Compared with healthy controls，ET patients are more susceptible to cognitive impairment，anxiety，depression，poor sleep quality，daytime sleepiness，and fatigue，and the non-motor symptoms of ET should be taken seriously in clinical practice. TCS examination has a relatively low diagnostic value in ET patients and healthy individuals.

Objective:To investigate the impact of antenatal corticosteroid (ACS) exposure on neonatal outcomes in late preterm infants.Methods:This retrospective cohort study analyzed 406 late preterm infants (gestational age 34 +0-36 +6 weeks) born at Tongji University Affiliated Dongfang Hospital between January 2021 and June 2024. Participants were divided into ACS-exposed ( n=254) and control ( n=152) groups. Maternal characteristics, neonatal profiles, and outcomes [respiratory disorders (respiratory distress syndrome, respiratory failure, bronchopulmonary dysplasia), neonatal hypoglycemia, and early-onset sepsis] were compared. And they were stratified by plurality (154 twins, 252 singletons) and gestational age (96 at 34 +0-34 +6 weeks; 111 at 35 +0-35 +6 weeks; 199 at 36 +0-36 +6 weeks), the effects of ACS exposure on neonatal outcomes were analyzed. Late preterm infants were also divided into affected ( n=13) and unaffected ( n=393) groups according to whether they had respiratory disorders, and the risk factors of respiratory disorders were analyzed. Statistical methods included independent t-test, Mann-Whitney U, Chi-square test, and multivariate logistic regression. Results:The ACS-exposed group exhibited significantly higher rates of assisted reproductive technology conception [53.1% (135/254) vs. 37.5% (57/152), χ2=9.37], twin pregnancy [43.3% (110/254) vs. 28.9% (44/152), χ2=6.84], cesarean delivery [83.5% (212/254) vs. 66.4% (101/152), χ2=15.66], and neonatal intensive care unit admission than those in the control group [59.1% (150/254) vs. 40.8% (62/152), χ2=12.61] (all P<0.05). No significant differences emerged between ACS-exposed and control groups in respiratory disorders [3.1% (8/254) vs. 3.3% (5/152), χ2=0.01], early-onset sepsis [1.6% (4/254) vs. 1.3% (2/152), χ2=0.71], or neonatal hypoglycemia [1.6% (4/254) vs. 1.3% (2/152), χ2=0.71] (all P>0.05). Stratified analyses by plurality or gestational age strata revealed no significant differences in respiratory disorders, early-onset sepsis or neonatal hypoglycemia between ACS-exposed and control groups (all P>0.05). Multivariate logistic regression identified ACS exposure as non-protective against respiratory disorders ( OR=0.37, 95% CI: 0.10-1.39, P=0.144), with maternal glucose metabolism disorders (pre-gestational/gestational diabetes) as a risk factor ( OR=5.26, 95% CI: 1.57-17.71, P=0.007) and higher gestational age as protective ( OR=0.34, 95% CI: 0.15-0.78, P=0.012). Conclusions:ACS administration at 34 +0-36 +6 weeks demonstrated no significant benefits for preventing respiratory disorders in late preterm infants and did not increase risks of hypoglycemia or early-onset sepsis. Maternal glucose dysregulation and lower gestational age elevate respiratory morbidity risk in this population.

Objective To develop a risk prediction model for ischemic stroke in symptomatic intracranial atherosclerotic stenosis(ICAS)patients based on high-resolution magnetic resonance imaging(HR-MRI)and arterial spin labeling(ASL)imaging.Methods A total of 142 patients were included and divided into acute ischemic stroke(AIS)and transient ischemic attack(TIA)groups based on stroke occurrence.Clinical risk factors,plaque characteristics,and arterial transit artifact(ATA)presence on ASL images were compared between the two groups.Multivariate logistic regression analysis was performed,incorporating clinical risk factors,plaque characteristics,and double post labeling delay(PLD)ATA presence.The predictive value of different models was compared using receiver operating characteristic(ROC)curve and DeLong tests.Results Hypertension,positive lumen remodeling,plaque enhance-ment rate,1.5 s-ATA presence,and 2.5 s-ATA presence were independent risk factors for AIS(P＜0.05).The combination of HR-MRI and ASL imaging predicted AIS most effectively[area under the curve(AUC)=0.908;95％ confidence interval(CI)0.862-0.954].No significant difference was found between the prediction performances of HR-MRI and ASL(95％CI-0.041-0.082,Z=0.659,P=0.509).Conclusion ASL is more convenient than HR-MRI for predicting ischemic stroke in ICAS patients.A model combining plaque characteristics and ATA presence effectively predicts AIS occurrence.

Objective To investigate the protective effect of carvacrol(CAR)on high glucose(HG)-induced retinal ganglion cell(RGC)damage by regulating the protein kinase B(PKB,also known as Akt)/nuclear factor erythroid 2-relat-ed factor 2(Nrf2)signaling pathway.Methods The RGC-5 cells in the logarithmic growth phase were inoculated into 96-well cell culture plates with 4 × 104 cells/well and then treated with CAR(5.0 μmol·L-1,10.0 μmol·L-1,20.0 μmol·L-1,40.0 μmol·L-1,80.0 μmol·L-1,and 160.0 μmol·L-1)together with 30.0 mmol·L-1 glucose for 24 hours.Cell viability was detected by the 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT)assay to screen the ex-perimental concentration of CAR.Then,these RGC-5 cells were inoculated into 6-well plates and randomly assigned into the Control group,30.0 mmol·L-1 glucose(HG)group,low-,medium-,and high-concentration CAR groups(CAR-L group,CAR-M group,and CAR-H group),and high-concentration CAR+Nrf2 pathway inhibitor(ML385)group(CAR-H+ML385 group).Flow cytometry was used to detect the apoptosis of RGC-5 cells.The fluorescent probe was used to de-tect the level of oxidative stress in RGC-5 cells.The enzyme-linked immunosorbent assay(ELISA)was employed to detect the level of superoxide dismutase(SOD),lactate dehydrogenase(LDH),malondialdehyde(MDA),glutathione peroxidase(GSH-PX),and reactive oxygen species(ROS)in the supernatant of RGC-5 cells.Western blot was used to detect the ex-pression of proteins related to the Akt/Nrf2 signaling pathway.Results Compared with the HG group,the survival rate of RGC-5 cells increased significantly when the concentration of CAR was above 20.0 μmol·L-1(all P＜0.05).Therefore,20.0 μmol·L-1,40.0 μmol·L-1,and 80.0 μmol·L-1 of CAR were used for subsequent experiments.Compared with the Control group,the apoptosis rate of RGC-5 cells in the HG group increased significantly,the protein expression of Bax and Caspase-3 was up-regulated significantly,the level of interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),ROS,LDH,and MDA increased significantly,and the level of SOD and GSH-PX decreased significantly(all P＜0.05).Compared with the HG group,the apoptosis rate of RGC-5 cells in the CAR-L,CAR-M,and CAR-H groups de-creased significantly,the protein expression of Bax and Caspase-3 was down-regulated significantly,the level of IL-1β,IL-6,TNF-α,ROS,LDH,and MDA decreased significantly,and the level of SOD and GSH-PX increased significantly(all P＜0.05).Compared with the CAR-H group,the apoptosis rate of RGC-5 cells in the CAR-H+ML385 group increased signifi-cantly,the protein expression of Bax and Caspase-3 was up-regulated significantly,the level of IL-1β,IL-6,TNF-α,ROS,LDH,and MDA increased significantly,and the level of GSH-PX and SOD decreased significantly(all P＜0.05).Compared with the Control group,the p-Akt/Akt expression ratio and the relative expression level of Nrf2 in RGC-5 cells decreased significantly in the HG group(both P＜0.05).Compared with the HG group,the p-Akt/Akt expression ratio and the rela-tive expression level of Nrf2 in RGC-5 cells increased significantly in the CAR-L,CAR-M,and CAR-H groups(all P＜0.05).Compared with the CAR-H group,the p-Akt/Akt expression ratio and the relative expression level of Nrf2 decreased signifi-cantly in the CAR-H+ML385 group(both P＜0.05).Conclusion CAR may reduce the inflammatory response level in RGC-5 cells by activating the Akt/Nrf2 signaling pathway,thus inhibiting oxidative stress-related injury and apoptosis.

Objective To develop a risk prediction model for ischemic stroke in symptomatic intracranial atherosclerotic stenosis(ICAS)patients based on high-resolution magnetic resonance imaging(HR-MRI)and arterial spin labeling(ASL)imaging.Methods A total of 142 patients were included and divided into acute ischemic stroke(AIS)and transient ischemic attack(TIA)groups based on stroke occurrence.Clinical risk factors,plaque characteristics,and arterial transit artifact(ATA)presence on ASL images were compared between the two groups.Multivariate logistic regression analysis was performed,incorporating clinical risk factors,plaque characteristics,and double post labeling delay(PLD)ATA presence.The predictive value of different models was compared using receiver operating characteristic(ROC)curve and DeLong tests.Results Hypertension,positive lumen remodeling,plaque enhance-ment rate,1.5 s-ATA presence,and 2.5 s-ATA presence were independent risk factors for AIS(P＜0.05).The combination of HR-MRI and ASL imaging predicted AIS most effectively[area under the curve(AUC)=0.908;95％ confidence interval(CI)0.862-0.954].No significant difference was found between the prediction performances of HR-MRI and ASL(95％CI-0.041-0.082,Z=0.659,P=0.509).Conclusion ASL is more convenient than HR-MRI for predicting ischemic stroke in ICAS patients.A model combining plaque characteristics and ATA presence effectively predicts AIS occurrence.

Objective To investigate the protective effect of carvacrol(CAR)on high glucose(HG)-induced retinal ganglion cell(RGC)damage by regulating the protein kinase B(PKB,also known as Akt)/nuclear factor erythroid 2-relat-ed factor 2(Nrf2)signaling pathway.Methods The RGC-5 cells in the logarithmic growth phase were inoculated into 96-well cell culture plates with 4 × 104 cells/well and then treated with CAR(5.0 μmol·L-1,10.0 μmol·L-1,20.0 μmol·L-1,40.0 μmol·L-1,80.0 μmol·L-1,and 160.0 μmol·L-1)together with 30.0 mmol·L-1 glucose for 24 hours.Cell viability was detected by the 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT)assay to screen the ex-perimental concentration of CAR.Then,these RGC-5 cells were inoculated into 6-well plates and randomly assigned into the Control group,30.0 mmol·L-1 glucose(HG)group,low-,medium-,and high-concentration CAR groups(CAR-L group,CAR-M group,and CAR-H group),and high-concentration CAR+Nrf2 pathway inhibitor(ML385)group(CAR-H+ML385 group).Flow cytometry was used to detect the apoptosis of RGC-5 cells.The fluorescent probe was used to de-tect the level of oxidative stress in RGC-5 cells.The enzyme-linked immunosorbent assay(ELISA)was employed to detect the level of superoxide dismutase(SOD),lactate dehydrogenase(LDH),malondialdehyde(MDA),glutathione peroxidase(GSH-PX),and reactive oxygen species(ROS)in the supernatant of RGC-5 cells.Western blot was used to detect the ex-pression of proteins related to the Akt/Nrf2 signaling pathway.Results Compared with the HG group,the survival rate of RGC-5 cells increased significantly when the concentration of CAR was above 20.0 μmol·L-1(all P＜0.05).Therefore,20.0 μmol·L-1,40.0 μmol·L-1,and 80.0 μmol·L-1 of CAR were used for subsequent experiments.Compared with the Control group,the apoptosis rate of RGC-5 cells in the HG group increased significantly,the protein expression of Bax and Caspase-3 was up-regulated significantly,the level of interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),ROS,LDH,and MDA increased significantly,and the level of SOD and GSH-PX decreased significantly(all P＜0.05).Compared with the HG group,the apoptosis rate of RGC-5 cells in the CAR-L,CAR-M,and CAR-H groups de-creased significantly,the protein expression of Bax and Caspase-3 was down-regulated significantly,the level of IL-1β,IL-6,TNF-α,ROS,LDH,and MDA decreased significantly,and the level of SOD and GSH-PX increased significantly(all P＜0.05).Compared with the CAR-H group,the apoptosis rate of RGC-5 cells in the CAR-H+ML385 group increased signifi-cantly,the protein expression of Bax and Caspase-3 was up-regulated significantly,the level of IL-1β,IL-6,TNF-α,ROS,LDH,and MDA increased significantly,and the level of GSH-PX and SOD decreased significantly(all P＜0.05).Compared with the Control group,the p-Akt/Akt expression ratio and the relative expression level of Nrf2 in RGC-5 cells decreased significantly in the HG group(both P＜0.05).Compared with the HG group,the p-Akt/Akt expression ratio and the rela-tive expression level of Nrf2 in RGC-5 cells increased significantly in the CAR-L,CAR-M,and CAR-H groups(all P＜0.05).Compared with the CAR-H group,the p-Akt/Akt expression ratio and the relative expression level of Nrf2 decreased signifi-cantly in the CAR-H+ML385 group(both P＜0.05).Conclusion CAR may reduce the inflammatory response level in RGC-5 cells by activating the Akt/Nrf2 signaling pathway,thus inhibiting oxidative stress-related injury and apoptosis.

Objective:To investigate the impact of antenatal corticosteroid (ACS) exposure on neonatal outcomes in late preterm infants.Methods:This retrospective cohort study analyzed 406 late preterm infants (gestational age 34 +0-36 +6 weeks) born at Tongji University Affiliated Dongfang Hospital between January 2021 and June 2024. Participants were divided into ACS-exposed ( n=254) and control ( n=152) groups. Maternal characteristics, neonatal profiles, and outcomes [respiratory disorders (respiratory distress syndrome, respiratory failure, bronchopulmonary dysplasia), neonatal hypoglycemia, and early-onset sepsis] were compared. And they were stratified by plurality (154 twins, 252 singletons) and gestational age (96 at 34 +0-34 +6 weeks; 111 at 35 +0-35 +6 weeks; 199 at 36 +0-36 +6 weeks), the effects of ACS exposure on neonatal outcomes were analyzed. Late preterm infants were also divided into affected ( n=13) and unaffected ( n=393) groups according to whether they had respiratory disorders, and the risk factors of respiratory disorders were analyzed. Statistical methods included independent t-test, Mann-Whitney U, Chi-square test, and multivariate logistic regression. Results:The ACS-exposed group exhibited significantly higher rates of assisted reproductive technology conception [53.1% (135/254) vs. 37.5% (57/152), χ2=9.37], twin pregnancy [43.3% (110/254) vs. 28.9% (44/152), χ2=6.84], cesarean delivery [83.5% (212/254) vs. 66.4% (101/152), χ2=15.66], and neonatal intensive care unit admission than those in the control group [59.1% (150/254) vs. 40.8% (62/152), χ2=12.61] (all P<0.05). No significant differences emerged between ACS-exposed and control groups in respiratory disorders [3.1% (8/254) vs. 3.3% (5/152), χ2=0.01], early-onset sepsis [1.6% (4/254) vs. 1.3% (2/152), χ2=0.71], or neonatal hypoglycemia [1.6% (4/254) vs. 1.3% (2/152), χ2=0.71] (all P>0.05). Stratified analyses by plurality or gestational age strata revealed no significant differences in respiratory disorders, early-onset sepsis or neonatal hypoglycemia between ACS-exposed and control groups (all P>0.05). Multivariate logistic regression identified ACS exposure as non-protective against respiratory disorders ( OR=0.37, 95% CI: 0.10-1.39, P=0.144), with maternal glucose metabolism disorders (pre-gestational/gestational diabetes) as a risk factor ( OR=5.26, 95% CI: 1.57-17.71, P=0.007) and higher gestational age as protective ( OR=0.34, 95% CI: 0.15-0.78, P=0.012). Conclusions:ACS administration at 34 +0-36 +6 weeks demonstrated no significant benefits for preventing respiratory disorders in late preterm infants and did not increase risks of hypoglycemia or early-onset sepsis. Maternal glucose dysregulation and lower gestational age elevate respiratory morbidity risk in this population.

Objective To identify the current research hotspots of global health training, and construct a global health talent training evaluation index system. Methods Publications pertaining to global health talent training evaluation were retrieved in China National Knowledge Infrastructure, Wanfang Database, and Web of Science Core Collection from 2003 to 2022, and keywords were extracted from eligible publications for co-occurrence and cluster analyses using the CiteSpace software. Based on keywords clustering results, a global health talent training evaluation index system was constructed using a context, input, process, and product (CIPP) evaluation model as a theoretical framework. Results A total of 692 Chinese publications and 1 264 English publications were included. Keyword co-occurrence and cluster analyses yielded 10 Chinese and 10 English keyword clusters, and the 10 Chinese keyword clusters included analytic hierarchy process, health diplomacy, personnel structure, crossdiscipline, educational assessment, global health discipline development, training needs, curriculum program, quality evaluation and logistics support, while the English keyword clusters included evidence-based practice, capacity building, global health, quality of life, machine learning, leadership, sub-Saharan Africa, health equity, global health security and global health diplomacy. Based on keyword clustering, a global health talent training evaluation index system was constructed with CIPP as the theoretical framework, which contained 4 primary indicators, 15 secondary indicators and 59 tertiary indicators, and the primary indicators included 4 dimensions of context evaluation, input evaluation, process evaluation and product evaluation. Conclusions A global health talent training evaluation index system has been constructed, which provides an effective evaluation tool and quantitative evidence for future global health talent training.

Objective:To construct and test the reliability and validity of an assessment scale for self-management of patients with dry eye, so as to help patients establish dry eye related health behaviors.Methods:Based on the knowledge attitude and practice theory, the initial scale was constructed on the basis of literature review and qualitative interview, and revised through Delphi expert consultation and expert argumentation. After the preliminary investigation, 211 dry eye patients treated in the dry eye nursing outpatient department of Beijing Tongren Hospital from August 2023 to January 2024 were selected by convenience sampling method for questionnaire investigation to test the reliability and validity of the scale.Results:Among 211 dry eye patients, there were 58 males and 153 females, aged (39.31 ± 12.81) years old. The scale of self-management of patients with dry eye included 27 items in 3 dimensions: knowledge, attitude and behavior. The authority coefficient of the two rounds of expert consultation was 0.86, and the Kendall coordination index increased from 0.175 to 0.223 (both P < 0.01). The cumulative variance contribution rates of the three dimensions were 41.843%, 54.219% and 44.273%, respectively. The Cronbach α coefficient of the scale was 0.787, and the Spearman-Brown coefficient was 0.641. Conclusions:The scale of self-management of patients with dry eye has good reliability and validity and can be used in the assessment of dry eye patients to provide a reference basis for targeted guidance and intervention.

The many-banded krait, Bungarus multicinctus, has been recorded as the animal resource of JinQianBaiHuaShe in the Chinese Pharmacopoeia. Characterization of its venoms classified chief phyla of modern animal neurotoxins. However, the evolutionary origin and diversification of its neurotoxins as well as biosynthesis of its active compounds remain largely unknown due to the lack of its high-quality genome. Here, we present the 1.58 Gbp genome of B. multicinctus assembled into 18 chromosomes with contig/scaffold N50 of 7.53 Mbp/149.8 Mbp. Major bungarotoxin-coding genes were clustered within genome by family and found to be associated with ancient local duplications. The truncation of glycosylphosphatidylinositol anchor in the 3'-terminal of a LY6E paralog released modern three-finger toxins (3FTxs) from membrane tethering before the Colubroidea divergence. Subsequent expansion and mutations diversified and recruited these 3FTxs. After the cobra/krait divergence, the modern unit-B of β-bungarotoxin emerged with an extra cysteine residue. A subsequent point substitution in unit-A enabled the β-bungarotoxin covalent linkage. The B. multicinctus gene expression, chromatin topological organization, and histone modification characteristics were featured by transcriptome, proteome, chromatin conformation capture sequencing, and ChIP-seq. The results highlighted that venom production was under a sophisticated regulation. Our findings provide new insights into snake neurotoxin research, meanwhile will facilitate antivenom development, toxin-driven drug discovery and the quality control of JinQianBaiHuaShe.