BACKGROUND:Sarcopenia is an age-related systemic skeletal muscle disease,which is associated with a variety of adverse outcomes such as falls,functional decline,frailty,and death.Postmenopausal women are one of the high-risk groups for sarcopenia.OBJECTIVE:To develop a predictive model for assessing the risk of sarcopenia in Chinese postmenopausal women based on high-quality database.METHODS:Data for this study were derived from 2 370 postmenopausal women from the China Health and Retirement Longitudinal Study(CHARLS),and sarcopenia was assessed using the Asian Working Group on Sarcopenia 2019(AWGS2019)recommended metrics.The study cohort was randomized into a training set(70％)and a validation set(30％).Risk factors for sarcopenia in postmenopausal women were screened using the least absolute shrinkage and selection operator,ten-fold cross-validation,and logistic regression.Nomogram predicting the risk of sarcopenia in postmenopausal women was constructed based on the risk factors,and the model efficacy was evaluated by the receiver operating characteristic curve and area under the curve(AUC),calibration curve,and decision curve analysis.RESULTS AND CONCLUSION:The prevalence of sarcopenia in this study was 23.50％and age,place of residence,sleep quality,cognitive function,depression,and the number of chronic diseases were selected as predictors of sarcopenia in postmenopausal women.The nomogram model showed good discrimination between the training and validation sets,with an AUC value of 0.751(95％confidence interval=0.724-0.778,P＜0.001),a specificity of 72.2％,and a sensitivity of 63.2％in the training set,and an AUC value of 0.763(95％confidence interval=0.721-0.805,P＜0.001),with a specificity of 69.6％and a sensitivity of 70.8％.The calibration curve showed a relatively significant agreement between the nomogram model and the actual observations,and the decision curve analysis demonstrated broad and good clinical utility.To conclude,the nomogram to assess the risk of sarcopenia constructed based on age,place of residence,sleep quality,cognitive function,depression,and number of chronic diseases,provides an effective tool for identifying and eliminating risk factors for sarcopenia in Chinese postmenopausal women,and helps to reduce the incidence of sarcopenia.

BACKGROUND:Sarcopenia is an age-related systemic skeletal muscle disease,which is associated with a variety of adverse outcomes such as falls,functional decline,frailty,and death.Postmenopausal women are one of the high-risk groups for sarcopenia.OBJECTIVE:To develop a predictive model for assessing the risk of sarcopenia in Chinese postmenopausal women based on high-quality database.METHODS:Data for this study were derived from 2 370 postmenopausal women from the China Health and Retirement Longitudinal Study(CHARLS),and sarcopenia was assessed using the Asian Working Group on Sarcopenia 2019(AWGS2019)recommended metrics.The study cohort was randomized into a training set(70％)and a validation set(30％).Risk factors for sarcopenia in postmenopausal women were screened using the least absolute shrinkage and selection operator,ten-fold cross-validation,and logistic regression.Nomogram predicting the risk of sarcopenia in postmenopausal women was constructed based on the risk factors,and the model efficacy was evaluated by the receiver operating characteristic curve and area under the curve(AUC),calibration curve,and decision curve analysis.RESULTS AND CONCLUSION:The prevalence of sarcopenia in this study was 23.50％and age,place of residence,sleep quality,cognitive function,depression,and the number of chronic diseases were selected as predictors of sarcopenia in postmenopausal women.The nomogram model showed good discrimination between the training and validation sets,with an AUC value of 0.751(95％confidence interval=0.724-0.778,P＜0.001),a specificity of 72.2％,and a sensitivity of 63.2％in the training set,and an AUC value of 0.763(95％confidence interval=0.721-0.805,P＜0.001),with a specificity of 69.6％and a sensitivity of 70.8％.The calibration curve showed a relatively significant agreement between the nomogram model and the actual observations,and the decision curve analysis demonstrated broad and good clinical utility.To conclude,the nomogram to assess the risk of sarcopenia constructed based on age,place of residence,sleep quality,cognitive function,depression,and number of chronic diseases,provides an effective tool for identifying and eliminating risk factors for sarcopenia in Chinese postmenopausal women,and helps to reduce the incidence of sarcopenia.

Objective To summarize and statistically analyze the automatic monitoring data of environmental gamma dose rates in Beijing, 2020-2024, identify the main influencing factors of the monitoring data, and inform management decisions and public services. Methods A statistical analysis was performed using data collected from national automatic radiation environment monitoring stations. Results For five environmental monitoring stations, the annual mean gamma dose rates from 2020 to 2024 ranged from 60.9 to 90.3 nGy/h. The overall annual mean was 71.4 nGy/h, with a standard deviation of 11.3 nGy/h. All values were within the range of statistical fluctuations of the local natural background radiation. The gamma dose rates of monitoring stations followed the order of E > A > D > B > C. Conclusion The gamma radiation levels at all monitoring stations were stable, and the monitoring results were closely related to their surrounding environments.

Background and aims:Radiofrequency ablation(RFA)is the first-line treatment for early-stage hepato-cellular carcinoma(HCC).However,recurrence after curative RFA remains a significant challenge for HCC patients.Although RFA induces an immune response,the anti-tumor effect is often limited by the immunosuppressive tumor microenvironment.Enhancing anti-tumor immunity is essential to improve treatment efficacy and prevent recurrence.In this study,we explore the efficacy and underlying mechanisms of the combination of RFA and anti-PD-1 in suppressing abscopal and recurrent tumors.Methods:We established a bilateral subcutaneous HCC mouse model and performed complete RFA on the right-flank tumor.Anti-PD-1 or anti-IgG was administered post-RFA.Tumor growth,immune cell profiles,and molecular pathways were assessed using flow cytometry,immunohistochemistry staining,RNA-sequencing,and Western blot.Chemokines released by the tumor were detected by ELISA.An in vivo tumor rechallenge experiment was performed after a complete tumor regression to evaluate the immune memory induced by the RFA+anti-PD-1 treatment.Results:RFA combined with anti-PD-1 significantly suppressed abscopal tumor growth and prolonged survival.Compared with RFA monotherapy,the infiltration of CD8+T cells and dendritic cells was sig-nificantly increased in the combined treatment group,while PMN-MDSCs were markedly reduced.Mechanistically,the chemokine signaling pathway and JAK-STAT signaling pathway were activated in the tumor of the RFA+anti-PD-1 group with upregulation of CXCL10 to recruit CD8+T cells.In addition,the combination therapy induced durable immune memory that inhibited rechallenge tumor outgrowth.Conclusions:Our study discovered that RFA combined with anti-PD-1 induced anti-tumor immunity to inhibit abscopal tumors and durable immune memory to prevent recurrence,suggesting RFA+anti-PD-1 as a potential therapeutic strategy for multifocal HCC and preventing recurrence.

[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 explore the application value of dynamic airway computed tomography(DACT)based on retrospective ECG-gating technology in the diagnosis of cardiovascular-related airway stenosis.Methods A retrospective analysis was performed on the bronchoscopy and DACT data of 48 children clinically suspected of having congenital heart disease(CHD)or cardiovascular-related airway stenosis.The image quality of DACT was assessed,and the accuracy differences in diagnosing airway abnormalities between bronchoscopy and DACT were compared.The correlation between DACT and bronchoscopy in diagnosing the degree of airway steno-sis was also evaluated.Results The DACT image quality met diagnostic requirements for all children.There was no significant statistical difference in the diagnosis of airway abnormalities between DACT based on retrospective ECG-gating technology and bronchoscopy.A good correlation was observed between DACT and bronchoscopy in the grading of tracheal stenosis.Conclusion DACT based on retrospective ECG-gating technology can effectively address the issue of motion artifacts in CT scans among infants and young children.It has certain value in clarifying the diagnosis of cardiovascular-related airway stenosis,guiding treatment,and assessing prognosis.

BACKGROUND:Osteonecrosis is an orthopedic disease that severely limits joint function,with complex pathogenesis involving multiple risk factors.Cathepsins,as a class of enzymes that play a key role in bone metabolism,are closely related to the proliferation,differentiation of bone cells,and remodeling of the bone matrix.However,previous studies have mostly focused on descriptive analyses,lacking direct evidence of causal relationships.OBJECTIVE:To clarify the potential causal relationship between cathepsins and osteonecrosis and to explore their possible mechanisms by analyzing large-scale sample data from the FinnGen database.METHODS:We obtained osteonecrosis-related data from the FinnGen database,including R9(a total of 359 399 samples:1 385 cases and 358 014 controls)and R10 versions(a total of 392 580 samples:1 543 cases and 391 037 controls).Single nucleotide polymorphisms associated with nine cathepsins(cathepsin B,E,F,G,H,O,S,L2,and Z)were acquired from a previous study(3 301 individuals).Univariate Mendelian randomization,reverse univariate Mendelian randomization,and multivariate Mendelian randomization analyses were conducted using the inverse variance weighted method,MR-Egger method,weighted median method,simple mode method,and weighted mode method.Initially,Mendelian randomization analysis was performed using osteonecrosis data from R9.Additionally,sensitivity analyses were conducted using Cochran's Q test,MR-Egger intercept,MR-PRESSO global test,and leave-one-out analysis to check for horizontal pleiotropy and heterogeneity.Subsequently,a validation analysis study was carried out on the R10 dataset,and a meta-analysis was conducted to combine the two datasets to explore the joint effect.RESULTS AND CONCLUSION:Univariate Mendelian randomization analysis results showed that higher levels of cathepsin B were significantly associated with a reduced risk of osteonecrosis(inverse variance weighted:odds ratio(OR)=0.865,95％confidence interval(CI):0.762-0.982,P=0.025),and no reverse causal relationship was found between the nine cathepsins and osteonecrosis(P＞0.05).These associations were validated by meta-analysis.Multivariate analysis,using the nine cathepsins as covariates,revealed a reverse causal relationship between the levels of cathepsin Band the risk of osteonecrosis(inverse variance weighted:OR=0.8710,95％CI:0.761-0.997,P=0.045),consistent with the results before adjustment.Sensitivity analyses based on heterogeneity and horizontal pleiotropy suggested that the results were relatively robust.This study suggests that there is a causal relationship between high levels of cathepsin B and the reduced risk of osteonecrosis,and it may serve as a biomarker for osteonecrosis,providing new directions and insights for the diagnosis and treatment of osteonecrosis.Although this study is based on data analysis of European populations,these findings have important implications for Chinese biomedical research,especially in understanding disease mechanisms,developing biomarkers,and formulating treatment strategies.They also encourage similar studies conducted on Chinese populations to explore the impact of racial and genetic background differences on the occurrence of osteonecrosis.

BACKGROUND:Previous studies by the research group have shown that core proteoglycan in Cornus Cervi Col la can enter the bone,promote the proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells,and has a good repair effect on steroid-induced osteonecrosis of the femoral head.OBJECTIVE:To investigate the therapeutic effect and potential mechanism of Cornus Cervi Colla on steroid-induced osteonecrosis of the femoral head in rats by fecal non-targeted fecal metabolomics.METHODS:Thirty SD rats were randomly divided into three groups using a random number table method:the control group(n=10)was injected with normal saline into the right gluteal muscle(injected on the first 3 days of each week for 3 consecutive weeks),and was given pure water gavage(once a day for 6 consecutive weeks).The model group(n=10)was injected with methylprednisolone sodium succinate into the right gluteal muscle(injected on the first 3 days of each week for 3 consecutive weeks)to establish a steroid-induced osteonecrosis of the femoral head model,and was given pure water gavage(once a day for 6 consecutive weeks).The Cornus Cervi Co I la group(n=10)was also established with a steroid-induced osteonecrosis of the femoral head model,and was given Cornus Cervi Col la gavage(once a day for 6 consecutive weeks).After gavage,cecal feces and femoral heads were collected for fecal metabolomics analysis and bone tissue Micro-CT and hematoxylin-eosin staining,respectively.RESULTS AND CONCLUSION:(1)Metabolomics analysis results showed that there were 233 differential metabolites between the Cornus Cervi Col la and model groups,with 65 significantly differing and clearly annotated metabolites.Lipid and amino acid metabolites were significantly increased,with bile acids,sulfated steroids,ephedrine,hypoxanthine,betaine,L-carnitine,B-mouse bile acid,cytidine,4-pyridoxic acid,taurine,N-acetyl-d-glucosamine,and butyric acid being the most impacted(variable weight value VIP＞5).The metabolic pathways of taurine and hypotaurine were crucial in the metabolic regulatory network(pathway impact=0.428 57).(2)Micro-CT scanning results of bone tissue showed that the femoral heads of rats in the model group and the Cornus Cervi Col la group had different degrees of damage;the femoral head contour was irregular;the trabeculae in the subchondral bone of the femoral head were missing and disordered,and some cystic structures were visible.Compared with the model group,the degree of trabecular damage in the rats of the Cornus Cervi Colla group was milder.Hematoxylin-eosin staining results showed that the trabeculae in the subchondral bone of the femoral heads of rats in the model group and the Cornus Cervi Colla group were sparse or interrupted,and the empty bone lacuna rate and adipocyte invasion were increased.Compared with the model group,the empty bone lacuna rate and adipocyte invasion in the subchondral bone of the femoral heads of rats in the Cornus Cervi Colla group were reduced.(3)These results conclude that Cornus Cervi Colla potentially mitigates steroid-induced osteonecrosis of the femoral head through the metabolic processes involving taurine and associated pathways.

Objective To explore the application value of dynamic airway computed tomography(DACT)based on retrospective ECG-gating technology in the diagnosis of cardiovascular-related airway stenosis.Methods A retrospective analysis was performed on the bronchoscopy and DACT data of 48 children clinically suspected of having congenital heart disease(CHD)or cardiovascular-related airway stenosis.The image quality of DACT was assessed,and the accuracy differences in diagnosing airway abnormalities between bronchoscopy and DACT were compared.The correlation between DACT and bronchoscopy in diagnosing the degree of airway steno-sis was also evaluated.Results The DACT image quality met diagnostic requirements for all children.There was no significant statistical difference in the diagnosis of airway abnormalities between DACT based on retrospective ECG-gating technology and bronchoscopy.A good correlation was observed between DACT and bronchoscopy in the grading of tracheal stenosis.Conclusion DACT based on retrospective ECG-gating technology can effectively address the issue of motion artifacts in CT scans among infants and young children.It has certain value in clarifying the diagnosis of cardiovascular-related airway stenosis,guiding treatment,and assessing prognosis.

BACKGROUND:Osteonecrosis is an orthopedic disease that severely limits joint function,with complex pathogenesis involving multiple risk factors.Cathepsins,as a class of enzymes that play a key role in bone metabolism,are closely related to the proliferation,differentiation of bone cells,and remodeling of the bone matrix.However,previous studies have mostly focused on descriptive analyses,lacking direct evidence of causal relationships.OBJECTIVE:To clarify the potential causal relationship between cathepsins and osteonecrosis and to explore their possible mechanisms by analyzing large-scale sample data from the FinnGen database.METHODS:We obtained osteonecrosis-related data from the FinnGen database,including R9(a total of 359 399 samples:1 385 cases and 358 014 controls)and R10 versions(a total of 392 580 samples:1 543 cases and 391 037 controls).Single nucleotide polymorphisms associated with nine cathepsins(cathepsin B,E,F,G,H,O,S,L2,and Z)were acquired from a previous study(3 301 individuals).Univariate Mendelian randomization,reverse univariate Mendelian randomization,and multivariate Mendelian randomization analyses were conducted using the inverse variance weighted method,MR-Egger method,weighted median method,simple mode method,and weighted mode method.Initially,Mendelian randomization analysis was performed using osteonecrosis data from R9.Additionally,sensitivity analyses were conducted using Cochran's Q test,MR-Egger intercept,MR-PRESSO global test,and leave-one-out analysis to check for horizontal pleiotropy and heterogeneity.Subsequently,a validation analysis study was carried out on the R10 dataset,and a meta-analysis was conducted to combine the two datasets to explore the joint effect.RESULTS AND CONCLUSION:Univariate Mendelian randomization analysis results showed that higher levels of cathepsin B were significantly associated with a reduced risk of osteonecrosis(inverse variance weighted:odds ratio(OR)=0.865,95％confidence interval(CI):0.762-0.982,P=0.025),and no reverse causal relationship was found between the nine cathepsins and osteonecrosis(P＞0.05).These associations were validated by meta-analysis.Multivariate analysis,using the nine cathepsins as covariates,revealed a reverse causal relationship between the levels of cathepsin Band the risk of osteonecrosis(inverse variance weighted:OR=0.8710,95％CI:0.761-0.997,P=0.045),consistent with the results before adjustment.Sensitivity analyses based on heterogeneity and horizontal pleiotropy suggested that the results were relatively robust.This study suggests that there is a causal relationship between high levels of cathepsin B and the reduced risk of osteonecrosis,and it may serve as a biomarker for osteonecrosis,providing new directions and insights for the diagnosis and treatment of osteonecrosis.Although this study is based on data analysis of European populations,these findings have important implications for Chinese biomedical research,especially in understanding disease mechanisms,developing biomarkers,and formulating treatment strategies.They also encourage similar studies conducted on Chinese populations to explore the impact of racial and genetic background differences on the occurrence of osteonecrosis.