Objective: To characterize longitudinal trajectories of testicular development in boys and breast development in girls, so as to provide reference data for understanding patterns of pubertal sexual maturation. Methods: Based on the Shanghai Pudong New Area Cohort Study on Growth, Development and Health in Children and Adolescents, a baseline survey was conducted in 2020 using a mult stage cluster random sampling method. A total of 2 184 children who completed all follow ups during the primary school period from 13 elementary schools in Pudong New Area,Shanghai,with annual follow ups during 2021-2025. Testicular volume and Tanner stage of breast development were assessed by professional physicians using standardized visual inspection and palpation. The age distribution of testicular volume and breast development was fitted by using cumulative link mixed models and Turnbull s nonparametric maximum likelihood estimation method. Results: Median ages for testicular volumes of 2, 3, 4 and 5 mL in boys were 7.07, 9.24, 10.29, and 11.57 years old, respectively. Median ages for Tanner breast stages Ⅱ, Ⅲ, Ⅳ, and Ⅴ in girls were 8.55 , 10.17, 11.18, and 13.78 years old, respectively. Based on overweight and obesity, stratified analysis showed that earlier pubertal onset among overweight/obesity children, and the key milestones for pubertal initiation were testicular volume reaching 4 mL in boys and breast Tanner II in girls for 10.29, 10.83; 8.18, 9.00 years. Conclusion Overweight and obesity are associated with earlier pubertal initiation,but there are certain gender and developmental stage specific patterns.

Diabetic nephropathy（DN） is a common and severe microvascular complication of diabetes. In recent years， the classical herbal formula Shenqi dihuang decoction has demonstrated unique advantages in the clinical treatment of DN. This article conducts a systematic review of the mechanisms of action and clinical applications of Shenqi dihuang decoction in the treatment of DN. It reveals that the mechanism by which this formula improves DN involves multi-target synergistic regulation. For instance, Shenqi dihuang decoction exerts multiple pharmacological effects by regulating signaling pathways including phosphatidy linostiol 3-kinase/protein kinase B， AMP-activated protein kinase/silent information regulator 1/forkhead box O1， and nuclear factor erythroid 2-related factor 2/heme oxygenase-1 pathways.These effects include regulating glucose and lipid metabolism， inhibiting oxidative stress， reducing inflammation， improving insulin resistance， modulating cell death （apoptosis/autophagy/ferroptosis/pyroptosis）， and preventing renal fibrosis. Existing clinical studies indicate that Shenqi dihuang decoction and its modified formulas， alone or in combination with other therapeutic methods， can significantly improve glucose and lipid metabolism， reduce proteinuria， and delay renal function decline in patients with DN. These effects are superior to those of Western medicines such as irbesartan， valsartan， and empagliflozin， and the treatment demonstrates good safety. Future research should leverage systems biology and artificial intelligence technologies to further elucidate the integrated mechanisms in the treatment of DN by Shenqi dihuang decoction， thereby advancing the precision and standardization of its clinical application.

This article reports a rare case of autoinflammatory disease presenting initially with skin induration and swelling after trauma as the initial manifestation, followed by progressive limb weakness. The patient was a middle-aged female who developed skin induration and swelling after trauma, which gradually progressed to limb weakness, dysarthria and bilateral facial paralysis, accompanied by livedo reticularis of the lower extremities, diffuse skin induration of the limbs, and beaded subcutaneous nodules in the right upper limb. The patient had a susceptibility to infection since childhood and a history of chronic livedo reticularis. Skin pathological examination revealed panniculitis. A comprehensive etiological screening for special infections and autoimmune diseases was completed with an unremarkable results, and whole-exome sequencing showed no abnormal findings. Following a multidisciplinary discussion combined with RNA sequencing results, the patient was diagnosed with an autoinflammatory disease, with a suspected type Ⅰ interferonopathy. Treatment with tofacitinib resulted in gradual improvement of clinical symptoms. This case highlights the importance of detailed medical history collection, systematic physical examination and multidisciplinary collaborative diagnosis and treatment, and underscores the pivotal role of molecular diagnosis in the confirmation of rare diseases. It can provide a reference for the clinical diagnosis and management of similar rare cases.

Objective:To fine-tune the mT5 (massively multilingual pre-trained text-to-text transformer) large language model, automatically generate report conclusions for teaching purposes from chest CT image descriptions, and assess the quality of automatically generated conclusions.Methods:The training set included 3 000 high-quality physical examination chest CT reports from one hospital, and the external validation set consisted of 600 physical examination chest CT reports from two other hospitals. Experienced radiology teaching physicians assessed the consistency between the generated conclusions and the original physician-written conclusions in the external validation set using a 5-point Likert scale across five linguistic indicators (correctness of examination information, correctness of lesion detection, standardization of terminology, applicability of the conclusions, and simplicity of conclusions). Using the original report conclusions as the reference, the accuracy of the conclusions generated based on the external validation set in describing four major thoracic conditions (pulmonary nodules, pneumonia, emphysema, pleural effusion) was evaluated. Perform chi square test using SPSS 25.0.Results:In the external validation set, the mean consistency score between the generated conclusions and the original conclusions given by the radiology teaching physicians was >4 points, indicating agreement with the original conclusions. In the generated conclusions, the description of the four major thoracic conditions demonstrated 0.95-1.00 (95% CI=0.91-1.00) accuracy, 0.76-1.00 (95% CI=0.59-1.00) sensitivity, and 0.97-1.00 (95% CI=0.91-1.00) specificity. Conclusions:The chest CT report conclusion generation system based on the mT5 large language model demonstrated high accuracy and is expected to provide immediate and efficient automated guidance for standardized residency training.

This study is to explore the antibiofilm activity of tirapazamine(TPZ)against Salmonella and the mechanism of inhibiting biofilm formation.In this study,crystal violet staining was used to determine the effect of TPZ on the minimal biofilm inhibitory concentration(MBIC)of Salmonel-la and on the development stage of Salmonella biofilm.The effects of TPZ on bacteria and biofilm of Salmonella were observed by scanning electron microscope and fluorescence microscope.Phe-nol-sulfuric acid method,spectrophotometer and BCA method were used to detect the effects of the bacteria on the content of main extracellular matrix of Salmonella.The autocoagulation and hydro-phobicity of Salmonella were measured and their effects on the cell wall of Salmonella were meas-ured by AKP method.The result showed that the MBIC value of TPZ on Salmonella ATCC 14028 was 1.563 μmol/L,it had destructive effects on both Salmonella bacteria and mature biofilm structure,it inhibited the formation of early Salmonella biofilm in a concentration-dependent manner,and inhibited the synthesis and secretion of extracellular polymers in Salmonella biofilm.The autoagglutination ability,hydrophobicity and cell wall integrity of Salmonella were affected.To sum up,the TPZ may inhibit the formation of a large number of Salmonella biofilms in the early stage of biofilm development by affecting the extracellular polymer and cell agglutination a-bility,which is expected to be a potential candidate drug against biofilm infection and provide a new idea for finding alternative antibiotics.

Objective To investigate whether Dauricine(Dau)can ameliorate acute kidney injury induced by renal ischemia-reperfusion(IR)in mice.Methods C57BL/6 mice were randomly assigned to three experimental groups:sham operation,ischemia-reperfusion injury(IRI),and IRI treated with daunorubicin(IRI+Dau),with 12 animals in each group.Following oral administration of Dau(15 mg/kg),renal ischemia-reperfusion was induced,and blood and kidney tissue samples were collected 24 hours post-surgery.Histopathological changes were assessed using hematoxylin and eosin(HE)staining.Renal function was evaluated by measuring serum creatinine and blood urea nitrogen(BUN)levels.Protein expression related to lipid peroxidation was analyzed using western blotting and immunofluorescence.Inflammatory gene expression was determined via quantitative polymerase chain reaction(qPCR).Nuclear translocation of nuclear factor κB(NF-κB),a key inflammatory marker,was assessed using immu-nofluorescence.Statistical comparisons between groups were performed using t-tests.Results The administration of Dau significantly ameliorated IR-induced acute kidney injury compared to the Sham group.Serum creatinine(P<0.001)and urea nitrogen(P<0.000 1)levels were markedly decreased in Dau-treated mice relative to those in the IRI group.Furthermore,Dau significantly suppressed lipid peroxide production in renal tissues(P<0.001),without significantly affecting the expression levels of Gpx4(P=0.919)and Acsl4(P=0.086),two key proteins involved in lipid peroxidation.In addition,Dau effectively inhibited IR-induced nuclear translocation of NF-κB(P<0.001)and reduced apoptosis in kidney cells(P=0.004).Conclusion Dau mitigates IR-induced kidney damage by reducing the accumulation of lipid peroxides and inhibiting the nuclear translocation of NF-κB,thereby attenuating inflammation and renal cell apoptosis.

Objective:To explore the role and mechanism of serum response factor (SRF) and lncRNA FGD5-AS1 in lung adenocarcinoma (LUAD).Methods:The plasma and tissue wax of LUAD patients treated in Tangshan People's Hospital from 2020 to 2022 and the plasma of healthy people were collected. The expression of SRF in LUAD tissues and cells, and the expression of lncRNA FGD5-AS1 in LUAD tissues, plasma and cells were detected by quantitative real-time polymerase chain reaction (qRT-PCR). The expression levels of SRF and lncRNA FGD5-AS1 in LUAD tissue microarray were detected by immunohistochemistry and in situ hybridization. LUAD cells A549, H1299 and H1975 were cultured in vitro and divided into si-NC and si-SRF groups, si-NC and si-lncRNA FGD5-AS1 groups, pcDNA3.1 and lncRNA FGD5-AS1 groups, si-NC+pcDNA3.1/si-SRF+pcDNA3.1/si-SRF+lncRNA FGD5-AS1 groups. The effects of the above groups on the proliferation, invasion and migration of LUAD cells were detected by CCK-8, cloning formation, EdU, Transwell and scratch test. The JASPAR database was used to predict the downstream lncRNA FGD5-AS1 that can be regulated by SRF; double luciferase experiment, chromatin Immunoprecipitation (CHIP) and electrophoretic mobility shift assay (EMSA) experiment were used to verify the regulatory effect between SRF and lncRNA FGD5-AS1, and the subcutaneous tumorigenesis experiment in nude mice was used to detect the effects of cells that stably knock down SRF and stably overexpress lncRNA FGD5-AS1 on the growth of transplanted tumors. Results:The results of immunohistochemistry showed that the mean optical density of SRF in LUAD tissues (1.49±0.33) was higher than that in adjacent tissues (1.00±0.00, P＜0.001). The expression level of SRF in paraffin tissues of LUAD patients was higher than that in normal tissues adjacent to cancer ( P=0.037). CCK-8, cloning, scratch and Transwell experiments showed that knockdown SRF could inhibit the proliferation, migration and invasion of A549 and H1299 cells, respectively. [For A549 cells: The clone formation count, migration count, invasion count, and 48-h migration distance ratio were (233.70±18.50), (808.70±6.11), (489.70±53.00), and 1.00±0.03, respectively, in the si-NC group; and (131.30±22.50), (403.00±9.54), (372.70±26.27), and 2.14±0.09, respectively, in the si-SRF group. For H1299 cells: The clone formation count, migration count, invasion count, and 48-h migration distance ratio were (194.30±20.98), (988.70±64.52), (907.70±67.02), and 1.00±0.05, respectively, in the si-NC group; and (137.70±7.77), (665.70±157.10), (565.70±67.01), and 1.52±0.03, respectively, in the si-SRF group. All comparisons showed statistically significant differences ( P＜0.05)] JASPAR database prediction shows that SRF and lncRNA FGD5-AS1 have binding site. The double luciferase experiment, CHIP and EMSA experiments showed that SRF could regulate lncRNA FGD5-AS1. In situ hybridization showed that the mean optical density of lncRNA FGD5-AS1 in tissue microarray of LUAD patients (1.28±0.31) was higher than that in adjacent tissues (1.00±0.00, P＜0.001). The results of qRT-PCR experiment showed that the expression level of lncRNA FGD5-AS1 in wax tissues of LUAD patients was higher than that in normal tissues adjacent to cancer ( P=0.017). The expression level of lncRNA FGD5-AS1 in plasma of LUAD patients (3.48±2.62) was higher than that of healthy people (1.02±0.03, P＜0.001). CCK-8, cloning, EDU, scratch and Transwell experiments showed that overexpression of lncRNA FGD5-AS1 could promote cell proliferation [For A549 cells: The clone formation count, EdU-positive cell count, invasion count, and 48-h migration distance ratio were (22.67±5.86), (1.00±0.09), (135.70±13.20), and 0.35±0.02, respectively, in the pcDNA3.1 group; and (46.33±9.07), (1.65±0.10), (205.00±13.23), and 0.20±0.01, respectively, in the FGD5-AS1-overexpressing group. All comparisons showed statistically significant differences ( P＜0.05)], migration and invasion and vice versa [For H1975 cells: The clone formation count, EdU-positive cell count, invasion count, and 48-h migration distance ratio were (75.33±4.16), (1.00±0.02), (258.70±45.79), and 0.18±0.01, respectively, in the NC group; and (37.00±4.00), (0.52±0.07), (130.70±9.07), and 0.53±0.04, respectively, in the lncRNA FGD5-AS1 knockdown group (si-lncRNA FGD5-AS1 group). All comparisons showed statistically significant differences ( P＜0.05)]. Overexpression of lncRNA FGD5-AS1 could rescue the effect of knockdown SRF on the proliferation, migration and invasion of A549 and H1299 cells. The results of subcutaneous tumorigenesis experiment in nude mice indicated that the tumorigenicity of LUAD cells stably knockdown SRF was weakened and vice versa. Conclusion:SRF can promote the progress of LUAD by regulating lncRNA FGD5-AS1.

This study is to explore the antibiofilm activity of tirapazamine(TPZ)against Salmonella and the mechanism of inhibiting biofilm formation.In this study,crystal violet staining was used to determine the effect of TPZ on the minimal biofilm inhibitory concentration(MBIC)of Salmonel-la and on the development stage of Salmonella biofilm.The effects of TPZ on bacteria and biofilm of Salmonella were observed by scanning electron microscope and fluorescence microscope.Phe-nol-sulfuric acid method,spectrophotometer and BCA method were used to detect the effects of the bacteria on the content of main extracellular matrix of Salmonella.The autocoagulation and hydro-phobicity of Salmonella were measured and their effects on the cell wall of Salmonella were meas-ured by AKP method.The result showed that the MBIC value of TPZ on Salmonella ATCC 14028 was 1.563 μmol/L,it had destructive effects on both Salmonella bacteria and mature biofilm structure,it inhibited the formation of early Salmonella biofilm in a concentration-dependent manner,and inhibited the synthesis and secretion of extracellular polymers in Salmonella biofilm.The autoagglutination ability,hydrophobicity and cell wall integrity of Salmonella were affected.To sum up,the TPZ may inhibit the formation of a large number of Salmonella biofilms in the early stage of biofilm development by affecting the extracellular polymer and cell agglutination a-bility,which is expected to be a potential candidate drug against biofilm infection and provide a new idea for finding alternative antibiotics.

Objective To investigate whether Dauricine(Dau)can ameliorate acute kidney injury induced by renal ischemia-reperfusion(IR)in mice.Methods C57BL/6 mice were randomly assigned to three experimental groups:sham operation,ischemia-reperfusion injury(IRI),and IRI treated with daunorubicin(IRI+Dau),with 12 animals in each group.Following oral administration of Dau(15 mg/kg),renal ischemia-reperfusion was induced,and blood and kidney tissue samples were collected 24 hours post-surgery.Histopathological changes were assessed using hematoxylin and eosin(HE)staining.Renal function was evaluated by measuring serum creatinine and blood urea nitrogen(BUN)levels.Protein expression related to lipid peroxidation was analyzed using western blotting and immunofluorescence.Inflammatory gene expression was determined via quantitative polymerase chain reaction(qPCR).Nuclear translocation of nuclear factor κB(NF-κB),a key inflammatory marker,was assessed using immu-nofluorescence.Statistical comparisons between groups were performed using t-tests.Results The administration of Dau significantly ameliorated IR-induced acute kidney injury compared to the Sham group.Serum creatinine(P<0.001)and urea nitrogen(P<0.000 1)levels were markedly decreased in Dau-treated mice relative to those in the IRI group.Furthermore,Dau significantly suppressed lipid peroxide production in renal tissues(P<0.001),without significantly affecting the expression levels of Gpx4(P=0.919)and Acsl4(P=0.086),two key proteins involved in lipid peroxidation.In addition,Dau effectively inhibited IR-induced nuclear translocation of NF-κB(P<0.001)and reduced apoptosis in kidney cells(P=0.004).Conclusion Dau mitigates IR-induced kidney damage by reducing the accumulation of lipid peroxides and inhibiting the nuclear translocation of NF-κB,thereby attenuating inflammation and renal cell apoptosis.

Objective:To explore the longitudinal predictive relationship between self-neglect and frailty among older adults.Methods:Data were drawn from the Chinese Longitudinal Healthy Longevity Survey conducted in 2011 (T1), 2014 (T2), and 2018 (T3). A total of 1 495 older adults aged≥65 years at T1 who participated in three consecutive surveys and had no missing key variables were included. General demographic information, self-neglect scores, and frailty status were extracted. Spearman correlation analysis was used to examine the association between self-neglect and frailty. Cross-lagged analysis was employed to investigate the potential causal relationship between the two variables.Results:The self-neglect scores for 1 495 older adults at T1, T2, and T3 were (2.84±1.39), (2.47±1.30), and (2.41±1.20), respectively, showing a declining trend. The frailty scores at T1, T2, and T3 were 0 (0, 1.00), 0 (0, 2.00), and 1.00 (0, 2.00), respectively, indicating an increasing trend. Cross-lagged analysis revealed that self-neglect at T1 positively predicted frailty at T2 (β=0.076, P=0.004). Frailty at both T1 and T2 positively predicted self-neglect at T2 (β=0.057, P=0.044) and T3 (β=0.058, P=0.029), respectively. Conclusions:Frailty among older adults positively predicts self-neglect, and self-neglect also has a certain predictive effect on frailty. Medical staff should strengthen early screening and intervention for frailty in older adults to delay the occurrence and progression of self-neglect.