Objective To investigate the post-discharge exercise behavior and factors influencing moderate to vigorous intensity physical activity (MVPA) in patients undergoing lung surgery. Methods A total of 2874 patients from the large prospective, observational perioperative lung symptom study cohort (CN-PRO-Lung 3) in the Department of Thoracic Surgery at Sichuan Cancer Hospital between April 7, 2021, and January 31, 2024, were selected as the survey subjects. A survey was conducted using the Investigation of Exercise Behavior after Lung Surgery questionnaire and the International Physical Activity Questionnaire-Short Form (IPAQ-SF) among patients who underwent lung surgery. Binary logistic regression was used to analyze the factors influencing patients’ engagement in MVPA. Results A total of 702 patients were surveyed, including 252 males and 450 females, with an average age of (52.4±10.2) years. Patients with lung cancer accounted for 85.9%. Only 36.0% of the patients had regular exercise habits, while 42.3% did not engage in any physical activity. The three main barriers for postoperative exercise were physical discomfort (pain, coughing, shortness of breath, etc, 54.7%), lack of professional guidance (41.7%), and concerns about the surgical wound (28.9%). The proportions of patients engaging in vigorous, moderate, and low-intensity physical activity were 5.7%, 28.2%, and 66.1%, respectively. Multivariate analysis showed that patients with a personal annual income ≥50000 yuan (OR=1.52, 95%CI 1.01-2.29, P=0.044), high school education or above (OR=1.92, 95%CI 1.33-2.76, P<0.001), and lobectomy (OR=1.44, 95%CI 1.02-2.03, P=0.037) engaged in more MVPA. Conclusion Patients undergoing lung surgery have inadequate physical activity after discharge, particularly lacking in MVPA. Patients with higher income, higher educational levels, and lobectomy are more frequently engaged in MVPA. Measures such as symptom control, providing exercise guidance, and enhancing education on wound care may potentially improve the inadequate physical activity in lung surgery patients after discharge.

Objective To explore the predictive value of the classification of carotid plaque reporting and data system (Plaque-RADS) and ultrasound features for the severity of coronary artery stenosis. Methods This was a single-center prospective observational study. Patients with suspected coronary artery disease or at high cardiovascular risk, who were hospitalized in the Department of Cardiology of Zhongshan Hospital, Fudan University from July 2023 to June 2024, were consecutively enrolled and divided into mild-to-moderate stenosis group and severe stenosis group according to the degree of coronary artery stenosis. Clinical parameters, carotid ultrasound features, and Plaque-RADS classification were compared between the two groups. A multivariate logistic regression model was constructed, and its predictive performance was assessed using receiver operating characteristic curve. Results A total of 271 patients were included, with age of (65.49±9.44) years. The proportion of males, patients with diabetes and hyperlipidemia, and smokers was significantly higher in the severe stenosis group, accompanied by greater plaque thickness as well as lower maximum elasticity (E_max) and mean elasticity (E_mean; P＜0.05). Statistically significant differences were also observed between the two groups in target plaque location, Plaque-RADS classification, and plaque stability distribution (P＜0.05). Specifically, type Ⅱ plaques predominated in the mild-to-moderate stenosis group, whereas the severe stenosis group had a higher proportion of type Ⅲ plaques and vulnerable plaques. Multivariate logistic regression analysis demonstrated that male, diabetes, and type Ⅲ–Ⅳ plaques were risk factors for severe coronary artery stenosis, while E_max served as a protective factor. The predictive model constructed by the above indicators exhibited favorable predictive performance (AUC＝0.838). Conclusions The combination of Plaque-RADS classification, E_max, sex, and comorbid diabetes has certain predictive value for the severity of coronary artery stenosis.

Objective To explore the application value of MR MAGiC sequence reconstructed based on deep learning reconstruction(DLR)for localizing epileptogenic focus of intractable epilepsy.Methods Fifty intractable epilepsy patients(epilepsy group)and 20 healthy controls(control group)were retrospectively collected.Brain MR MAGiC sequence was scanned,then traditional reconstruction(inverse Fourier transform)and DLR algorithm were performed to obtain MAGiC and MAGiC DLR images,respectively.The corresponding quantitative parameter maps were generated after post-processing,including T1 mapping,T2 mapping and proton density(PD)mapping.The subjective scores of noise,artifacts,structural clarity and overall quality were compared between two kinds of quantitative parameter images.The asymmetry index(AI)of quantitative parameters(T1,T2 and PD values)between the affected side and the contralateral side in epilepsy group,the contralateral side or the suspected epileptogenic focus in epilepsy group and HC group were calculated.Then epileptogenic focus were localized based on performance of MAGiC and MAGiC DLR corresponding quantitative parameter maps combining obtained AI of quantitative parameter values.According to surgical results,follow-up review,electroencephalogram or PET results,the accuracy of MAGiC and MAGiC DLR images for localizing epileptogenic focus was calculated.Results Compared with MAGiC quantitative parametric maps,noise of MAGiC DLR quantitative parametric maps reduced,while subjective scores of structure clarity and overall quality improved(all P＜0.05).The accuracy of MAGiC and MAGiC DLR images for localizing epileptogenic focus was 82.00％(41/50)and 88.00％(44/50),respectively.Conclusion MR MAGiC sequence based on DLR was beneficial for improving accuracy of localizing epileptogenic focus in intractable epilepsy.

Objective To analyze the etiological characteristics of children with pneumonia and provide a reference for regional pneumonia prevention and control.Methods A retrospective analysis was conducted on the clinical data of 864 children with pneumonia admitted to this hospital from January to December 2023.The disease types,common pathogen infections,and drug-resistant Mycoplasma pneumoniae infections in dif-ferent age groups were analyzed.Results Among the 864 children with pneumonia,there were 466 cases(53.94%)of bronchopneumonia,290 cases(33.56%)of asthmatic bronchopneumonia,and 108 cases(12.50%)of lobar pneumonia.The infections were caused by Mycoplasma pneumoniae in 470 cases(54.40%),Haemophilus influenzae in 196 cases(22.69%),Streptococcus pneumoniae in 172 cases(19.91%),Moraxella catarrhalis in 143 cases(16.55%),Staphylococcus aureus in 142 cases(16.43%),Re-spiratory syncytial virus in 54 cases(6.25%).The drug resistance rate of Mycoplasma pneumoniae was 20.00%(94/470),and that of Staphylococcus aureus was 7.75%(11/142).Among 864 children with pneumo-nia,there was 1 case(0.12%)of drug-resistant of Mycoplasma pneumoniae infection in the 0-<1 year age group,29 cases(3.36%)in the 1-<4 years age group,39 cases(4.51%)in the 4-<7 years age group,21 cases(2.43%)in the 7-<10 years age group,and 4 cases(0.46%)in the 10-<15 years age group.Conclu-sion Mycoplasma pneumoniae is the main pathogen in children with pneumonia,and its drug resistance rate is relatively high.

Objective To investigate the value of integrin subunit αM(ITGAM)and integrin subunit β2(ITGB2)levels in peripheral blood mononuclear cells(PBMC)in the diagnosis and prognosis evaluation for patients with severe acute pancreatitis(SAP)complicated with acute lung injury(ALI).Methods A total of 205 patients with SAP admitted from November 2022 to February 2024 in the hospital were selected,and they were divided into ALI group(103 cases)and non-ALI group(102 cases)according to whether they were com-plicated with ALI.Meanwhile,110 healthy people who underwent the physical examination were selected as the control group.The differences of the levels of ITGAM and ITGB2 in PBMC in different groups were com-pared.Logistic regression was used to analyze the influencing factors for ALI in patients with SAP.The re-ceiver operating characteristic(ROC)curve was used to analyze the diagnostic value of levels of ITGAM and ITGB2 in PBMC for SAP patients complicated with ALI and the predictive value for poor prognosis.Results The levels of ITGAM,ITGB2 in PBMC,and serum amylase and urine amylase levels in ALI group were higher than those in non-ALI group and control group(P＜0.05).Multivariate Logistic regression anal-ysis showed that the increase of ITGAM,ITGB2 and serum amylase levels were risk factors for ALI in pa-tients with SAP(P＜0.05).ROC curve results showed that the area under the curve(AUC)of ITGAM com-bined with ITGB2 in diagnosing ALI in patients with SAP was significantly higher than those of ITGAM and ITGB2 alone(P＜0.05).The levels of ITGAM and ITGB2 in PBMC in the poor prognosis group were higher than those in the good prognosis group(P＜0.05).ROC curve results showed that the AUC of ITGAM com-bined with ITGB2 in predicting poor prognosis in patients with SAP complicated with ALI was significantly higher than those of ITGAM and ITGB2 alone(P＜0.05).Conclusion Increased levels of ITGAM and IT-GB2 in PBMC are risk factors for ALI in patients with SAP.ITGAM combined with ITGB2 has a good predic-tive efficacy for the poor prognosis in patients with SAP complicated with ALI,which has important value in clinical practice and is expected to become potential biomarkers.

BackgroundIn recent years， the incidence of non-suicidal self-injury （NSSI） behaviors among adolescents has been increasing annually. Self-esteem and alexithymia are strongly associated with NSSI behaviors， and alienation is closely linked to both self-esteem and alexithymia. However， there is limited research on the relationship between alienation and NSSI behaviors among adolescents in China. ObjectiveTo analyze the relationship between alienation and NSSI behaviors among adolescents， and to explore the factors influencing NSSI behaviors in this population， so as to provide insights for the prevention and treatment of NSSI behaviors in adolescents. MethodsAdolescents admitted to the Department of Psychiatry and Psychology at the 923^rd Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from September 1， 2021 to March 1， 2023， who met the diagnostic criteria for NSSI in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）， were selected as the study group （n=60）. Concurrently， middle school students from Nanning were recruited as the control group （n=60）. Participants were assessed using Adolescent Self Harm Scale （ASHS）， Rosenberg Self-Esteem Scale （RSES）， Toronto Alexithymia Scale （TAS） and Adolescent Students′ Alienation Scale （ASAS）. Pearson correlation analysis was employed to examine the relationships between scale scores in the study group， and Logistic regression analysis was used to identify the influencing factors of NSSI behaviors among adolescents. ResultsThe RSES score of the study group was significantly lower than that of the control group （t=-7.033， P<0.01）. The TAS and ASAS scores of the study group were significantly higher than those of the control group （t=5.591， 8.124， P<0.01）. The ASHS score was negatively correlated with RSES score （r=-0.410， P<0.01） and positively correlated with ASAS score （r=0.555， P<0.01）. The RSES scores of the study group were negatively correlated with TAS and ASAS scores （r=-0.317， -0.590， P<0.05 or 0.01）. Logistic regression analysis showed that being female （OR=0.714， 95% CI： 0.042~0.709） was a protective factor for NSSI behaviors among adolescents， while high alienation （OR=1.028， 95% CI： 1.013~1.043） and residing in rural areas （OR=6.692， 95% CI： 2.038~21.967） were risk factors for NSSI behaviors among adolescents. ConclusionAlienation was positively correlated with NSSI behaviors in adolescents. Female adolescents had a lower risk of NSSI behaviors， while those with higher levels of alienation or residing in rural areas were more prone to NSSI behaviors. ［Funded by Self-financed Scientific Research Project of the Health Commission of Guangxi Zhuang Autonomous Region （number， Z20210656）； Self-financed Scientific Research Project of the Health Commission of Guangxi Zhuang Autonomous Region （number， Z-A20231057）］

Benzylisoquinoline alkaloids (BIAs) are a structurally diverse group of plant metabolites renowned for their pharmacological properties. However, sustainable sources for these compounds remain limited. Consequently, researchers are focusing on elucidating BIA biosynthetic pathways and genes to explore alternative sources using synthetic biology approaches. CYP80B, a family of cytochrome P450 (CYP450) enzymes, plays a crucial role in BIA biosynthesis. Previously reported CYP80Bs are known to catalyze the 3'-hydroxylation of (S)-N-methylcoclaurine, with the N-methyl group essential for catalytic activity. In this study, we successfully cloned a full-length CYP80B gene (StCYP80B) from Stephania tetrandra (S. tetrandra) and identified its function using a yeast heterologous expression system. Both in vivo yeast feeding and in vitro enzyme analysis demonstrated that StCYP80B could catalyze N-methylcoclaurine and coclaurine into their respective 3'-hydroxylated products. Notably, StCYP80B exhibited an expanded substrate selectivity compared to previously reported wild-type CYP80Bs, as it did not require an N-methyl group for hydroxylase activity. Furthermore, StCYP80B displayed a clear preference for the (S)-configuration. Co-expression of StCYP80B with the CYP450 reductases (CPRs, StCPR1, and StCPR2), also cloned from S. tetrandra, significantly enhanced the catalytic activity towards (S)-coclaurine. Site-directed mutagenesis of StCYP80B revealed that the residue H205 is crucial for coclaurine catalysis. Additionally, StCYP80B exhibited tissue-specific expression in plants. This study provides new genetic resources for the biosynthesis of BIAs and further elucidates their synthetic pathway in natural plant systems.
Cytochrome P-450 Enzyme System/chemistry* ; Benzylisoquinolines/chemistry* ; Hydroxylation ; Plant Proteins/chemistry* ; Alkaloids/metabolism* ; Stephania tetrandra/genetics*

Objective : To analyze the differential expression profile of miRNAs in amniotic fluid exosomes of fetu- ses with Down syndrome (DS) and provide insights for identifying novel biomarkers for the prenatal diagnosis of DS . Methods : Amniotic fluid samples were collected from fetuses with DS and chromosomally normal fetuses . Exo- somes were isolated from the amniotic fluid and subjected to high-throughput sequencing. Differentially expressed miRNAs were identified , and target genes were predicted using TargetScan and miRanda. Target genes located on chromosome 21 were selected , and their biological functions and associated diseases were analyzed using Gene- Cards , HGNC , NCBI Gene , UniProtKB/Swiss-Prot , Ensembl , and OMIM databases . GO and KEGG enrichment analyses were performed to investigate the biological functions of the enriched genes . Results : A total of 59 differ- entially expressed miRNAs were identified , including 31 upregulated and 28 downregulated miRNAs . Based on a fold change > 2 and P < 0. 05 , 10 upregulated and 9 downregulated miRNAs with the highest expression levels were selected . Key miRNAs included hsa-let-7b-5p , hsa-let-7c-5p , hsa-let-7b-3p _ 1ss22CT , and hsa-miR-199b-5p , with BACH1 and IFNAR1 identified as their shared target genes . GO analysis revealed that the enriched target genes were primarily involved in protein binding , metal ion binding , transferase activity , DNA binding , transcriptional regulation by RNA polymerase Ⅱ , and nucleotide binding. KEGG pathway analysis indicated that the target genes were mainly associated with metabolic pathways , cancer-related pathways , the PI3K-Akt signaling pathway , and the Rap1 signaling pathway . Conclusion Differential expression of miRNAs in amniotic fluid exosomes was ob- served between DS fetuses and those with normal karyotypes . Combined analysis with placental miRNAs revealed hsa-miR-199b-5p as a common differentially expressed miRNA in both DS amniotic fluid and placenta. It is hypoth- esized that BACH1 and IFNAR1 , shared target genes of hsa-miR-199b-5p , hsa-let-7b-5p , hsa-let-7c-5p , and hsa- let-7b-3p_1ss22CT , may play a role in the pathogenesis of DS .

Background::Intrauterine growth restriction (IUGR) is associated with adverse metabolic outcomes during adulthood. Histone modifications and changes in DNA methylation-affected genes are important for fetal development. This study aimed to investigate the epigenetic mechanisms in IUGR.Methods::IUGR models were established in Sprague–Dawley rats using a maternal nutritional restriction approach during pregnancy. The abundance of insulin-like growth factor 2 (IGF2), phosphoinositide 3-kinase (PI3K), AKT serine/threonine kinase 2 (AKT2), and peroxisome proliferators-activated receptor gamma coactivator 1 alpha (PGC-1α) was examined by real-time polymerase chain reaction (RT-PCR) and Western blotting analysis. Chromatin immunoprecipitation RT-PCR was employed to analyze histone modification in CCCTC-binding factor (CTCF) 1–4 binding sites of the Igf2/H19 imprinting control region (ICR). The methylation states of CTCF1–4 binding sites were studied by pyrosequencing. Results::The IUGR models were constructed successfully. Igf2 mRNA abundance in the placenta, fetal liver, and newborn liver was decreased in the IUGR group ( P <0.01). Meanwhile, as compared with the control group, the expression levels of AKT2, PI3K, and PGC-1α were lower in newborn and 8-week-old livers in the IUGR group ( P <0.05). In addition, knocking down Igf2 reduced the protein expression levels of AKT2-phosphorylation and PGC-1α ( P <0.05). In CTCF binding sites 1-4 of the Igf2/ H19 ICR, acetylated histones H3 (AcH3) enrichment was significantly lower in CTCF1-3 in newborn and 8-week-old IUGR rats. Histone H3 tri-methylated lysine 4 (H3K4me3) enrichment was significantly lower in the CTCF1–4 of newborn and 8-week-old IUGR groups ( P <0.01). H3K9me2 enrichment was significantly higher in the IUGR group ( P <0.01). The CpG dinucleotide methylation levels of CTCF1 and CTCF3, but not those of CTCF2 and CTCF4 binding sites in IUGR rat fetal, 4-week old, and 8-week-old livers decreased significantly ( P <0.05). Conclusion::The methylation status and histone modification in the Igf2/H19 ICR are related to growth and lipid metabolism via the PGC-1α/PI3K/AKT2 pathway in IUGR rats.

Objective To enhance the qualified rate of preoperative bladder filling and improve the experience of embryo transfer by implementing a nursing intervention based on the root cause analysis and plan-do-check-act(RCA-PDCA)cycle.Methods A before-after comparative study was conducted among the patients who received embryo transfer at a Tire-ⅢA specialist hospital between January and April 2024.The patient who received embryo transfer between January and February 2024(n=130)were assigned to the control group with routine nursing.Those who received embryo transfer between March and April 2024 were assigned to the trial group(n=136)with nursing intervention based on RCA-PDCA.The two groups were compared in terms of the qualified rate of bladder filling,endometrial visualisation rate,instrument-assisted transfer rate and level of comfort.Results A total of 126 women in the control group and 131 in the trial group completed the study.The patient in the trial group demonstrated significantly higher qualified rate of bladder filling and endometrial visualisation rate in comparison with those in the control group(70.2％vs.38.1％,81.7％vs.51.6％,respectively).The trial group also had lower rates in both of the instrument-assisted transfer and the incidence of mild pain than those in the control group(2.3％vs.7.9％,32.1％vs.53.2％,respectively;P<0.05).Conclusion RCA-PDCA is effective in improving preoperative bladder filling and endometrial visualisation,reducing instrument-assisted transfer and enhancing preoperative bladder comfort in the women receiving embryo transfer.