BACKGROUND: The mechanisms distinguishing metabolically healthy from unhealthy phenotypes within the same BMI categories remain unclear. This study aimed to investigate the associations between regional fat distribution and metabolically unhealthy phenotypes in Chinese adults across different BMI categories. METHODS: This cross-sectional study involving 11833 Chinese adults aged 20 years and older. Covariance analysis, adjusted for age, compared the percentage of regional fat (trunk, leg, or arm fat divided by whole-body fat) between metabolically healthy and unhealthy participants. Trends in regional fat percentage with the number of metabolic abnormalities were assessed by the Jonckheere-Terpstra test. Odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated by logistic regression models. All analyses were performed separately by sex. RESULTS: In non-obese individuals, metabolically unhealthy participants exhibited higher percent trunk fat and lower percent leg fat compared to healthy participants. Additionally, percent trunk fat increased and percent leg fat decreased with the number of metabolic abnormalities. After adjustment for demographic and lifestyle factors, as well as BMI, higher percent trunk fat was associated with increased odds of being metabolically unhealthy [highest vs. lowest quartile: ORs (95%CI) of 1.64 (1.35, 2.00) for men and 2.00 (1.63, 2.46) for women]. Conversely, compared with the lowest quartile, the ORs (95%CI) of metabolically unhealthy phenotype in the highest quartile for percent arm and leg fat were 0.64 (0.53, 0.78) and 0.60 (0.49, 0.74) for men, and 0.72 (0.56, 0.93) and 0.46 (0.36, 0.59) for women, respectively. Significant interactions between BMI and percentage of trunk and leg fat were observed in both sexes, with stronger associations found in individuals with normal weight and overweight. CONCLUSIONS Trunk fat is associated with a higher risk of metabolically unhealthy phenotype, while leg and arm fat are protective factors. Regional fat distribution assessments are crucial for identifying metabolically unhealthy phenotypes, particularly in non-obese individuals.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Adipose Tissue ; Body Fat Distribution ; Body Mass Index ; China/epidemiology* ; Cross-Sectional Studies ; Health Surveys ; Phenotype

Traditional development of small protein scaffolds has relied on display technologies and mutation-based engineering, which limit sequence and functional diversity, thereby constraining their therapeutic and application potential. Protein design tools have significantly advanced the creation of novel protein sequences, structures, and functions. However, further improvements in design strategies are still needed to more efficiently optimize the functional performance of protein-based drugs and enhance their druggability. Here, we extended an evolution-based design protocol to create a novel minibinder, BindHer, against the human epidermal growth factor receptor 2 (HER2). It not only exhibits super stability and binding selectivity but also demonstrates remarkable properties in tissue specificity. Radiolabeling experiments with ^99mTc, ⁶⁸Ga, and ¹⁸F revealed that BindHer efficiently targets tumors in HER2-positive breast cancer mouse models, with minimal nonspecific liver absorption, outperforming scaffolds designed through traditional engineering. These findings highlight a new rational approach to automated protein design, offering significant potential for large-scale applications in therapeutic mini-protein development.

Objective Investigate the expression level and clinical significance of microRNA-223-3p(miR-223-3p)in the serum of pregnant women with preterm premature rupture of membranes(PPROM).Methods A total of 91 pregnant women who underwent cesarean delivery at the Xuzhou Maternal and Child Health Hospital affiliated with Xuzhou Medical University between April and September 2023 were selected for the study.This included 60 cases of PPROM and 31 cases of term normal pregnant women as the research subjects.The study group was divided based on the pathological results of the membranes into:PPROM group without histological chorioamnionitis(HCA)(PPROM group,n = 37),and PPROM group with HCA(PPROM+HCA group,n = 23).Serum samples from pregnant women were collected before hospital treatment,and the expression level of miR-223-3p in the serum was detected by quantitative real-time PCR(qRT-PCR).The levels of inflammatory factors such as IL-1β,IL-6,IL-8,and TNF-α in the serum were measured by enzyme-linked immunosorbent assay(ELISA).Results The expression level of miR-223-3p in the serum of the PPROM+HCA group was significantly higher than that of the PPROM group and the normal group(P＜0.05).The expression levels of IL-1β,IL-6,IL-8,and TNF-α in the serum of the PPROM+HCA group were also significantly higher than those of the PPROM group and the normal group(P＜0.05).There was a positive correlation between the expression level of miR-223-3p in the serum of the PPROM+HCA group and the expression levels of IL-1β,IL-6,IL-8,and TNF-α(r = 0.553,0.505,0438,0.656,P＜0.05).Conclusion The upregulation of miR-223-3p in the serum of pregnant women with PPROM+HCA is associated with the severity of inflammation in PPROM.

Objective:To investigate the expression level and clinical significance of HMGB1-TLR4-IL-23-IL-17A axis in se-rum of patients with psoriasis vulgaris.Methods:The expression levels of HMGB1,TLR4,IL-23 and IL-17A in serum of 60 patients with psoriasis vulgaris and 30 healthy volunteers were detected by ELISA.In addition,the differences of cytokines expression levels between moderate and severe psoriasis patients were compared,and the correlation between the expression levels of cytokines and the disease severity expressed by psoriasis area and severity index(PASI)were analyzed.The differences of expression levels of HMGB1-TLR4-IL-23-IL-17A axis before and after IL-17A inhibitor induction treatment were detected and compared in 22 moderate to severe psoriasis patients reached PASI75 and higher level.Results:The expression levels of serum HMGB1,TLR4,IL-23 and IL-17A in patients with psoriasis were obviously higher than those of healthy controls.Moreover,the expression levels of serum HMGB1,TLR4,IL-23 and IL-17A were even elevated in severe patients compared with moderate patients,and were positively correlated with PASI score.After induction treatment of IL-17A inhibitor,the expression levels of HMGB1-TLR4-IL-23-IL-17A aixs decreased significantly in serum of patients with psoriasis.Conclusion:HMGB1-TLR4-IL-23-IL-17A axis is highly expressed in patients with psoriasis vulgaris,and positively related to the disease severity,which may be involved in the disease process of psoriasis vulgaris and provide a new idea for the immunotherapy of psoriasis.

Objective To investigate the differential expression of proteins in the serum of diabetic patients quantitative proteomics technologies, and to identify specific protein biomarkers. Methods Serum samples from three diabetic patients and three healthy controls in Shenzhen in 2023 were collected. Immunoprecipitation and nano liquid chromatography-quadrupole-electrostatic orbitrap-linear ion trap mass spectrometry (easy-nanoLC-Q-orbitrap-fusion) were employed to perform fraction and no-fraction-based quantitative analysis of the serum proteome in diabetic patients and healthy controls. The mass spectrometry data were analyzed by MaxQuant1.6.1.0, and the differential proteins identified by the fraction-based method were subjected to gene ontology (GO) functional clustering and kyoto encyclopedia of genes and genomes (KEGG) pathway analysis. Results A total of 251 reliable proteins were identified by the no-fraction-based method, among which 17 differentially expressed proteins were selected. In contrast, 494 reliable proteins were identified by the fraction-based method, and 74 differentially expressed proteins were selected. Among them, seven proteins showed consistent changes in both methods. Five proteins were downregulated, including pregnancy zone protein (PZP), carbonic anhydrase 1 (CAH1), mannose-binding protein C (MBL2), fibrinogen alpha chain (FIBA), and haptoglobin (HPT). Two proteins were upregulated, including apolipoprotein(a) (LPA) and complement factor H-related protein 4 (CFH4). GO analysis revealed that the differentially expressed proteins were mainly involved in molecular functions such as glycosaminoglycan binding and heparin binding. KEGG pathway analysis showed that the differentially expressed proteins were mainly associated with complement and coagulation cascades, cell adhesion, PI3K-Akt signaling pathway, and other pathways. Conclusions Fraction-based no-fractional quantitative proteomics analysis provides an effective approach for analyzing differential protein expression in the serum of diabetic patients, and offers a valuable technique for screening specific protein biomarkers of serum samples in large-scale cohorts of disease.

Objective: To investigate the expression of CD155/TIGIT in patients with osteosarcoma and its significance Methods : The expression differences of CD155 and TIGIT in tumor tissues of distant metastatic osteosarcoma patients and non⁃metastatic osteosarcoma patients were analyzed by cancer Genome Atlas ( TCGA) database.The surgically removed tissues of osteosarcoma patients were collected to prepare pathological sections and tissue chips , and the tumor tissue and cell morphology were observed by HE staining. Immunohistochemical staining was used to detect the expression of CD155 and TIGIT , and the scores were divided into high expression group and low expression group according to the scores. Chi⁃square test was used to analyze the relationship between CD155/TIG⁃IT expression and clinical features and prognosis. Results : TCGA database data showed higher expression of CD155 and TIGIT in patients with osteosarcoma accompanied by metastasis. HE staining of pathological sections revealed that tumor tissues with high expression of CD155/TIGIT contained more binuclear or multinucleated , hyperchromatic and obviously heteromorphic tumor cells. Immunohistochemical staining and score analysis of tissue chip showed that the expression of CD155 and TIGIT was correlated with clinical stage and distant metastasis ( P < 0. 05) , but not with age , sex , tumor size , pathological type and tumor necrosis rate. Conclusion CD155 and TIGIT may be one of the prognostic indicators of osteosarcoma.

Objective:To analyze the epidemiological characteristics of geriatric hip fractures.Methods:This study retrospectively analyzed the clinical characteristics of 2 054 elderly patients with hip fracture aged 60 years and over who were admitted to Beijing Hospital from January 2011 to December 2020.The epidemiological characteristics of geriatric hip fractures were analyzed from the aspects of age, gender, fracture type, length of stay, surgical method and surgical complications.Results:The total number of hip fractures patients admitted from 2011 to 2020 showed a general upward trend in quantity.Among them, there were 1 177 femoral neck fractures(57.3%, 1 177/2 054), and 877 intertrochanteric femoral fractures(42.7%, 877/2 054)with statistical differences in the distribution of fracture types between patients at different ages( χ2=61.727, P<0.001). A total of 1 839 patients chose surgical treatment, accounting for 89.5% of the total number of patients.Artificial femoral head arthroplasty was the most common operation mode for patients with femoral neck fractures(783 cases, 75.4%).534 patients with intertrochanteric femoral fractures(66.8%)were treated with closed reduction and femoral intramedullary nailing.There was a statistically significant difference in operation modes among different fracture types( χ2=1 480.800, P<0.001). The length of hospital stay in patients with femoral neck fracture was(14.2±8.3)days, which was significantly longer than in patients with femoral neck fracture(13.2±10.9)days( t=2.417, P=0.016). There was no significant difference in the time from admission to operation between the two groups[(5.7±3.5)days vs.(5.4±3.3)days]( t=1.954, P=0.051). Among all the comorbidities of hip fracture patients, the top 5 diseases were cardiovascular system diseases(2 001 cases, 97.4%), nervous system diseases(1 105 cases, 53.8%), endocrine system diseases(814 cases, 39.6%), skeletal and muscular system diseases(623 cases, 30.3%), digestive system diseases(472 cases, 23.0%).1 485 patients(72.3%)had 3 or more comorbidities. Conclusions:Hip fractures in the elderly have some epidemiological distribution characteristics in terms of age, gender, length of hospitalization, injury mechanism and comorbidities, which is conducive to further improve the prevention and treatment strategies for hip fractures and promote the rational allocation of medical resources.

A case of hemolytic disease of the newborn (HDFN) caused by immunoglobulin (Ig) G anti-E was analyzed in this study. The ABO and Rh blood group of the newborn was O and CcDEe, respectively. The ABO and Rh blood group of her mother was A and CCDee, respectively. Thus, the reason of ABO and RhD hemolysis were impossible. The incompatible antibodies were found in the newborn serum by three serological tests. The antibody screening and identification test using the plasma and the red blood cell eluate from the newborn and the plasma from her mother showed that the HDFN was caused by the IgG anti-E antibodies. The case was caused by failing to prenatal screening for irregular antibodies. Therefore, the prenatal screening for irregular antibodies seems necessary for pregnant women to prevent, diagnose or manage the HDFN at an early time, reducing the occurrence of perinatal complications.

Objective To explore whether inhibiting autophagy can enhance the sensitivity of photothermal treatment under mild photothermal conditions. Methods CQ@PLGA@PDA NPs were prepared by an improved double emulsification method and a PDA-based surface modification method. After basic characterization, CCK-8 method was used to detect the cytotoxicity of nanoparticles; the near-infrared laser irradiation nanoparticle solution was used to detect the heating effect; CCK-8 method and live-dead cell staining were used to detect the killing effect of tumor cells; Western blot was used to detect the expression of autophagy-related proteins. Results The CQ@PLGA@PDA NPs were successfully prepared, with a particle size of 253.10±2.39 nm, a zeta potential of -22.57±0.80 mV, uniform particle size and good dispersion. The temperature of nanoparticle solution increased to 45℃ after the near-infrared laser irradiation for 10 min. CQ@PLGA@PDA NPs had no obvious toxicity to cells. The survival rates of breast cancer cell MDA-MB-231 and mouse embryonic fibroblast NIH-3T3 cell were above 95%. The inhibition of autophagy under mild photothermal conditions could improve the sensitivity of photothermal therapy. Conclusion The prepared CQ@PLGA@PDA NPs have good photothermal performance and high biological safety; by inhibiting autophagy, they can effectively kill tumor cells under mild photothermal conditions(< 50℃).

Objective To compare the effectiveness of Remifentanil versus Fentanyl anesthesia applied in urological laparoscopic surgery. Methods A total of 78 patients undergoing urologic endoscopy in our hospital from July 2016 to December 2017 were recruited ,and randomly divided into the Remifentanil group(n= 39)with Remifentanil anesthesia and the Fentanyl group(n= 39)with Fentanyl anesthesia. The changes in mean arterial pressure and heart rate ,anesthetic effects and adverse reaction rates during anesthesia were compared between the two groups. Results The reduction of mean arterial pressure of premedication/induction of anesthesia(T0)was more pronounced in the Fentanyl group than in the Remifentanil group(t=2.855 ,P=0.003) ,but the heart rate was lower in the Remifentanil group than in the Fentanyl group(t= 4.405 ,P= 0.000).The changes of heart rate and mean arterial pressure were more significant in the Fentanyl group than in Remifentanil group immediately after tracheal intubation (T1) ,during incision of skin(T2) ,immediately after suture of the abdomen (T3) and immediately after removal of the tracheal tube (T4) ( P ＜ 0.05 ). The spontaneous respiration recovery time ,blinking time ,extubation time ,force recovery time and recovery time were shorter in the Remifentanil group than in the Fentanyl group(P＜0.05).The incidence of anesthetic adverse reactions was lower in the Remifentanil group than in the Fentanyl group (10.3% , 4/39 vs.28.2% ,11/39 ,χ2= 4.044 ,P= 0.044). Conclusions Both Remifentanil and Fentanyl groups have good anesthetic effects in urological anesthesia ,but Remifentanil has less fluctuations of perioperative blood pressure and heart rate ,has higher recovery quality and less anesthetic adverse reactions. Therefore ,Remifentanil anesthesia is worthy of promotion.