Objective To investigate the role of activating transcription factor 4 (ATF4) in benign prostatic hyperplasia (BPH) in order to elucidate the molecular mechanism underlying BPH progression. Methods Firstly, we analyzed the correlation between the expression of ATF4 and the volume of prostate transition zone in BPH tissues using publicly available datasets. Subsequently, we explored the potential association among ATF4, epithelial-mesenchymal transition (EMT) and BPH through single-cell RNA sequencing (scRNA-seq). Finally, we validated the findings by silencing ATF4 and treating BPH cells with ATF4 protein inhibitors, followed by reverse transcription quantitative polymerase chain reaction (RT-qPCR), CCK-8 assay, and Western blot. Results The expression of ATF4 in BPH tissues exhibited a significant positive correlation with the volume of prostate transition zone (r=0.64, P＜0.05). scRNA-seq analysis revealed that ATF4 was significantly upregulated in the prostate epithelial cells of BPH patients (P＜0.05), and its expression demonstrated a significant positive correlation with the Hallmark EMT singscore (r=0.14, P＜0.05). In vitro experiments further indicated that knockdown of ATF4 led to a significant reduction in the proliferative activity of BPH-1 cells (P＜0.05). Similarly, inhibition of ATF4 activity resulted in a marked decrease in the proliferative capacity and EMT of BPH-1 cells (P＜0.05). Conclusion ATF4 may exert a promoting effect on BPH by modulating the EMT signaling pathway;therefore, ATF4 may serve as a novel therapeutic target of BPH.

Angiogenesis within atherosclerotic plaques is a critical determinant of plaque stability.The biome-chanical microenvironment,consisting of fluid shear force,plaque structural stress,and matrix stiffness,serves as signifi-cant factors in mediating plaque angiogenesis.Endothelial cells respond to mechanical signals and participate in plaques neovascularization through force chemical signal transduction mechanisms.This review provides an overview of the mecha-nisms by which mechanical factors regulate angiogenesis within plaques and offers a novel therapeutic approach for the pre-vention and treatment of atherosclerosis.

Objective:To investigate the diagnostic value of metagenomic next-generation sequencing (mNGS) for pyogenic spinal infections.Methods:A total of 255 patients diagnosed with pyogenic spinal infections were enrolled between September 2022 and September 2024 at Qingdao University Affiliated Hospital, Fuzhou Second General Hospital, First Affiliated Hospital of Nanchang University, Shandong University Affiliated Public Health Clinical Center, and the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. Among them, 155 were male and 100 were female, with an average age of 62.5±14.2 years (ranging from 13 to 90 years). All patients had samples of infected tissue and/or pus collected for microbial culture and mNGS testing. The number, types, and positive rates of pathogens detected by microbial culture and mNGS were compared. Using culture results as the gold standard, receiver operating characteristic (ROC) curve analysis was performed for mNGS testing and the combined method of mNGS and microbial culture, calculating the area under the curve (AUC) and 95% CI. Results:All 255 cases were clinically diagnosed as pyogenic spinal infections, with 194 cases providing microbiological evidence. The most common Gram-positive bacterium was Staphylococcus aureus, while the most common Gram-negative bacterium was Escherichia coli. A total of 33 pathogenic microorganisms were detected by mNGS, while microbial culture detected 18 pathogenic microorganisms. The positive rate of mNGS was 72.2% (184 out of 255), which was significantly higher than that of 30.2% (77 out of 255) for microbial culture, showing a significant difference (χ 2=90.150, P<0.001); the positive rate of mNGS combined with microbial culture was 76.1% (194 out of 255) with significant difference compared to mNGS alone (χ 2=8.100, P<0.001). Among 178 culture-negative samples, the detection rate of mNGS was 65.7% (117 out of 178); among 77 culture-positive samples, the detection rate of mNGS was 87.0% (67 out of 77), and 97.0% (65 out of 67) of the detected pathogens matched the culture results at the species level. The AUCs of the ROC curves for mNGS testing and the combination of mNGS with microbial culture were 0.606 [95% CI (0.534, 0.678)] and 0.671 [95% CI (0.606, 0.736)], respectively, with significant differences compared to microbial culture ( P=0.007; P=0.007). Conclusions:mNGS demonstrates superior performance over conventional culture in identifying pathogens in pyogenic spinal infections. Moreover, combining mNGS with culture further improves diagnostic yield, supporting its integration into clinical practice.

Angiogenesis within atherosclerotic plaques is a critical determinant of plaque stability.The biome-chanical microenvironment,consisting of fluid shear force,plaque structural stress,and matrix stiffness,serves as signifi-cant factors in mediating plaque angiogenesis.Endothelial cells respond to mechanical signals and participate in plaques neovascularization through force chemical signal transduction mechanisms.This review provides an overview of the mecha-nisms by which mechanical factors regulate angiogenesis within plaques and offers a novel therapeutic approach for the pre-vention and treatment of atherosclerosis.

Objective:To investigate the diagnostic value of metagenomic next-generation sequencing (mNGS) for pyogenic spinal infections.Methods:A total of 255 patients diagnosed with pyogenic spinal infections were enrolled between September 2022 and September 2024 at Qingdao University Affiliated Hospital, Fuzhou Second General Hospital, First Affiliated Hospital of Nanchang University, Shandong University Affiliated Public Health Clinical Center, and the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. Among them, 155 were male and 100 were female, with an average age of 62.5±14.2 years (ranging from 13 to 90 years). All patients had samples of infected tissue and/or pus collected for microbial culture and mNGS testing. The number, types, and positive rates of pathogens detected by microbial culture and mNGS were compared. Using culture results as the gold standard, receiver operating characteristic (ROC) curve analysis was performed for mNGS testing and the combined method of mNGS and microbial culture, calculating the area under the curve (AUC) and 95% CI. Results:All 255 cases were clinically diagnosed as pyogenic spinal infections, with 194 cases providing microbiological evidence. The most common Gram-positive bacterium was Staphylococcus aureus, while the most common Gram-negative bacterium was Escherichia coli. A total of 33 pathogenic microorganisms were detected by mNGS, while microbial culture detected 18 pathogenic microorganisms. The positive rate of mNGS was 72.2% (184 out of 255), which was significantly higher than that of 30.2% (77 out of 255) for microbial culture, showing a significant difference (χ 2=90.150, P<0.001); the positive rate of mNGS combined with microbial culture was 76.1% (194 out of 255) with significant difference compared to mNGS alone (χ 2=8.100, P<0.001). Among 178 culture-negative samples, the detection rate of mNGS was 65.7% (117 out of 178); among 77 culture-positive samples, the detection rate of mNGS was 87.0% (67 out of 77), and 97.0% (65 out of 67) of the detected pathogens matched the culture results at the species level. The AUCs of the ROC curves for mNGS testing and the combination of mNGS with microbial culture were 0.606 [95% CI (0.534, 0.678)] and 0.671 [95% CI (0.606, 0.736)], respectively, with significant differences compared to microbial culture ( P=0.007; P=0.007). Conclusions:mNGS demonstrates superior performance over conventional culture in identifying pathogens in pyogenic spinal infections. Moreover, combining mNGS with culture further improves diagnostic yield, supporting its integration into clinical practice.

Objective: To investigate the status and influencing factors of influenza vaccination among the elderly, so as to provide insights into improving the strategies for influenza vaccination among the elderly. Methods: Elderly people aged 60 years and above were recruited from one community each in five sub-districts of Shihezi City, Xinjiang Uygur Autonomous Region using a random sampling method. Demographic information, knowledge about influenza and influenza vaccines, vaccine literacy and influenza vaccination status in the past year were collected through questionnaire surveys. Factors affecting influenza vaccination among the elderly were analyzed using a multivariable logistic regression model. Results: Totally 1 121 valid questionnaires were recovered, with an effective recovery rate of 95.08%. There were 417 males (37.20%) and 704 females (62.80%). The majority were aged 60-<81 years, accounting for 80.37% (901 individuals). The awareness of knowledge about influenza and influenza vaccines was 78.86%. Low vaccine literacy was observed in 786 individuals, representing 70.12%. The influenza vaccination rate was 20.96%. Multivariable logistic regression analysis showed that age (71-<81 years, OR=1.607, 95%CI: 1.041-2.479; ≥81 years, OR=1.719, 95%CI: 1.040-2.842), educational level (middle school/technical secondary school, OR=0.616, 95%CI: 0.416-0.911), medical expense payment (employee medical insurance, OR=6.531, 95%CI: 2.030-21.010; resident medical insurance, OR=3.385, 95%CI: 1.095-10.466; public expense, OR=4.828, 95%CI: 1.700-13.712), vaccination willingness (yes, OR=6.237, 95%CI: 3.277-11.871), influenza vaccination history (yes, OR=14.600, 95%CI: 8.733-24.408) and vaccine literacy (medium and above, OR=2.412, 95%CI: 1.636-3.555) were associated with influenza vaccination among the elderly. Conclusion The influenza vaccination rate among the elderly was relatively low, and was mainly affected by age, educational level, medical expense payment, vaccination willingness, influenza vaccination history and vaccine literacy.

Objective To explore the mediating effect of psychological resilience between perceived spousal support and dignity loss in breast cancer patients.Methods A convenience sampling method was employed,involving 377 breast cancer patients who met the study criteria and received treatment at a tertiary oncology hospital in Yunnan Province from March to September 2023.Data were collected using a general information questionnaire,the Dignity Scale,the Perceived Spousal Support Scale,and the Psychological Resilience Scale.Data analysis was conducted using IBM SPSS 26.0 software.Results The scores for dignity loss,perceived spousal support,and psychological resilience of breast cancer patients were(41.72±6.77),(100.42±6.93),and(75.27±8.50),respectively.Pearson correlation analysis showed that dignity loss was negatively correlated with both perceived spousal support and psychological resilience(r1=-0.568,r2=-0.640,both P＜0.05).Mediation effect analysis indicated that psychological resilience had a mediating effect between perceived spousal support and dignity loss,with a value of-0.320(95％CI-0.409 to-0.246),accounting for 57.1％of the total effect.Conclusion The dignity of breast cancer patients in this study is in a state of mild loss,and psychological resilience plays a partial mediating role between perceived spousal support and dignity loss.This suggests that clinical medical staff should pay attention to the spousal support situation of breast cancer patients,provide timely guidance and health education to spouses,enhance the level of support from spouses,and strengthen the confidence and capability of couples in jointly coping with the disease,thereby alleviating dignity loss in breast cancer patients and improving their quality of life.

Mitochondrial dysfunction in chondrocytes is a key pathogenic factor in osteoarthritis (OA), but directly modulating mitochondria in vivo remains a significant challenge. This study is the first to verify a correlation between mitochondrial dysfunction and the downregulation of the FOXO3 gene in the cartilage of OA patients, highlighting the potential for regulating mitophagy via FOXO3 gene modulation to alleviate OA. Consequently, we developed a chondrocyte-targeting CRISPR/Cas9-based FOXO3 gene-editing tool (FoxO3) and integrated it within a nanoengineered 'truck' (NETT, FoxO3-NETT). This was further encapsulated in injectable hydrogel microspheres (FoxO3-NETT@SMs) to harness the antioxidant properties of sodium alginate and the enhanced lubrication of hybrid exosomes. Collectively, these FoxO3-NETT@SMs successfully activate mitophagy and rebalance mitochondrial function in OA chondrocytes through the Foxo3 gene-modulated PINK1/Parkin pathway. As a result, FoxO3-NETT@SMs stimulate chondrocytes proliferation, migration, and ECM production in vitro, and effectively alleviate OA progression in vivo, demonstrating significant potential for clinical applications.

Objective:To study the effects of low-dose dexmedetomidine via nasal spray on preoperative anxiety and tracheal intuba-tion induced stress response in elderly patients with maxillofacial surgery using heart rate variability(HRV).Methods:60 elderly pa-tients underwent maxillofacial surgery were randomly divided into the dexmedetomidine group(group D)and the control group(group C).Patients in the group D were treated with nasal spray of dexmedetomidine at 45 min preoperatively.Those in the group C were giv-en the same dose of normal saline spray at the same time.All patients were given intravenous combined with inhalation general anes-thesia.The hemodynamics,HRV index,sedation score and BIS value of the 2 groups of patients were compared at 3 time points,be-fore operation(T0),entrance(T1)and tracheal intubation(T2)respectively.Results:At T1,the average score of Ramsay in group D and group C was 2.8±0.7 and 1.1±0.39,BIS 87.3±6.1 and 97.4±0.5,SD1 20.9±7.0 and 15.4±5.4,SDNN 30.9±6.6 and 37.1±7.0,LF/HF 1.3±0.3 and 2.6±0.4,respectively(P＜O.01).At T2,the average score of SD1 in group D and group C was 10.4±3.5 and 7.7±3.1,SDNN 59.2±6.5 and 70.1±7.1,LF/HF 5.l±0.5 and 7.5±0.5,respectively(P＜0.01).Conclusion:Low-dose dexmedetomidine nasal spray can effectively relieve the preoperative anxiety of elderly patients in maxillofacial surgery and reduce the stress response of tracheal intubation.

Post-dialysis fatigue is a common complication in hemodialysis patients, which can lead to increased all-cause mortality and readmission rates, limiting their participation in daily life. This article mainly summarizes the application of assessment tools and theoretical models on post-dialysis fatigue in the management of post-dialysis fatigue in hemodialysis patients, providing a reference for medical and nursing staff to manage post-dialysis fatigue in patients.