Objective: To fabricate a hydrogel loaded with inositol hexaphosphate-zinc and preliminarily evaluate its performance in self-mineralization and osteoinduction, thereby providing a theoretical basis for the development of bone regeneration materials. Methods: The hydrogel framework (designated DF0) was formed by copolymerizing methacryloyloxyethyltrimethylammonium chloride and four-armed poly(ethylene glycol) acrylate, followed by sequentially loading inositol hexaphosphate anions via electrostatic interaction and zinc ions via chelation. The hydrogel loaded only with inositol hexaphosphate anions was named DF1, while the co-loaded hydrogel was named DF2. The self-mineralization efficacy of the DF0 , DF1 and DF2 hydrogels was characterized using scanning electron microscopy, transmission electron microscopy (TEM), energy dispersive spectroscopy (EDS), and selected area electron diffraction (SAED). The biocompatibility was assessed via live/dead cell staining and a CCK-8 assay. The osteoinductive capacity of the DF0 , DF1 and DF2 hydrogels on MC3T3-E1 cells was assessed via alkaline phosphatase (ALP) and Alizarin Red S (ARS) staining. In the aforementioned cell experiments, cells cultured in standard medium served as the control group Results: The DF0, DF1, and DF2 hydrogels were successfully synthesized. Notably, DF1 and DF2 exhibited distinct self-mineralization within 6 days. Results from TEM, EDS, and SAED confirmed that the mineralization products were amorphous calcium phosphate in group DF1, and amorphous calciumzinc phosphate in group DF2. Biocompatibility tests revealed that none of the hydrogels (DF0, DF1, and DF2) adversely affected cell viability or proliferation. In osteogenic induction experiments, both ALP and ARS staining were intensified in the DF1 and DF2 groups, with the most profound staining observed in the DF2 group. Conclusion The developed inositol hexaphosphate-zinc hydrogel (DF2) demonstrates the dual capacity to generate calcium-phosphate compounds through self-mineralization while exhibiting excellent osteoinductive properties. This biocompatible, dual-promoting osteogenic hydrogel presents a novel strategy for bone regeneration.

Dry eye disease(DED)and depression(DEP), though anatomically and clinically distinct, show significant epidemiological, pathophysiological, and prognostic interplay. Their co-occurrence has risen sharply in recent years, yet the mechanisms driving this comorbidity remain under-investigated. This review systematically synthesizes current evidence, highlighting that pro-inflammatory cytokines, neuro-regulatory imbalance, mitochondrial dysfunction, and gut-microbiota dysbiosis constitute a shared molecular network, while sleep deprivation and antidepressant use further amplify the vicious cycle. By identifying limitations in existing studies, this review proposes future research directions to offer new theoretical and clinical insights for managing DED-DEP comorbidity.

Xiang thinking is a cognitive approach that reflects the relationships between phenomena and their underlying principles by analyzing their external manifestations through methods such as analogy， reasoning， deduction， and symbolism. This article applied xiang thinking to analyze the etiology and pathogenesis of "wind， fire， phlegm， and blood stasis" in stroke， thereby exploring its impact on the principles of syndrome differentiation and treatment of this condition. Meanwhile， the article traced the construction process of xiang thinking， and interpreted the concept of "toxin pathogen" in traditional Chinese medicine from four perspectives， state， attribute， origin， and law. Furthermore， the relationship between the process of constructing xiang thinking and the origin of etiology， identification methods， pathogenesis evolution， and treatment strategies for stroke with syndrome of combined blood stasis and toxin was explored， so as to provide insights into research on the etiology and pathogenesis of stroke， as well as clinical diagnosis and treatment approaches.

Objective:To investigate the correlation between the density and volume of left atrial-epicardial adipose tissue(LA-EAT)and the occurrence and severity of atrial fibrillation(AF)in elderly patients.Methods:This was a retrospective case-control study.A total of 197 elderly patients with AF and 82 patients with sinus rhythm who were hospitalized in the Department of Cardiology and Geriatric Cardiology of the First Affiliated Hospital of Nanjing Medical University from June 2023 to July 2024.were selected.The AF group was further divided into paroxysmal AF(PAF)subgroup(111 cases)and persistent AF(PeAF)subgroup(86 cases). The density and volume of LA-EAT in all patients were meansured by coronary artery enhanced CT or left atrial enhanced CT.The differences in LA-EAT density, volume and related data among the 3 groups were compared, and their relationship with different severity of senile AF was analyzed.Logistic regression was used to analyze whether LA-EAT density and volume were risk factors for senile AF.The predictive value of LA-EAT density and volume for AF in the elderly was compared throuh restricted cubic spline analysis.Results:The average LA-EAT density in the sinus rhythm group, PAF group and PeAF group was -82.75(-87.15, -79.63), -81.70(-85.55, -75.85)and -80.45(-83.40, -76.10)HU, respectively; the standard deviation of density was 34.70(31.93, 36.28), 36.20(34.30, 37.65)and 35.45(33.63, 37.28)HU, respectively; the LA-EAT volume was 23 483.40(13 964.10, 31 645.53), 25 112.20(18 479.10, 36 917.50)and 37 836.50(25 933.80, 45 537.90)mm 3, respectively.The LA-EAT density and volume in the PAF group and PeAF group were higher than those in the sinus rhythm group(all P<0.05). The LA-EAT volume in the PeAF group was greater than that in the PAF group( P<0.001), but there was no significant difference in LA-EAT density between the two groups( P>0.05). Multivariate logistic regression analysis showed that LA-EAT density and volume, left atrial diameter(LAD)and body mass index(BMI)were the independent risk factors for AF in the elderly( P<0.05). Conclusions:LA-EAT density and volume are significantly correlated with occurrence of senile AF, and show a positive dose-response relationship.LA-EAT volume is significantly related to the severity of AF( P<0.05), while the density is not significantly related to it( P>0.05).

Objective:To identify the risk factors for deep vein thrombosis (DVT) in lower limbs after total hip arthroplasty (THA) in elderly patients.Methods:Medical records of elderly patients, aged ≥ 65 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅳ, who underwent unilateral THA from June 2013 to May 2019, were retrospectively collected. Postoperative screening for DVT was performed using Doppler ultrasound, and the patients were divided into non-DVT group and DVT group based on the results. Logistic regression analysis was then employed to identify the risk factors associated with DVT.Results:The results of logistic regression analysis revealed that female, preoperative C-reaction protein concentration>8 mg/L, intraoperative hypotension, and postoperative transfer to intensive care unit were independent risk factors for DVT after THA in elderly patients ( P<0.05). Conclusions:Female, preoperative C-reaction protein concentration>8 mg/L, intraoperative hypotension, and postoperative transfer to intensive care unit are independent risk factors for DVT in lower limbs following THA in elderly patients.

Objective:To investigate the impact of immunosuppressive therapy on the severity of SARS-CoV-2 infection and cytokine levels in pediatric patients with kidney diseases.Methods:A retrospective analysis was conducted on the clinical data of 40 hospitalized pediatric patients who were diagnosed with SARS-CoV-2 infection at the 900th Hospital of PLA Joint Logistic Support Force from December 2022 to February 2023. Based on their immunosuppressive status prior to SARS-CoV-2 infection, these patients were categorized into immunosuppressive group and non-immunosuppressive group. Independent sample t-tests, Mann-Whitney U tests, and χ2 test were employed to compare the clinical baseline characteristics and laboratory data, the severity of SARS-CoV-2 infection, and the levels of cytokines between the 2 groups. Results:Among the 40 patients, 11 were in the immunosuppressive group (aged 13 (8, 14) years, 9 males and 2 females) and 29 in the non-immunosuppressive group (aged 2 (1, 4) years, 15 males and 14 females). In the immunosuppressive group, 2 were asymptomatic cases, 8 were mild cases, and 1 was moderate case, and there was no severe or critical cases. In the non-immunosuppressive group, 8 were mild cases, 5 were moderate, 15 were severe cases, 1 was critical case, and no asymptomatic cases. The underlying diseases in the immunosuppressive group included nephrotic syndrome (6 cases), IgA vasculitis nephritis (2 cases), lupus nephritis (1 case), post-renal transplantation (1 case), and renal failure (1 case), with a mean total immunosuppression score (TIS) of (3.6±1.4) points. In the non-immunosuppressive group, 2 patients had a history of epilepsy, and the remaining 27 cases had no underlying conditions, all with TIS scores of 0. Compared to the children in the non-immunosuppressive group, those in the immunosuppressive group were more likely to exhibit asymptomatic or mild infection, with lower risks of severe disease, cytokine storm, fever, and cough, but a higher risk of fatigue ( OR=1.22, 2.66, 0.48, 0.12, 0.12, 0.13, 1.22; 95% CI 0.93-1.62, 0.99-7.15, 0.33-0.70, 0.03-0.57, 0.03-0.57, 0.03-0.65, 0.93-1.62; all P<0.05). The levels of cytokine IL-6, interferon-α and interferon-γ in the immunosuppressive group were all lower than those in the non-immunosuppressive group ( Z=2.23, 2.51, 2.92, respectively; all P<0.05). Conclusion:Pediatric patients with kidney diseases receiving appropriate immunosuppressive therapy may mitigate the severity of SARS-CoV-2 infection by suppressing the expression of cytokines.

Objective To analyze the deployment of policy instruments and the distribution of stakeholder engagement in provincial policies on nursing assistant training and management.Methods The relevant policy texts on nursing assistant training and management were systematically searched and collected from the official websites of provincial governments and their direct departments,CNKI,and the PKU Law Database.A two-dimensional framework of policy instruments-stakeholder was constructed,and the content analysis was used to classify,encode and quantify policy clauses.Results The study encompassed 20 provincial-level nursing assistant training and management policies,yielding a total of 359 codes.Within the policy instruments dimension,environmental,supply,and demand instruments constituted 66.30％,28.97％,and 4.74％,respectively.In terms of stakeholders,the management-side accounted for 56.55％,providers and trainers for 18.11％each,partners for 5.01％,and demand-side for 2.23％.Both management-side and trainers engaged with 3 policy instruments,providers with 2,and partners and demand-side with one each.Conclusion In the provincial nursing assistant training and management policies,there are differences in the deployment of policy instruments,and the distribution of stakeholders is uneven.Managers should pay attention to publicity guidance and platform construction,improve incentive mechanisms and training programs,and innovate cooperation models with stakeholders,as well as strengthen communication and exchange.

Objective To systematically evaluate the influencing factors for antiretroviral therapy(ART)discontinuation in Chinese human immunodeficiency virus(HIV)/acquired immuno deficiency syn-drome(AIDS)patients.Methods A computer-based search was conducted in PubMed,Web of Science,Em-base,The Cochrane Library,CNKI,Wanfang,VIP,and China Biology Medicine(CBM)databases for studies on influencing factors of ART discontinuation in Chinese HIV/AIDS patients from the establishment of the databases to August 2024.Meta-analysis was performed on the included studies by using Stata16.0.Results A total of 17 studies were included.Meta-analysis showed that the following factors were associated with ART discontinuation:male gender(OR=1.301,95%CI:1.099-1.540),age≥50 years(OR=1.212,95%CI:1.109-1.324),unmarried/divorced/widowed marital status(OR=1.198,95%CI:1.060-1.354),education level was or below senior high school(OR=1.778,95%CI:1.508-2.096),infection route was in-travenous drug use(OR=2.420,95%CI:1.989-2.945),baseline CD4 cell count>500 cells/μL(OR=1.157,95%CI:1.020-1.313),tuberculosis co-infection before ART(OR=1.559,95%CI:1.398-1.739),hepatitis B co-infection before ART(OR=1.554,95%CI:1.305-1.851),AIDS-related symptoms occur be-fore ART(OR=1.245,95%CI:1.148-1.351),time from diagnosis to treatment initiation≥365 days(OR=1.449,95%CI:1.301-1.615),initial treatment regimen containing zidovudine(OR=1.573,95%CI:1.206-2.052),treatment at county-level or lower institutions(OR=1.204,95%CI:1.153-1.257),exist drug adverse reactions(OR=7.043,95%CI:3.142-15.786),and compliance education(OR=0.182,95%CI:0.094-0.352).Conclusion There are multiple factors influencing ART discontinuation in Chinese HIV/AIDS patients.Early identification of individuals at risk of discontinuation and targeted interventions are nec-essary to promote their maintenance of ART.

The research on the mechanism of Chinese materia medica in the treatment of viral pneumonia (VP) is mainly based on the monomer components of Chinese materia medica and TCM compounds. Among them, the monomer components are mainly polyphenols, flavonoids and anthraquinones, which have anti-inflammatory, antiviral, immunomodulatory and antioxidant pharmacological effects. The efficacy of TCM compounds is mainly based on clearing heat, and it has the functions of removing phlegm, removing blood stasis, removing dampness, moistening lung and so on. The intervention of Chinese materia medica in VP mainly involves NF-κB, MAPK, JAK/STAT, PI3K/Akt and other signaling pathways. The mechanism includes regulating oxidative stress, apoptosis, regulating immune function, inhibiting inflammatory response, etc., which can reduce the pathological damage of inflammatory cell infiltration and edema in lung tissue, and achieve the protective effect on lung tissue. The current research models exhibit unclear patterns of syndrome differentiation, and the mechanisms of Chinese materia medica involving multiple targets and pathways are poorly understood. Future research should integrate disease-syndrome combination models to further explore the mechanisms by which TCM regulates multiple targets and pathways, thereby providing insights and methodologies for the treatment of viral pneumonia with Chinese materia medica.

Objective To investigate the effects and regulatory mechanisms of carboxyamidotriazole orotate(CTO)on the metabolism and inflammatory mediators of glioma-associated microglia(GAM).Methods Tumor volume was regularly monitored by in vivo imaging,and histological examination was performed to detect the extent of tumor in-filtration;non-targeted metabolomics analysis was used to detect the level of tricarboxylic acid cycle metabolites in cells;seahorse cell energy measurement method was used to detect the oxygen consumption rate(OCR)and extra-cellular acidification rate(ECAR)of cells;immunofluorescence was used to detect the degree of hypoxia in cells;quantitative PCR was used to detect the mRNA level of pro-cancer mediators M1/M2 in cells;Western blot was used to detect the protein level of hypoxia-inducible factor-1α(HIF-1α)and programmed death receptor-ligand 1(PD-L1).Results CTO inhibited the tumor progression in mice,and down-regulated the oxidative phosphorylation level and improved cell hypoxia in vitro(P＜0.01).It also downregulated the expression of pro-oncogenic mediators iNos,Arg-1,Il-10,and Irf4 in GAM(P＜0.01).When combined with lactate dehydrogenase inhibitor stiripentol(STP),CTO-induced enhancement of glycolysis and upregulation of PD-L1 expression in GAM was attenuated(P＜0.01),and the expressions of Arg-1 and Il-10 was further downregulated(P＜0.000 1).Conclusions CTO down-regulates the expression of several oncogenic genes in GAM and inhibits tumor progression in mice.Combined use of lactate dehydrogenase inhibitors can weaken the adverse effect of CTO and reduce the transcriptional level of GAM oncogenic mediators.