Objective To evaluate the accuracy of bioelectrical impedance analysis(BIA)in measurement of appendicular skeletal muscle mass(ASM)of adults.Methods A total of 836 adults aged 18-42 years were recruited in Guangzhou using a convenient sampling method from April 2021 to September 2022.ASM was measured using BIA and Dual-energy X-ray absorptiometry(DXA).Using DXA as the standard method,the consistency between the BIA and DXA measurements was evaluated by intra-class correlation coefficients(ICCs)and Bland-Altman analysis in logarithmically transformed data,in order to evaluate the accuracy of BIA in ASM measurement.Receiver operating characteristic curve was plotted to evaluate the diagnostic value of BIA for screening low muscle mass.Results A total of 774 individuals were included for analysis finally.ICCs for ASM measured by BIA and DXA were 0.774 and 0.667 in males and females,respectively.Mean ratios(limits of Agreement)of ASM were 0.94(0.80-1.10)and 0.91(0.78-1.05)in males and females,respectively.Area under curve of BIA for screening low muscle mass were 0.91 and 0.94 in males and females,respectively.The optimal cut-off values of Z-score by BIA for males and females were-0.57 and-0.66,respectively.Sensitivity and specificity for males were 82.5%and 86.0%,while being 86.8%and 93.8%,for females.Conclusion BIA shows a moderate consistency with DXA for measuring ASM in adults.Furthermore,BIA yields a good diagnostic value in identifying low muscle mass in adults aged 18-42 years.

Objective To explore the mechanism underlying the protective effect of α2-macroglobulin (A2M) against glucocorticoid-induced femoral head necrosis. Methods In a human umbilical vein endothelial cell (HUVEC) model with injuries induced by gradient concentrations of dexamethasone (DEX;10-8-10-5 mol/L), the protective effects of A2M at 0.05 and 0.1 mg/mL were assessed by examining the changes in cell viability, migration, and capacity of angiogenesis using CCK-8 assay, Transwell and scratch healing assays and angiogenesis assay. The expressions of CD31 and VEGF-A proteins in the treated cells were detected using Western blotting. In BALB/c mouse models of avascular necrosis of the femoral head induced by intramuscular injections of methylprednisolone, the effects of intervention with A2M on femoral trabecular structure, histopathological characteristics, and CD31 expression were examined with Micro-CT, HE staining and immunohistochemical staining. Results In cultured HUVECs, DEX treatment significantly reduced cell viability, migration and angiogenic ability in a concentration- and time-dependent manner (P<0.05), and these changes were obviously reversed by treatment with A2M in positive correlation with A2M concentration (P<0.05). DEX significantly reduced the expression of CD31 and VEGF-A proteins in HUVECs, while treatment with A2M restored CD31 and VEGF-A expressions in the cells (P<0.05). The mouse models of femoral head necrosis showed obvious trabecular damages in the femoral head, where a large number of empty lacunae and hypertrophic fat cells could be seen and CD31 expression was significantly decreased (P<0.05). A2M treatment of the mouse models significantly improved trabecular damages, maintained normal bone tissue structures, and increased CD31 expression in the femoral head (P<0.05). Conclusion A2M promotes proliferation, migration, and angiogenesis of DEX-treated HUVECs and alleviates methylprednisolone-induced femoral head necrosis by improving microcirculation damages and maintaining microcirculation stability in the femoral head.

Objective To explore the mechanism underlying the protective effect of α2-macroglobulin (A2M) against glucocorticoid-induced femoral head necrosis. Methods In a human umbilical vein endothelial cell (HUVEC) model with injuries induced by gradient concentrations of dexamethasone (DEX;10-8-10-5 mol/L), the protective effects of A2M at 0.05 and 0.1 mg/mL were assessed by examining the changes in cell viability, migration, and capacity of angiogenesis using CCK-8 assay, Transwell and scratch healing assays and angiogenesis assay. The expressions of CD31 and VEGF-A proteins in the treated cells were detected using Western blotting. In BALB/c mouse models of avascular necrosis of the femoral head induced by intramuscular injections of methylprednisolone, the effects of intervention with A2M on femoral trabecular structure, histopathological characteristics, and CD31 expression were examined with Micro-CT, HE staining and immunohistochemical staining. Results In cultured HUVECs, DEX treatment significantly reduced cell viability, migration and angiogenic ability in a concentration- and time-dependent manner (P<0.05), and these changes were obviously reversed by treatment with A2M in positive correlation with A2M concentration (P<0.05). DEX significantly reduced the expression of CD31 and VEGF-A proteins in HUVECs, while treatment with A2M restored CD31 and VEGF-A expressions in the cells (P<0.05). The mouse models of femoral head necrosis showed obvious trabecular damages in the femoral head, where a large number of empty lacunae and hypertrophic fat cells could be seen and CD31 expression was significantly decreased (P<0.05). A2M treatment of the mouse models significantly improved trabecular damages, maintained normal bone tissue structures, and increased CD31 expression in the femoral head (P<0.05). Conclusion A2M promotes proliferation, migration, and angiogenesis of DEX-treated HUVECs and alleviates methylprednisolone-induced femoral head necrosis by improving microcirculation damages and maintaining microcirculation stability in the femoral head.

With the widespread use of CT scan in lung cancer screening,in clinical practice the detection rate of pulmonary ground-glass nodule(GGN),especially multiple GGNs,has become higher and higher.So far,the guidelines for the treatment of multiple pulmonary nodules mainly focus on the high-risk nodules,while there is no uniform guideline for the management of multiple high-risk GGNs.The main treatment strategies for GGNs include follow-up check and surgical resection.However,for patients who are unable to undergo or refuse to receive surgery,non-surgical therapies such as stereotactic body radiation therapy(SBRT),interventional ablation(such as radiofrequency ablation,micro wave ablation,cryoablation,etc.)can be considered.This article reviews the clinical management strategies and therapeutic evaluation of multiple pulmonary nodules,aiming to provide reference for the clinical management of multiple pulmonary nodules.

Objective To develop an nomogram model for predicting the lung hemorrhage after CT-guided microwave ablation(MWA)in stage ⅠA non-small cell lung cancer(NSCLC)patients.Methods Stage ⅠA NSCLC patients treated with MWA were randomly divided into a training group and a validation group in a 3∶1 ratio.The risk factors of lung hemorrhage identified by univariable and multivariable logistic regression analysis in the training group were used to develop a nomogram model.The C-statistic was used to evaluate the predictive accuracy in both the training and validation groups.Results A total of 208 patients(training group,156 cases;validation group,52 cases)were included in this study.The risk factors of lung hemorrhage after MWA were the number of vessels passing through the lung parenchyma[odds ratio(OR)=3.815;95％confidence interval(CI)1.485-9.800;P=0.005],number of focal blood supplies(OR=2.922;95％CI 1.198-7.126;P=0.018)and number of punctures(OR=2.802;95％CI 1.792-4.381;P＜0.001).The C-statistic in training group was 0.928(95％CI 0.875-0.963)and the C-statistic in validation group was 0.906(95％CI 0.793-0.969).The optimal cut-off value for lung hemorrhage was 0.14.Conclusion The nomogram model can effectively predict the lung hemorrhage after MWA.Patients showing a high risk(＞0.14)on the nomogram model should be monitored for lung hemorrhage.

Objective:To propose a differential privacy fuzzy C-means clustering algorithm based on Gaussian kernel function(DPFCM_GF)to optimize the data privacy and security issues brought about by data analysis and mining of medical data in the context of big data,and to provide a theoretical basis for data privacy protection.Methods:In order to solve the problem of reducing the accuracy of the algorithm by randomly initializing the fuzzy C-mean membership matrix,the maximum distance method was used to determine the initial center point,the Gaussian value of the clustering center point was used to calculate the privacy budget allocation ratio,and the Laplace noise was added to complete the differential privacy protection and the DPFCM_GF was constructed.The effectiveness of DPFCM_GF was verified by collecting and collating the heart disease,breast cancer,thyroid disease and diabetes public data sets from the machine learning repository of the University of California,Irvine,and the gastric cancer and lung cancer datasets of The Second People's Hospital Huai'an were collected to verify the usability of the DPFCM_GF,and the analysis results were compared with the fuzzy C-means clustering algorithm(FCM)and the differentially private fuzzy C-means clustering algorithm(DPFCM).Results:For public datasets of heart disease,breast cancer,thyroid disease and diabetes,the optimal clustering effects of DPFCM_GF and DPFCM were equivalent to those of FCM;compared with DPFCM,the iteration time of DPFCM_GF was faster,the convergence speed was significant,the difference was statistically significant(t=4.01,4.71,4.01,12.38,P<0.05).For lung cancer and gastric cancer dataset,with the increase of privacy budget ε,the correct recognition rate of DPFCM_GF gradually converged to 91.9%and 93.9%,and the AUC values converged to 0.79 and 0.81,respectively,and when the privacy function ε was 0.1,0.5,1 and 2(ε<3),the DPFCM_GF clustering effect was significantly better than that of DPFCM,and the clustering effect was better and the difference was statistically significant(x2=12.25,87.12,68.58,7.76,P<0.05;x2=4.74,43.51,42.47,4.89,P<0.05).Conclusion:The DPFCM_GF is an effective method for protecting the privacy of medical data,and can also perform data analysis and mining tasks,which has certain research significance and prospects.

Nicotinamide mononucleotide (NMN) is one of the key precursors of coenzyme Ⅰ (NAD⁺). NMN exists widely in a variety of organisms, and β isomer is its active form. Studies have shown that β-NMN plays a key role in a variety of physiological and metabolic processes. As a potential active substance in anti-aging and improving degenerative and metabolic diseases, the application value of β-NMN has been deeply explored, and it is imminent to achieve large-scale production. Biosynthesis has become the preferred method to synthesize β-NMN because of its high stereoselectivity, mild reaction conditions, and fewer by-products. This paper reviews the physiological activity, chemical synthesis as well as biosynthesis of β-NMN, highlighting the metabolic pathways involved in biosynthesis. This review aims to explore the potential of improving the production strategy of β-NMN by using synthetic biology and provide a theoretical basis for the research of metabolic pathways as well as efficient production of β-NMN.
Nicotinamide Mononucleotide/metabolism* ; NAD/metabolism*

Objective: To investigate the factors influencing parents willingness to vaccinate their children against influenza in Guangzhou, and to provide a scientific basic for effectively improving the coverage rate of influenza vaccine in children. Methods: According to economic level, one secondary school and one elementary school in each of the central administrative and peripheral districts of Guangzhou were selected by stratified cluster sampling. A questionnaire survey was conducted among 5 133 parents of the school students. Questionnaire content included the basic characteristics of children and their parents, and parents knowledge of influenza vaccination for children. Results: A total of 14.57%(748/5 133) of parents were unwilling to have their children vaccinated against influenza. The results of the multivariate Logistic regression analysis found that, compared with parents aged ≤35 years old, parents aged 41-45 years and ≥46 years were 49% (adjusted OR=1.49, 95%CI =1.11-2.00) and 86% (adjusted OR= 1.86 , 95%CI =1.33-2.60), respectively, more likely to refuse vaccinating their children. Parents with an annual income ≥ 200 000 yuan were 52% more likely to be unwilling to vaccinate their children than those with annual income <100 000 yuan (adjusted OR=1.52, 95%CI =1.12-2.06). Parents living within a walking distance ≥30 minutes from the vaccination clinic were 52% more likely to be vaccinereluctant than those living within a walking distance of ≤10 minutes (adjusted OR=1.52, 95%CI = 1.16- 1.99). Compared with parents who regarded the vaccine as safe, parents who did not believe that it was safe or who were unsure of its safety were more likely to refuse vaccinating their children, with adjusted OR(95%CI ) of 12.75(9.44-17.23) and 3.37(2.73- 4.15 ), respectively( P <0.01). Conclusion Parents age, annual income, recognition of the safety of influenza vaccines, and walking distance to the vaccination clinic are associated with parents willingness to vaccinate children against influenza. Hospitals, communities and schools should cooperate to carry out vaccination and popular science propaganda, and arrange vaccination sites rationally to improve the coverage of influenza vaccines.

The new external preparations of tr aditional Chinese medicine （TCM）mainly include transdermal drug delivery preparation and transmucosal drug delivery system. With the development of modern science and technology ，new external preparations of TCM are widely used in internal medicine ，gynecology，pediatrics and other diseases. In order to provide reference for dosage form development of TCM and safe use of drug in clinic ，this paper reviews the research progress of new external preparation technology for TCM （skin penetration method ，carrier encapsulation technology ，etc.），new external dosage forms of TCM（microneedles，gels，patches，film sprays ，suppositories，film agents ，in situ gels ，etc.）. In the future ，the research of new external preparations of TCM should conduct under the guidance of TCM theory ，and pay attention to the new drug delivery system of previous drugs and the development of TCM components of “drug-adjuvant integration ”，strengthen the research on new external preparations of TCM compounds ，and establish an evaluation system in line with the overall characteristics of TCM so as to promote the sustainable development of new external preparations of TCM.

Colorectal cancer (CRC), a malignant tumor worldwide consists of microsatellite instability (MSI) and stable (MSS) phenotypes. Although SHP2 is a hopeful target for cancer therapy, its relationship with innate immunosuppression remains elusive. To address that, single-cell RNA sequencing was performed to explore the role of SHP2 in all cell types of tumor microenvironment (TME) from murine MC38 xenografts. Intratumoral cells were found to be functionally heterogeneous and responded significantly to SHP099, a SHP2 allosteric inhibitor. The malignant evolution of tumor cells was remarkably arrested by SHP099. Mechanistically, STING-TBK1-IRF3-mediated type I interferon signaling was highly activated by SHP099 in infiltrated myeloid cells. Notably, CRC patients with MSS phenotype exhibited greater macrophage infiltration and more potent SHP2 phosphorylation in CD68⁺ macrophages than MSI-high phenotypes, suggesting the potential role of macrophagic SHP2 in TME. Collectively, our data reveals a mechanism of innate immunosuppression mediated by SHP2, suggesting that SHP2 is a promising target for colon cancer immunotherapy.