Due to the difficulty of overcoming the abnormal epidermal barriers and addressing S. aureus infections without disrupting indigenous skin microbiota, effective treatment of bacterial infection atopic dermatitis (AD) remains a significant clinical challenge. Skin microbiota-derived extracellular vesicles (EVs) shows protentional for skin disease treatment, but the lack of antimicrobial activity and limited skin penetration hamper their application in bacterial infection AD treatment. Here, we developed novel nanoantibiotics by loading Lev into S. epidermidis-derived EVs (Lev@SE-EVs), with supreme antimicrobial activity, regulating epidermal immune responses and enhanced epidermal barrier functionality. The nanoantibiotics were further integrated into hyaluronic acid-based microneedle (MN) for efficient transdermal delivery of therapeutic agents and effectively treating bacterial infection in AD. Upon insertion into the skin, the rapidly released Lev@SE-EVs from MN are uptake by S. aureus in a selective manner, fibroblasts, and surrounding immune cells to exert therapeutic effects in the infected dermal layer, resulting in mitigated skin inflammation, reduced S. aureus burden and increased dermis repair. Notably, Lev@SE-EVs induce IL-17A⁺ CD8⁺ T-cell accumulation in the skin in an unrelated inflammation manner, which may represent heterologous protection. This EVs-integrated MN assisted Lev@SE-EVs to alleviate skin inflammation, repair skin, and provide an effective and safe therapeutic approach for bacterial infection AD treatment.

Synthetic biology is a crucial tool for the development of the bio-industry and bio-economy, representing a significant aspect of new quality productive forces. As a core course for graduate students in bioengineering, Synthetic Biology plays a vital role in ensuring the supply of essential talents for the development of the bio-industry in the new era. To better serve regional economic development and provide high-level talents for China's progress in the bio-industry, we analyzed typical issues encountered in the past teaching activities, set up a multi-disciplinary teaching team, optimized the course contents, adjusted the teaching mode, and mobilized students' learning interest. With the application of scientific research project as the starting point, we guided students to think and discuss deeply through the simulation of application writing and project defense, which improved students' critical thinking and innovative thinking. With industrialization as a focus, we explored a new training model combining production, education, and research through the joint practice base of the university and enterprises introduced typical cases of biomanufacturing to encourage students to engage in scientific research. The teaching reform significantly enhances the comprehensive abilities and national sentiments of graduate students. This paper hopes to serve as a reference for colleagues engaged in teaching in this field.
Synthetic Biology/education* ; Teaching ; China ; Humans

Objective:To explore the diagnostic value of small field of view ZooMit diffusion weighted imaging(Z-DWI)sequence of magnetic resonance imaging(MRI)in assessing benign and malignant pulmonary nodules.Methods:A total of 60 patients with pulmonary nodules who underwent MR examination at the First Affiliated Hospital with Nanjing Medical University from January 2021 to December 2022 were prospectively collected.All patients underwent conventional DWI(C-DWI)and Z-DWI.The signal to noise ratio(SNR),contrast to noise ratio(CNR),and apparent diffusion coefficient(ADC)of them were measured and analyzed.Two physicians with more than 8 years of experience in diagnosing pulmonary nodules implemented subjective scores for the image quality.Then,the ADC values of benign and malignant nodules between two kinds of images were compared.Results:The scores of Z-DWI images quality in terms of artifact,display of anatomical detail,lesion clarity,and image distortion were respectively(3.53±0.52),(3.27±0.70),(2.87±0.64),and(2.93±0.71),which were all higher than those of C-DWI images,and the differences were statistically significant(t=-4.68,-3.56,-2.44,-2.87,P<0.05).The SNR and CNR values of Z-DWI sequence were respectively(123.4±39.9)and(124.9±24.7),all of which were higher than those of C-DWI sequence,and the differences were statistically significant(t=-8.63,-7.09,P<0.05).The ADC values of C-DWI images of benign and malignant nodules were respectively(1.53±0.27)and(1.09±0.22),and the difference of that between them were statistically significant(t=9.88,P<0.001).The ADC values of Z-DWI images of benign and malignant nodules were respectively(1.39±0.18)and(0.99±0.19),and the difference of that between them was statistically significant(t=7.30,P<0.001).The ADC values of benign and malignant nodules of C-DWI images were higher than those of Z-DWI images,and the differences were statistically significant(t=3.40,2.13,P<0.05).Conclusion:Z-DWI can improve the image quality of benign and malignant pulmonary nodules,which has important clinically diagnostic significance in assessing the benign and malignant natures of pulmonary nodules.

Objective To develop a predictive model for guiding blood transfusion decisions in pediatric patients with traumatic brain injury(TBI)by identifying and analyzing key factors that influence blood transfusion requirements.Methods A retrospective analysis was conducted on the clinical data of 1,535 pediatric patients with TBI admitted to four medical institutions from January 1,2015,to December 31,2022.Patients were divided into two groups:those who received red blood cell transfusions during hospitalization and those who did not.Comparative analyses were performed on demographic,clinical,and laboratory data between these two groups.Logistic regression analysis was used to identify risk factors associated with in-hospital blood transfusion,and a predictive model was developed using a nomogram.The performance of this model was evaluated using a receiver operating characteristic(ROC)curve.Results Significant differences were observed between the blood transfusion and non-blood transfusion groups in terms of baseline demographics,clinical indicators,and laboratory test results(all P<0.05).Patients in the blood transfusion group exhibited significantly higher in-hospital mortality,compli-cation rates,use of mechanical ventilation,ICU admission rates,and length of stay compared to those in the non-blood transfusion group(all P<0.05).Multivariate logistic regression analysis identified heart rate,presence of other fractures,treatment methods,hemoglobin(Hb),platelet count(Plt),activated partial thromboplastin time(APTT),and D-dimer levels as independent risk factors for blood transfusion in TBI patients.The area under the ROC curve for the blood transfusion prediction model,based on these independent risk factors,was 0.95(95%CI:0.94～0.97),indicating excellent predictive accuracy.Calibration and decision curves further validated the robust-ness and reliability of the model's predictive capacity.Conclusions Heart rate,presence of other fractures,treatment methods,Hb,Plt count,APTT,and D-dimer levels serve as independent risk factors for blood transfusion in TBI patients.The prediction model developed based on these factors demonstrates excellent predictive performance,thereby guiding clinicians in making informed blood transfusion decisions and enhancing the success rate of patient outcomes.

Objective To develop a predictive model for guiding blood transfusion decisions in pediatric patients with traumatic brain injury(TBI)by identifying and analyzing key factors that influence blood transfusion requirements.Methods A retrospective analysis was conducted on the clinical data of 1,535 pediatric patients with TBI admitted to four medical institutions from January 1,2015,to December 31,2022.Patients were divided into two groups:those who received red blood cell transfusions during hospitalization and those who did not.Comparative analyses were performed on demographic,clinical,and laboratory data between these two groups.Logistic regression analysis was used to identify risk factors associated with in-hospital blood transfusion,and a predictive model was developed using a nomogram.The performance of this model was evaluated using a receiver operating characteristic(ROC)curve.Results Significant differences were observed between the blood transfusion and non-blood transfusion groups in terms of baseline demographics,clinical indicators,and laboratory test results(all P<0.05).Patients in the blood transfusion group exhibited significantly higher in-hospital mortality,compli-cation rates,use of mechanical ventilation,ICU admission rates,and length of stay compared to those in the non-blood transfusion group(all P<0.05).Multivariate logistic regression analysis identified heart rate,presence of other fractures,treatment methods,hemoglobin(Hb),platelet count(Plt),activated partial thromboplastin time(APTT),and D-dimer levels as independent risk factors for blood transfusion in TBI patients.The area under the ROC curve for the blood transfusion prediction model,based on these independent risk factors,was 0.95(95%CI:0.94～0.97),indicating excellent predictive accuracy.Calibration and decision curves further validated the robust-ness and reliability of the model's predictive capacity.Conclusions Heart rate,presence of other fractures,treatment methods,Hb,Plt count,APTT,and D-dimer levels serve as independent risk factors for blood transfusion in TBI patients.The prediction model developed based on these factors demonstrates excellent predictive performance,thereby guiding clinicians in making informed blood transfusion decisions and enhancing the success rate of patient outcomes.

Objective:To explore the diagnostic value of small field of view ZooMit diffusion weighted imaging(Z-DWI)sequence of magnetic resonance imaging(MRI)in assessing benign and malignant pulmonary nodules.Methods:A total of 60 patients with pulmonary nodules who underwent MR examination at the First Affiliated Hospital with Nanjing Medical University from January 2021 to December 2022 were prospectively collected.All patients underwent conventional DWI(C-DWI)and Z-DWI.The signal to noise ratio(SNR),contrast to noise ratio(CNR),and apparent diffusion coefficient(ADC)of them were measured and analyzed.Two physicians with more than 8 years of experience in diagnosing pulmonary nodules implemented subjective scores for the image quality.Then,the ADC values of benign and malignant nodules between two kinds of images were compared.Results:The scores of Z-DWI images quality in terms of artifact,display of anatomical detail,lesion clarity,and image distortion were respectively(3.53±0.52),(3.27±0.70),(2.87±0.64),and(2.93±0.71),which were all higher than those of C-DWI images,and the differences were statistically significant(t=-4.68,-3.56,-2.44,-2.87,P<0.05).The SNR and CNR values of Z-DWI sequence were respectively(123.4±39.9)and(124.9±24.7),all of which were higher than those of C-DWI sequence,and the differences were statistically significant(t=-8.63,-7.09,P<0.05).The ADC values of C-DWI images of benign and malignant nodules were respectively(1.53±0.27)and(1.09±0.22),and the difference of that between them were statistically significant(t=9.88,P<0.001).The ADC values of Z-DWI images of benign and malignant nodules were respectively(1.39±0.18)and(0.99±0.19),and the difference of that between them was statistically significant(t=7.30,P<0.001).The ADC values of benign and malignant nodules of C-DWI images were higher than those of Z-DWI images,and the differences were statistically significant(t=3.40,2.13,P<0.05).Conclusion:Z-DWI can improve the image quality of benign and malignant pulmonary nodules,which has important clinically diagnostic significance in assessing the benign and malignant natures of pulmonary nodules.

Background/Aims: Metabolic syndrome is common in patients with acute pancreatitis and its components have been reported to be associated with infectious complications. In this post hoc analysis, we aimed to evaluate whether metabolic abnormalities impact the effect of immuneenhancing thymosin alpha-1 (Tα1) therapy in acute necrotizing pancreatitis (ANP) patients. Methods: All data were obtained from the database for a multicenter randomized clinical trial that evaluated the efficacy of Tα1 in ANP patients. Patients who discontinued the Tα1 treatment prematurely were excluded. The primary outcome was 90-day infected pancreatic necrosis (IPN) after randomization. Three post hoc subgroups were defined based on the presence of hyperglycemia, hypertriglyceridemia, or both at the time of randomization. In each subgroup, the correlation between Tα1 and 90-day IPN was assessed using the Cox proportional-hazards regression model. Multivariable propensity-score methods were used to control potential bias. Results: Overall, 502 participants were included in this post hoc analysis (248 received Tα1 treatment and 254 received matching placebo treatment). Among them, 271 (54.0%) had hyperglycemia, 371 (73.9%) had hypertriglyceridemia and 229 (45.6%) had both. Tα1 therapy was associated with reduced incidence of IPN among patients with hyperglycemia (18.8% vs 29.7%: hazard ratio, 0.80; 95% confidence interval, 0.37 to 0.97; p=0.03), but not in the other subgroups. Additional multivariate regression models using three propensity-score methods yielded similar results. Conclusions Among ANP patients with hyperglycemia, immune-enhancing Tα1 treatment was associated with a reduced risk of IPN (ClinicalTrials.gov, Registry number: NCT02473406).

Attention deficit hyperactivity disorder(ADHD)is a common childhood neurodevelopmental disorders.In recent years,some studies have shown that there is a high comorbidity between ADHD and childhood allergic diseases such as bronchial asthma,atopic dermatitis,allergic rhinitis,and food allergies.Inflammatory reactions caused by allergic diseases may affect central nervous system function,Thereby further affecting the occurrence and development of ADHD,suggesting that there may be a close connection between the two diseases at the neuro-immune level.Although the common pathogenesis and causal relationship between the two have not been fully elucidated,multiple studies have revealed the epidemiological association between them.This article provides a review of the research on the association between children's allergic diseases and ADHD,and explores the possible comorbid mechanisms between them,and explore the treatment of comorbidities of allergic diseases and ADHD,aiming to provide new ideas for further clinical diagnosis,treatment,and research.In addition,more attention needs to be paid to the importance of prevention.By strengthening children's health education and raising the health awareness of parents and teachers,it can help reduce the risk of illness in children and build a more comprehensive and solid protective barrier for their health.

OBJECTIVE To study the pharmacokinetics of Esketamine hydrochloride nasal spray in rats and ciliary toxicity to maxillary mucosa of bullfrog. METHODS The plasma concentration of esketamine hydrochloride in rats was determined by LC-MS/ MS after intravenous injection of esketamine hydrochloride solution and nasal administration of esketamine hydrochloride； the pharmacokinetic parameters were calculated by using Phoenix WinNonlin 8.1.0 software. Using the maxillary mucosa of isolated bullfrog as a model， the morphological changes of maxillary mucosa were investigated， and the duration and recovery of ciliary oscillation were recorded after nasal administration of esketamine hydrochloride. RESULTS The peak of blood concentration occurred 2 min after nasal administration of esketamine hydrochloride； cmax was （814.58±418.80） ng/mL， AUC0－∞ was （203.75± 92.76） ng·h/mL， and the absolute bioavailability was 60.68%. After nasal administration of esketamine hydrochloride， it was observed that the cilia of bullfrog were arranged neatly， the edges were clear， the cilia tissue structure was complete and the cilia moved actively. The cilia movement time was （178.17±13.30） min for the first time， and after the cilia moved again， the ciliary movement time measured again was （24.50±9.19）min with a relative movement percentage of 53.56%. CONCLUSIONS Esketamine hydrochloride nasal spray has a rapid onset of action， high bioavailability， and low ciliary toxicity.