BACKGROUND:In vitro construction of tissue-engineered intestinal models plays an important role in intestinal regeneration and intestinal disease research.The interaction of intestinal nervous system and intestinal epithelial barrier to maintain body homeostasis is a hot topic in the bionic construction of tissue-engineered intestinal tract.OBJECTIVE:To construct a bionic model that can mimic the enteric nervous system in vivo.METHODS:Using fibroin protein with villus structure as scaffold,human induced neural stem cells solidified with collagen were added to intestinal epithelial cells(Caco-2 and HT29-MTX-E12)for 3-day culture to construct a co-culture system of intestinal epithelial cells and nerve cells(co-culture group).Human induced neural stem cells or intestinal epithelial cells cultured alone that were inoculated with fibroin scaffolds were set as controls.Cell morphology was observed by scanning electron microscopy and hematoxylin-eosin staining.Cell activity was detected by Live/Dead cell staining.Human induced neural stem cell differentiation was detected by β-microtubulin immunofluorescence staining.Intestinal epithelial histological properties and barrier function were detected by microvillin,sucrase-isomaltase,tight junction protein 1,E-calmodulin,and mucin-2 immunofluorescence staining.The function of mucus secretion from intestinal epithelial cells was detected by Alcian blue staining.Alkaline phosphatase staining was performed to detect differentiation of intestinal epithelial cells,at the same time,sucrase-isomaltase,tight junction protein 1,and alkaline phosphatase mRNAs were detected by RT-qRCR.RESULTS AND CONCLUSION:The neuralized intestinal mucosal co-culture model with villi structure was successfully constructed,and neural stem cells and intestinal epithelial cells on the fibroin scaffold showed good cellular activities.After neuralization,the activity of alkaline phosphatase and sucrase-isomaltase in intestinal epithelial cells was enhanced,while the expression level of tight junction protein 1 was up-regulated.To conclude,the neuralized bionic intestinal epithelial model is beneficial to the maturation of intestinal mucosal epithelial cells and the formation of barrier function.

BACKGROUND:In vitro construction of tissue-engineered intestinal models plays an important role in intestinal regeneration and intestinal disease research.The interaction of intestinal nervous system and intestinal epithelial barrier to maintain body homeostasis is a hot topic in the bionic construction of tissue-engineered intestinal tract.OBJECTIVE:To construct a bionic model that can mimic the enteric nervous system in vivo.METHODS:Using fibroin protein with villus structure as scaffold,human induced neural stem cells solidified with collagen were added to intestinal epithelial cells(Caco-2 and HT29-MTX-E12)for 3-day culture to construct a co-culture system of intestinal epithelial cells and nerve cells(co-culture group).Human induced neural stem cells or intestinal epithelial cells cultured alone that were inoculated with fibroin scaffolds were set as controls.Cell morphology was observed by scanning electron microscopy and hematoxylin-eosin staining.Cell activity was detected by Live/Dead cell staining.Human induced neural stem cell differentiation was detected by β-microtubulin immunofluorescence staining.Intestinal epithelial histological properties and barrier function were detected by microvillin,sucrase-isomaltase,tight junction protein 1,E-calmodulin,and mucin-2 immunofluorescence staining.The function of mucus secretion from intestinal epithelial cells was detected by Alcian blue staining.Alkaline phosphatase staining was performed to detect differentiation of intestinal epithelial cells,at the same time,sucrase-isomaltase,tight junction protein 1,and alkaline phosphatase mRNAs were detected by RT-qRCR.RESULTS AND CONCLUSION:The neuralized intestinal mucosal co-culture model with villi structure was successfully constructed,and neural stem cells and intestinal epithelial cells on the fibroin scaffold showed good cellular activities.After neuralization,the activity of alkaline phosphatase and sucrase-isomaltase in intestinal epithelial cells was enhanced,while the expression level of tight junction protein 1 was up-regulated.To conclude,the neuralized bionic intestinal epithelial model is beneficial to the maturation of intestinal mucosal epithelial cells and the formation of barrier function.

Objective To explore the differences in terahertz(THz)signal characteristics between normal and ischemic liver tissues of New Zealand rabbits using THz time-domain spectroscopy(THz-TDS),thereby providing a novel detection technique for the pathological detection of liver tissues.Methods Liver ischemia models were established in New Zealand rabbits.The THz scanning signal maps of normal and ischemic liver tissues were obtained using a reflective THz-TDS system,and the acquired signals were subjected to principal component analysis.Results Both normal and ischemic liver tissues displayed two distinct peaks in their THz signals.However,the amplitude of the THz signal in ischemic liver tissue was higher than that in normal liver tissue,with significant differences also observed in their signal morphologies.Principal component analysis results revealed a clear clustered distribution between the signals of normal and ischemic liver tissues,indicating that THz-TDS could effectively distinguish between the two tissue types.Conclusion THz-TDS can be applied to the detection of ischemic liver tissue,providing experimental evidence to support further research on the early diagnosis of liver ischemia and exhibiting broad prospects for clinical application.

Objective To explore the differences in terahertz(THz)signal characteristics between normal and ischemic liver tissues of New Zealand rabbits using THz time-domain spectroscopy(THz-TDS),thereby providing a novel detection technique for the pathological detection of liver tissues.Methods Liver ischemia models were established in New Zealand rabbits.The THz scanning signal maps of normal and ischemic liver tissues were obtained using a reflective THz-TDS system,and the acquired signals were subjected to principal component analysis.Results Both normal and ischemic liver tissues displayed two distinct peaks in their THz signals.However,the amplitude of the THz signal in ischemic liver tissue was higher than that in normal liver tissue,with significant differences also observed in their signal morphologies.Principal component analysis results revealed a clear clustered distribution between the signals of normal and ischemic liver tissues,indicating that THz-TDS could effectively distinguish between the two tissue types.Conclusion THz-TDS can be applied to the detection of ischemic liver tissue,providing experimental evidence to support further research on the early diagnosis of liver ischemia and exhibiting broad prospects for clinical application.

Cadmium is a pervasive environmental pollutant with strong bioaccumulative properties and multisystem toxici-ty.Elderly individuals,as a vulnerable group,are particularly susceptible to the detrimental effects of long-term cadmium expo-sure on cognitive function.This review summarizes domestic and international research on the association between cadmium ex-posure,cognitive impairment in older adults,and Alzheimer's disease,while also discussing the potential underlying biological mechanisms.Current epidemiological studies predominantly use cross-sectional or case-control designs.Numerous studies have reported that cadmium exposure is associated with cognitive impairment in the elderly and an increased incidence or mortality of Alzheimer's disease.The neurotoxic mechanisms of cadmium are complex and varied,including disruption of the blood-brain barrier,impairment of mitochondrial function,interference with synaptic transmission,induction of autophagy and apoptosis,as well as disturbances in metal ion homeostasis and glycogen metabolism.Although numerous studies support the adverse effects of cadmium exposure on cognitive function in the elderly,these conclusions remain controversial,and the underlying biological mechanisms have not been fully elucidated.Therefore,further prospective cohort studies and in-depth biological research are ur-gently needed to better understand the health risks posed by cadmium exposure in the elderly.

Cadmium is a pervasive environmental pollutant with strong bioaccumulative properties and multisystem toxici-ty.Elderly individuals,as a vulnerable group,are particularly susceptible to the detrimental effects of long-term cadmium expo-sure on cognitive function.This review summarizes domestic and international research on the association between cadmium ex-posure,cognitive impairment in older adults,and Alzheimer's disease,while also discussing the potential underlying biological mechanisms.Current epidemiological studies predominantly use cross-sectional or case-control designs.Numerous studies have reported that cadmium exposure is associated with cognitive impairment in the elderly and an increased incidence or mortality of Alzheimer's disease.The neurotoxic mechanisms of cadmium are complex and varied,including disruption of the blood-brain barrier,impairment of mitochondrial function,interference with synaptic transmission,induction of autophagy and apoptosis,as well as disturbances in metal ion homeostasis and glycogen metabolism.Although numerous studies support the adverse effects of cadmium exposure on cognitive function in the elderly,these conclusions remain controversial,and the underlying biological mechanisms have not been fully elucidated.Therefore,further prospective cohort studies and in-depth biological research are ur-gently needed to better understand the health risks posed by cadmium exposure in the elderly.

Objective:To investigate the dosimetric advantages of deep inspiration breath-hold (DIBH) technique in postoperative radiotherapy for left-sided breast cancer.Methods:A prospective study was conducted on patients requiring adjuvant radiotherapy after left-sided breast cancer surgery at Jiangsu Cancer Hospital from January 2018 to May 2023. CT simulation images were acquired under both free breathing (FB) and DIBH respiratory modes. Planning target volumes (PTV) and organs at risk (OAR) were delineated, and dosimetric parameters were compared between the two respiratory modes. Additionally, patients were grouped into subgroups [internal mammary lymph node irradiation (IMNI) vs. non-IMNI, breast-conserving surgery (BCS) followed by radiotherapy vs. modified radical mastectomy (MRM) followed by radiotherapy], and dosimetric differences among subgroups for both breathing modes were compared. The Velocity system was used to measure the minimum distances from the heart and left anterior descending coronary artery (LAD) to the PTV surface on CT images. These distances were defined as the heart-to-PTV and LAD-to-PTV distances. Pearson correlation analysis was performed to assess the relationships between heart D max and LAD D max, heart-to-PTV distance and heart D mean, and LAD-to-PTV distance and LAD D max under both respiratory modes. Results:A total of 132 patients were included. Compared to the FB, DIBH showed no significant difference in target dose distribution, but significantly reduced dose to OAR. Specifically, the heart D mean and D max decreased by 1.8 Gy and 8.1 Gy, respectively, and the LAD D max decreased by 7.9 Gy, and the affected lung V 5 Gy and V 20 Gy were reduced by 6.4% and 2.5%, respectively (all P<0.05). All subgroups benefited from DIBH, with greater decrease of dose to OAR in the IMNI subgroup (compared with the non-IMNI subgroup) and the subgroup of MRM followed by radiotherapy (compared with the BCS followed by radiotherapy group). Under both FB and DIBH modes, heart D max and LAD D max showed linear correlations ( r=0.62 and 0.84, respectively; both P<0.001), heart-to-PTV distance correlated with heart D mean ( r=-0.61 and -0.67, respectively; both P<0.001), and LAD-to-PTV distance correlated with LAD D max ( r=-0.58 and -0.63, respectively; both P<0.001). Conclusions:The DIBH technique can significantly reduce dose to the heart, LAD, and lungs in patients undergoing postoperative radiotherapy for left-sided breast cancer without compromising target dose. Patients receiving IMNI after left-sided breast cancer surgery benefit more from the DIBH technique.

Objectives  There are only a few quantitative studies focusing on religious and cultural barriers among non-Japanese-speaking patients and discussing the association in Japanese healthcare institutions. This study aims to clarify the association between the religious and cultural backgrounds of non-Japanese-speaking patients and their difficult experiences in the healthcare institutions.Methods  The Google Forms questionnaire survey was conducted in four languages (Plain Japanese, English, Chinese, Vietnamese) among non-Japanese-speaking patients who had visited a Japanese healthcare institution. Of the 376 respondents (response rate: 19.7%), 350 were included in the analysis while excluding invalid responses. The association between their religions and difficulties were examined by logistic regression analysis with putting their gender, age, Japanese language proficiency, the purpose of visit and the way to communicate in examination rooms as adjustment variables. Results  237 (67.7%) had no religion, 29 (8.3%) were Christian, 12 (3.4%) were Muslim, 22 (6.3%) were Hindu and 50 (14.3%) were Buddhist of those analyzed. Odds ratios for experiencing difficulties were significantly higher for Hindu (odds ratio ［95% confidence interval］＝6.35［1.51-26.77］) and Christian (3.67［1.27-10.61］) compared with those who do not have religion. Regarding difficulties, it was found that the half of Hindu respondents identified “food” (50%) indicating a religious and cultural background, while various difficulties were identified for Christian respondents including “religion” (22%), “culture” (22%), and “medical costs” (22%).Conclusions  This study demonstrated an association between religion and difficulties in Japanese healthcare institutions among non-Japanese patients with a large proportion of outpatients. It was observed that Christian and Hindu respondents were more likely to have difficult experiences in the healthcare institutions. The results of this study suggest a need for religious and cultural consideration in outpatient settings such as the use of healthcare interpreters and the practice of transcultural nursing by medical professionals.

Objective:To investigate the dosimetric advantages of deep inspiration breath-hold (DIBH) technique in postoperative radiotherapy for left-sided breast cancer.Methods:A prospective study was conducted on patients requiring adjuvant radiotherapy after left-sided breast cancer surgery at Jiangsu Cancer Hospital from January 2018 to May 2023. CT simulation images were acquired under both free breathing (FB) and DIBH respiratory modes. Planning target volumes (PTV) and organs at risk (OAR) were delineated, and dosimetric parameters were compared between the two respiratory modes. Additionally, patients were grouped into subgroups [internal mammary lymph node irradiation (IMNI) vs. non-IMNI, breast-conserving surgery (BCS) followed by radiotherapy vs. modified radical mastectomy (MRM) followed by radiotherapy], and dosimetric differences among subgroups for both breathing modes were compared. The Velocity system was used to measure the minimum distances from the heart and left anterior descending coronary artery (LAD) to the PTV surface on CT images. These distances were defined as the heart-to-PTV and LAD-to-PTV distances. Pearson correlation analysis was performed to assess the relationships between heart D max and LAD D max, heart-to-PTV distance and heart D mean, and LAD-to-PTV distance and LAD D max under both respiratory modes. Results:A total of 132 patients were included. Compared to the FB, DIBH showed no significant difference in target dose distribution, but significantly reduced dose to OAR. Specifically, the heart D mean and D max decreased by 1.8 Gy and 8.1 Gy, respectively, and the LAD D max decreased by 7.9 Gy, and the affected lung V 5 Gy and V 20 Gy were reduced by 6.4% and 2.5%, respectively (all P<0.05). All subgroups benefited from DIBH, with greater decrease of dose to OAR in the IMNI subgroup (compared with the non-IMNI subgroup) and the subgroup of MRM followed by radiotherapy (compared with the BCS followed by radiotherapy group). Under both FB and DIBH modes, heart D max and LAD D max showed linear correlations ( r=0.62 and 0.84, respectively; both P<0.001), heart-to-PTV distance correlated with heart D mean ( r=-0.61 and -0.67, respectively; both P<0.001), and LAD-to-PTV distance correlated with LAD D max ( r=-0.58 and -0.63, respectively; both P<0.001). Conclusions:The DIBH technique can significantly reduce dose to the heart, LAD, and lungs in patients undergoing postoperative radiotherapy for left-sided breast cancer without compromising target dose. Patients receiving IMNI after left-sided breast cancer surgery benefit more from the DIBH technique.

Objective:To investigate the association of serum fibroblast growth factor 23(FGF23) level with insulin resistance(IR) and sex hormone levels in patients with polycystic ovary syndrome(PCOS).Methods:A retrospective study was performed in eighty-seven patients with PCOS, fifty-seven patients with simple IR, and sixty-one healthy women who were admitted to Affiliated Hospital of Zunyi Medical University during October 2021 and November 2022. According to the homeostasis model assessment-IR index, all subjects were divided into normal control group( n=61), IR group( n=57), PCOS without IR group(PCOS group, n=15), and PCOS+ IR group( n=72). The levels of serum FGF23, adiponectin, and sex hormones in all groups were compared, and their correlations with glucose and lipid metabolism indicators were analyzed. Results:The FGF23 level was significantly elevated in the IR group, while markedly reduced in the PCOS group and PCOS+ IR group, with the PCOS group showing a significantly lower concentration. The adiponectin levels were significantly decreased in the IR group, PCOS group, and PCOS+ IR group(all P<0.05). The correlation analysis showed that FGF23 level was positively correlated with adiponectin and sex hormone binding globulin, and negatively correlated with luteinizing hormone, luteinizing hormone/follicle stimulating hormone, and free testosterone index(all P<0.05). Logistic regression results indicated that both FGF23 and adiponectin could be used as good indicators for the diagnosis of PCOS and PCOS with IR(all P<0.05). Conclusion:FGF23 is closely related to IR and androgen as well, and under certain conditions, it can reflect the severity of IR and hyperandrogenemia in PCOS patients. The cutoff value of FGF23 obtained in this study can provide a good reference for the diagnosis of PCOS diseases.