Objective: To investigate the coexistence of comorbidity of myopia, overweight/obesity and depressive symptoms among middle school students in Quzhou and its associated factors, so as to provide evidence for integrated prevention and control of common multiple health issues in students. Methods: From September to November 2023, a total of 5 867 middle school students from 6 counties (cities and districts) in Quzhou City were selected by stratified random cluster sampling. Physical and visual examinations were conducted, and the Center for Epidemiological Studies - Depression Scale (CES-D) along with a questionnaire on health status and influencing factors were completed. Multivariate Logistic regression was used to analyze the related factors of coexistence of myopia, overweight/obesity, and depressive symptoms among middle school students, and a nomogram model was constructed based on the results. Results: A total of 161 middle school students in Quzhou City were identified as having comorbid myopia, overweight/ obesity and depressive symptoms, with a detection rate of 2.74%. The results of multivariate Logistic regression analysis showed that the coexistence of myopia, overweight/obesity and depressive symptoms increased among middle school students with older age ( OR =1.11), a greater number unhealthy dietary behaviors (1,2,≥3; OR =2.40, 2.70, 4.63), insufficient sleep( OR =1.78) and alcohol consumption ( OR =2.11)(all P <0.05). Compared with no homework after class, those whose homework duration after class was 1 to < 2 hour had a lower risk of comorbidity of myopia, overweight/obesity and depressive symptoms ( OR =0.53, P <0.05). The results of the nomogram model showed that the AUC (95% CI ) was 0.71 (0.67-0.74). Conclusions The coexistence of myopia, overweight/obesity and depressive symptoms among middle school students in Quzhou City is related to age, sleeping, alcohol consumption, poor dietary behavior and the duration of after school homework. The nomogram model can assist in the early screening and intervention of multiple health issues among students.

Hereditary angioedema (HAE) is a rare autosomal dominant genetic disorder characterized by recurrent episodes of subcutaneous and submucosal edema, which can be life-threatening in severe cases. Lanadelumab, a recombinant human monoclonal antibody against kallikrein, has been recommended as a first-line option for long-term prophylaxis of HAE. This paper analyzed the clinical data of four patients with HAE diagnosed and treated with lanadelumab for long-term prophylaxis in our department since 2020. It also reviewed relevant literature, summarizing the clinical manifestations of HAE, as well as the efficacy and safety of lanadelumab in treating HAE, to provide therapeutic references for clinicians.

Objective To investigate the effect and mechanism of Di'ao Xinxuekang(hereinafter referred to as Xinxuekang)combined with Simvastatin on atherosclerosis(AS)mice.Methods Eight C57BL/6J mice were used as control group,and 32 ApoE-/-mice were randomly divided into model group,Xinxuekang group(160 mg·kg-1),Simvastatin group(1.3 mg·kg-1)and combined treatment group(Xinxuekang 160 mg·kg-1+Simvastatin 1.3 mg·kg-1),with eight mice in each group.The control group was fed with conventional diet,and the other four groups were fed with high-fat diet.At the same time,each administration group was given intragastric administration according to the above dose,and the volume of intragastric administration was 10 mL·kg-1,once a day for 18 weeks.After administration,the levels of serum total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)and high density lipoprotein cholesterol(HDL-C)were detected.Oil red O staining was used to observe the formation of aortic plaque and liver lipid accumulation in mice.Serum PCSK9 level was detected by ELISA.The mRNA and protein expression levels of LDLR,HNF1α and SREBP2 in liver tissues were detected by qRT-PCR and Western Blot.Results(1)Compared with the control group,the levels of serum TC,TG and LDL-C in the model group were significantly increased(P＜0.01),and the level of HDL-C was significantly decreased(P＜0.01).The percentage of aortic root plaque area,the percentage of total aortic plaque area and the percentage of liver lipid droplet area were significantly increased(P＜0.01).The mRNA and protein expression levels of LDLR in liver tissue were significantly decreased(P＜0.01),and the serum PCSK9 level was significantly increased(P＜0.01).The mRNA and protein expression levels of HNF1α and SREBP2 in liver tissues were significantly increased(P＜0.05,P＜0.01).(2)Compared with the model group,the levels of serum TC,TG and LDL-C in the Xinxuekang group and the combined treatment group were significantly decreased(P＜0.05,P＜0.01),and the level of HDL-C was significantly increased(P＜0.05).The level of serum LDL-C in Simvastatin group was significantly decreased(P＜0.01).The percentage of aortic root plaque area and the percentage of total aortic plaque area in the Xinxuekang group and the combined treatment group were significantly decreased(P＜0.05,P＜0.01),and the percentage of liver lipid droplet area in each administration group was significantly decreased(P＜0.01).The protein expression level of LDLR in liver tissue of mice in Xinxuekang group and combined treatment group was significantly increased(P＜0.05),the serum PCSK9 level was significantly decreased(P＜0.05,P＜0.01),and the mRNA and protein expression levels of HNF1 α and SREBP2 in liver tissue were significantly decreased(P＜0.05,P＜0.01).(3)Compared with the Simvastatin group,the serum HDL-C level in the combined treatment group was significantly increased(P＜0.05).The percentage of aortic root plaque area and the percentage of liver lipid droplet area were significantly decreased(P＜0.05,P＜0.01).The protein expression level of LDLR in liver tissue was significantly increased(P＜0.01),and the serum PCSK9 level was significantly decreased(P＜0.01).The expression levels of HNF1α protein and SREBP2 mRNA in liver tissues were significantly decreased(P＜0.05,P＜0.01).Conclusion Xinxuekang may play a synergistic effect on lipid-lowering and anti-AS effects of Simvastatin by inhibiting the expressions of SREBP2 and HNF1α and regulating the PCSK9/LDLR signaling pathway.

Papaya, which is mainly cultivated in the southeastern region of China, is one of the four famous fruits in Lingnan. It is favored by people because of its edible and medicinal value. Fructose-6-phosphate, 2-kinase/fructose-2, 6-bisphosphatase (F2KP) is a unique bifunctional enzyme with a kinase domain and an esterase domain that catalyzes the synthesis and degradation of fructose-2, 6-bisphosphate (Fru-2, 6-P₂), an important regulator of glucose metabolism in organisms. In order to study the function of the gene CpF2KP encoding the enzyme in papaya, it is particularly important to obtain the target protein. In this study, the coding sequence (CDS) of CpF2KP, with a full-length of 2 274 bp, was got from the papaya genome. The amplified sequence of full-length CDS was cloned into the vector PGEX-4T-1 which was double digested with EcoR I and BamH I. The amplified sequence was constructed into a prokaryotic expression vector by genetic recombination. After exploring the induction conditions, the results of SDS-PAGE showed that the size of the recombinant GST-CpF2KP protein was about 110 kDa. The optimum IPTG concentration and temperature for CpF2KP induction were 0.5 mmol/L and 28 ℃, respectively. The purified sin[A1] gle target protein was obtained after purifying the induced CpF2KP protein. In addition, the expression level of this gene was detected in different tissues, and showed that the gene was expressed at the highest level in seeds and the lowest in pulp. This study provides an important basis for further revealing the function of CpF2KP protein and studying the involved biological processes of this gene in papaya.
Humans ; Carica/genetics* ; Recombinant Proteins ; Carbohydrate Metabolism ; Cloning, Molecular ; China

Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease with unclear etiology and limited treatment options. The median survival time for IPF patients is approximately 2-3 years and there is no effective intervention to treat IPF other than lung transplantation. As important components of lung tissue, endothelial cells (ECs) are associated with pulmonary diseases. However, the role of endothelial dysfunction in pulmonary fibrosis (PF) is incompletely understood. Sphingosine-1-phosphate receptor 1 (S1PR1) is a G protein-coupled receptor highly expressed in lung ECs. Its expression is markedly reduced in patients with IPF. Herein, we generated an endothelial-conditional S1pr1 knockout mouse model which exhibited inflammation and fibrosis with or without bleomycin (BLM) challenge. Selective activation of S1PR1 with an S1PR1 agonist, IMMH002, exerted a potent therapeutic effect in mice with bleomycin-induced fibrosis by protecting the integrity of the endothelial barrier. These results suggest that S1PR1 might be a promising drug target for IPF therapy.

OBJECTIVE: To systematically evaluate the effect of early systematic rehabilitation on muscle strength and prognosis of patients undergoing mechanical ventilation in intensive care unit (ICU). METHODS: Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure (CNKI), VIP database (VIP) and Wanfang database were searched by computer for randomized controlled trial (RCT) on early systematic rehabilitation of patients undergoing mechanical ventilation in ICU published from the establishment of the database to October 2022. The observation group was given early systematic rehabilitation, while the control group was given routine activities. The outcome indicators included Medical Research Council muscle strength score (MRC score), incidence of ICU-acquired weakness (ICU-AW), 36-item short form health survey scale (SF-36), length of hospital stay, and hospital mortality. Two researchers independently screened the literature, extracted the data, and evaluated the quality of the literature to conduct a Meta-analysis of the studies that met the quality criteria. Funnel plot was used to analyze the publication bias of each study. RESULTS: A total of 14 articles were enrolled, 13 in English and 1 in Chinese. A total of 1 835 patients were involved, including 922 cases in the observation group and 913 cases in the control group. The overall literature quality was good. Compared with the control group, the incidence of ICU-AW in the observation group was significantly reduced [relative risk (RR) = 0.78, 95% confidence interval (95%CI) was 0.62-0.98, P < 0.05], but the MRC score was not significantly increased [weighted mean difference (WMD) = 2.51, 95%CI was 0.77-4.25, P = 0.05]. There were no significant differences in ICU mortality (RR = 1.05, 95%CI = 0.59-1.87, P > 0.05), hospital mortality (RR = 1.15, 95%CI was 0.76-1.74, P > 0.05), length of ICU stay (WMD = -3.02, 95%CI was -7.29-1.24, P > 0.05), total length of hospital stay (WMD = -3.67, 95%CI was -8.04-0.70, P > 0.05), and physical component summary (PCS; WMD = 1.83, 95%CI was -0.28-3.93, P > 0.05) and mental component summary (MCS; WMD = 1.72, 95%CI was -0.76-4.20, P > 0.05) of SF-36 scale at 6 months after discharge between the two groups. It was shown by funnel plot that the publication bias of each literature was relatively small, manifested as the effect points included in the literature were basically in a "inverted funnel" shape and symmetrical, in terms of MRC score, incidence of ICU-AW, mortality, length of hospital stay and scores of SF-36 scale. CONCLUSIONS Early systematic rehabilitation can significantly reduce the incidence of ICU-AW, without increasing the mortality, and has no significant improvement on muscle strength and physical function.
Humans ; Respiration, Artificial ; Intensive Care Units ; Prognosis ; Incidence ; Muscle Strength

The rapid and accurate authentication of traditional Chinese medicines(TCMs)has always been a key scientific and technical problem in the field of pharmaceutical analysis.Herein,a novel heating online extraction electrospray ionization mass spectrometry(H-oEESI-MS)was developed for the rapid and direct analysis of extremely complex substances without the requirement for any sample pretreatment or pre-separation steps.The overall molecular profile and fragment structure features of various herbal medicines could be completely captured within 10-15 s,with minimal sample(＜0.5 mg)and solvent consumption(＜20 μL for one sample).Furthermore,a rapid differentiation and authentication strategy for TCMs based on H-oEESI-MS was proposed,including metabolic profile characterization,characteristic marker screening and identification,and multivariate statistical analysis model validation.In an analysis of 52 batches of seven types of Aconitum medicinal materials,20 and 21 key compounds were screened out as the characteristic markers of raw and processed Aconitum herbal medicines,respectively,and the possible structures of all the characteristic markers were comprehensively identified based on Com-pound Discoverer databases.Finally,multivariate statistical analysis showed that all the different types of herbal medicines were well differentiated and identified(R2X＞0.87,R2Y＞0.91,and Q2＞0.72),which further verified the feasibility and reliability of this comprehensive strategy for the rapid authentication of different TCMs based on H-oEESI-MS.In summary,this rapid authentication strategy realized the ultra-high-throughput,low-cost,and standardized detection of various complex TCMs for the first time,thereby demonstrating wide applicability and value for the development of quality standards for TCMs.

Tumor-associated tertiary lymphoid structures(TLSs)are ectopic lymphoid formations within tumor tissue,with mainly B and T cell populations forming the organic aggregates.The presence of TLSs in tumors has been strongly associated with patient responsiveness to immunotherapy regimens and improving tumor prognosis.Researchers have been motivated to actively explore TLSs due to their bright clinical application prospects.Various studies have attempted to decipher TLSs regarding their formation mechanism,structural composition,induction generation,predictive markers,and clinical utilization.Meanwhile,the scientific approaches to qualitative and quantitative descriptions are crucial for TLS studies.In terms of detection,hematoxylin and eosin(H&E),multiplex immunohistochemistry(mIHC),multiplex immunofluorescence(mIF),and 12-chemokine gene signature have been the top approved methods.However,no standard methods exist for the quantitative analysis of TLSs,such as absolute TLS count,analysis of TLS constituent cells,structural features,TLS spatial location,density,and maturity.This study reviews the latest research progress on TLS detection and quantification,proposes new directions for TLS assessment,and addresses issues for the quantitative application of TLSs in the clinic.

AIM: To compare ultrasound-guided vertebroplasty (percutaneous vertebroplasty, PVP) with X-ray guided vertebroplasty (PVP) to confirm the success rate of puncture point, X-ray radiation dose, operation time and postoperative outcome to explore the clinical application value of ultrasound-guided vertebroplasty. METHODS: Patients with thoracolumbar vertebral compression fractures treated by PVP in our hospital from November 2018 to October 2021 were divided into ultrasound-guided group and X-ray guided group. The success rate of puncture, the X-ray radiation dose, operation time and postoperative outcome were compared between the two groups. RESULTS: A total of 97 patients were included in this study, with an average follow-up time of (14.412±10.261) months. The success rate of one-time puncture was 60.4% in the ultrasound-guided group and 30.6% in the X-ray guided group (P<0.05). The X-ray radiation dose, fluoroscopy times and operation time in the ultrasound-guided group were significantly lower than those in the X-ray-guided group (P<0.05). The difference was statistically significant (P<0.05). The VAS of low back pain was significantly relieved in the two groups, but there was no significant difference between the two groups. There were no postoperative complications such as infection, puncture site hematoma and fracture nonunion between the two groups. CONCLUSION: Ultrasound guidance is a safe and effective method to determine the needle entry point of PVP. Skillful operation can improve the success rate of one-time puncture. Compared with traditional X-ray guidance, it can shorten the operation time, reduce the number of X-ray fluoroscopy and radiation during PVP operation.

Objective:To explore the metabolic outcomes of type 2 diabetes patients with different durations after 1 year treatment under the standardized metabolic disease management model.Methods:(1)From September 2017 to September 2018, 345 type 2 diabetes patients in the Standardized Metabolic Management Center(MMC) of Shanghai General Hospital were recruited and included in this research. They were divided into newly-diagnosed type 2 diabetes(duration≤1 year) and long-term groups(duration>1 year). The general characteristics, blood pressures, glycemic levels, lipids levels, control rates and comprehensive compliance rates(blood glucose, pressure and lipids all reached targets) were compared at baseline between 2 groups.(2)All patients underwent one year standardized management, and metabolic indicators mentioned above and control rates at the time were compared as well.Results:(1) At baseline, compared with long-term group, patients in newly-diagnosed type 2 diabetes group were younger ( P<0.01), and 2 h blood glucose level after glucose loading were higher [(15.20±5.26 vs 13.68±4.94) mmol/L, P<0.01]. (2) After one year standardized management, body weight, blood pressure, glucose and lipids metabolism in all patients were significantly improved. Compared with patients in long-term group, newly-diagnosed type 2 diabetes patients achieved better glycemic level [fasting blood glucose(6.27±1.56 vs 7.63±2.08) mmol/L, P<0.01; glycated hemoglobin(6.33±0.96 vs 7.23±1.37) %, P<0.01] , and had higher HOMA-β [(74.01±56.45 vs 40.17±37.07) %, P<0.01]. The glycemic control, blood pressure and blood lipids control rates in both groups increased significantly in one year. Comprehensive compliance rate of the whole patients increased from 5.80% to 24.06%. The metabolism indexes of the newly-diagnosed type 2 diabetes group were better than those of the long-term group[comprehensive compliance rate: (24.73% vs 17.18%, P=0.087, glycemic control rate(84.62% vs 53.37%, P<0.01)]. Conclusion:Standardized metabolic disease management promoted the overall improvement in blood glucose, blood pressure, and lipids levels in type 2 diabetes patients, especially in terms of blood glucose and those of the newly-diagnosed type 2 diabetes. In the future, we should focus on the early diagnosis and treatment of type 2 diabetes, actively promote the MMC model and stress the integrated management of blood glucose, blood pressure, and blood lipid levels. We should pay more attention to the long-term patients, to improve their awareness and treatment compliance.