Objective To explore the diagnostic value of exhaled volatile organic compounds (VOCs) for cystic fibrosis (CF). Methods A systematic search was conducted in PubMed, EMbase, Web of Science, Cochrane Library, CNKI, Wanfang, VIP, and SinoMed databases up to August 7, 2024. Studies that met the inclusion criteria were selected for data extraction and quality assessment. The quality of included studies was assessed by the Newcastle-Ottawa Scale (NOS), and the risk of bias and applicability of included prediction model studies were assessed by the prediction model risk of bias assessment tool (PROBAST). Results A total of 10 studies were included, among which 5 studies only identified specific exhaled VOCs in CF patients, and another 5 developed 7 CF risk prediction models based on the identification of VOCs in CF. The included studies reported a total of 75 exhaled VOCs, most of which belonged to the categories of acylcarnitines, aldehydes, acids, and esters. Most models (n=6, 85.7%) only included exhaled VOCs as predictive factors, and only one model included factors other than VOCs, including forced expiratory flow at 75% of forced vital capacity (FEF75) and modified Medical Research Council scale for the assessment of dyspnea (mMRC). The accuracy of the models ranged from 77% to 100%, and the area under the receiver operating characteristic curve ranged from 0.771 to 0.988. None of the included studies provided information on the calibration of the models. The results of the Prediction Model Risk of Bias Assessment Tool (PROBAST) showed that the overall bias risk of all predictive model studies was high, and the overall applicability was unclear. Conclusion The exhaled VOCs reported in the included studies showed significant heterogeneity, and more research is needed to explore specific compounds for CF. In addition, risk prediction models based on exhaled VOCs have certain value in the diagnosis of CF, but the overall bias risk is relatively high and needs further optimization from aspects such as model construction and validation.

Objective To employ next-generation sequencing(NGS)to analyze differentially expressed mRNAs in the gingival tissue of hypertensive rats with or without periodontitis to provide a theoretical basis for the prevention and treatment of hypertension with periodontitis.Methods After obtaining approval from the Animal Experiment Ethics Committee,a hypertensive rat model was established by administering high-salt feed containing 8％(w/w)NaCl,and a periodontitis rat model was established by ligating the first molar of the mandibular region using 3-0 sterile silk thread.Rat models of the normal control(N),hypertension(H),and hypertension with periodontitis(PH)groups were estab-lished.The blood pressure,heart rate,alveolar bone resorption,and number of osteoclasts in the alveolar bone were measured,before harvesting the gingival tissues from the three groups for NGS to analyze the expression of significantly different genes.Gene ontology(GO)enrichment analysis was performed for all significantly differentially expressed genes between the H and PH groups.Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis was per-formed.Key genes were screened by protein-protein interaction(PPI)networks,and the key gene expression in each group was verified using immunohistochemistry(IHC).The expression of key genes in the systemic circulation of each group was analyzed using enzyme-linked immunosorbent assay(ELISA).Results At the end of the experiment(11th week),the blood pressure was higher in both the H and PH groups than that in the N group(P<0.001),but there was no statistically significant difference in blood pressure between the H and PH groups.There was no statistical difference in heart rate among the 3 groups.Micro-CT showed that the distance from the cemento-enamel junction to the alveolar bone crest(CEJ-ABC)of the mandibular first molar in the PH group was significantly higher than that in the N and H groups(P<0.016 7).The number of osteoclasts in the alveolar bone of the PH group was significantly higher than that of the N and H groups(P<0.0167).No common differentially expressed genes were found among the 3 groups.There were 235 significantly differentially expressed genes in the gingival tissue between the H and PH groups,and 137 upreg-ulated genes(e.g.,P-selectin,keratin 16,and S100 calcium binding protein A)and 98 downregulated genes(e.g.,FK506 binding protein 5,mediator complex subunit 22,zinc finger and BTB domain containing 16)in the PH group compared to the H group.GO analysis showed that the major enriched biological processes(BP)were leukocyte migra-tion,the major cellular component(CC)was complex of collagen trimers,and the significant molecular function(MF)was extracellular matrix structural constituent in the H and PH groups.KEGG pathway analysis showed that signaling pathways such as cytokine-cytokine receptor interaction,IL-17 signaling pathway,and TNF-α signaling pathway were significantly enriched in the H and PH groups.PPI analysis identified four key genes affecting periodontitis in hyperten-sive conditions,including interleukin-1β(IL-1β),matrix metalloproteinase-9(MMP-9),collagen type Ⅰ alpha1(COL1α 1),and chemokine ligand 1(CXCL1).Compared to the N and H groups,the expressions of IL-1β and TNF-α were all upregulated in the gingival tissue and systemic serum in the PH group(P<0.016 7).Conclusion The differentially expressed mRNAs in hypertension with or without periodontitis included IL-1β and MMP-9,while the differentially ex-pressed signaling pathways were IL-17 and TNF-α.These results provide a theoretical reference for further investigation of the molecular regulatory mechanism of hypertension with periodontitis in the future.

Objective To investigate the impacts of quercetin(QUE)on angiogenesis and hypoxia inducible factor-1α/vascular endothelial growth factor(HIF-1α/VEGF)signaling pathway in periodontal tissue of orthodontic tooth movement in rats.Methods A rat model of orthodontic tooth movement was constructed,and the modeled rats were randomly separated into the model group,the low-dose quercetin treatment(QUE-L)group,the high-dose quercetin treatment(QUE-H)group and the QUE-H+pathway inhibitor YC-1(QUE-H+YC-1)group,with 12 rats in each group.Another 12 rats were regarded as the control group.The movement distance of the first molar of rats in each group was measured.HE staining was applied to observe the pathological changes of periodontal tissue and count the number of blood vessels generated in periodontal tissue.Immunohistochemistry was applied to detect expression levels of bone morphogenetic protein 2(BMP2)and bone morphogenetic protein 4(BMP4)in periodontal tissue.Western blot assay was applied to detect the expression of HIF-1α/VEGF signaling pathway related proteins.Results Compared with the control group,the periodontal tissue fibers were scattered and disordered in the model group,with an increased intercellular space,infiltration of a large number of inflammatory cells and bone resorption pits,the movement distance of the first molar increased,the number of periodontal tissue blood vessels decreased,and the expression of BMP2,BMP4,HIF-1α and VEGF decreased(P＜0.05).The fibrous arrangement of periodontal tissue was relatively tight in the QUE-L group and the QUE-H group compared to the model group,with reduced infiltration of inflammatory cells and reduced alveolar bone resorption.The movement distance of the first molar decreased,the number of periodontal tissue blood vessels increased,and the expression of BMP2,BMP4,HIF-1α and VEGF increased(P＜0.05).Compared with the QUE-H group,the periodontal tissue fibers in the QUE-H+YC-1 group were scattered and disordered,with obvious intercellular gaps,increased infiltration of inflammatory cells and increased bone resorption pits,the movement distance of the first molar increased,the number of blood vessels in periodontal tissue decreased,and the expression of BMP2,BMP4,HIF-1α and VEGF decreased(P＜0.05).Conclusion Quercetin can promote angiogenesis in periodontal tissue during orthodontic tooth movement in rats,and its mechanism is related to the activation of the HIF-1α/VEGF signaling pathway.

Objective:To investigate the current status of activation in patients with spinal cord injury and analyze its influencing factors.Methods:Using the convenient sampling method, a total of 127 patients from Department of Spinal Surgery in the Third Affiliated Hospital of Soochow University from October 2020 to August 2021 were selected as the research objects. The patients were investigated by General Data Questionnaire, Patient Activation Measure (PAM) , General Self-Efficacy Scale (GSES) , Connor-Davidson Resilience Scale (CD-RISC) , Social Support Rating Scale (SSRS) and Hospital Anxiety and Depression Scale (HADS) . Multiple linear hierarchical regression analysis was used to investigate the influencing factors of activation in patients with spinal cord injury.Results:A total of 127 questionnaires were sent out, and 122 were effectively received, with the effective recovery of 96.1%. The score of activation in patients with spinal cord injury was (54.71±7.23) . Regression analysis showed that injury site, mental resilience and social support were the main influencing factors of activation ( P<0.05) , and the global regression model explained 50.0% of the variation in activation in patients with spinal cord injury. Conclusions:Patients with spinal cord injury generally have moderate levels of activation during hospitalization. The activation of patients with spinal cord injury is a positive psychosocial resource, and rehabilitation nurses should pay more attention to it, and improve the mental resilience and social support of patients, so as to further enhance the activation of patients.

Colon cancer is a common malignant tumor in the world, however, its pathogenesis still needs further research. FEZF1- AS1 is highly expressed in colon cancer and other malignant tumors, and is associated with clinicopathological features and prognosis of colon cancer patients. In addition, FEZF1- AS1 promotes the proliferation, invasion and migration of colon cancer cells, regulates the cell cycle and inhibits apoptosis through various mechanisms, suggesting that FEZF1- AS1 may be a new important molecular biomarker and a potential therapeutic target for colon cancer. This article reviews the advances in the study of function and mechanism of FEZF1- AS1 in colon cancer.

Numerous studies have suggested that liquid-liquid phase separation (LLPS) may be involved in occurrence and progression of neurodegenerative diseases through mediating immune inflammation, transcriptional regulation, protein homeostasis, genomic stability, and oxidative stress, and regulation of LLPS-mediated protein homeostasis has attracted particular attention. Therefore, this paper reviews the research progress of mechanism of protein homeostasis regulation in neurodegenerative diseases in recent years, and discusses the prospect of LLPS related research.

Objective:To investigate the incidence of asthma and the characteristics of acute attacks in children aged 3-14 in different administrative areas of Wuxi, and to analyze the correlation of asthma with the outdoor environmental factors.Methods:A total of 10 175 children aged 3-14 were randomly selected from 5 different administrative regions in Wuxi City, Jiangsu Province for childhood asthma epidemiological survey from January to December in 2017.Results:The complete questionnaires were collected from 8 318 children with a response rate of 81.70%.There were 6 734 valid questionnaires.Asthma occurred to 259 children, and the prevalence rate was 3.84%.The prevalence of asthma in male and female children was 4.89% (163 cases) and 2.82% (96 cases), respectively.The ratio of male patients to female patients was 1.70∶1.00, and the difference was significant ( χ2=19.72, P<0.01). Children were most prone to suffer from asthma attacks at the turn of seasons (87/259 cases, 33.59%). The frequency of asthma was the lowest from June to August (9/259 cases, 3.47%). Among 244 cases attacked by acute asthma, the prevailing time period of acute attacks was irregular in 88 patients (36.07%), bedtime in 64 cases (26.23%). In different regions of the city, the lowest prevalence rate of asthma was found in Binhu District (50/1 830 cases, 2.73%), the highest prevalence rate of asthma was found in Xinwu District (71/1 502 cases, 4.72%), the difference between the highest and lowest prevalence rates of asthma was significant ( χ2=13.19, P<0.05). In terms of the air quality in different admi-nistrative regions of Wuxi, the nitrogen dioxide (NO 2) concentration, the carbon monoxide (CO) concentration, PM 10 and PM 2.5 in Binhu District were lower than other 4 regions.In different seasons in Wuxi city, the sulfur dioxide(SO 2) concentration, the NO 2 concentration, the CO concentration, PM 10 and PM 2.5 from June to August were significantly lower than those in other months.The prevalence of asthma in children in different administrative districts of Wuxi was weakly positively correlated with the SO 2 concentration, the NO 2 concentration and PM 10 ( r=0.10, P<0.01; r=0.22, P<0.01; r=0.06, P<0.01, respectively). The prevalence of asthma was weakly negatively associated with the ozone(O 3) concentration ( r=-0.06, P<0.01). Acute asthma attacks were weakly positively correlated with the SO 2 concentration ( r=0.22, P<0.01), the NO 2 concentration ( r=0.28, P<0.01), the CO concentration ( r=0.23, P<0.01), PM 10 ( r=0.18, P<0.01) and PM 2.5 ( r=0.18, P<0.01), and weakly negatively correlated with the O 3 concentration ( r=-0.40, P<0.01). Conclusions:The prevalence of asthma in Wuxi is higher in boys than in girls, and the frequency of asthma attacks is related to the season.The SO 2, NO 2, CO, PM 10, PM 2.5 and O 3 concentration affect the prevalence and acute attacks of asthma.

Background: Several studies have shown that proton pump inhibitors (PPIs) can enhance the sensitivity of gastric cancer (GC) cells to chemotherapy and inhibit tumor proliferation and invasion. Aims: To investigate whether PPI could enhance chemosensitivity by inhibition of cell cycle-related genes in GC cells. Methods: Two human GC cell lines, AGS and HGC27 were treated with pantoprazole in different concentrations, and the cell viability was detected by CCK-8 assay. Transcriptome sequencing combined with KEGG enrichment analysis were used to determine the effect of PPI on cell cycle of GC cells, and the changes of cell cycle and its related genes were validated by flow cytometry, real-time PCR and Western blotting, respectively. Bioinformatics websites were employed to analyze the major differentially expressed cell cycle-related genes in GCs and their relationship with patients' prognosis. After transfection with FOXM1 plasmid or control plasmid, the inhibitory effect of PPI combined with cisplatin on GC cells was determined by CCK-8 assay. Results: PPI inhibited the proliferation of GC cells effectively in vitro. Transcriptome sequencing showed that the expression levels of G2/M phase-related genes, including FOXM1, PLK1, and AURKB were down-regulated in PPI-treated GC cells, and G2/M arrest was suggested by KEGG enrichment analysis. All these changes were proved by flow cytometry, real-time PCR and Western blotting. Bioinformatics analysis revealed that FOXM1, PLK1, and AURKB genes were highly expressed in GCs and correlated with a poor prognosis. The inhibitory effect of PPI combined with cisplatin on GC cells was superior to that of cisplatin alone, but could be partially reversed by overexpression of FOXM1. Conclusions: PPI treatment can induce G2/M arrest in GC cells by inhibiting cell cycle-related genes, and subsequently enhance the sensitivity of GC cells to chemotherapy.

Objective:To evaluate the effect of different reconstruction images on cardiac dose evaluation by comparing the differences between 4D-CT series and special reconstruction images in evaluating the dose-volume index of cardiac structures.Methods:ECG 4D-CT series were scanned in 15 female patients with left breast cancer. The images of 0-95% 20 phases were reconstructed at an interval of 5% cardiac cycle. The maximum intensity projection (MIP), minimum intensity projection (MinIP), average intensity projection (AIP) and sum intensity projection (SIP) images were obtained by special reconstruction of 4D-CT series. Left ventricle (LV) and left anterior descending coronary artery (LADCA) were delineated on 4D-CT and special reconstruction series, respectively. The intensity-modulated radiation therapy plan of the left breast cancer was designed on the basis of 0% phase, and the cumulative dose (Dose-cumulate) of 20 phases was obtained by deformation registration. The doses of 0% phase were deformed and registered to MIP, MinIP, AIP and SIP images to obtain the corresponding dose distribution. The dose-volume indexes of LV and LADCA based on different CT images were compared.Results:In the evaluation of dose-volume index of LV, compared with 4D-CT series, the change rates of V 5Gy, V 30Gy, V 40Gy, D max and D mean on MIP images were 3.8%, 2.0%, 0.9%, 3.8% and 1.7%, respectively. There was significant difference in V 5 and D max between MIP and 4D-CT (both P<0.05). Compared with 4D-CT, the change rates of D max on MinIP, SIP and AIP images were 2.5%, 3.1% and 1.5%, respectively (all P<0.05). In the evaluation of dose-volume index of LADCA, only the change rate of D max on four special reconstructed images was<5%( P<0.05). Conclusions:In the dose-volume evaluation of LV, the V 30Gy, V 40Gy and D mean obtained by MIP are basically equivalent to those obtained by 4D-CT series, which can be used to substitute 4D-CT series to evaluate the dose-volume. The special reconstruction image of LADCA can not replace 4D-CT series.

Enteral nutrition plays an irreplaceable role in the nutritional treatment of critically ill patients. In order to help clinical medical staff to manage the common complications during the implementations of enteral nutrition for critically ill patients, the consensus writing team carried out literature retrieval, literature quality evaluation, evidence synthesis. Several topics such as diarrhea, aspiration, high gastric residual volume, abdominal distension, etc. were assessed by evidence-based methodology and Delphi method. After two rounds of expert investigations, Expert consensus on prevention and management of enteral nutrition therapy complications for critically ill patients in China (2021 edition) developed, and provided guidance for clinical medical staff.