Effect of an integrated care model on ST-segment elevation myocardial infarction management in China: a prospective, multicentre, non-randomised controlled study.

Background: Early reperfusion therapy is critical in patients with ST-segment elevation myocardial infarction (STEMI). However, limitations in resources and patient-level and system-level barriers delay the administration of reperfusion therapy. This study evaluated the impact of an integrated care strategy for STEMI management in China.

Trends in the incidence of lung cancer in never smokers in Eastern China: a retrospective population-based cohort study using regional electronic health records.

Objectives: Although lung cancer in never smokers (LCNSs) accounts for an estimated 25% of all lung cancer cases, the temporal trends in LCNS incidence and its broader epidemiological patterns remain poorly understood. Our study examines the temporal trends in LCNS incidence and analyses key epidemiological characteristics, specifically, the trends in mortality rates, survival rates and changes in age at onset to illuminate the reasons for temporal trends in LCNS incidence.

Design: Retrospective population-based cohort study.

Hepatic arterial infusion chemotherapy plus lenvatinib and PD-1 inhibitors versus lenvatinib plus PD-1 inhibitors as first-line treatment for hepatocellular carcinoma with high tumour burden and portal vein tumour thrombus (CHANCE 2416): study protocol of a multicentre, retrospective, target trial emulation design.

Background: Advanced-stage hepatocellular carcinoma (HCC) with high tumour burden and portal vein tumour thrombus (PVTT) is usually associated with poor survival outcomes. Rapid tumour control usually benefits long-term outcomes, which could be hardly achieved by solely systematic targeted and immunotherapy in current guidelines. Hepatic arterial infusion chemotherapy (HAIC) is reported as an effective intervention for rapid decrease of tumour burden.

Design of aSpiration based thrombectomy in acUte large vessel oCclusive sTroke with dIfferent etiOlogies: a real-world multiceNtre (SUCTION) study.

Introduction: Intracranial atherosclerosis is the main cause of stroke globally, with acute large vessel occlusive (LVO) stroke being a predominant contributor to stroke-related mortality. In recent years, aspiration thrombectomy (AT) has emerged as a novel therapeutic method for treating acute LVO stroke. The purpose of this study aims to investigate the safety and efficacy of AT alone or combined with stent retriever thrombectomy (SRT) in the treatment of acute LVO stroke METHODS AND ANALYSIS: This is a multicentre and observational real-world study involving patients diagnosed with acute LVO stroke.

Dosage and safety of transcranial magnetic stimulation and transcranial direct current stimulation for managing patients with chronic musculoskeletal pain: a scoping review protocol.

Introduction: Although emerging evidence supports the short-term efficacy of transcranial magnetic stimulation (TMS), including repetitive TMS (rTMS) and theta-burst transcranial magnetic stimulation (TBS-TMS), and transcranial direct current stimulation (tDCS) for managing patients with chronic musculoskeletal pain (CMP), their clinical utility in managing CMP remains inconclusive. This uncertainty may arise from methodological limitations, including heterogeneity in treatment parameters such as stimulation targets and dosages. Additionally, safety profiles for these non-invasive brain stimulation interventions in patients with CMP remain insufficiently reported, with limited data on adverse events, cumulative risks and long-term safety outcomes.

Effects of non-pharmacological interventions on nutrition and immune status of nasopharyngeal carcinoma patients during chemoradiotherapy: a systematic review and meta-analysis protocol.

Background: Nasopharyngeal carcinoma (NPC) presents significant nutritional challenges during concurrent chemoradiotherapy, adversely affecting treatment outcomes and quality of life. Non-pharmacological interventions may help improve nutritional and immune status, reduce complications and enhance overall well-being. However, evidence of their effectiveness is scattered and inconsistent, and no systematic review has yet synthesised the evidence on their effectiveness.

Proximal core strengthening training for anterior cruciate ligament injury prevention with biomechanical improvements in knee/hip kinematics and strength gains: a systematic review and meta-analysis of low-certainty evidence.

Objectives: This study evaluated the effects of proximal core training on biomechanical risk factors and strength parameters in individuals at high risk of anterior cruciate ligament (ACL) injury (specifically: those exhibiting pathological movement patterns, neuromuscular deficits or biomechanical risk factors) and compared direct versus indirect interventions. We hypothesised that targeted training enhances dynamic knee stabilisation and hip control during high-risk manoeuvres, with direct approaches providing superior biomechanical benefits through neuromuscular control optimisation.

Design: Systematic review and meta-analysis using the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach.

Crystal structures of distinct parallel and antiparallel DNA G-quadruplexes reveal structural polymorphism in C9orf72 G4C2 repeats.

The abnormal expansion of GGGGCC (G4C2) repeats in the noncoding region of the C9orf72 gene is a major genetic cause of two devastating neurodegenerative disorders, amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). These G4C2 repeats are known to form G-quadruplex (G4) structures, which are hypothesized to contribute to disease pathogenesis. Here, we demonstrated that four DNA G4C2 repeats can fold into two structurally distinct G4 conformations: a parallel and an antiparallel topology.

CRISPR/Cas12a DTR system: a topology-guided Cas12a assay for specific dual detection of RNA and DNA targets.

The CRISPR/Cas12a technology has revolutionized molecular diagnostics. However, existing Cas12a systems depend on continuous target DNA activation, which limits them to single-target detection. In this study, we developed a novel topology-guided Cas12a system, the double-target responsive (DTR) system, capable of being activated by noncontiguous dual RNA/DNA targets.

A Bimolecular Simultaneous Macrocyclization Strategy to Synthesize Cyclic Dinucleotide Analogues with Internucleoside Guanidinium Linkages.

Internucleoside guanidinium linkages are excellent mimics of phosphodiesters and have been used to improve the properties of oligonucleotides. Herein we reported a step economic bimolecular simultaneous macrocyclization (BSM) protocol to prepare cyclic dinucleotide (CDN) analogues with guanidinium linkages. Compared with the 26 steps protocol reported in literature, the current method could provide CDN analogues with internucleoside guanidinium linkages in 9 steps, and the key intermediate prepared in the first 3 steps could be shared to prepare CDN analogues with different nucleobases.

Management of preterm premature rupture of membranes: Antimicrobial stewardship and novel therapeutic strategies.

Purpose: Preterm premature rupture of membranes (PPROM) is a major contributor to preterm birth and is associated with increased risks of maternal and neonatal complications. The aim of this review is to summarize current antibiotic strategies and explore emerging adjunctive therapies, including probiotics, amnioinfusion, and fetal membrane repair, to improve the management of PPROM.

Methods: Relevant literature on antibiotic therapy for PPROM and emerging treatment strategies was systematically retrieved from PubMed.

Association Between Body Composition and Obesity Phenotypes in Children and Adolescents.

Assessment of influencing factors is critical for the management of different obesity phenotypes among children and adolescents. We investigated the association between body composition and metabolically unhealthy phenotypes independently or in an interaction with physical activity or sleep, among 7572 children and adolescents with normal weight or overweight/obesity from Guangzhou, China. High body fat percentage (BF%), trunk-to-limb fat ratio (T/L), waist-to-height ratio (WHtR), low soft lean mass percentage (SLM%), and appendicular skeletal muscle percentage (ASM%) were all associated with increased risk of metabolically unhealthy overweight/obesity (MUO) (odds ratios ranging from 1.

High Capacity and Efficient Adsorption of Lutetium(III) by the Metal-Organic Framework HKUST-1 in Simulated Medical Wastewater.

Lutetium (Lu(III)), a heavy rare earth element, plays a critical role in advanced industrial processes and nuclear medicine applications. Given its high economic value and potential environmental risks, the recovery of Lu(III) from medical wastewater is both necessary and urgent. However, previous studies on the adsorption behavior of Lu(III) have been limited by low adsorption capacity, competition from coexisting metal ions, and the influence of environmental temperature.

Integrative multi-omics and genomic prediction reveal genetic basis of early salt tolerance in alfalfa.

The genetic basis of early-stage salt tolerance in alfalfa (Medicago sativa L.), a key factor limiting its productivity, remains poorly understand. To dissect this complex trait, we integrate genome-wide association study (GWAS) and transcriptomics (RNA-seq) from 176 accessions within a machine learning based genomic prediction framework.

NFATc3 and PML Synergistically Regulate Tumor-Associated Gene Expression in a SUMOylation-Independent Manner.

The nuclear factor of activated T cells 3 (NFATc3) plays a significant role in various cancer-related processes, but its interactions with transcriptional modulators, particularly Promyelocytic Leukemia protein (PML), remain poorly understood. PML, a nuclear scaffold protein, is involved in tumor suppression and transcriptional regulation. This study investigates the interaction between NFATc3 and PML, focusing on the role of SUMOylation and its impact on downstream target genes.

Sexual dimorphism of white-matter functional connectome in healthy young adults.

Background: Sexual dimorphism in human brain has garnered significant attention in neuroscience research. Although multiple investigations have examined sexual dimorphism in gray matter (GM) functional connectivity (FC), the research of white matter (WM) FC remains relatively limited.

Methods: Utilizing resting-state fMRI data from 569 healthy young adults, we investigated sexual dimorphism in the WM functional connectome.

Oxymatrine attenuates the type 1 diabetes mellitus via negative regulation of the follicular helper T cells.

Type 1 diabetes mellitus (T1DM) is an autoimmune disorder in which autoantibodies cause the immune system to attack and destroy pancreatic β-cells, leading to insufficient insulin production and impaired blood glucose control. T follicular helper (Tfh) cells are recognized as a group of CD4 T cells that help B cells to produce high-affinity antibodies. Our previous research found that oxymatrine (OMT) exhibits excellent immunomodulatory properties on Tfh cells in autoimmune diseases.

Inhibition of ferroptosis rescues BMP osteogenic differentiation impaired by iron overload in the osteoporotic microenvironment.

Bone morphogenetic proteins (BMPs) are effective for treating various orthopedic conditions and are widely used clinically. However, their therapeutic efficacy is limited in osteoporosis patients. Iron overload represents a key risk factor for osteoporosis, inducing ferroptosis and suppressing the osteogenic differentiation of bone marrow stromal cells (BMSCs).

AID/HAT1-mediated epigenetic priming of JAG1/NOTCH signaling drives tumor microenvironment reprogramming in TNBC.

Triple-negative breast cancer (TNBC) presents a formidable therapeutic challenge due to its aggressive behavior, molecular heterogeneity, and lack of actionable targets. This study identifies activation-induced cytidine deaminase (AID) as a pivotal epigenetic driver reprogramming the tumor microenvironment (TME) via non-canonical regulation of NOTCH signaling. Mechanistically, AID recruits histone acetyltransferase 1 (HAT1) to form a chromatin-remodeling complex that binds the JAG1 promoter region (-1.

Estradiol alleviates disease phenotypes caused by m.3635G > a mutations by activating mitochondrial biogenesis and PINK1-Parkin mediated mitophagy in iPSC-derived retinal pigment epithelium cells.

Leber's hereditary optic neuropathy (LHON), a mitochondrial disorder marked by central vision loss, exhibits incomplete penetrance and male predominance. Since there are no adequate models for understanding the rapid vision loss associated with LHON, we generated induced pluripotent stem cells (iPSCs) from LHON patients carrying the pathogenic m.3635G > A mutation and differentiated them into retinal pigment epithelium (RPE) cells.

Endoplasmic reticulum stress regulates intestinal motility in acute pancreatitis by regulating the expression and phosphorylation of nNOS through IRE1α/XBP1s-PI3K/Akt signaling axis.

Intestinal dysmotility is a major complication that significantly impacts the prognosis of acute pancreatitis (AP). The neuronal nitric oxide synthase (nNOS) -expressing neurons within the enteric nervous system promote intestinal relaxation via the release of nitric oxide (NO). As the rate-limiting enzyme of NO synthesis, nNOS directly regulates NO production, thereby modulating intestinal motility.

Single-Cell Transcriptomic Profiling Reveals Diet-Dependent Dynamics of Glucosinolate Sulfatases Expression and Cellular Origin in the Midgut of Plutella xylostella.

The diamondback moth (Plutella xylostella), a globally destructive pest, has Brassicaceae as its long-term co-evolved host and can also utilize Fabaceae as an alternative field host. The primary differential factor between these plant families is glucosinolates (GLs). Conventional transcriptome data revealed high midgut expression of glucosinolate sulfatases (GSSs) in response to glucosinolates.

Design, synthesis and antitumor activity of pentacyclic triterpenoid Asiatic acid derivatives as Sp1 inhibitors.

Asiatic acid (AA) was used as the lead compound and 22 inhibitors of specificity protein 1 (Sp1) were designed and synthesized with modification at A ring and C-28 position of AA, whose structures were confirmed by HRMS, H NMR and C NMR. The growth inhibitory effects of Asiatic acid derivatives on human breast cancer cells (MCF-7) and cervical cancer cells (Hela) were determined by tetramethyl azole salt (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide, MTT) colorimetric assay. The results showed that all of these compounds inhibited the proliferation of HeLa and MCF-7 cells, and all the derivatives showed stronger tumor cytotoxicity than AA, among which compounds I, II, and III were comparable to the positive control drug cisplatin.

The effect of muscle quality index on the risk of adverse health outcomes: a prospective cohort study of 355,209 adults.

Background: Muscle quality index (MQI), a new metric for assessing sarcopenia, reflects the functional capacity of muscle. However, the associations between MQI and adverse health outcomes and the corresponding mechanisms are not well understood.

Objective: We aimed to prospectively evaluate the associations of MQI with risk of nine adverse health outcomes (ie, osteoarthritis, cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM), respiratory disease, chronic kidney disease (CKD), liver disease, dementia, depression, and all-cause mortality), as well as the mediating role of metabolomics in these associations.

Global Burden of Psoriasis from 1990 to 2021 and Potential Factors: A Systematic Analysis.

Psoriasis is a chronic, immune-mediated inflammatory skin disorder affecting approximately 100 million people worldwide. This study aimed to understand the global impact of psoriasis on health and economics over the past three decades. we analyzed trends in psoriasis cases, its effects on people's quality of life, and the associated costs.