Interface-constrained catalytic hairpin assembly permits highly sensitive SERS signaling of miRNA.

The rapid and precise monitoring of peripheral blood miRNA levels holds paramount importance for disease diagnosis and treatment monitoring. In this study, we propose an innovative research strategy that combines the catalytic hairpin assembly reaction with SERS signal congregation and enhancement. This combination can significantly enhance the stability of SERS detection, enabling stable and efficient detection of miRNA. Specifically, our paper-based SERS detection platform incorporates a streptavidin-modified substrate, biotin-labeled catalytic hairpin assembly reaction probes, 4-ATP, and primer-co-modified gold nanoparticles. In the presence of miRNA, the 4-ATP and primer-co-modified gold nanoparticles can specifically recognize the miRNA and interact with the biotin-labeled CHA probes to initiate an interfacial catalytic hairpin assembly reaction. This enzyme-free high-efficiency catalytic process can accumulate a large amount of biotin on the gold nanoparticles, which then bind to the streptavidin on the substrate with the assistance of the driving liquid, forming red gold nanoparticle stripes. These provide a multitude of hotspots for SERS, enabling enhanced signal detection. This innovative design achieves a low detection limit of 3.47 fM while maintaining excellent stability and repeatability. This conceptually innovative detection platform offers new technological possibilities and solutions for clinical miRNA detection.

Causal effects of PM2.5 exposure on neuropsychiatric disorders and the mediation via gut microbiota: A Mendelian randomization study.

BACKGROUND: Growing evidence has revealed the impacts of exposure to fine particulate matter (PM2.5) and dysbiosis of gut microbiota on neuropsychiatric disorders, but the causal inference remains controversial due to residual confounders in observational studies. METHODS: This study aimed to examine the causal effects of exposure to PM2.5 on 4 major neuropsychiatric disorders (number of cases = 18,381 for autism spectrum disorder [ASD], 38,691 for attention deficit hyperactivity disorder [ADHD], 67,390 for schizophrenia, and 21,982 cases for Alzheimer's disease [AD]), and the mediation pathway through gut microbiota. Two-sample Mendelian randomization (MR) analyses were performed, in which genetic instruments were identified from genome-wide association studies (GWASs). The included GWASs were available from (1) MRC Integrative Epidemiology Unit (MRC-IEU) for PM2.5, PMcoarse, PM10, and NOX; (2) the Psychiatric Genomics Consortium (PGC) for ASD, ADHD, and schizophrenia; (3) MRC-IEU for AD; and (4) MiBioGen for gut microbiota. Multivariable MR analyses were conducted to adjust for exposure to NOX, PMcoarse, and PM10. We also examined the mediation effects of gut microbiota in the associations between PM2.5 exposure levels and neuropsychiatric disorders, using two-step MR analyses. RESULTS: Each 1 standard deviation (1.06 ug/m3) increment in PM2.5 concentrations was associated with elevated risk of ASD (odds ratio [OR] 1.42, 95% confidence interval [CI] 1.00-2.02), ADHD (1.51, 1.15-1.98), schizophrenia (1.47, 1.15-1.87), and AD (1.57, 1.16-2.12). For all the 4 neurodevelopmental disorders, the results were robust under various sensitivity analyses, while the MR-Egger method yielded non-significant outcomes. The associations remained significant for all the 4 neuropsychiatric disorders after adjusting for PMcoarse, while non-significant after adjusting for NOX and PM10. The effects of PM2.5 exposure on ADHD and schizophrenia were partially mediated by Lachnospiraceae and Barnesiella, with the proportions ranging from 8.31% to 15.77%. CONCLUSIONS: This study suggested that exposure to PM2.5 would increase the risk of neuropsychiatric disorders, partially by influencing the profile of gut microbiota. Comprehensive regulations on air pollutants are needed to help prevent neuropsychiatric disorders.

A comprehensive evaluation of influencing factors of neonicotinoid insecticides (NEOs) in farmland soils across China: First focus on film mulching.

Neonicotinoid insecticide (NEO) residues in agricultural soils have concerning and adverse effects on agroecosystems. Previous studies on the effects of farmland type on NEOs are limited to comparing greenhouses with open fields. On the other hand, both NEOs and microplastics (MPs) are commonly found in agricultural fields, but their co-occurrence characteristics under realistic fields have not been reported. This study grouped farmlands into three types according to the covering degree of the film, collected 391 soil samples in mainland China, and found significant differences in NEO residues in the soils of the three different farmlands, with greenhouse having the highest NEO residue, followed by farmland with film mulching and farmland without film mulching (both open fields). Furthermore, this study found that MPs were significantly and positively correlated with NEOs. As far as we know this is the first report to disclose the association of film mulching and MPs with NEOs under realistic fields. Moreover, multiple linear regression and random forest models were used to comprehensively evaluate the factors influencing NEOs (including climatic, soil, and agricultural indicators). The results indicated that the random forest model was more reliable, with MPs, farmland type, and total nitrogen having higher relative contributions.

[Analysis of dissatisfaction and related factors following total hip arthroplasty in patients with Crowe type â ¢-â £ developmental dysplasia of the hip].

OBJECTIVE: To investigate the satisfaction of patients with Crowe Ⅲ-Ⅳ developmental dysplasia of the hip(DDH) after total hip arthroplasty and the related factors. METHODS: A retrospective study included 169 patients with Crowe type Ⅲ-Ⅳ DDH who underwent total hip arthroplasty between March 2013 and March 2018. Patients were surveyed through WeChat, covering overall satisfaction with the operation, satisfaction with ten daily functions, and the top five questions perceived to have a great impact on daily life. Preoperative and postoperative hip function was evaluated by Harris score. RESULTS: One hundred and forty-five questionnaires were received, with a follow-up period ranging from 1 to 5 years with an average of (3.23±1.22) years. Among these patients, 118 patients were satisfied with the surgical outcomes, while 27 patients were dissatisfied, with the overall satisfaction rate of 81.38%(118/145). The top five problems affecting patient life were postoperative hip pain, limb length discrepancy, walking, stair climbing, and squatting. There were no statistical differences in age, sex, body mass index, preoperative Harris scores (P>0.05). However, the dissatisfied group had lower postoperative Harris scores. Postoperative hip pain and limb length discrepancy were identified as direct factors contributing to postoperative surgical dissatisfaction. CONCLUSION: Total hip arthroplasty for patients with Crowe type Ⅲ-Ⅳ DDH is challenging. Postoperative hip pain (mild or severe) and limb length discrepancy (>2 cm) are independent risk factors for postoperative dissatisfaction.

RGS20 promotes non-small cell lung carcinoma proliferation via autophagy activation and inhibition of the PKA-Hippo signaling pathway.

BACKGROUND: Novel therapeutic targets are urgently needed for treating drug-resistant non-small cell lung cancer (NSCLC) and overcoming drug resistance to molecular-targeted therapies. Regulator of G protein signaling 20 (RGS20) is identified as an upregulated factor in many cancers, yet its specific role and the mechanism through which RGS20 functions in NSCLC remain unclear. Our study aimed to identify the role of RGS20 in NSCLC prognosis and delineate associated cellular and molecular pathways. METHODS: Immunohistochemistry and lung cancer tissue microarray were used to verify the expression of RGS20 between NSCLC patients. CCK8 and cell cloning were conducted to determine the proliferation ability of H1299 and Anip973 cells in vitro. Furthermore, Transcriptome sequencing was performed to show enrichment genes and pathways. Immunofluorescence was used to detect the translocation changes of YAP to nucleus. Western blotting demonstrated different expressions of autophagy and the Hippo-PKA signal pathway. In vitro and in vivo experiments verified whether overexpression of RGS20 affect the proliferation and autophagy of NSCLC through regulating the Hippo pathway. RESULTS: The higher RGS20 expression was found to be significantly correlated with a poorer five-year survival rate. Further, RGS20 accelerated cell proliferation by increasing autophagy. Transcriptomic sequencing suggested the involvement of the Hippo signaling pathway in the action of RGS20 in NSCLC. RGS20 activation reduced YAP phosphorylation and facilitated its nuclear translocation. Remarkably, inhibiting Hippo signaling with GA-017 promoted cell proliferation and activated autophagy in RGS20 knock-down cells. However, forskolin, a GPCR activator, increased YAP phosphorylation and reversed the promoting effect of RGS20 in RGS20-overexpressing cells. Lastly, in vivo experiments further confirmed role of RGS20 in aggravating tumorigenicity, as its overexpression increased NSCLC cell proliferation. CONCLUSION: Our findings indicate that RGS20 drives NSCLC cell proliferation by triggering autophagy via the inhibition of PKA-Hippo signaling. These insights support the role of RGS20 as a promising novel molecular marker and a target for future targeted therapies in lung cancer treatment.

Electrochemical desulfurative formation of C-N bonds through selective activation of inert C(sp3)-S bonds.

In this study, we introduce an efficient, metal-free electrocatalytic desulfurative protocol for forming C-N bonds by selectively activating inert C(sp3)-S bonds of alkyl thioethers. This method offers a straightforward and environmentally friendly approach for modification of heterocyclic compounds from readily accessible thioethers. Preliminary mechanistic investigations suggest that the reaction proceeds via a carbocation intermediate. Furthermore, successful synthesis on a 10-gram scale was achieved in a continuous flow electrochemical reactor.

Enhanced and Sustainable Removal of Indoor Formaldehyde by Naturally Porous Bamboo Activated Carbon Supported with MnOx: Synergistic Effect of Adsorption and Oxidation.

Novel bamboo activated carbon (BAC) catalysts decorated with manganese oxides (MnOx) were prepared with varying MnOx contents through a facile one-step redox reaction. Due to the physical anchoring effect of the natural macropore structure for catalyst active components, homogeneous MnOx nanoparticles (NPs), and high specific surface area over catalyst surface, the BAC@MnOx-N (N = 1, 2, 3, 4, 5) catalyst shows encouraging adsorption and catalytic oxidation for indoor formaldehyde (HCHO) removal at room temperature. Dynamic adsorption and catalytic activity experiments were conducted. The higher Smicro (733 m2/g) and Vmicro/Vt (82.6%) of the BAC@MnOx-4 catalyst could facilitate its excellent saturated and breakthrough adsorption capacity (5.24 ± 0.42 mg/g, 2.43 ± 0.22 mg/g). The best performer against 2 ppm HCHO is BAC@MnOx-4 catalyst, exhibiting a maximum HCHO removal efficiency of 97% for 17 h without any deactivation as RH = 0, which is higher than those of other MnOx-based catalysts. The average oxidation state and in situ DRIFTS analysis reveal that abundant oxygen vacancies on the BAC@MnOx-4 catalyst could be identified as surface-active sites of decomposing HCHO into the intermediate species (dioxymethylene and formate). This study provides a potential approach to deposit MnOx nanoparticles onto the BAC surface, and this hybrid BAC@MnOx material is promising for indoor HCHO removal at room temperature.

Cross-Video Pedestrian Tracking Algorithm with a Coordinate Constraint.

Pedestrian tracking in surveillance videos is crucial and challenging for precise personnel management. Due to the limited coverage of a single video, the integration of multiple surveillance videos is necessary in practical applications. In the realm of pedestrian management using multiple surveillance videos, continuous pedestrian tracking is quite important. However, prevailing cross-video pedestrian matching methods mainly rely on the appearance features of pedestrians, resulting in low matching accuracy and poor tracking robustness. To address these shortcomings, this paper presents a cross-video pedestrian tracking algorithm, which introduces spatial information. The proposed algorithm introduces the coordinate features of pedestrians in different videos and a linear weighting strategy focusing on the overlapping view of the tracking process. The experimental results show that, compared to traditional methods, the method in this paper improves the success rate of target pedestrian matching and enhances the robustness of continuous pedestrian tracking. This study provides a viable reference for pedestrian tracking and crowd management in video applications.

Pollution characteristics and affecting factors of phthalate esters in agricultural soils in mainland China.

Phthalate esters (PAEs), the most commonly produced and used plasticizers, are widely used in plastic products and agroecosystems, posing risks to agricultural products and human health. However, current research on PAE pollution characteristics in agricultural soils in China is not comprehensive; affecting factors and relationships with microplastics and plasticizer organophosphate esters have not been sufficiently considered. In this study, farmland soil samples were collected with field questionnaires on a national scale across mainland China. The results showed that the detection rate of PAEs was 100% and the Σ16PAEs concentrations were 23.5 - 903 µg/kg. The level of PAEs was highest in the greenhouse, and significantly higher than that in mulched farmland (p < 0.05). The PAE concentration in northwestern China was the lowest among different physical geographic zones. PAEs in farmlands posed a low cancer risk to Chinese people. PAE pollution in farmlands was significantly (p < 0.05) affected by agronomic measures (such as disposal method), environmental factors, and socioeconomic factors. Overall, PAEs were significantly and positively correlated (p < 0.05) with organophosphate esters but not with microplastics. This study aims to provide scientific data for relevant prevention and control policies, as well as actionable recommendations for pollution reduction.

Deep Learning Radiomics Nomogram Based on Enhanced CT to Predict the Response of Metastatic Lymph Nodes to Neoadjuvant Chemotherapy in Locally Advanced Gastric Cancer.

BACKGROUND: We aimed to construct and validate a deep learning (DL) radiomics nomogram using baseline and restage enhanced computed tomography (CT) images and clinical characteristics to predict the response of metastatic lymph nodes to neoadjuvant chemotherapy (NACT) in locally advanced gastric cancer (LAGC). METHODS: We prospectively enrolled 112 patients with LAGC who received NACT from January 2021 to August 2022. After applying the inclusion and exclusion criteria, 98 patients were randomized 7:3 to the training cohort (n = 68) and validation cohort (n = 30). We established and compared three radiomics signatures based on three phases of CT images before and after NACT, namely radiomics-baseline, radiomics-delta, and radiomics-restage. Then, we developed a clinical model, DL model, and a nomogram to predict the response of LAGC after NACT. We evaluated the predictive accuracy and clinical validity of each model using the receiver operating characteristic curve and decision curve analysis, respectively. RESULTS: The radiomics-delta signature was the best predictor among the three radiomics signatures. So, we developed and validated a DL delta radiomics nomogram (DLDRN). In the validation cohort, the DLDRN produced an area under the receiver operating curve of 0.94 (95% confidence interval, 0.82-0.96) and demonstrated adequate differentiation of good response to NACT. Furthermore, the DLDRN significantly outperformed the clinical model and DL model (p < 0.001). The clinical utility of the DLDRN was confirmed through decision curve analysis. CONCLUSIONS: In patients with LAGC, the DLDRN effectively predicted a therapeutic response in metastatic lymph nodes, which could provide valuable information for individualized treatment.

Multi-Contrast Complementary Learning for Accelerated MR Imaging.

Thanks to its powerful ability to depict high-resolution anatomical information, magnetic resonance imaging (MRI) has become an essential non-invasive scanning technique in clinical practice. However, excessive acquisition time often leads to the degradation of image quality and psychological discomfort among subjects, hindering its further popularization. Besides reconstructing images from the undersampled protocol itself, multi-contrast MRI protocols bring promising solutions by leveraging additional morphological priors for the target modality. Nevertheless, previous multi-contrast techniques mainly adopt a simple fusion mechanism that inevitably ignores valuable knowledge. In this work, we propose a novel multi-contrast complementary information aggregation network named MCCA, aiming to exploit available complementary representations fully to reconstruct the undersampled modality. Specifically, a multi-scale feature fusion mechanism has been introduced to incorporate complementary-transferable knowledge into the target modality. Moreover, a hybrid convolution transformer block was developed to extract global-local context dependencies simultaneously, which combines the advantages of CNNs while maintaining the merits of Transformers. Compared to existing MRI reconstruction methods, the proposed method has demonstrated its superiority through extensive experiments on different datasets under different acceleration factors and undersampling patterns.

Characteristics of dissolved organic matter (DOM) in Chinese farmland soils under different climate zone types: A molecular perspective.

Interactions between dissolved organic matter (DOM) and surrounding environments are highly complex. Understanding DOM at the molecular level can contribute to the management of soil pollution and safeguarding agricultural fields. Fourier transform ion cyclotron resonance mass spectrometry (FTICR-MS) has enabled a molecular-level understanding of DOM. Accordingly, in this study, we investigated soil samples from 27 different regions of mainland China with various soil types and climatic characteristics. Based on the geographical features of the four typical climatic zones in mainland China (temperate monsoon, temperate continental, subtropical monsoon, and Qinghai-Tibet Plateau climates), we employed high-resolution mass spectrometry to determine the molecular diversity of DOM under different climatic conditions. The results indicated that lignin and tannin-like substances were the most active categories of DOM in the soils. Collectively, the composition and unsaturation of DOM molecules are influenced by sunlight, precipitation, temperature, and human activity. All climatic regions contained a substantial number of characteristic molecules, with CHO and CHON constituting over 80%, and DOM containing nitrogen and sulfur was relatively more abundant in the monsoon regions. The complex composition of DOM incorporates various active functional groups, such as -NO2 and -ONO2. Furthermore, soil DOM in the monsoon regions showed higher unsaturation and facilitated various (bio) biochemical reactions in the soil.

Influence of Smoking Habits on the Efficacy of EGFR-TKI Therapy in Patients with Advanced NSCLC: A Systematic Review and Meta-Analysis.

Background: Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are considered as the first-line treatment for advanced EGFR mutation-positive non-small cell lung cancer (NSCLC). We aimed to analyze the efficacy of EGFR-TKIs treatment in patients with advanced NSCLC of different smoking habits. Methods: We conducted a search for meta-analyses and systematic reviews on the PubMed, MEDLINE, Embase, and the Cochrane Library to address this knowledge gap. Patients were divided into 2 groups: (1) experimental group: treated with EGFR-TKIs or EGFR-TKIs combined with chemotherapy, immunotherapy, antiangiogenesis, radiotherapy and (2) control group: treated with chemotherapy. Progressive-free survival (PFS) and total survival (OS) were adopted for evaluating the efficacy of EGFR-TKIs between experimental group and control group. Results: Eleven studies including 6760 patients were included in the meta-analysis. The results showed that smoking (including previous and current smoking) significantly reduces the PFS and OS in comparison to non-smoking group in the treatment of NSCLC with EGFR-TKIs. In addition, EGFR-TKIs combined with anti-vascular endothelial growth factor therapy can reduce the risk of disease progression in smokers. Conclusions: Our study indicated that smoking significantly reduced the PFS and OS in comparison to non-smoking group in the treatment of NSCLC with EGFR-TKIs.

Low-RCS low-profile MIMO antenna and array antenna using a polarization conversion metasurface.

A specially designed dumbbell type polarization conversion metasurface (PCM) is proposed. The designed PCM achieves line-to-line polarization conversion in ultra-wideband (UWB) from 7.63 GHz to 18.80 GHz. A low-profile metasurface antenna composed of PCM and slot feed is proposed based on characteristic mode analysis (CMA), which realizes the integrated design of radiation and scattering. Because of the checkerboard scattering properties, low-radar cross section (RCS) low-profile multiple-input-multiple-output (MIMO) antenna and array antenna are designed with PCM. The low-RCS high-isolation low-profile MIMO antenna with size of 1.27×1.27×0.07λ 0 3 (λ0: the free-space wavelength corresponding to the center frequency point) operating at 5.8 GHz consists of four orthogonal arranged metasurface antennas. The isolation is greater than 26 dB with impedance bandwidth from 5.51 GHz to 6.06 GHz. In addition, the low-RCS high-gain low-profile array antenna with size of 2.55×2.55×0.07λ 0 3 is also designed. The operating band covers from 5.63 GHz to 6.12 GHz with the gain of 12-15.6 dBi. The RCS reduction of the two antennas for normal incidence is between 6 dB and 23 dB in both X- and Ku-bands. The measured results of the antennas agree with the simulated results, which shows that they have potential application value in 5.8 GHz WLAN wireless communication.

Evolution of SARS-CoV-2 Spikes shapes their binding affinities to animal ACE2 orthologs.

IMPORTANCE: Spike-receptor interaction is a critical determinant for the host range of coronaviruses. In this study, we investigated the SARS-CoV-2 WHU01 strain and five WHO-designated SARS-CoV-2 variants of concern (VOCs), including Alpha, Beta, Gamma, Delta, and the early Omicron variant, for their Spike interactions with ACE2 proteins of 18 animal species. First, the receptor-binding domains (RBDs) of Alpha, Beta, Gamma, and Omicron were found to display progressive gain of affinity to mouse ACE2. More interestingly, these RBDs were also found with progressive loss of affinities to multiple ACE2 orthologs. The Omicron RBD showed decreased or complete loss of affinity to eight tested animal ACE2 orthologs, including that of some livestock animals (horse, donkey, and pig), pet animals (dog and cat), and wild animals (pangolin, American pika, and Rhinolophus sinicus bat). These findings shed light on potential host range shift of SARS-CoV-2 VOCs, especially that of the Omicron variant.

Metal-free photoinduced C(sp3)-H/C(sp3)-H cross-coupling to access α­tertiary amino acid derivatives.

The cross-dehydrogenative coupling (CDC) reaction is the most direct and efficient method for constructing α-tertiary amino acids (ATAAs), which avoids the pre-activation of C(sp3)-H substrates. However, the use of transition metals and harsh reaction conditions are still significant challenges for these reactions that urgently require solutions. This paper presents a mild, metal-free CDC reaction for the construction of ATAAs, which is compatible with various benzyl C-H substrates, functionalized C-H substrates, and alkyl substrates, with good regioselectivity. Notably, our method exhibits excellent functional group tolerance and late-stage applicability. According to mechanistic studies, the one-step synthesized and bench-stable N-alkoxyphtalimide generates a highly electrophilic trifluoro ethoxy radical that serves as a key intermediate in the reaction process and acts as a hydrogen atom transfer reagent. Therefore, our metal-free and additive-free method offers a promising strategy for the synthesis of ATAAs under mild conditions.

[Investigation on the current situation of the development of intensive care units in Inner Mongolia Autonomous Region in 2022].

OBJECTIVE: To investigate the development present situation of the department of critical care medicine in Inner Mongolia Autonomous Region (hereinafter referred to as Inner Mongolia), in order to promote the standardized and homogeneous development of critical care medicine in Inner Mongolia, and also provide a reference for discipline construction and resource allocation. METHODS: A survey study was conducted in comprehensive intensive care unit (ICU) of tertiary and secondary hospitals in Inner Mongolia by online questionnaire survey and telephone data verification. The questionnaire was based on the Guidelines for the Construction and Management of Intensive Care Units (Trial) (hereinafter referred to as the Guidelines) issued by the National Health Commission in 2009 and the development trend of the discipline. The questionnaire covered six aspects, including hospital basic information, ICU basic information, personnel allocation, medical quality management, technical skill and equipment configuration. The questionnaire was distributed in September 2022, and it was filled out by the discipline leaders or department heads of each hospital. RESULTS: As of October 24, 2022, a total of 101 questionnaires had been distributed, 85 questionnaires had been recovered, and the questionnaire recovery rate had reached 84.16%, of which 71 valid questionnaires had been collected in a total of 71 comprehensive ICU. (1) There were noticeable regional differences in the distribution of comprehensive ICU in Inner Mongolia, with a relatively weak distribution in the east and west, and the overall distribution was uneven. The development of critical care medicine in Inner Mongolia was still lacking. (2) Basic information of hospitals: the population and economy restricted the development of ICU. The average number of comprehensive ICU beds in the western region was only half of that in the central region (beds: 39.0 vs. 86.0), and the average number of ICU beds in the eastern region was in the middle (83.6 beds), which was relatively uneven. (3) Basic information of ICU: among the 71 comprehensive ICU surveyed, there were 44 tertiary hospitals and 27 secondary hospitals. The ratio of ICU beds to total beds in tertiary hospitals was significantly lower than that in secondary hospitals [(1.59±0.81)% vs. (2.11±1.07)%, P < 0.05], which were significantly lower than the requirements of the Guidelines of 2%-8%. The utilization rate of ICU in tertiary and secondary hospitals [(63.63±22.40)% and (44.65±20.66)%, P < 0.01] were both lower than the bed utilization rate required by the Guidelines (75% should be appropriate). (4) Staffing of ICU: there were 376 doctors and 1 117 nurses in tertiary hospitals, while secondary hospitals had 122 doctors and 331 nurses. There were significant differences in the composition ratio of the titles of doctors, the degree of doctors, and the titles of nurses between tertiary and secondary hospitals (all P < 0.05). Most of the doctors in tertiary hospitals had intermediate titles (attending physicians accounted for 41.49%), while most of the doctors in secondary hospitals had junior titles (resident physicians accounted for 43.44%). The education level of doctors in tertiary hospitals was generally higher than that in secondary hospitals (doctors: 2.13% vs. 0, masters: 37.24% vs. 8.20%). The proportion of nurses in tertiary hospitals was significantly lower than that in secondary hospitals (17.01% vs. 24.47%). The ratio of ICU doctors/ICU beds [(0.64±0.27)%, (0.59±0.34)%] and ICU nurses/ICU beds [(1.76±0.56)%, (1.51±0.48)%] in tertiary and secondary hospitals all failed to meet the requirements above 0.8 : 1 and 3 : 1 of the Guidelines. (5) Medical quality management of ICU: compared with secondary hospitals, the proportion of one-to-one drug-resistant bacteria care in tertiary hospitals (65.91% vs. 40.74%), multimodal analgesia and sedation (90.91% vs. 66.67%), and personal digital assistant (PDA) barcode scanning (43.18% vs. 14.81%) were significantly higher (all P < 0.05). (6) Technical skills of ICU: in terms of technical skills, the proportion of bronchoscopy, blood purification, jejunal nutrition tube placement and bedside ultrasound projects carried out in tertiary hospitals were higher than those in secondary hospitals (84.09% vs. 48.15%, 88.64% vs. 48.15%, 61.36% vs. 55.56%, 88.64% vs. 70.37%, all P < 0.05). Among them, the placement of jejunal nutrition tube, bedside ultrasound and extracorporeal membrane oxygenation were mainly completed independently in tertiary hospitals, while those in secondary hospitals tended to be completed in cooperation. (7) Equipment configuration of ICU: in terms of basic equipment, the ratio of the total number of ventilators/ICU beds in tertiary and secondary hospitals [0.77% (0.53%, 1.07%), 0.88% (0.63%, 1.38%)], and the ratio of injection pump/ICU beds [1.70% (1.00%, 2.56%), 1.25% (0.75%, 1.88%)] didn't meet the requirements of the Guidelines. The equipment ratio was insuffcient, which means that the basic needs of development had not been met yet. CONCLUSIONS: The development of comprehensive ICU in Inner Mongolia has tended to mature, but there is still a certain gap in the development scale, personnel ratio and instruments and equipment compared with the Guidelines. Moreover, the comprehensive ICU appears the characteristics of relatively weak eastern and western regions, and the overall distribution is uneven. Therefore, it is necessary to increase efforts to invest in the construction of the department of critical care medicine.

Metabolic characteristics of non-obese and obese metabolic dysfunction-associated fatty liver disease in type 2 diabetes mellitus and its association with diabetic peripheral neuropathy and diabetic retinopathy.

Aim: To assess the metabolic characteristics of non-obese metabolic dysfunction-associated fatty liver disease (MAFLD) compared with obese MAFLD and the relationship of MAFLD with diabetic peripheral neuropathy and diabetic retinopathy in patients with Type 2 diabetes mellitus (T2DM). Methods: Data were obtained from 536 T2DM patients (355 women, 181 men; age 58.2 ± 12.0 years). We explored the difference in clinical characteristics between obese MAFLD (body mass index ≥25 kg/m2) and non-obese MAFLD (body mass index <25 kg/m2) in T2DM patients. One-way analysis of variance (ANOVA) was used to compare the means of continuous variables, and the Chi-squared test was used to compare the differences in frequencies of categorical variables. Logistic regression models were adopted to calculate odds ratios. Results: The prevalence of MAFLD in hospitalized Chinese T2DM patients was calculated to be 42.7%. Both obese and non-obese MAFLD patients had higher levels of body mass index (BMI), waist circumfere nce, triglyceride, alanine aminotransferase, aspar tate aminotransferase, γ-glutamyltransferase, you nger age, higher prevalence of hyperlipidemia and shorter duration of T2DM and lower incidence of diabetic retinopathy, compared with participants with out MAFLD in the same weight group. Uric acid levels were positively correlated with the risk of MAFLD only in non-obese subjects but not in obese subjects. In non-obese patients with T2DM, a negative correlation was found between the prevalence of MAFLD and diabetic retinopathy. Conclusion: Even in non-obese patients with T2DM, BMI was found to be an independent risk factor for MAFLD. These findings support a more structured, risk-factor-based approach to MAFLD management, particularly in patients with T2DM. Non-obese MAFLD has unique results in metabolic characteristics and the correlation with diabetic retinopathy and diabetic peripheral neuropathy, which should be further explored.