Triptonide protects retinal cells from oxidative damage via activation of Nrf2 signaling.

Age­related macular degeneration (AMD) is an ocular disease that threatens the visual function of older adults worldwide. Key pathological processes involved in AMD include oxidative stress, inflammation and choroidal vascular dysfunction. Retinal pigment epithelial cells and Müller cells are most susceptible to oxidative stress. Traditional herbal medicines are increasingly being investigated in the field of personalized medicine in ophthalmology. Triptonide (Tn) is a diterpene tricyclic oxide, the main active ingredient in the extract from the Chinese herbal medicinal plant Tripterygium wilfordii, and is considered an effective immunosuppressant and anti­inflammatory drug. The present study investigated the potential beneficial role of Tn in retinal oxidative damage in order to achieve personalized treatment for early AMD. An oxidative stress model of retinal cells induced by H2O2 and a retinal injury model of mice induced by light and N­Methyl­D­aspartic acid were constructed. In vitro, JC­1 staining, flow cytometry and apoptosis assay confirmed that low concentrations of Tn effectively protected retinal cells from oxidative damage, and reverse transcription­quantitative PCR and western blotting analyses revealed that Tn reduced the expression of retinal oxidative stress­related genes and inflammatory factors, which may depend on the PI3K/AKT/mTOR­induced Nrf2 signaling pathway. In vivo, by retinal immunohistochemistry, hematoxylin and eosin staining and electroretinogram assay, it was found that retinal function and structure improved and choroidal neovascularization was significantly inhibited after Tn pretreatment. These results suggested that Tn is an efficient Nrf2 activator, which can be expected to become a new intervention for diseases such as AMD, to inhibit retinal oxidative stress damage and pathological neovascularization.

LILRB4 regulates multiple myeloma development through STAT3-PFKFB1 pathway.

Although multiple myeloma (MM) responds well to immunotherapeutic treatment, certain portions of MM are still unresponsive or relapse after immunotherapy. Other immune molecules are needed for the immunotherapy of MM. Here, we revealed that leukocyte immunoglobulin-like receptor B4 (LILRB4) was highly expressed in multiple myeloma cell lines and patient samples and that the expression of LILRB4 was adversely correlated with the overall survival of MM patients. Knockdown of LILRB4 efficiently delayed the growth of MM cells both in vitro and in vivo. Mechanistically, IKZF1 transactivated LILRB4 expression to trigger the downstream of STAT3-PFKFB1 pathways to support MM cell proliferation. Blockade of LILRB4 signaling by blocking antibodies can effectively inhibit MM progression. Our data show that targeting LILRB4 is potentially an additional therapeutic strategy for the immunotherapeutic treatment of MM.

Circadian disruption reduces MUC4 expression via the clock molecule BMAL1 during dry eye development.

Circadian disruption, as a result of shiftwork, jet lag, and other lifestyle factors, is a common public health problem associated with a wide range of diseases, such as metabolic disorders, neurodegenerative diseases, and cancer. In the present study, we established a chronic jet lag model using a time shift method every 3 days and assessed the effects of circadian disruption on ocular surface homeostasis. Our results indicated that jet lag increased corneal epithelial defects, cell apoptosis, and proinflammatory cytokine expression. However, the volume of tear secretion and the number of conjunctival goblet cells did not significantly change after 30 days of jet lag. Moreover, further analysis of the pathogenic mechanism using RNA sequencing revealed that jet lag caused corneal transmembrane mucin deficiency, specifically MUC4 deficiency. The crucial role of MUC4 in pathogenic progression was demonstrated by the protection of corneal epithelial cells and the inhibition of inflammatory activation following MUC4 replenishment. Unexpectedly, genetic ablation of BMAL1 in mice caused MUC4 deficiency and dry eye disease. The underlying mechanism was revealed in cultured human corneal epithelial cells in vitro, where BMAL1 silencing reduced MUC4 expression, and BMAL1 overexpression increased MUC4 expression. Furthermore, melatonin, a circadian rhythm restorer, had a therapeutic effect on jet lag-induced dry eye by restoring the expression of BMAL1, which upregulated MUC4. Thus, we generated a novel dry eye mouse model induced by circadian disruption, elucidated the underlying mechanism, and identified a potential clinical treatment.

Description of control measures, attitudes, and behaviours at a scientific conference with a confirmed COVID-19 case but no reported onward transmission, November 2021 England.

Background: COVID-19 (coronavirus disease 2019) outbreaks in workplace settings have been investigated to understand how transmission occurred. However, there is limited data looking at COVID-19 transmission in conference settings in England, particularly where an outbreak did not occur. The aim of this work was to investigate COVID-19 infection risk factors and control measures at a large conference, with a known case but no reported onward transmission to inform prevention of future outbreaks of respiratory infections in conferences and similar settings. Methods: This cross-sectional study was part of a wider COVID-19 Outbreak Investigation to Understand Transmission (COVID-OUT) study. A two-day in-person conference on SARS-CoV-2 transmission and environment was held at a university conference centre on 17-November 18, 2021, in England, with about 100 delegates. A questionnaire survey was conducted among 50 conference attendees to identify any confirmed cases and understand transmission, history of COVID-19 symptoms, testing and vaccination. Results: One person met the definition of a confirmed case at the conference. This case was most likely infectious when attending the conference, however there were no known secondary cases. All respondents reported receiving at least two doses of a COVID-19 vaccine before the conference and an increased frequency of handwashing/sanitising hands during the study period in comparison to before the pandemic. Prior to the conference, a COVID-19 risk assessment including a review of the ventilation at the site was completed. All attendees were advised to take an LFD test before travelling to the conference, wear face coverings, and maintain 1-m distance during the conference. Conclusion: A multipronged approach, encouraging attendee behaviours (regular hand washing, mask wearing, being vaccinated against COVID-19) and introducing control measures at the conference site (ventilation, sufficient spacing capacity, combined with prior knowledge of COVID-19 transmission, were effective in limiting the spread of COVID-19 in this setting.

Botulinum toxin type A in treating early-stage patients with small-angle acute acquired comitant esotropia.

AIM: To investigate botulinum toxin A (BTXA) efficacy on small-angle (≤25Δ) acute acquired concomitant esotropia (AACE) in early-stage patients. METHODS: The electronic medical record data of AACE patients during March 2019 and June 2023 were collected in this retrospective and hospital-based cohort study. A total of 72 small-angle AACE patients received BTXA extraocular muscle injection. Patients were grouped by onset-to-treatment time (Group A: ≤6mo, Group B: >6mo). Deviation of esotropia, eye alignment and stereopsis were analyzed at the period of pre/post-injection (1wk, 1, 3, and 6mo). Orthophoria rate at 6mo (horizontal deviation <10Δ and binocular single vision) were considered as outcome index. RESULTS: There were no significant baseline differences (P>0.05) between two groups except onset-to-treatment time (2mo vs 11mo, P<0.001). Higher orthophoria rates were in Group A at last follow-up (94.74% vs 73.53%, P=0.013). Post-BTXA deviations of two groups at 1mo showed no difference (P>0.05); while in 3 and 6mo Group A was significantly smaller than group B (all P<0.001). No statistically significant differences were observed among all post-BTXA deviations of near and distance in Group A. In Group B, deviation at 3mo (near: 2Δ vs 0, P<0.001; distance: 4Δ vs 0, P<0.001) and 6mo (near: 6Δ vs 0, P<0.001; distance: 6Δ vs 0, P<0.001) was significant increased compared to deviation at 1wk after treatment. Group A showed better stereopsis recovery in last follow-up compared to Group B (80″ vs 200″, P=0.002). Both groups obtained improved stereopsis after treatment (Group A: 80″ vs 300″, P<0.001; Group B: 200″ vs 300″, P=0.037). CONCLUSION: BTXA is effective for AACE with small deviation (≤25Δ) in early stage. Delayed treatment (>6mo) may reduce BTXA efficacy. Early BTXA intervention benefits long-term eye alignment and stereopsis recovery.

Necroptosis in bacterial infections.

Necroptosis, a recently discovered form of cell-programmed death that is distinct from apoptosis, has been confirmed to play a significant role in the pathogenesis of bacterial infections in various animal models. Necroptosis is advantageous to the host, but in some cases, it can be detrimental. To understand the impact of necroptosis on the pathogenesis of bacterial infections, we described the roles and molecular mechanisms of necroptosis caused by different bacterial infections in this review.

Paeoniflorin regulates RhoA/ROCK1 and Nrf2 pathways in PDLIM1-dependent or independent manners in oxidative stressed melanocytes.

BACKGROUND: The adhesive properties of vitiligo melanocytes have decreased under oxidative stress., cytoskeleton proteins can control cell adhesion. Paeoniflorin (PF) was proved to resist hydrogen peroxide (H2O2)-induced oxidative stress in melanocytes via nuclear factorE2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) pathway. OBJECTIVES: This study was to investigate whether PF exerts anti-oxidative effect through influencing cytoskeleton markers or potential signaling pathway. METHODS: Human Oxidative Stress Plus array was used to identify the differentially expressed genes between H2O2 + PF group and H2O2 only group, in PIG1 and PIG3V melanocyte cell lines respectively. Western blotting was used to verify the PCR array results and to test the protein expression levels of cytoskeleton markers including Ras homolog family member A (RhoA), Rho-associated kinase 1 (ROCK1) and antioxidative marker Nrf2. Small interfering RNA was used to knock down PDZ and LIM domain 1 (PDLIM1). RESULTS: PF increased the expressions of PDLIM1, RhoA and ROCK1 in H2O2-induced PIG1, in contrast, decreased the expressions of PDLIM1 and ROCK1 in H2O2-induced PIG3V. Knockdown of PDLIM1 increased the expressions of RhoA and Nrf2 in PF-pretreated H2O2-induced PIG1, and ROCK1 and Nrf2 in PF-pretreated H2O2-induced PIG3V. CONCLUSIONS: PF regulates RhoA/ROCK1 and Nrf2 pathways in PDLIM1-dependent or independent manners in H2O2-induced melanocytes. In PIG1, PF promotes PDLIM1 to inhibit RhoA/ROCK1 pathway or activates Nrf2/HO-1 pathway, separately. In PIG3V, PF directly downregulates ROCK1 in PDLIM1-independent manner or upregulates Nrf2 dependent of PDLIM1.

Cellular structural and functional imaging of donor and pathological corneas with label-free dual-mode full-field optical coherence tomography.

In this study, a dual-mode full-field optical coherence tomography (FFOCT) was customized for label-free static and dynamic imaging of corneal tissues, including donor grafts and pathological specimens. Static images effectively depict relatively stable structures such as stroma, scar, and nerve fibers, while dynamic images highlight cells with active intracellular metabolism, specifically for corneal epithelial cells. The dual-mode images complementarily demonstrate the 3D microstructural features of the cornea and limbus. Dual-modal imaging reveals morphological and functional changes in corneal epithelial cells without labeling, indicating cellular apoptosis, swelling, deformation, dynamic signal alterations, and distinctive features of inflammatory cells in keratoconus and corneal leukoplakia. These findings propose dual-mode FFOCT as a promising technique for cellular-level cornea and limbus imaging.

HBeAg induces neutrophils activation impairing NK cells function in patients with chronic hepatitis B.

BACKGROUND: The role of neutrophils in hepatitis B virus (HBV) infection has been a subject of debate due to their involvement in antiviral responses and immune regulation. This study aimed to elucidate the neutrophil characteristics in patients with chronic hepatitis B (CHB). METHODS: Through flow cytometry and ribonucleic acid-sequencing analysis, the phenotypes and counts of neutrophils were analyzed in patients with CHB. Moreover, the effects of HBeAg on neutrophils and the corresponding pattern recognition receptors were identified. Simultaneously, the cross-talk between neutrophils and natural killer (NK) cells was investigated. RESULTS: Neutrophils were activated in patients with CHB, characterized by higher expression levels of programmed death-ligand 1 (PD-L1), cluster of differentiation 86, and interleukin-8, and lower levels of CXC motif chemokine receptor (CXCR) 1 and CXCR2. Hepatitis B e antigen (HBeAg) partially induces neutrophil activation through the Toll-like receptor 2 (TLR2). A consistent upregulation of the TLR2 and HBeAg expression was observed in patients with CHB. Notably, the genes encoding molecules pivotal for NK-cell function upon NK receptor engagement enriched in neutrophils after HBeAg activation. The HBeAg-activated neutrophils demonstrated the ability to decrease the production of interferon-gamma (IFN-γ) and tumor necrosis factor-alpha (TNF-α) in NK cells, while the PD-1 and PD-L1 pathways partially mediated the immunosuppression. CONCLUSIONS: The immunosuppression of neutrophils induced by HBeAg suggests a novel pathogenic mechanism contributing to immune tolerance in patients with CHB.

Study on the Application of Group Psychological Nursing in Non-suicidal Self-injury among Adolescents.

Background: Non-suicidal self-injury (NSSI) refers to direct and deliberate suicidal actions that damage the body but are not recognized by society and culture. Adolescence is the transition period when children change into adult roles. At this time, teenagers are in the critical development period of physical and mental intelligence, and all aspects of their development have not yet been fully developed, so there are fierce inner conflicts. If the psychological problems of teenagers do not get timely counseling, it is very likely to choose self-injury suicide behavior, in such an extreme way to vent their bad emotions. The prevalence rate of NSSI among adolescents is much higher than that of other age groups. Studies have shown that psychological nursing is safe and effective, which can alleviate patients' negative emotions and avoid NSSI. Objective: To explore the impact of group psychological nursing with guardian participation on reducing NSSI behaviors and improving psychological well-being among adolescents. Design: This was a retrospective study. Setting: This study was performed in the Departments of the Third Psychiatry, Hangzhou Seventh People's Hospital. Participants: 132 adolescent patients with NSSI admitted to our center from August 2020 to July 2022 were selected as subjects and divided into 2 groups according to the time of admission, with 66 patients in each group. Interventions: Patients in the control group (CG) received drug therapy and commonly used cognitive behavioral therapy. Patients in the observation group (OG) received group psychological nursing with guardian participation. The participation of the guardian strengthens the level of understanding, tolerance and support of both parties, and helps to enhance the strength of family support, which in turn relives negative emotions. Primary Outcome Measures: (1) Ottawa self-injury inventory (OSI) scores were used to assess NSSI behavior severity; (2) Self-rating Anxiety Scale (SAS) and self-rating Depression Scale (SDS) scores were used to assess anxiety and depression; (3) General Self-efficacy Scale (GSES) scores were used to assess self-efficacy; (4) Trait Coping Style Questionnaire (TCSQ) scores were used to assess the quality of life; (5) social function Assessment Scale (SSPI) scores were used to assess social function; (6) Adolescent Life Events Scale (ASLEC) scores were used to evaluate the stress intensity of coping with life events; (7) multidimensional sub-health questionnaire assessment (MSQA) scores were used to assess adolescents' physical and psychological sub-health. Results: Before intervention, there were no significant differences in OSI, SAS, SDS, GSES, TCSO, SSPI ASLEC, and MSQA scores in both groups (P > .05). Compared to before intervention, the scores of OSI, SAS, SDS, GSES, TCSO, SSPI ASLEC and MSQA in both groups were improved after intervention (P < .05). The observation group showed significant improvements across all measures compared to the control group, indicating a reduction in NSSI behaviors and improvements in mental health. Conclusion: Application of group psychological nursing with guardian participation in adolescent patients with NSSI behavior can better reduce NSSI behavior and improve physical and mental health, underline the importance of family support in treating NSSI, which also highlights the importance of family support in the treatment of NSSI.

Effect of Acceptance and Commitment Therapy on Emotion Regulation in Adolescent Patients with Nonsuicidal Self-Injury.

Objective: This study aimed to explore the effect of acceptance and commitment therapy (ACT) on emotion regulation in adolescent patients with nonsuicidal self-injury (NSSI). Methods: A total of 72 adolescent patients with NSSI were selected as research subjects from June 2022 to May 2023 for retrospective analysis. They were divided into control group (CG) and experimental group (EG) in accordance with different management methods. CG received routine psychological support treatment, whereas EG was given ACT management on the basis of routine psychological support. The clinical management effects of the 2 groups were compared. Results: At the end of week 6 (T1) and the end of week 12 (T2), the EG had significantly higher scores of positive emotion regulation and cognitive fusion questionnaire-fusion (CFQ-F) (P < .05). However, they had significantly lower scores on the negative emotion regulation, behavior questionnaire, function questionnaire, and adolescent self-rating life events checklist (ASLEC) than the CG (P < .05). Conclusion: Acceptance and commitment therapy can effectively regulate the emotional state of adolescent patients with NSSI, improve psychological flexibility, reduce the effectiveness of self-injury behavior, and help such adolescents acquire the correct values in life.

Different correlation between depressive symptoms and sleep duration on weekdays/weekends among adolescents in Taiyuan, North China.

OBJECTIVE: In Chinese adolescents, the co-occurrence of depressive symptoms and short sleep duration constitute a serious public health issue. This study investigates the association between depressive symptoms and sleep duration of Chinese adolescents on weekdays as well as weekends. METHODS: A multistage random cluster selection was utilized to select 2660 adolescents in Taiyuan, China. The survey contents included demographic characteristics, sleep duration, and depressive symptoms. RESULTS: About 41.95 % of students reported depressive symptoms with an average sleep duration of 7.71 ± 0.90 h. After adjusting for covariates, depressive symptoms were found to be positively correlated with sleep duration <6 h (OR = 1.88, 95 % CI: 1.20, 2.95) and 6 ~ h (OR = 1.61, 95 % CI: 1.18, 2.20) on weekdays, and sleep duration <6 h (OR = 2.10, 95 % CI: 1.17, 3.79) and 6 ~ hours (OR = 1.74, 95 % CI: 1.16, 2.62) on weekends compared with a sleep duration of 8 ~ hours. Only on weekdays, sleep duration of 7 ~ hours was positively correlated with depressive symptoms (OR = 1.39, 95%CI: 1.05, 1.84). On weekends, it was not associated with depressive symptoms (OR = 1.06, 95%CI: 0.82, 1.39). In subgroup analyses, female students (OR = 2.88, 1.97, 1.50) and middle school students (OR = 3.50, 2.07, 1.50) were more likely to experience depressive symptoms on weekdays with a sleep duration of <6 h, 6 ~ hours and 7 ~ hours. LIMITATIONS: Sleep duration and depressive symptoms were self-reported measures. CONCLUSION: The study highlights that short sleep duration (< 7 h) increases the risk of depressive symptoms among adolescents regardless of weekdays or weekends. Just on weekdays, the sleep duration of 7 ~ hours was a risk factor for depressive symptoms. Further, gender, grade, and the only-child played significant modification effects between depressive symptoms and sleep duration. To conclude, this study will assist in the effective promotion of the education of adolescents' sleep health.

AATCT-IDS: A benchmark Abdominal Adipose Tissue CT Image Dataset for image denoising, semantic segmentation, and radiomics evaluation.

BACKGROUND AND OBJECTIVE: The metabolic syndrome induced by obesity is closely associated with cardiovascular disease, and the prevalence is increasing globally, year by year. Obesity is a risk marker for detecting this disease. However, current research on computer-aided detection of adipose distribution is hampered by the lack of open-source large abdominal adipose datasets. METHODS: In this study, a benchmark Abdominal Adipose Tissue CT Image Dataset (AATCT-IDS) containing 300 subjects is prepared and published. AATCT-IDS publics 13,732 raw CT slices, and the researchers individually annotate the subcutaneous and visceral adipose tissue regions of 3213 of those slices that have the same slice distance to validate denoising methods, train semantic segmentation models, and study radiomics. For different tasks, this paper compares and analyzes the performance of various methods on AATCT-IDS by combining the visualization results and evaluation data. Thus, verify the research potential of this data set in the above three types of tasks. RESULTS: In the comparative study of image denoising, algorithms using a smoothing strategy suppress mixed noise at the expense of image details and obtain better evaluation data. Methods such as BM3D preserve the original image structure better, although the evaluation data are slightly lower. The results show significant differences among them. In the comparative study of semantic segmentation of abdominal adipose tissue, the segmentation results of adipose tissue by each model show different structural characteristics. Among them, BiSeNet obtains segmentation results only slightly inferior to U-Net with the shortest training time and effectively separates small and isolated adipose tissue. In addition, the radiomics study based on AATCT-IDS reveals three adipose distributions in the subject population. CONCLUSION: AATCT-IDS contains the ground truth of adipose tissue regions in abdominal CT slices. This open-source dataset can attract researchers to explore the multi-dimensional characteristics of abdominal adipose tissue and thus help physicians and patients in clinical practice. AATCT-IDS is freely published for non-commercial purpose at: https://figshare.com/articles/dataset/AATTCT-IDS/23807256.

Salidroside Ameliorates Lung Injury Induced by PM 2.5by Regulating SIRT1-PGC-1α in Mice.

Objective: This study aimed to clarify the intervention effect of salidroside (SAL) on lung injury caused by PM 2.5 in mice and illuminate the function of SIRT1-PGC-1ɑ axis. Methods: Specific pathogen-free (SPF) grade male C57BL/6 mice were randomly assigned to the following groups: control group, SAL group, PM 2.5 group, SAL+PM 2.5 group. On the first day, SAL was given by gavage, and on the second day, PM 2.5 suspension was given by intratracheal instillation. The whole experiment consist of a total of 10 cycles, lasting 20 days. At the end of treatment, blood samples and lung tissues were collected and analyzed. Observation of pathological changes in lung tissue using inverted microscopy and transmission electron microscopy. The expression of inflammatory, antioxidants, apoptosis, and SIRT1-PGC-1ɑ proteins were detected by Western blotting. Results: Exposure to PM 2.5 leads to obvious morphological and pathologica changes in the lung of mice. PM 2.5 caused a decline in levels of antioxidant-related enzymes and protein expressions of HO-1, Nrf2, SOD2, SIRT1 and PGC-1ɑ, and an increase in the protein expressions of IL-6, IL-1ß, Bax, caspase-9 and cleaved caspase-3. However, SAL reversed the aforementioned changes caused by PM 2.5 by activating the SIRT1-PGC-1α pathway. Conclusion: SAL can activate SIRT1-PGC-1ɑ to ameliorate PM 2.5-induced lung injury.

[Ecological Environment Dynamical Evaluation of Hutuo River Basin Using Remote Sensing].

Hutuo River Basin straddles Shanxi and Hebei provinces, and Hutuo River was once cut off due to economic development and urban expansion after 2000; however, with the national emphasis on ecological civilization and the implementation of the South-North Water Diversion Project, the ecological protection of Hutuo River Basin has been significantly improved. MODIS data, Landsat data, and night light remote sensing data were selected based on the google earth engine (GEE) platform, and a new evaluation index system was generated by combining the biological richness index, vegetation cover index, land stress index, and pollution load index in the ecological environment index (EI) and the humidity index in the remote sensing ecological index (RSEI), using the variation coefficient method and entropy weighting method to assign weights to these indices. An ecological environment evaluation model was constructed to evaluate and classify the ecological environment quality of Hutuo River Basin from 2000 to 2020, and the driving factors were interpreted by using geographic probes. The results showed that:① on a time scale, the ecological environment of Hutuo River Basin was in a decline period from 2000 to 2015 and a recovery period from 2015 to 2020. From a grid scale, the ecological environment quality in the central part of the basin showed a state of improvement year by year, and in the western and eastern parts of the basin, the ecological environment quality in the decline period decreased year by year, whereas the ecological environment quality in the recovery period improved. ② Hot spot analysis showed that the spatial distribution of the ecological environment quality in Hutuo River Basin was high in the middle and low on both sides. Cold spot regions were mainly located in major cities and towns in the eastern and southern parts and scattered in the river valley area on the west side. ③ Geodetection analysis showed that the single factor detection drivers were mainly population density, vegetation net primary productivity (NPP), fractional vegetation cover (FVC), and geomorphological type. The dominant factor of cross-detection was "geomorphological type + FVC." With the deepening of ecological civilization construction and the implementation of Hutuo River Protection Regulations, in combination with different factors such as the natural environment and social characteristics in this basin, the research on ecological environment evaluation in Hutuo River Basin can provide data support for proposing localized policies to improve the ecological environment.

Investigating the nexus of metabolic syndrome, serum uric acid, and dementia risk: a prospective cohort study.

BACKGROUND: The global dementia prevalence is surging, necessitating research into contributing factors. We aimed to investigate the association between metabolic syndrome (MetS), its components, serum uric acid (SUA) levels, and dementia risk. METHODS: Our prospective study comprised 466,788 participants without pre-existing MetS from the UK Biobank. We confirmed dementia diagnoses based on the ICD-10 criteria (F00-03). To evaluate the dementia risk concerning MetS, its components, and SUA levels, we applied Cox proportional hazards models, while adjusting for demographic factors. RESULTS: Over a median follow-up of 12.7 years, we identified 6845 dementia cases. Individuals with MetS had a 25% higher risk of all-cause dementia (hazard ratio [HR] = 1.25, 95% confidence interval [CI] = 1.19-1.31). The risk increased with the number of MetS components including central obesity, dyslipidemia for high-density lipoprotein (HDL) cholesterol, hypertension, hyperglycemia, and dyslipidemia for triglycerides. Particularly for those with all five components (HR = 1.76, 95% CI = 1.51-2.04). Dyslipidemia for HDL cholesterol, hypertension, hyperglycemia, and dyslipidemia for triglycerides were independently associated with elevated dementia risk (p < 0.01). MetS was further linked to an increased risk of all-cause dementia (11%) and vascular dementia (VD, 50%) among individuals with SUA levels exceeding 400 µmol/L (all-cause dementia: HR = 1.11, 95% CI = 1.02-1.21; VD: HR = 1.50, 95% CI = 1.28-1.77). CONCLUSIONS: Our study provides robust evidence supporting the association between MetS, its components, and dementia risk. These findings emphasize the importance of considering MetS and SUA levels in assessing dementia risk, offering valuable insights for prevention and management strategies.

The prognostic value of collateral circulation in coronary chronic total occlusion underwent percutaneous coronary intervention.

BACKGROUND: The prognostic value of coronary collateral circulation (CC) in patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is underdetermined. The purpose of the study was to assess the prognostic value of current two CC grading systems and their association with long-term outcomes in patients with CTO underwent PCI. METHODS: We consecutively enrolled patients with single-vessel CTO underwent PCI between January 2010 and December 2013. All patients were categorized into well-developed or poor-developed collaterals group according to angiographic Werner's CC (grade 2 vs. grade 0-1) or Rentrop (grade 3 vs. grade 0-2) grading system. The primary endpoint was 5-year cardiac death. RESULTS: Of 2452 enrolled patients, the overall technical success rate was 74.1%. Well-developed collaterals were present in 686 patients (28.0%) defined by Werner's CC grade 2, and in 1145 patients (46.7%) by Rentrop grade 3. According to Werner's CC grading system, patients with well-developed collaterals had a lower rate of 5-year cardiac death compared with those with poor-developed collaterals (1.6% vs. 3.3%, P = 0.02), those with suboptimal recanalization was associated with higher rate of 5-year cardiac death compared with optimal recanalization (4.7% vs. 0.8%, P = 0.01) and failure patients (4.7% vs. 1.6%, P = 0.12). However, the similar effect was not shown in Rentrop grading system. CONCLUSIONS: In patients with the single-vessel CTO underwent PCI, well-developed collaterals by Werner's CC definition were associated with lower rate of 5-year cardiac death. Werner's CC grading system had a greater prognostic value than Rentrop grading system in patients with CTO underwent PCI.

Phyllanthus emblica Linn: A comprehensive review of botany, traditional uses, phytonutrients, health benefits, quality markers, and applications.

Phyllanthus emblica Linn is not only an edible fruit with high nutritional value, but also a medicinal plant with multiple bioactivities. It is widely used in clinical practice with functions of clearing heat, cooling blood, digesting food, strengthening stomach, promoting fluid production, and relieving cough. This review summarized a wide variety of phytonutrients, including nutritional components (mineral elements, amino acids, vitamins, polysaccharides, unsaturated free fatty acids) and functional components (phenolic acids (1-34), tannins (35-98), flavonoids (99-141), sterols (142-159), triterpenoids (160-175), lignans (176-183), alkaloids (184-197), alkanes (198-212), aromatic micromolecules (213-222), other compounds (223-239)). The isolated compounds and the various extracts of P. emblica Linn presented a diverse spectrum of biological activities such as anti-oxidant, anti-cancer, anti-inflammatory, anti-bacterial, hepatoprotective, hypoglycemic, anti-atherosclerosis, neuroprotective, enhancing immunity, anti-fatigue, anti-myocardial fibrosis. The quality markers of P. emblica Linn were predicted and analyzed based on traditional medicinal properties, traditional efficacy, plant genealogy and chemical component characteristics, biogenic pathway of chemical components, measurability of chemical components, transformation characteristics of polyphenolic components, homologous characteristics of medicine and food, compound compatibility environment, and clinical applications. This review also summarized and prospected applications of P. emblica Linn in beverages, preserved fruits, fermented foods, etc. However, the contents of mechanism, structure-activity relationship, quality control, toxicity, extraction, processing of P. emblica Linn are not clear, and are worth further studies in the future.