Novel Serum Markers that Distinguish Behcet's Disease from Idiopathic Recurrent Aphthous Stomatitis.

BACKGROUND: Behcet's disease (BD) is a rare and recurrent autoinflammatory disorder characterized by systemic vasculitis, frequently manifested as recurrent aphthous stomatitis (RAS). We aim to identify specific serum proteins to discriminate between BD and idiopathicRAS. METHOD: Peripheral blood was collected from 12 BD patients, 12 idiopathic RAS patients, and 21 healthy volunteers. The serum samples underwent Tandem Mass Tag-based mass spectrometry analysis. Differentially expressed proteins (DEPs) were identified for KEGG pathway enrichment, Gene Ontology (GO), and protein-protein interaction (PPI) analyses. ELISA was utilized to verify two BD-specific DEPs in another cohort consisting of 18 BD patients, 18 idiopathic RAS patients, and 18 controls. RESULTS: Compared with RAS serum, BD serum showed 242 DEPs. 49 proteins were differentially expressed in BD but not RAS serum compared to healthy controls. KEGG pathway and GO analyses revealed that DEPs in BD and RAS have similar biological functions and cellular distributions, featuring a significant association with pathways regulating blood coagulation and immune response. When comparing DEPs between BD and RAS, several keratins emerged as markers that distinguish RAS from BD. We also identified multiple DEPs in BD but not RAS patients. PPI analysis uncovered that lipoprotein metabolism regulators serve as hub proteins, indicating their potentially essential roles in BD pathology. In addition, ELISA results confirmed the elevated LRG1 and SOD3 levels in BD, but not RAS patients, compared to healthy donors. CONCLUSION: Our data uncovered novel serum proteins that distinguish BD from RAS, which may potentially be useful in BD diagnosis and treatment.

Association of Non-Suicidal Self-Injury with Tryptophan Hydroxylase 2 Gene Polymorphism and Negative Life Events Among Adolescents with Depression in Northern China.

Objective: To investigate the association between single nucleotide polymorphisms (SNPs) of tryptophan hydroxylase 2 (TPH2) (rs11178997, rs11178998, and rs120074175) and negative life events in adolescent depression with Non-suicidal self-injury (NSSI). Methods: Genomic DNA was extracted from 197 adolescents with depression (participants group, including NSSI group and non-NSSI group), as well as from 100 healthy controls (control group), in northern China. PCR technology was utilized to amplify DNA fragments and detect genotypes in both groups. The Adolescent Life Event Scale (ASLEC) was employed to conduct a questionnaire survey among the participants and control groups. Differences in allele and genotype frequency distribution between the two groups were analyzed using the X^2 test, while generalized multifactor dimensionality reduction (GMDR) was used to analyze gene-environment interactions. Results: Significant differences were observed in ASLEC scores between the control group and both the NSSI group and non-NSSI group (P<0.05). Additionally, significant differences were found in the interpersonal relationship factor and punishment factor between the NSSI group and non-NSSI group (P < 0.05). Moreover, a significant difference was identified in SNP genotype of rs11178997 between the depression group (NSSI group + non-NSSI group) and control group (P<0.05). GMDR analysis revealed an interaction among rs11178997, rs11178998, and ASLEC. Conclusion: Adolescents with depression, particularly females, may exhibit a tendency to employ NSSI as an emotional coping mechanism when confronted with greater family and interpersonal challenges. The AT genotype of TPH2 gene locus rs11178997 is more prevalent among adolescents with depression. Furthermore, the occurrence of NSSI may be associated with an interaction involving polymorphic sites rs11178997 and rs11178998 along with life events.

Mechanism and use strategy of uric acid-lowering drugs on coronary heart disease.

Coronary heart disease (CHD) is a serious cardiovascular illness, for which an elevated uric acid (UA) level presents as a considerable risk factor. This can be treated with UA-lowering drugs such as allopurinol and benzbromarone, which can reduce UA levels by the inhibition of UA production or by promoting its excretion. Such drugs can also be beneficial to CHD in other ways, such as reducing the degree of coronary arteriosclerosis, improving myocardial blood supply and alleviating ventricular remodeling. Different UA-lowering drugs are used in different ways: allopurinol is preferred as a single agent in clinical application, but in absence of the desired response, a combination of drugs such as benzbromarone with ACE inhibitors may be used. Patients must be monitored regularly to adjust the medication regimen. Appropriate use of UA-lowering drugs has great significance for the prevention and treatment of CHD. However, the specific mechanisms of the drugs and individualized drug use need further research. This review article expounds the mechanisms of UA-lowering drugs on CHD and their clinical application strategy, thereby providing a reference for further optimization of treatment.

Identification of differentially expressed genes of blood leukocytes for Schizophrenia.

Background: Schizophrenia (SCZ) is a severe neurodevelopmental disorder with brain dysfunction. This study aimed to use bioinformatic analysis to identify candidate blood biomarkers for SCZ. Methods: The study collected peripheral blood leukocyte samples of 9 SCZ patients and 20 healthy controls for RNA sequencing analysis. Bioinformatic analyses included differentially expressed genes (DEGs) analysis, pathway enrichment analysis, and weighted gene co-expression network analysis (WGCNA). Results: This study identified 1,205 statistically significant DEGs, of which 623 genes were upregulated and 582 genes were downregulated. Functional enrichment analysis showed that DEGs were mainly enriched in cell chemotaxis, cell surface, and serine peptidase activity, as well as involved in Natural killer cell-mediated cytotoxicity. WGCNA identified 16 gene co-expression modules, and five modules were significantly correlated with SCZ (p < 0.05). There were 106 upregulated genes and 90 downregulated genes in the five modules. The top ten genes sorted by the Degree algorithm were RPS28, BRD4, FUS, PABPC1, PCBP1, PCBP2, RPL27A, RPS21, RAG1, and RPL27. RAG1 and the other nine genes belonged to the turquoise and pink module respectively. Pathway enrichment analysis indicated that these 10 genes were mainly involved in processes such as Ribosome, cytoplasmic translation, RNA binding, and protein binding. Conclusion: This study finds that the gene functions in key modules and related enrichment pathways may help to elucidate the molecular pathogenesis of SCZ, and the potential of key genes to become blood biomarkers for SCZ warrants further validation.

Tuning instability in suspended monolayer 2D materials.

Monolayer two-dimensional (2D) materials possess excellent in-plane mechanical strength yet extremely low bending stiffness, making them particularly susceptible to instability, which is anticipated to have a substantial impact on their physical functionalities such as 2D-based Micro/Nanoelectromechanical systems (M/NEMS), nanochannels, and proton transport membrane. In this work, we achieve quantitatively tuning instability in suspended 2D materials including monolayer graphene and MoS2 by employing a push-to-shear strategy. We comprehensively examine the dynamic wrinkling-splitting-smoothing process and find that monolayer 2D materials experience stepwise instabilities along with different recovery processes. These stepwise instabilities are governed by the materials' geometry, pretension, and the elastic nonlinearity. We attribute the different instability and recovery paths to the local stress redistribution in monolayer 2D materials. The tunable instability behavior of suspended monolayer 2D materials not only allows measuring their bending stiffness but also opens up new opportunities for programming the nanoscale instability pattern and even physical properties of atomically thin films.

Association between plasma maresin 1 and the risk of atherosclerotic cardiovascular disease in Chinese adults: A community-based cohort study.

BACKGROUND AND AIMS: It has been reported that maresin 1 (MaR1) is able to protect against the development of atherogenesis in cellular and animal models. This study was performed to investigate whether plasma MaR1 is associated with the risk of atherosclerotic cardiovascular disease (ASCVD) at the population level. METHODS AND RESULTS: The study included 2822 non-ASCVD participants from a community-based cohort who were followed for about 8 years. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) for ASCVD events according to baseline MaR1 quartiles were calculated using the Cox proportional hazards model. During follow-up, a total of 290 new ASCVD cases were identified. The restricted cubic spline analysis indicated a linear dose-response association between plasma MaR1 and incident ASCVD. In addition, the adjusted-HR (95% CI) for ASCVD events associated with one standard deviation increase in MaR1 was 0.79 (0.68-0.91). Moreover, the adjusted-HRs (95% CIs) for ASCVD events associated with the second, third and fourth quartiles versus the first quartile of plasma MaR1 were 1.00, 1.04 (0.76, 1.42), 0.88 (0.64, 1.22) and 0.58 (0.41, 0.84), respectively. Mediation analyses showed that the association between MaR1 and incident ASCVD was partially mediated by small dense low-density lipoprotein cholesterol, with a mediation proportion of 9.23%. Further, the net reclassification improvement and integrated discrimination improvement of ASCVD risk were significantly improved when MaR1 was added to basic model established by conventional risk factors (all p < 0.01). CONCLUSIONS: Elevated plasma MaR1 concentrations are associated with a lower risk of ASCVD development.

Impact of lighting environment on human performance and prediction modeling of personal visual comfort in enclosed cabins.

Enclosed cabins are of great significance in various fields, including national defense, scientific research, and industrial applications. It is important to clarify the impact of the lighting environment in these cabins on the people operating within them. This study investigated the effects of the lighting environment in enclosed cabins on the physiological, operational, and comfort performance of operators through simulated experiments. In Addition, using the Random Forest Algorithm and ExpandNet technique, we developed a prediction model to evaluate the comfort level of the lighting environment for personnel in enclosed cabins. The results indicated that pupil diameter exhibited the highest sensitivity to ambient light. The appropriate luminance combination of the screen and the ambient scene have a positive effect on human performance. In particular, it was observed that the average cognitive performance and comfort of participants tended to be relatively high in the luminance combinations 13, 14, and 15 at CCT 5500 K. The screen luminance of these combinations are all 284.75 cd/m2. Although no statistically significant relationship was found between the cognitive performance of the participants and their comfort, the comfort of the participants tended to decrease after the cognitive operations was completed. According to the proposed personal comfort prediction model, the visual comfort of different people varies even under the same lighting conditions. This study provides a solid theoretical basis for improving the design of lighting environments in enclosed spaces and contributes to developing a pleasant and productive working environment within limited cabins.

Significant hydrogen generation via photo-mechanical coupling in flexible methylammonium lead iodide nanowires.

The flexoelectric effect, which refers to the mechanical-electric coupling between strain gradient and charge polarization, should be considered for use in charge production for catalytically driving chemical reactions. We have previously revealed that halide perovskites can generate orders of higher magnitude flexoelectricity under the illumination of light than in the dark. In this study, we report the catalytic hydrogen production by photo-mechanical coupling involving the photoflexoelectric effect of flexible methylammonium lead iodide (MAPbI3) nanowires (NWs) in hydrogen iodide solution. Upon concurrent light illumination and mechanical vibration, large strain gradients were introduced in flexible MAPbI3 NWs, which subsequently induced significant hydrogen generation (at a rate of 756.5 µmol g-1 h-1, surpassing those values from either photo- or piezocatalysis of MAPbI3 nanoparticles). This photo-mechanical coupling strategy of mechanocatalysis, which enables the simultaneous utilization of multiple energy sources, provides a potentially new mechanism in mechanochemistry for highly efficient hydrogen production.

Effect of Eccentricity Difference on the Mechanical Response of Microfluidics-Derived Hollow Silica Microspheres during Nanoindentation.

Hollow microspheres as the filler material of syntactic foams have been adopted in extensive practical applications, where the physical parameters and their homogeneity have been proven to be critical factors during the design process, especially for high-specification scenarios. Based on double-emulsion droplet templates, hollow microspheres derived from microfluidics-enabled soft manufacturing have been validated to possess well-controlled morphology and composition with a much narrower size distribution and fewer defects compared to traditional production methods. However, for more stringent requirements, the innate density difference between the core-shell solution of the double-emulsion droplet template shall result in the wall thickness heterogeneity of the hollow microsphere, which will lead to unfavorable mechanical performance deviations. To clarify the specific mechanical response of microfluidics-derived hollow silica microspheres with varying eccentricities, a hybrid method combining experimental nanoindentation and a finite element method (FEM) simulation was proposed. The difference in eccentricity can determine the specific mechanical response of hollow microspheres during nanoindentation, including crack initiation and the evolution process, detailed fracture modes, load-bearing capacity, and energy dissipation capability, which should shed light on the necessity of optimizing the concentricity of double-emulsion droplets to improve the wall thickness homogeneity of hollow microspheres for better mechanical performance.

Advances in the synthesis and modification of two-dimensional antimonene.

Antimonene with a honeycomb layered structure has great application prospects in a wide spectrum of domains due to its high carrier mobility, high thermal conductivity, and layer-dependent electrical properties. Since the first successful synthesis of antimonene by epitaxy in 2015, various fabrication methods have been proposed successively. Herein, several representative synthetic methods are described in detail, including mechanical exfoliation, epitaxial growth, liquid-phase exfoliation, electrochemical exfoliation, etc. In addition, band engineering via modification strategies of antimonene, particularly intercalation and doping, is discussed based on available theoretical studies. By comparing the achieved structure characteristics and performances of these different synthesis and modification strategies, we present promising future developments and critical challenges for antimonene.

Ductile amorphous boron nitride microribbons.

The broad applications of ceramic materials in functional devices are often limited by their intrinsic brittleness. Amorphous boron nitride (a-BN), as a promising ceramic has shown high thermal stability and excellent dielectric properties that can be applied to microfabricated aerogel and nano dielectric layers, while its mechanical properties at small scales are yet to be studied. Here we report synthesized a-BN microribbons can have a uniform elongation at a breaking strain of more than 50% upon tension, exhibiting outstanding ductility. Such a-BN microribbons with lengths ranging from tens to hundreds of micro-meters were prepared via the small molecule precursors sol-gel method. Through in situ uniaxial tensile measurements, we demonstrated that a-BN microribbons also display a surprising flaw-tolerance behaviour. Combining high-resolution atomic characterization with molecular dynamics simulations, we reveal that the large tensile plasticity of a-BN originates from the topological deformation induced multiple energy-dissipation mechanisms including unfolding and reorientation of local curly h-BN layers and their interlayer debonding, slippage as well as the intralayer tearing. Our findings provide new insights to develop ductile amorphous covalent-bonded materials for emerging applications.

Nomogram Based on Inflammatory Factor to Predict Therapeutic Response of Thrombocytopenia in Patients with Primary Sjögren's Syndrome.

Objective: Thrombocytopenia is a common manifestation of blood system involvement in primary Sjögren's syndrome (pSS) patients, and the treatment approach involves glucocorticoids and immune agents. However, a proportion of patients do not respond well to this therapy and failed to achieve remission. Accurate prediction of therapeutic response in pSS patients with thrombocytopenia is of great significance for improving the prognosis. This study aims to analyze the influencing factors of no remission to treatment in pSS patients with thrombocytopenia and establish an individualized nomogram to predict the treatment response of patients. Materials and Methods: The demographic data, clinical manifestations and laboratory examinations of 119 patients with thrombocytopenia pSS in our hospital were retrospectively analyzed. According to the 30-day treatment response, patients were divided into remission group and non-remission group. Logistic regression was used to analyze the influencing factors related to the treatment response of patients, and then a nomogram was further established. The discriminative ability and clinical benefit of the nomogram were evaluated by receiver operating characteristic (ROC) curve, calibration chart and decision curve analysis (DCA). Results: After treatment, there were 80 patients in the remission group and 39 in the non-remission group. Comparative analysis and multivariate logistic regression analysis identified hemoglobin (P=0.023), C3 level (P=0.027), IgG level (P=0.040), and bone marrow megakaryocyte counts (P=0.001) as independent predictors of treatment response. The nomogram was constructed based on the above four factors, and the C-index of the model was 0.882 (95% CI 0.810-0.934). The calibration curve and DCA proved that the model has better performance. Conclusion: The nomogram incorporating hemoglobin, C3 level, IgG level, and bone marrow megakaryocyte counts could be used as an auxiliary tool to predict the risk of treatment non-remission in pSS patients with thrombocytopenia.

Oceanaut's personal acoustic comfort prediction model and sound environment improvement method in the cabin of a Deep-Sea manned submersible.

In this study, a personal acoustic comfort prediction model (PACPM) for exploring the acoustic comfort of oceanauts in a deep-sea manned submersible cabin was proposed, and an oceanauts' task performance model (OTPM) was constructed in this study. Based on oceanauts' comfort and task performance, the change characteristics in six different pure-noise environments (the sound pressure levels of the noise audio are 40 dB (A), 45 dB (A), 50 dB (A), 55 dB (A), 60 dB (A), and 65 dB (A) respectively) were analysed. An effective method for improving acoustic comfort was proposed. According to the analysis, personal comfort at 40 and 45 dB(A) was higher than that at other noise levels. The oceanaut's comfort and task performance of normal-weight people were significantly higher than those of thin people. Meanwhile, a comprehensive consideration of the demographic characteristics and physiological responses can effectively improve the prediction accuracy of the personnel acoustic comfort. Furthermore, the 45 dB (A) pure-noise environment overlaid with 40 dB(A) fast-paced light music effectively improves oceanauts' comfort. Practitioner summary: This study provides a convenient and available method for analysing acoustic comfort in the cabins of deep-sea manned submersibles, including a quantitative prediction model and an effective method for sound environment improvements. These can be used to improve the comfort, task performance, and working efficiency of manned submersibles.

[The mediating effects of self-efficacy between symptom experience and quality of life in prostatic hyperplasia patients after cystostomy].

OBJECTIVE: To evaluate the symptom experience of patients with benign prostatic hyperplasia and bladder fistula. Exploring the mediating effect of self-efficacy on the relationship between symptom experience and quality of life in patients with benign prostatic hyperplasia undergoing long-term indwelling cystostomy. METHODS: This study used a cross-sectional survey design. Patients with prostatic hyperplasia with cystostomy in the Urology department of General Hospital of Eastern Theater Command from January 2020 to February 2023 were selected, and relevant data were collected by IPSS, IIEF-5, HAMD, GSES, and quality of life score scale for statistical analysis. We then construct a structural equation model to evaluate the mediating effect of self-efficacy between symptom experience and quality of life. RESULTS: The average score of IPSS was (22.55±8.26) ; the average score of IIEF-5 was (10.54±4.10) ; the average score of HAMD was (6.82±2.35) ; the average score of self-efficacy was (20.80±8.65) ; and the average score of quality of life was (71.65±12.55) . Symptom experience was significantly negatively correlated with self-efficacy and quality of life( r=－0.496 , P<0.01；r=－0.518 , P<0.01) . Self-efficacy was significantly positively correlated with quality of life( r= 0.412，P<0.05). Symptom experience significantly negatively affected quality of life through self-efficacy (Effect = －0.218，P = 0.014) . CONCLUSION: Self-efficacy is positively correlated with the quality of life of patients with benign prostatic hyperplasia who have long-term indwelling cystostomy tube. Nursing staff can improve the level of self-efficacy of patients by implementing corresponding interventions.

Can Fluoxetine Combined with Cognitive Behavioral Therapy Reduce the Suicide and Non-Suicidal Self-Injury Incidence and Recurrence Rate in Depressed Adolescents Compared with Fluoxetine Alone? A Meta-Analysis.

Objective: The efficacy of medication and psychotherapy for adolescent depression is controversial, so we conducted a meta-analysis to evaluate the efficacy of combination therapy. Methods: We followed the PRISMA checklist in completing the meta-analysis. Relevant literature was searched in PubMed, Web of Science and Embase, Chinese databases CNKI and WanFang Data. We included the literature on the comparison of the fluoxetine plus psychotherapy or cognitive-behavioral therapy (CBT) and each treatment alone for adolescent depression published in 1980-2021. All statistical analyses were performed using Stata software. Results: After careful review, a total of 489 relevant articles were retrieved, and 13 studies were finally included. In comparison with the control group (fluoxetine alone), fluoxetine plus CBT achieved higher response rate (RR=1.12, 95% CI: 1.04, 1.21), lower incidence of adverse Reactions (RR=0.62,95% CI:0.40,0.96), lower proportion of suicide or self-injury (RR=0.94,95% CI:0.74,1.20), and lower one-year recurrence rate (RR=0.27, 95% CI: 0.16, 0.45). Before treatment, there were no significant differences in Hamilton Depression Scale score (HAMD), Children's Depression Rating Scale Revised (CDRS-R) score, and Clinical Global Impression (CGI) Severity score. After treatment, HAMD score (SMD=-1.01, 95% CI:-1.39,-0.63), CDRS-R score (SMD= -0.10,95% CI:-0.26,-0.07), and CGI score (SMD = -0.22, 95% CI: -0.54, -0.10) were significantly lower in the combined treatment group than in the control group. Conclusion: Adolescents simultaneously treated with fluoxetine and CBT had significantly reduced incidence of depressive symptoms, suicide or NSSI, adverse reactions, and one-year recurrence of symptoms, than adolescents treated with fluoxetine alone. This indicates fluoxetine plus CBT may be superior to fluoxetine alone for the clinical treatment of adolescent depression.

Three Dimensional Printing of Bioinspired Crossed-Lamellar Metamaterials with Superior Toughness for Syntactic Foam Substitution.

Biological materials such as conch shells with crossed-lamellar textures hold impressive mechanical properties due to their capability to realize effective crack control and energy dissipation through the structural synergy of interfacial modulus mismatch and lamellar orientation disparity. Integrating this mechanism with mechanical metamaterial design can not only avoid the catastrophic post-yield stress drop found in traditional architectural materials with uniform lattice structures but also effectively maintain the stress level and improve the energy absorption ability. Herein, a novel bioinspired design strategy that combines regional particularity and overall cyclicity is proposed to innovate the connotation of long-range periodicity inside the metamaterial, in which the node constraint gradient and crossed-lamellar struts corresponding to the core features of conch shells are able to guide the deformation sequence with a self-strengthening response during compression. Detailed in situ experiments and finite element analysis confirm that the rotated broad layer stacking can shorten and impede the shear bands, further transforming the deformation of bioinspired metamaterial into a progressive, hierarchical way, highlighted by the cross-layer hysteresis. Even based on a brittle polymeric resin, excellent specific energy absorption capacity [4544 kJ/kg] has been achieved in this architecture, which far exceeds the reported metal-based syntactic foams for two orders of magnitude. These results offer new opportunities for the bioinspired metamaterials to substitute the widespread syntactic foams in specific applications required for both lightweight and energy absorption.

Effects of two recovery methods on the leg muscle fatigue of oceanauts in a manned submersible.

BACKGROUND: The cabin of the manned submersible is a narrow and sealed space. The long-time work of oceanauts is easy to cause muscle fatigue and stiffness, which reduces efficiency. This paper explored the relative more effective way to relieve leg muscle fatigue of the oceanauts in the manned submersible. MATERIAL AND METHODS: Twenty healthy young people with an average age of 24 years were selected as the participants, while the usual natural relaxation and the stretching method proposed by the surveys were selected as the relieve method for muscle fatigue. This study compared the effects of the 2 recovery ways using the electromyography data from the quadriceps femoris and biceps femoris, and the subjective scales. RESULTS: With the support of data of integral electromyogram (iEMG), root-mean-square (RMS), subjective scales, authors finally found that the 2 muscles of the leg are fatigued significantly, and biceps femoris has more accumulation of fatigue. Although the 2 recovery ways have a significant relief effect on muscle fatigue, the stretching method can reduce more muscle fatigue in a short period of time, especially for biceps femoris. The stretching method is advocated for the oceanauts. CONCLUSIONS: The findings suggested that the stretching method was optimal for relieving the muscle fatigue of the oceanauts during the operation. Med Pr. 2022;73(2):95-107.

Serum levels of interleukin-34 and RANKL as multivariable predictors of bone erosion seen by ultrasonography in patients with ankylosing spondylitis.

Background: Ankylosing spondylitis (AS) is a chronic inflammatory arthritic disease, and sacroiliitis, enthesitis, and propensity for sacroiliac and spinal fusion are characteristic pathological features. Interleukin-34 (IL-34) plays a role in the induction and differentiation of osteoclasts. Other inflammatory factors are not directly involved in the induction and differentiation, but play an indirect role by modulating the level of receptor activator of nuclear factor-κB (RANKL) and other molecules during the process of inflammatory bone destruction in AS. However, to our knowledge, the relationship between enthesitis and bone erosion, and IL-34 and RANKL in AS has not yet been elucidated. Objective: To determine the correlation between serum IL-34, RANKL, and disease severity including enthesitis and bone erosion in patients with AS and develop multivariable predictive model. Methods: We conducted a cross-sectional study of 40 patients with AS, compared with 40 patients with osteoarthritis, and 40 healthy volunteers. Their serum levels of IL-34 and RANKL were measured using enzyme-linked immunosorbent assays (ELISAs). Enthesitis and bone erosion were assessed with real-time ultrasonography. Spearman rank correlation coefficients were determined to analyze the relationship between the variables. Multiple logistic regression was used to determine associations and receiver operating characteristic (ROC) curve analyses were conducted to determine the diagnostic performance of cytokine levels. Results: In patients with AS, serum levels of IL-34 (878.9 ± 116.4 pg/mL) and RANKL (155.6 ± 13.8 pg/mL) were significantly (P < 0.01) higher than those in patients with osteoarthritis (626.6 ± 79.0 and 138.1 ± 15.3 pg/mL, respectively) or a healthy group (612.9 ± 61.1 and 104.9 ± 15.4 pg/mL, respectively). Serum levels of IL-34 were not significantly correlated with the levels of RANKL. In patients with AS, serum levels of IL-34 and RANKL adjusted for age and weight were significantly correlated with enthesitis (0.798, P < 0.01; 0.347, P < 0.05, respectively) and bone erosion (0.822, P < 0.01; 0.368, P < 0.05, respectively). The area under the ROC curve (AUC) for the serum levels of IL-34 was 0.995 between patients with AS and healthy individuals. When serum level of IL-34 was >697.1 pg/mL, the sensitivity (SE) was >99% and specificity (SP) was 95.0%. The AUC for IL-34 was 0.982 between patients with AS and patients with osteoarthritis. When serum IL-34 was >688.4 pg/mL, the SE was >99% and SP 85.0%. IL-34 correlation with the number of bone erosions of enthesis was rs = 0.795, P < 0.01. The AUC for serum RANKL was 0.993 between patients with AS and healthy individuals. When serum RANKL was >126.2 pg/mL, the SE was 97.5% and SP 97.5%. The AUC for serum RANKL was 0.798 between patients with AS and patients with osteoarthritis. When serum RANKL was >149.3 pg/mL, the SE was 70% and SP was 80.0%. Conclusions: In patients with AS, serum levels of IL-34 and RANKL may be useful indicators of enthesitis, especially for bone erosions. IL-34 is associated with AS-associated enthesis damage and is a potential biomarker for predicting subsequent progression in patients with AS.

[Clinical application value of preoperative emotional management combined with family members' interactive description nursing in plasmakinetic enucleation of the prostate].

OBJECTIVE: To assess the clinical application value of preoperative emotional management combined with family members' interactive description nursing (PEM+FMID) in plasmakinetic enucleation of the prostate (PKEP). METHODS: This perspective study included 108 cases of PKEP performed in our hospital from July 2020 to May 2022. We randomly divided the patients into a control (n = 54) and an observation group (n = 54), the former receiving routine nursing, while the latter PEM+FMID in addition, before surgery. We recorded the operation time, perioperative blood loss and postoperative hospital stay, obtained the patients' Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) scores before and after nursing intervention, and their compliance, satisfaction and postoperative complications after intervention, and compared the data between the two groups. RESULTS: The average postoperative hospital stay was significantly shorter in the observation than in the control group (ï¼»6.35 ± 1.39ï¼½ d vs ï¼»7.19 ± 1.39ï¼½ d, P< 0.05). Compared with the baseline, the SDS and SAS scores of the patients were significantly decreased at 1 week after operation (P < 0.05), and markedly lower in the observation group than in the control (P < 0.05). The compliance rate (87.04% vs 66.67%) and satisfaction rate (92.59% vs 70.37%) of the patients were significantly higher in the observation than in the control group (both P < 0.05), while the total incidence rate of postoperative complications was lower in the former than in the latter (7.41% vs 33.33%, P < 0.05), particularly those of bladder irritation, hematuria, urinary retention and fever (all P < 0.05). CONCLUSION: Preoperative emotional management combined with family members' interactive description nursing can effectively relieve the negative emotions of the patients undergoing PKEP, improve their compliance and satisfaction, and reduce postoperative complications.

A method for designing the longitudinal position of a porthole in a manned submersible based on the back muscle fatigue characteristics.

OBJECTIVES: The proper porthole angle contributes to relieving the operation fatigue and improving the efficiency of oceanauts. In this study, the authors explored the effect of 3 different porthole longitudinal positions on the oceanauts' back muscles using surface electromyography (sEMG) analysis, and the characteristics of the perceived body comfort was obtained. MATERIAL AND METHODS: Overall, 40 healthy participants were recruited to perform tasks in a simulated cabin environment. Electromyographic (EMG) signals were recorded from the trapezius medius, lower trapezius, and erector spinal muscles for porthole angles of -5°, -15°, and +15°, relative to the horizontal line of sight during a 21-minute experiment. The subject comfort scores were collected at 7, 14 and 21 min. The integrated electromyogram (iEMG) and the root mean square (RMS) of EMG signals, as well as the mean power frequency (MPF), and the mean frequency (MF) were calculated. RESULTS: The subjective scores of the +15° porthole at each stage of work are higher than those of the -15° and -5° portholes. The results of iEMG, RMS, MF and MPF all indicated that the +15° porthole design was more conducive to lowering the rate of muscle fatigue, while the -5° and -15° portholes increased the muscle fatigue rate and led to greater fatigue. It was found that the lower trapezius was more prone to fatigue than the trapezius medius and erector spinal muscles. The height, weight and body mass index of the participants were found to negatively correlate with muscles at the +15° porthole, which is highly consistent with the actual situation. CONCLUSIONS: The findings suggested that the +15° position was optimal for delaying the muscle fatigue of the participants and for improving the work efficiency of oceanauts. Int J Occup Med Environ Health. 2021;34(6):701-21.