MiR-574-5p activates human TLR8 to promote autoimmune signaling and lupus.

Endosomal single-stranded RNA-sensing Toll-like receptor-7/8 (TLR7/8) plays a pivotal role in inflammation and immune responses and autoimmune diseases. However, the mechanisms underlying the initiation of the TLR7/8-mediated autoimmune signaling remain to be fully elucidated. Here, we demonstrate that miR-574-5p is aberrantly upregulated in tissues of lupus prone mice and in the plasma of lupus patients, with its expression levels correlating with the disease activity. miR-574-5p binds to and activates human hTLR8 or its murine ortholog mTlr7 to elicit a series of MyD88-dependent immune and inflammatory responses. These responses include the overproduction of cytokines and interferons, the activation of STAT1 signaling and B lymphocytes, and the production of autoantigens. In a transgenic mouse model, the induction of miR-574-5p overexpression is associated with increased secretion of antinuclear and anti-dsDNA antibodies, increased IgG and C3 deposit in the kidney, elevated expression of inflammatory genes in the spleen. In lupus-prone mice, lentivirus-mediated silencing of miR-574-5p significantly ameliorates major symptoms associated with lupus and lupus nephritis. Collectively, these results suggest that the miR-574-5p-hTLR8/mTlr7 signaling is an important axis of immune and inflammatory responses, contributing significantly to the development of lupus and lupus nephritis.

Licochalcone D exhibits cytotoxicity in breast cancer cells and enhances tumor necrosis factor-related apoptosis-inducing ligand-induced apoptosis through upregulation of death receptor 5.

Anticancer strategies using natural products or derivatives are promising alternatives for cancer treatment. Here, we showed that licochalcone D (LCD), a natural flavonoid extracted from Glycyrrhiza uralensis Fisch, suppressed the growth of breast cancer cells, and was less toxic to MCF-10A normal breast cells. LCD-induced DNA damage, cell cycle arrest, and apoptosis in breast cancer cells. Furthermore, LCD potentiated tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)-induced cytotoxicity. Mechanistically, LCD was revealed to reduce survival protein expression and to upregulate death receptor 5 (DR5) expressions. Silencing DR5 blocked the ability of LCD to sensitize cells to TRAIL-mediated apoptosis. LCD increased CCAAT/enhancer-binding protein homologous protein (CHOP) expression in breast cancer cells. Knockdown of CHOP attenuated DR5 upregulation and apoptosis triggered by cotreatment with LCD and TRAIL. Furthermore, LCD suppressed the phosphorylation of extracellular signal-regulated kinase and promoted the phosphorylation of c-Jun amino-terminal kinase (JNK) and p38 mitogen-activated protein kinase (MAPK). Pretreatment with JNK inhibitor SP600125 or p38 MAPK inhibitor SB203580 abolished the upregulation of DR5 and CHOP, and also attenuated LCD plus TRAIL-induced cleavage of poly(ADP-ribose) polymerase. Overall, our results show that LCD exerts cytotoxic effects on breast cancer cells and arguments TRAIL-mediated apoptosis by inhibiting survival protein expression and upregulating DR5 in a JNK/p38 MAPK-CHOP-dependent manner.

Characteristics of Virology and Immune Inflammation of Epstein-Barr Virus Infection Related Non-Neoplastic Diseases in Children.

BACKGROUND: The goal was to study the difference of virological, immunologic, and inflammatory indicators between Epstein-Barr associated infectious mononucleosis (EBV-IM) and EBV associated hemophagocytic lymphohistiocytosis (EBV-HLH) and to explore the evaluation indicators for monitoring the therapeutic efficacy of EBV-HLH. METHODS: Twenty children with EBV-IM (IM group) and 10 children with EBV-HLH (HLH group) were selected. Virology indicators were detected; the absolute count of lymphocyte, and lymphocyte subsets were detected; the levels of immunoglobulin and ferritin were assayed. RESULTS: Compared to the IM group, the HLH group showed a decrease in EBV-specific VCA-IgM antibody levels (U = 29.0, p = 0.006) and an increase in EBV-specific NA-IgG antibody levels (U = 17.0, p = 0.001), while there was no significant difference in EB-DNA loads (t = 0.417, p = 0.680). The counts of lymphocytes, and various lymphocyte subsets in the HLH group were lower than those in the IM group. Inflammatory markers in the HLH group were significantly higher than those in IM group. Dynamic monitoring of virological, immunological, and inflammatory indicators in HLH patients during treatment showed that EBV DNA gradually decreased in patients with good prognosis. Inflammatory indicators significantly decreased and returned to normal, lymphocyte count significantly increased and returned to normal during treatment. However, patients with poor prognosis showed rebound increase in EBV DNA and inflammatory indicators in the later stage of treatment, while lymphocyte count further decreased with the recurrence of the disease. CONCLUSIONS: Exhausted and damaged immune function in host by persistent stimulation of EB viral antigen is one of the main pathogeneses of EB-HLH. Lymphocyte count and serum ferritin level are effective indicators to monitor the therapeutic efficacy during the treatment to HLH.

Whole-genome resequencing uncovers diversity and selective sweep in Kazakh cattle.

The Kazakh cattle in the Xinjiang Uygur Autonomous Region of China are highly adaptable and have multiple uses, including milk and meat production, and use as draft animals. They are an excellent original breed that could be enhanced by breeding and hybrid improvement. However, the genomic diversity and signature of selection underlying the germplasm characteristics require further elucidation. Herein, we evaluated 26 Kazakh cattle genomes in comparison with 103 genomes of seven other cattle breeds from regions around the world to assess the Kazakh cattle genetic variability. We revealed that the relatively low linkage disequilibrium at large SNP distances was strongly correlated with the largest effective population size among Kazakh cattle. Using population structural analysis, we next demonstrated a taurine lineage with restricted Bos indicus introgression among Kazakh cattle. Notably, we identified putative selected genes associated with resistance to disease and body size within Kazakh cattle. Together, our findings shed light on the evolutionary history and breeding profile of Kazakh cattle, as well as offering indispensable resources for germplasm resource conservation and crossbreeding program implementation.

Higher N-terminal pro-brain natriuretic peptide level at onset of peritoneal dialysis-related peritonitis is a risk factor for technique failure.

BACKGROUND: Recent studies have suggested that the N-terminal fragment of B-type natriuretic peptide (NT-proBNP) level serve as a significant risk factor for mortality in patients with end-stage renal disease. However, the relationship between NT-proBNP levels and technique failure in peritoneal dialysis-associated peritonitis (PDAP) remains unclear. This study investigated the relationship between NT-proBNP levels at the onset of PDAP and the risk of technique failure in patients with PDAP. METHODS: A retrospective analysis was conducted on patients with PDAP from December 1, 2009, to December 31, 2021, at our peritoneal dialysis center. We recorded all demographic and baseline clinical data at the time of admission for each PDAP episode. Logistic and Cox regression analyses were performed to assess the association between NT-proBNP levels and technique failure. RESULTS: Of 485 PDAP episodes included in this study, 130 episodes of technique failure were observed. Multivariate logistic analysis revealed that hospital stay, Na and NT-proBNP levels, and peritoneal dialysate white blood cell counts on days 3 and 5 were independently associated with technique failure. The receiver operating characteristic curve demonstrated that the NT-proBNP level was a better indicator than the other four variables in indicating technique failure. In the multivariate Cox regression analysis, after adjusting for confounding factors, higher NT-proBNP levels (HR of 3.020, 95% CI 1.771, 5.150, P < 0.001) were associated with PDAP technique failure. CONCLUSIONS: This retrospective study identified the serum NT-proBNP level at the onset of PDAP as an independent risk factor for technique failure in these patients.

The impact of internet health information seeking on COVID-19 vaccination behavior in China.

BACKGROUND: Amid the COVID-19 pandemic, the significance of vaccination has been emphatically underscored. As the foremost and pivotal measure for preventing COVID-19 transmission, the COVID-19 pneumonia vaccine plays an instrumental role in the global response to this infectious respiratory disease. However, COVID-19 vaccination coverage remains challenging in low- and middle-income countries and regions. Studies have found that frequent seeking to health information is also associated with healthier behaviors, but these studies have not yet focused on the impact of Internet health information seeking on individual vaccination and the mechanism of this effect. METHODS: Data were obtained from the Chinese General Social Survey (CGSS) conducted in 2021, which included 7,218 individual samples. This study used COVID-19 vaccination as indicators for the health of interest, the key independent variable is Internet health information seeking. This study tried to analyze the impact of Internet health information seeking on COVID-19 vaccination using an OLS model and PSM method. RESULTS: The results show that Internet health information seeking has a significant positive impact on COVID-19 vaccination. This result passed a series of robustness tests. The mechanism analysis indicated that compared to non-Internet health information seeking individuals, Internet health information seeking individuals could know the superior advantages of vaccination and the potential for immunization through this method. And individuals who use Internet to seeking health information are more likely to acknowledge the constructive impact of online information on health behavior. This helps to explain why Internet health information seeking individuals have a higher rate of COVID-19 vaccination. CONCLUSIONS: This study delves into the influence of Internet health information seeking on individual COVID-19 vaccination within the digital era. The outcomes underscore that Internet-mediated seeking vaccine information holds the potential to bolster individuals' comprehension of vaccination benefits and foster increased acceptance of such information.

Laparoscopic versus open gastrectomy for nonmetastatic T4a gastric cancer: a meta-analysis of reconstructed individual participant data from propensity score-matched studies.

BACKGROUND: ​The applicability of laparoscopy to nonmetastatic T4a patients with gastric cancer remains unclear due to the lack of high-quality evidence. The purpose of this study was to compare the survival rates of laparoscopic gastrectomy (LG) versus open gastrectomy (OG) for these patients through a meta-analysis of reconstructed individual participant data from propensity score-matched studies. METHODS: PubMed, Embase, Web of Science, Cochrane library and CNKI were examined for relevant studies without language restrictions through July 25, 2023. Individual participant data on overall survival (OS) and disease-free survival (DFS) were extracted from the published Kaplan-Meier survival curves. One-stage and two-stage meta-analyses were performed. In addition, data regarding surgical outcomes and recurrence patterns were also collected, which were meta-analyzed using traditional aggregated data. RESULTS: Six studies comprising 1860 patients were included for analysis. In the one-stage meta-analyses, the results demonstrated that LG was associated with a significantly better DFS (Random-effects model: P = 0.027; Restricted mean survival time [RMST] up to 5 years: P = 0.033) and a comparable OS (Random-effects model: P = 0.135; RMST up to 5 years: P = 0.053) than OG for T4a gastric cancer patients. Two-stage meta-analyses resulted in similar results, with a 13% reduced hazard of cancer-related death (P = 0.04) and 10% reduced hazard of overall mortality (P = 0.11) in the LG group. For secondary outcomes, the pooled results showed an association of LG with less estimated blood loss, faster postoperative recovery and more retrieved lymph nodes. CONCLUSION: Laparoscopic surgery for patients with nonmetastatic T4a disease is associated with a potential survival benefit and improved surgical outcomes.

Ultrasound radiomics based XGBoost model to differential diagnosis thyroid nodules and unnecessary biopsy rate: Individual application of SHapley additive exPlanations.

OBJECTIVES: Radiomics-based eXtreme gradient boosting (XGBoost) model was developed to differentiate benign thyroid nodules from malignant thyroid nodules and to prevent unnecessary thyroid biopsies, including positive and negative effects. METHODS: The study evaluated a data set of ultrasound images of thyroid nodules in patients retrospectively, who initially received ultrasound-guided fine-needle aspiration biopsy (FNAB) for diagnostic purposes. According to ACR TI-RADS, a total of five ultrasound feature categories and the maximum size of the nodule were determined by four radiologists. A radiomics score was developed by the LASSO algorithm from the ultrasound-based radiomics features. An interpretative method based on Shapley additive explanation (SHAP) was developed. XGBoost was compared with ACR TI-RADS for its diagnostic performance and FNAB rate and was compared with six other machine learning models to evaluate the model performance. RESULTS: Finally, 191 thyroid nodules were examined from 177 patients. The radiomics score were calculated using 8 features, which were selected among 789 candidate features generated from the ultrasound images. The model yielded an AUC of 93% in the training cohort and 92% in the test cohort. It outperformed traditional machine learning models in assessing the nature of thyroid nodules. Compared with ACR TI-RADS, the FNAB rate decreased from 34% to 30% in training and from 35% to 41% in test. CONCLUSIONS: The radiomics-based XGBoost model proposed could distinguish benign and malignant thyroid nodules, thereby reduced significantly the number of unnecessary FNAB. It was effective in making preoperative decisions and managing selected patients using the SHAP visual interpretation tools.

Effective doses of midazolam oral solution for the prevention of preoperative anxiety in paediatric patients.

BACKGROUND: More than 60% children exhibit anxiety before undergoing an anesthetic-surgical procedure, particularly among pre-school paediatric patients. Oral midazolam can provide procedural sedation for children prior to anesthesia. However, extemporaneous solutions of midazolam are usually prepared from injectable drug solutions, leading to inconsistent efficacy due to variable preparation methods. Xiaoerjing® is the first commercially available oral formulation of midazolam for procedural sedation in children in China. Despite the recommended dosage range of 0.25-0.5 mg/kg, its effective dose is still largely unknown. AIM: To determine the 95% effective dose (ED95) of midazolam oral solution (Xiaoerjing®) for alleviating preoperative anxiety in children prior to mask induction of general anesthesia. DESIGN: The study included 61 children between the ages of 1 and 6 years undergoing elective surgery under general anesthesia. The first patient received a single dose of 0.5 mg/kg midazolam oral solution, which was adjusted for subsequent patients using the biased coin design method based on their response to the previous dose. Doses were increased or decreased at the rate of 0.1 mg/kg. An effective response was defined as having a modified Ramsay sedation score ≥3a, separation anxiety score ≤2, and mask acceptance score ≤2 during inhalational anesthesia induction. RESULTS: Fifty-six children were included in the final analysis. Of those, sedation was successful in 50 patients, with a median separation time of 15 (IQR: 25) min. Midazolam oral solution has an ED95 of 0.8254 mg/kg (95% CI: 0.6915-0.8700 mg/kg) for relieving preoperative anxiety in children. No adverse events occurred following drug administration. CONCLUSION: Midazolam oral solution is a safe and effective medication for relieving preoperative anxiety in children. The ED95 of a single oral dose of midazolam oral solution is 0.8254 mg/kg (95% CI: 0.6915-0.8700 mg/kg).

The Longitudinal Effect of Peer-Nominated Popularity on Defending Behaviors in Chinese Adolescents: The Moderating Role of Manipulative Traits, Desired Popularity, and Gender.

The factors influencing popular adolescents to defend victims require further exploration, particularly concerning their traits and the desire for higher peer status. In this one-year longitudinal study, 2464 Chinese adolescents (48.50% girls, Mage = 13.40 years, SD = 0.61) were investigated to examine the relationship between peer-nominated popularity, manipulative traits, desired popularity, and defending behaviors. The results revealed that peer-nominated popularity had a positive predictive effect on Chinese adolescents' defending behaviors. Furthermore, this longitudinal association was accentuated by desired popularity and manipulative traits in girls but was not in boys. Specifically, popular girls with high desired popularity demonstrated a higher likelihood of engaging in defending behaviors compared to other girls. These findings carry significant implications for understanding the influencing factors behind peer status and adolescents' defending behaviors.

Grpel2 maintains cardiomyocyte survival in diabetic cardiomyopathy through DLST-mediated mitochondrial dysfunction: a proof-of-concept study.

BACKGROUND: Diabetic cardiomyopathy (DCM) has been considered as a major threat to health in individuals with diabetes. GrpE-like 2 (Grpel2), a nucleotide exchange factor, has been shown to regulate mitochondrial import process to maintain mitochondrial homeostasis. However, the effect and mechanism of Grpel2 in DCM remain unknown. METHODS: The streptozotocin (STZ)-induced DCM mice model and high glucose (HG)-treated cardiomyocytes were established. Overexpression of cardiac-specific Grpel2 was performed by intramyocardial injection of adeno-associated virus serotype 9 (AAV9). Bioinformatics analysis, co-immunoprecipitation (co-IP), transcriptomics profiling and functional experiments were used to explore molecular mechanism of Grpel2 in DCM. RESULTS: Here, we found that Grpel2 was decreased in DCM induced by STZ. Overexpression of cardiac-specific Grpel2 alleviated cardiac dysfunction and structural remodeling in DCM. In both diabetic hearts and HG-treated cardiomyocytes, Grpel2 overexpression attenuated apoptosis and mitochondrial dysfunction, including decreased mitochondrial ROS production, increased mitochondrial respiratory capacities and increased mitochondrial membrane potential. Mechanistically, Grpel2 interacted with dihydrolipoyl succinyltransferase (DLST), which positively mediated the import process of DLST into mitochondria under HG conditions. Furthermore, the protective effects of Grpel2 overexpression on mitochondrial function and cell survival were blocked by siRNA knockdown of DLST. Moreover, Nr2f6 bond to the Grpel2 promoter region and positively regulated its transcription. CONCLUSION: Our study provides for the first time evidence that Grpel2 overexpression exerts a protective effect against mitochondrial dysfunction and apoptosis in DCM by maintaining the import of DLST into mitochondria. These findings suggest that targeting Grpel2 might be a promising therapeutic strategy for the treatment of patients with DCM.

Gender differences in vision health-seeking behavior and vision health outcomes among rural Chinese schoolchildren by birth order and family size.

BACKGROUND: The gender gap remains a major impediment in the path toward equality, and it is especially wide in low-income countries. Gender differences in health-seeking behaviors may be a factor. Family size and childbirth order are two critical factors affecting family resource allocation. This study examines gender differences in healthcare-seeking behaviors among children with visual impairment in rural China across different family structures (birth order and family size). METHODS: We draw on a dataset containing 19,934 observations constructed by combining data from 252 different school-level surveys spanning two provinces. The surveys were all conducted in 2012 using uniform survey instruments and data collection protocols in randomly selected schools across western provinces in rural China. The sample children range in grades from 4 to 5. Our analysis compares rural girls with rural boys regarding vision health outcome and behavior (vision examination and correction). RESULTS: The findings revealed that girls have worse vision than boys. Regarding vision health behaviors, girls have a lower overall vision examination rate than boys. There is no gender difference when the sample student is the only child or the youngest child in the family, but there is still a gender difference when the sample student is the oldest child in the family or the middle child in the birth order. When it comes to vision correction behavior, boys are more likely to own eyeglasses than girls are for groups of students with mild visual impairment, even when the sample student is the only child in the family. However, when the sample student has another brother or sister (the sample student is the youngest, the oldest child in the family, or the middle child in the birth order), the gender difference disappears. CONCLUSIONS: Gender differences in vision health outcomes are correlated with gender differences in vision health-seeking behaviors among rural children. Depending on the birth order and family size, gender disparities in visual health practices vary. In the future, consideration should be given to providing medical subsidies to reduce the cost of vision health behaviors and to provide information interventions to change gender inequality in households and promote equality in children's vision health behaviors. TRIAL REGISTRATION: The trial was approved by the Stanford University Institutional Review Board (Protocol No. ISRCTN03252665). Permission was received from local Boards of Education in each region and the principals of all schools. The principles of the Declaration of Helsinki were followed throughout. Written informed consent was obtained from at least one parent for all child participants.

Does having vulnerable friends help vulnerable youth? The co-evolution of friendships, victimization, and depressive symptoms in Chinese adolescents' social networks.

This study examined whether having vulnerable friends helps or hurts victimized and depressed (i.e., vulnerable) adolescents and whether this depends on classroom supportive norms. Students (n = 1461, 46.7% girls, 93.4% Han nationality) were surveyed four times from seventh and eighth grade (Mage = 13 years) in 2015 and 2016 in Central China. Longitudinal social network analyses indicated that having vulnerable friends can both hurt and help vulnerable adolescents. Depressed adolescents with depressed friends increased in victimization over time. Victimized adolescents with victimized friends increased in victimization but decreased in depressive symptoms. These processes were most likely in classrooms with high supportive norms. Having friends and a supportive classroom may hurt vulnerable adolescents' social position but help victims' emotional development.

Developmental interactions between peer victimization and depressive symptoms in adolescents: A latent change score analysis.

Peer victimization and depressive symptoms are highly relevant risks during adolescence. Understanding the dynamic patterns of interactions between peer victimization and depressive symptoms as well as gender differences in these variables can improve intervention strategies for adolescents navigating this critical transition period. In the present study, a large sample of Chinese adolescents reported peer victimization and depressive symptoms in four survey waves at six-month intervals. A total of 2534 adolescents (51.9% boys, M = 12.98 ± 0.60 years) were included in the latent change score (LCS) analysis. The results supported the reciprocal effects model obtained in the full sample. Changes in peer victimization were influenced by prior changes in depressive symptoms over time, and changes in depressive symptoms were influenced by prior levels of peer victimization. There were also gender differences, with boys exhibiting depressive symptom-driven effects on peer victimization, while girls exhibiting peer victimization-induced depressive symptoms. The dynamic relationships between peer victimization and depressive symptoms that promote and constrain each other in adolescents are elucidated in this study. Differentiating effects on boys and girls is crucial for enhancing the effectiveness of practical interventions.

Diosmetin-7-O-ß-D-glucopyranoside suppresses endothelial-mesenchymal transformation through endoplasmic reticulum stress in cardiac fibrosis.

Diosmetin-7-O-ß-D-glucopyranoside (Diosmetin-7-O-glucoside) is a natural flavonoid glycoside known to have a therapeutic application for cardiovascular diseases. Cardiac fibrosis is the main pathological change in the end stage of cardiovascular diseases. Endothelial-mesenchymal transformation (EndMT) induced by endoplasmic reticulum stress (ER stress) via Src pathways is involved in the process of cardiac fibrosis. However, it is unclear whether and how diosmetin-7-O-glucoside regulates EndMT and ER stress to treat cardiac fibrosis. In this study, molecular docking results showed that diosmetin-7-O-glucoside bound well to ER stress and Src pathway markers. Diosmetin-7-O-glucoside suppressed cardiac fibrosis induced by isoprenaline (ISO) and reduced the levels of EndMT, ER stress in mice heart. Primary cardiac microvascular endothelial cells (CMECs) were induced by transforming growth factor-ß1 (TGF-ß1) to perform EndMT. Diosmetin-7-O-glucoside could effectively regulate EndMT and diminish the accumulation of collagen I and collagen III. We also showed that the tube formation in CMECs was restored, and the capacity of migration was partially inhibited. Diosmetin-7-O-glucoside also ameliorated ER stress through the three unfolded protein response branches, as evidenced by organelle structure in transmission electron microscopy images and the expression of protein biomarkers like the glucose-regulated protein 78 (GRP78) and C/EBP homologous protein (CHOP). Further analysis showed that diosmetin-7-O-glucoside could suppress the expression level of Src phosphorylation, then block EndMT with the maintenance of endothelial appearance and endothelial marker expression. These results suggested that the diosmetin-7-O-glucoside can regulate EndMT through ER stress, at least in part via Src-dependent pathways.

ELMO1 Deficiency Reduces Neutrophil Chemotaxis in Murine Peritonitis.

Peritoneal inflammation remains a major cause of treatment failure in patients with kidney failure who receive peritoneal dialysis. Peritoneal inflammation is characterized by an increase in neutrophil infiltration. However, the molecular mechanisms that control neutrophil recruitment in peritonitis are not fully understood. ELMO and DOCK proteins form complexes which function as guanine nucleotide exchange factors to activate the small GTPase Rac to regulate F-actin dynamics during chemotaxis. In the current study, we found that deletion of the Elmo1 gene causes defects in chemotaxis and the adhesion of neutrophils. ELMO1 plays a role in the fMLP-induced activation of Rac1 in parallel with the PI3K and mTORC2 signaling pathways. Importantly, we also reveal that peritoneal inflammation is alleviated in Elmo1 knockout mice in the mouse model of thioglycollate-induced peritonitis. Our results suggest that ELMO1 functions as an evolutionarily conserved regulator for the activation of Rac to control the chemotaxis of neutrophils both in vitro and in vivo. Our results suggest that the targeted inhibition of ELMO1 may pave the way for the design of novel anti-inflammatory therapies for peritonitis.

Clique Hierarchy Moderates the Association between Social Preference and Defending Behaviors in Early Adolescence: The Role of Gender Differences.

Although social preference promotes adolescents' defending behaviors, its potential mechanisms across gender cliques remain unclear from the group dynamic perspective. This study investigated 2470 Chinese early adolescents (49% girls, Mage = 14.40, SD = 0.58) to explore how social preference and clique hierarchy are associated with defending behaviors and whether these associations differ across gender-specific cliques. The results revealed that social preference was positively related to defending behaviors in boys' cliques, but negatively in girls' cliques. Furthermore, the association was strengthened by hierarchization in boys' cliques but was weakened in girls' cliques, while the status structure strengthened the association in boys' but not girls' cliques. These findings hold crucial implications for understanding and promoting defending behaviors among adolescents.

Esketamine increases neurotransmitter releases but simplifies neurotransmitter networks in mouse prefrontal cortex.

General anesthesia induces a profound but reversible unconscious state, which is accompanied by changes in various neurotransmitters in the cortex. Unlike the "brain silencing" effect of γ-aminobutyric acid (GABA) receptor potentiator anesthesia, ketamine anesthesia leads the brain to a paradoxical active state with higher cortical activity, which is manifested as dissociative anesthesia. However, how the overall neurotransmitter network evolves across conscious states after ketamine administration remains unclear. Using in vivo microdialysis, high-performance liquid chromatography-mass spectrometry (HPLC-MS) analysis, and electroencephalogram (EEG) recording technique, we continuously measured the concentrations of six neurotransmitters and the EEG signals during anesthesia with esketamine, an S-enantiomer of ketamine racemate. We found that there was an increase in the release of five cortical neurotransmitters after the administration of esketamine. The correlation of cortical neurotransmitters was dynamically simplified along with behavioral changes until full recovery after anesthesia. The esketamine-increased gamma oscillation power was positively correlated only with the concentration of 5-hydroxytryptamine (5-HT) in the medial prefrontal cortex. This study suggests that the transformation of the neurotransmitter network rather than the concentrations of neurotransmitters could be more indicative of the consciousness shift during esketamine anesthesia.NEW & NOTEWORTHY In this study, we found that esketamine significantly increased the cortical concentration of multiple neurotransmitters in mice. However, esketamine dynamically simplified the overall network of cortical neurotransmitters at different behavioral states during the perianesthesia period. The concentration of 5-HT in the medial prefrontal cortex (mPFC) was highly correlated with the esketamine-increased gamma oscillation. These findings suggested that the transformation of the neurotransmitter network rather than the concentrations of neurotransmitters could be more indicative of the consciousness shift during esketamine anesthesia.

Toll-like receptor 4 signaling pathway mediates both liver and kidney injuries in mice with hepatorenal syndrome.

Hepatorenal syndrome (HRS) is a complication of cirrhosis with high morbidity and mortality. Nevertheless, the underlying mechanism involving how kidney injury aggravates the progression of cirrhosis remains unclear. This study aims to explore the role of the Toll-like receptor 4 (TLR4) signaling pathway in mediating liver and kidney injuries in HRS mice induced by unilateral ureteral obstruction (UUO) and/or bile duct ligation (BDL). Two weeks after UUO, there were no obvious pathological changes in mouse liver and the unligated side of kidney. Nevertheless, impaired liver and kidney functions, inflammatory response, and fibrosis were examined in mice after 2 wk of BDL. Compared with those of other groups, mice in the BDL + UUO group presented severer liver and kidney injuries, higher levels of inflammatory factors, and faster deposition of collagens, suggesting that kidney injuries accelerated the aggravation of HRS. Correlation analysis identified a positive correlation between expression levels of inflammatory factors and fibrotic levels. Meanwhile, TLR4 and its ligand MyD88 were upregulated during the process of liver and kidney injuries in HRS mice. Further animal experiments in transgenic TLR4-/- mice or in those treated with TAK242, a small molecule inhibitor of TLR4, showed that blocking the TLR4 signaling pathway significantly improved survival quality and survival rate in HRS mice by alleviating liver fibrosis and kidney injury. It is concluded that kidney dysfunction plays an important role in the aggravation of cirrhosis, which may be attributed to the TLR4 signaling pathway. Targeting TLR4 could be a promising therapeutic strategy for protecting both liver and kidneys in patients with HRS.NEW & NOTEWORTHY Our study established BDL, UUO, and BDL + UUO models, providing a novel idea for analyzing liver and kidney diseases. It is highlighted that the kidney injury accelerated the aggravation of HRS via inflammatory response, which could be protected by inhibiting the TLR4 signaling pathway. We believed that targeting TLR4 was a promising therapeutic strategy for protecting both liver and kidney functions in patients with HRS.

Sarcopenia and motoric cognitive risk syndrome: a moderated mediation model.

BACKGROUND: Sarcopenia has been identified as a risk factor for cognitive impairment, and motoric cognitive risk syndrome (MCR) is a recently defined pre-dementia syndrome. It is not known whether they are related. We aimed to investigate the association and potential pathways between sarcopenia and MCR in the community elderly by establishing a moderated mediation model. METHODS: 846 community residents aged ≥ 60 years were recruited from May 2021 to September 2021 and had a comprehensive geriatric evaluation. The diagnosis of sarcopenia followed the criteria issued by the Asian Working Group for Sarcopenia in 2019. MCR was defined as subjective cognitive decline and slow gait. Apathy symptoms and physical activity were assessed by the Apathy Evaluation Scale (AES) and the International Physical Activity Questionnaire (IPAQ). Logistic regression and moderated mediation analyses were conducted to explore the association between the four. RESULTS: 60 (7.1%) had MCR among 846 participants. After full adjustment, sarcopenia (odds ratio [OR] = 3.81, 95% confidence interval [CI] = 1.69-8.60, P = 0.001), AES score (OR = 1.09, 95% CI = 1.04-1.14, P < 0.001), and IPAQ level (OR = 0.43, 95% CI = 0.28-0.66, P < 0.001) were associated with MCR. Apathy partially mediated the relationship between sarcopenia and MCR. Physical activity played a moderation role in the indirect pathway of the mediation model. The increase in physical activity can alleviate the indirect effect of sarcopenia on MCR. CONCLUSION: We established a moderated mediation model to uncover the underlying association mechanism of sarcopenia and MCR preliminarily. These findings suggest that attention should be paid to the management of apathy and physical activity in the context of sarcopenia to prevent early dementia actively. Further validation is needed in future longitudinal studies.