Time trends of 16 modifiable risk factors on the burden of major cancers among the Chinese population.

The cancer burden in China is increasing. We aimed to assess the time trends in the prevalence of 16 modifiable risk factors involved in lifestyle, diet, infection, and air pollution between 1997 and 2025 based on the China Health and Nutrition Survey, the Global Burden of Disease website, and publically available studies. The population attributable fraction (PAF) and its 95% uncertainty interval (UI) from 2007 to 2035 were calculated to quantify the attributable cancer burden in major 12 anatomic sites using the comparative risk assessment method, considering a 10-year lag effect. As a result, 1,559,476 cancer cases (PAF = 54.1%, 95% UI: 36.8%-65.8%) from the 12 anatomic sites were attributable to these modifiable risk factors in 2007, with lung, liver, and gastric cancer raging the top three. It was predicted that by 2035, the attributable cancer cases would reach 1,680,098 (PAF = 44.2%, 95% UI: 29.1%-55.5%), with the top three of lung, liver, and colorectal cancer. Smoking, physical inactivity, insufficient fruit consumption, HBV infection, and Helicobacter pylori infection were the most attributable risk factors in 2007, contributing to 480,352, 233,684, 215,009, 214,455, and 187,305 associated cancer cases, respectively. In 2035, the leading factors for cancer would be smoking, physical inactivity, insufficient fruit intake, HPV infection, and HBV infection, resulting in 427,445, 424,327, 185,144, 156,535, and 154,368 cancer cases, respectively. Intervention strategies should be swiftly established and dynamically altered in response to risk factors like smoking, physical inactivity, poor fruit intake, and infectious factors that may cause a high cancer burden in the Chinese population.

Post-diagnostic lifestyle and mortality of cancer survivors: Results from a prospective cohort study.

OBJECTIVE: Lifestyle factors after cancer diagnosis could influence cancer survival. This study aimed to investigate the joint effects of smoking, physical activity, alcohol consumption, diet and sleep duration on all-cause, cancer and non-cancer mortality of cancer survivors in UK biobank. METHODS: The follow-up period concluded in December 2021, with post-diagnostic lifestyle factors assessed at baseline. A lifestyle score ranging from 0 to 5 was assigned based on adherence to the selected lifestyle factors. The study employed Cox regression models for hazard ratios (HRs) and Kaplan-Meier for survival rates, with stratified and sensitivity analyses to assess the robustness of our findings under various assumptions. RESULTS: During a median follow-up of 12.7 years, 5652 deaths were documented from 34,184 cancer survivors. Compared to scoring 0-1, the HRs (95% CIs) for all-cause mortality with lifestyle scores of 2, 3, 4, and 5 were 0.70 (95% CI: 0.64, 0.76), 0.57 (0.52, 0.62), 0.50 (0.45, 0.54) and 0.43 (0.38, 0.48), respectively. Specific cancer types, particularly digestive, breast, female reproductive, non-solid, and skin cancers, showed notable benefits from adherence to healthy lifestyle, with the HRs of 0.55 (0.39, 0.79), 0.54 (0.42, 0.70), 0.32 (0.19, 0.53), 0.58 (0.39, 0.86), and 0.36 (0.28, 0.46) for lifestyle score of 5, respectively. Stratified analyses indicated the association was particularly significant among those with normal/lower BMI and higher Townsend Deprivation Index (Pinteraction = 0.001 and < 0.001, respectively). CONCLUSIONS: Healthier lifestyles were significantly linked with reduced mortality among cancer survivors. These findings highlight the need for adherence to healthy lifestyle habits to improve survival.

Assessment of Cerebral White Matter Involvement in Amyotrophic Lateral Sclerosis Patients With Disease Progression and Cognitive Impairment by Fixel-Based Analysis and Neurite Orientation Dispersion and Density Imaging.

BACKGROUND: Previous studies using emerging diffusion MRI techniques have revealed damage to the white matter (WM) microstructure in amyotrophic lateral sclerosis (ALS), particularly the influence of crossed fibers, but there is a lack of subgroup analyses. PURPOSE: To detect WM microstructural changes in ALS patients using fixel-based analysis (FBA) and neurite orientation dispersion and density imaging (NODDI) MRI. STUDY TYPE: Prospective. POPULATION: Thirty-six ALS patients (aged 60.50 ± 9.5 years) and 25 healthy controls (HCs) (aged 58.90 ± 8.1 years). FIELD STRENGTH/SEQUENCE: 3 T; NODDI and FBA (b-values = 0, 1000, and 2500 seconds/mm2 ). ASSESSMENT: Subgroups were performed according to progression rate and cognition, including fast and slow progression (FP/SP), ALS with and without cognitive impairment (ALS-ci/ALS-nci). Fiber density (FD), fiber-bundle cross-section (FC), combined fiber density and cross-section (FDC), neurite density index (NDI), orientation dispersion index (ODI), isotropic volume fraction (ISO), and fractional anisotropy (FA) were calculated and their correlation with clinical variables examined. STATISTICAL TESTING: Chi-square test, Mann-Whitney U test, two-sample t test, partial correlation analysis, and false discovery rate (FDR) corrected. A P-value <0.05 was considered significant. RESULTS: ALS patients had lower FD and FDC values predominantly in the corticospinal tract (CST) and corpus callosum (CC) regions, as well as lower NDI value in the CC, radial crown, and internal capsule compared to HCs. Subgroup analysis based on progression rate and cognitive function showed significant differences in FBA results. The FC in the right CST region was significantly lower in the FP than SP, and the FD in the CC region was significantly lower in the ALS-ci than ALS-nci. Furthermore, a negative correlation was found between the mean FC value and the rate of progression in ALS patients (r = -0.408). DATA CONCLUSION: FBA is a powerful tool for detecting complex cerebral WM microstructural damage for evaluating ALS cognition and disease progression.

Potential impact of time trend of whole grain intake on burden of major cancers in China.

Numerous studies have revealed associations between high intake of whole grains and reduced risk of various cancers. Yet, in recent decades, the traditional Chinese diets have been challenged by reduction in whole grains and increase in refined grains. To assess the impact of this dietary transition on cancer prevention, we analyzed the time trend of whole grain intake using nationally representative sampling data of over 15 thousand individuals from the China Health and Nutrition Survey. We applied the comparative risk assessment method to estimate the population attributable fraction of cancers due to insufficient whole grain intake from 1997 to 2011 and projected the trend of whole grain intake and the associated burden of cancers to 2035. We found a significant decrease of approximately 59% of whole grain intake in the Chinese population from 1997 to 2011. Compared with 1997, insufficient intake of whole grains was responsible for 9940 more cases of breast cancer, 12,903 more cases of colorectal cancer and 434 more cases of pancreatic cancer in 2011. Our projections suggest that if every Chinese would consume 125 g whole grain per day as recommended by the latest Chinese Dietary Guidelines, 0.63% bladder cancer, 8.98% breast cancer, 15.85% colorectal cancer, 3.86% esophageal cancer, 2.52% liver cancer and 2.22% pancreatic cancer (totaling 186,659 incident cases) could theoretically be averted by 2035. Even if everyone maintained the 2011 whole grain intake level, an estimated 8.38% of cancer events could still be prevented by 2035.

Activation of cGAS-STING pathway - A possible cause of myofiber atrophy/necrosis in dermatomyositis and immune-mediated necrotizing myopathy.

OBJECTIVE: The objective was to investigate the expression of the cGAS-STING pathway-associated protein in idiopathic inflammatory myopathy (IIM) and to investigate whether it is related to myofiber atrophy/necrosis in patients with dermatomyositis and immune-mediated necrotizing myopathy. MATERIAL AND METHODS: Muscle specimens obtained by open biopsy from 26 IIM patients (14 with dermatomyositis (DM), 8 with immune-mediated necrotizing myopathy (IMNM), and 4 with other types of IIM), 4 dystrophinopathy, and 9 control patients were assessed for expression of cGAS-STING pathway members via Western blot, quantitative real-time PCR analysis (qRT-PCR), and immunochemistry. Meanwhile, analysis its location distribution througn immunochemistry. RESULTS: Compared to the control group, the expression of cGAS, STING, and related molecules was obviously increased in muscle samples of IIM patients. Upregulated cGAS and STING were mainly located in the vascular structure, inflammatory infiltrates, and atrophic and necrotic fibers. While comparing to the Dys patients, the mRNA level of cGAS, STING, and TNF-a was upregulated, meanwhile, the protein of the TBK1, P-TBK1, and P-IRF3 associated with interferon upregulation was overexpressed through Western blot in IMNM and DM. Considering that cGAS and STING are located in necrotic and Mx1-positive atrophic fibers, it is really possible that the cGAS-STING pathway may lead to fibers atrophy/necrosis by producing IFNs. CONCLUSION: The cGAS-STING pathway was activated in the muscle samples of IIM patients and its activation may be the reason of myofiber atrophy and necrosis in DM and IMNM patients.

Polycrystal Synthesis, Crystal Growth, Structure, and Optical Properties of AgGaGe nS2( n+1) ( n = 2, 3, 4, and 5) Single Crystals for Mid-IR Laser Applications.

AgGaGe nS2( n+1) crystal is a series of quaternary nonlinear optical materials for mid-IR laser applications of converting a 1.064 µm pump signal (Nd:YAG laser) to 4-11 µm laser output, but only AgGaGeS4 has attracted the most attention, remaining the other promising AgGaGe nS2( n+1) crystal whose physicochemical properties can be modulated by n value. In this work, AgGaGe nS2( n+1) ( n = 2, 3, 4, and 5) polycrystals are synthesized by vapor transport and mechanical oscillation method with different cooling processes. High-resolution X-ray diffraction analysis and refinement have revealed that all the four compounds are crystallized in the noncentrosymmetric orthorhombic space group Fdd2, resulting in the excellent nonlinear optical property, and the distortion of tetrahedron with the variation of n value causes the discrepancy of physicochemical property. Besides, using the modified Bridgman method, AgGaGe nS2( n+1) single crystals with 15 mm diameter and 20-40 mm length have been grown. We have discussed the structure and composition of AgGaGe nS2( n+1) by XPS spectra and analyzed the three kinds of vibration modes of tetrahedral clusters by the Raman spectra. The Hall measurement indicates that the AgGaGe nS2( n+1) single crystals are p-type semiconductor, and the carrier concentration decreases with the increasing n value. All the transmittances of as-grown AgGaGe nS2( n+1) samples exceeds 60% in the transparent range, especially the transmittance of AgGaGe2S6, is up to 70% at 1064 nm, and the band gap of as-grown crystal increases from 2.85 eV for AgGaGe2S6 to 2.92 eV for AgGaGe5S12. After a thermal annealing treatment, the absorptions at 2.9, 4, and 10 µm have been eliminated, and the band gap changed into the range of 2.89-2.96 eV.

Assessment of drinking water quality and health risk using water quality index and multiple computational models: a case study of Yangtze River in suburban areas of Wuhan, central China, from 2016 to 2021.

Water quality, increasingly recognized for its significant impact on health, is garnering heightened attention. Previous studies were limited by the number of water quality indicators and the duration of analysis. This study assessed the drinking water quality and its associated health risk in suburban areas of Wuhan, a city in central China, from 2016 to 2021. We collected 368 finished water samples and 1090 tap water samples and tested these for 37 different indicators. The water quality was evaluated using the water quality index, with trends over time analyzed via the Mann-Kendall test. Furthermore, an artificial neural network model was employed for future water quality prediction. Our findings indicated that the water quality in rural Wuhan was generally good and had an improvement from 2016 to 2021. The qualification and excellent rates were 98.91% and 86.81% for finished water, and 97.89% and 78.07% for tap water, respectively. The drinking water quality was predicted to maintain satisfactory in 2022 and 2023. Additionally, principal component analysis revealed that the primary sanitary issues in the water were poor sensory properties, elevated metal contents, high levels of dissolved solids, and microbial contamination. These issues were likely attributable to domestic and industrial waste discharge and aging water pipelines. The health risks associated with the long-term consumption of this water have been steadily decreasing over the years, underscoring the effectiveness of Wuhan's ongoing water management efforts.

Trends in cognitive function before and after myocardial infarction: findings from the China Health and Retirement Longitudinal Study.

Objectives: Incident stroke was associated with cognitive dysfunction after stroke and even before stroke. However, cognitive trends prior to myocardial infarction (MI) and the timeline of cognitive decline in a few years following incident MI remain unclear, especially among the Chinese population. We aimed to evaluate whether MI was associated with cognitive change both before and after MI in China. Methods: This cohort study included 11,287 participants without baseline heart problems or stroke from the China Health and Retirement Longitudinal Study. The exposure was self-reported MI. The outcomes were scores of cognitive functions in five domains, which reflected abilities of episodic memory, visuospatial abilities, orientation, attention and calculation, and global cognition as a summary measure. A Linear mixed model was constructed to explore cognitive function before and after incident MI among the MI participants and the cognitive trends of participants free of MI. Results: During the 7-year follow-up, 421 individuals [3.7% of 11,287, mean (SD) age, 60.0 (9.0) years; 59.1% female] experienced MI events. The cognitive scores of participants of both the MI group and the control group without MI declined gradually as time went by. The annual decline rate of the MI group before incident MI was similar to that of the control group during the whole follow-up period. Incident MI was not associated with acute cognitive decline in all five cognitive domains. Moreover, MI did not accelerate the cognitive decline rate after MI compared with the pre-MI cognitive trends. The decline rate of cognitive function after MI was similar to the rate before MI. Conclusions: Different from stroke, participants who had an MI did not show steeper cognitive decline before MI. MI was not associated with acute cognitive decline and accelerated decline in several years after MI. Future studies are needed to learn the mechanisms behind the different patterns of cognitive decline between MI and stroke.

Trends in Cognitive Function Before and After Diabetes Onset: The China Health and Retirement Longitudinal Study.

BACKGROUND AND OBJECTIVES: Individuals with prevalent diabetes were known to have a higher risk of dementia and lower cognitive function. However, trends of cognitive function before diabetes and in the short term after new-onset diabetes remain unclear. METHODS: This study included participants without baseline diabetes from the China Health and Retirement Longitudinal Study. Cognitive tests were conducted at baseline (wave 1) and at least one time from wave 2 (2013) to wave 4 (2018). Cognitive function was assessed using a global cognition score which was the summary measure of 4 cognitive tests. A linear mixed model was constructed to fit the trends in cognitive function before and after diabetes onset and the trends among nondiabetes. The threshold of statistical significance was p < 0.05. RESULTS: During the 7-year follow-up, 1,207 (9.7% of 12,422, 59.1 ± 8.6 years, 39.9% male participants) participants developed new-onset diabetes. The cognitive function of both the without diabetes group and the diabetes group declined annually during the follow-up. The annual decline rate of the diabetes group before diabetes onset was similar to that of the without diabetes group during the whole follow-up period. After diabetes onset, participants experienced statistically significant faster cognitive declines in global cognition (-0.023 SD/year; 95% CI -0.043 to -0.004; p = 0.019) and visuospatial abilities test (-0.036 SD/year; -0.061 to -0.011; p = 0.004), but not in tests of episodic memory (-0.018 SD/year; -0.041 to 0.004; p = 0.116), attention and calculation (-0.017 SD/year; -0.037 to 0.003; p = 0.090), or orientation (0.001 SD/year; -0.018 to 0.020; p = 0.894), compared with the cognitive slope before diabetes. In subgroup analysis, compared with those who developed diabetes between 45-54 years, those developing diabetes older (55-64 years, p for interaction = 0.701; 65-74 years, p for interaction = 0.996) did not demonstrate different rates of global cognitive decline after diabetes. DISCUSSION: Individuals experienced faster rate of cognitive decline in a few years after diabetes onset, but not during the prediabetes period. Age did not modify the effect of diabetes on postdiabetes cognitive decline. Efforts in eliminating the adverse impacts on cognition should be started on diagnosis of diabetes.

Constructing gellan gum/konjac glucomannan/wheat fiber composite hydrogel to simulate edible cartilage by ionic cross-link and moisture regulation.

The utilization of non-animal-derived materials to imitate cartilage is critical for the advancement of plant-based simulated meat. In this study, gellan gum (GG), konjac glucomannan (KGM), and wheat fiber (WF) were used to construct hydrogel, and the mechanical strength, water properties, and microstructure were regulated by constructing Ca2+ cross-links and moisture control. The hardness, chewiness, resilience, shear force, and shear energy of the Ca2+ cross-linked samples were significantly improved. Extrusion dehydration further changes the related mechanical properties of the hydrogel and results in a tighter microstructure. The findings suggest that the establishment of Ca2+ cross-links and water regulation are efficacious techniques for modifying the texture of the GG/KGM/WF composite hydrogel. Correlation analysis and sensory evaluation showed that the test indexes and sensory scores of the samples with Ca2+ crosslinking and 80 % moisture content were similar to chicken breast cartilage, and the samples with Ca2+ crosslinking and 70 % moisture content were similar to pig crescent bone. This study presents a framework for designing edible cartilage simulators using polysaccharide hydrogels, with implications for enhancing the resemblance of plant-based meat products to real meat and expanding the range of vegetarian offerings available.

Associations of ultra-processed food consumption with mortality among participants with a history of cancer: a prospective cohort analysis.

BACKGROUND: Although high ultra-processed food (UPF) consumption has been linked with increased mortality risk in the general population, whether UPFs harm participants with a history of cancer remains unclear. OBJECTIVE: This study aimed to evaluate the association of UPF consumption with mortality among participants with a history of cancer. METHODS: Prospective cohort analysis was conducted on 13640 participants with a history of cancer from the UK Biobank. UPFs were defined by the Nova classification. UPF consumption was calculated as the weight proportion of UPFs in the total food consumption. Cox proportional hazard models were used to assess the association between UPF consumption and mortality among participants with a history of cancer. RESULTS: The median UPF consumption was 29.25% (interquartile range: 19.46%-40.62%) for males and 25.81% (interquartile range: 16.61%-36.35%) for females in the total diet among participants with a history of cancer. During a median follow-up of 10.77 years, 1611 deaths were documented. Multivariable-adjusted hazard ratios (95% confidence intervals) among participants in the highest quartile of UPF consumption relative to the lowest were 1.17 (1.02, 1.35) for all-cause mortality and 1.22 (1.03, 1.44) for cancer mortality. CONCLUSIONS: Higher UPF consumption after the diagnosis among participants with a history of cancer is associated with higher risk of mortality.

Ultra-Processed Food Consumption and Mortality: Three Cohort Studies in the United States and United Kingdom.

INTRODUCTION: Given the increase in ultra-processed food (UPF) consumption, their potential health effects have aroused concern. Whether UPF consumption is associated with cancer and cardiovascular disease mortality is debatable. This study evaluates the association of UPF consumption with mortality. METHODS: A total of 108,714 U.S. adults from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (1993-2001), 208,051 UK adults from UK Biobank (2006-2010), and 41,070 U.S. adults from National Health and Nutrition Examination Survey (1999-2018) were included. Dietary data were collected by dietary questionnaire and classified using the NOVA classification. UPF consumption was expressed as the weight proportion of UPFs in total foods consumed. Cox proportional hazard models were used to calculate hazard ratios and 95% CIs. Mediation analysis was used to evaluate whether multiple metabolic pathways mediated the associations in UK Biobank. Analyses were performed in 2022-2023. RESULTS: Combined analyses of the three cohorts showed that those with the highest quartile of UPF consumption had higher risks of all-cause mortality (hazard ratio, 1.16; 95% CI, 1.11-1.20) and cardiovascular disease mortality (hazard ratio, 1.17; 95% CI, 1.06-1.28) compared to the lowest quartile of UPF consumption. UPF consumption was not associated with cancer mortality risk. Biomarkers of liver function have the greatest mediating effects on all-cause mortality (20.3%), and biomarkers of inflammation have the greatest mediating effects on cardiovascular disease mortality (29.2%). CONCLUSIONS: Higher UPF consumption was associated with increased all-cause and cardiovascular disease mortality risk, with multiple metabolic pathways playing mediating roles.

Single Cell Sequencing Analysis for Blood Tissue.

Single-cell sequencing is a technique based on sequencing genomic, transcriptomic and epigenomic analysis at the level of individual cells. Compared with traditional sequencing techniques, it can study intercellular heterogeneity and provide in-depth information on cell distribution, cell types and cell function of a specific population. This paper used blood tissue samples to analyze single-cell sequencing. Cells were downscaled by principal component analysis (PCA) and used Leiden clustering to discover cell heterogeneity in the same cluster and annotated after screening marker genes. Finally, 13 marker genes MTRNR2L8, NKG7, FLNA, IL7R, CCR7, CD8B, MKI67, LGALS3, TYROBP, C0251_TotalSeqC, CD79A, HLA-C, CCL4, and MCM5 in the experimental samples were found by cellular enrichment, which are strongly associated with white stuffy syndrome, skin damage, giant cell virus infection and other diseases are closely linked. In the medical field, the experimental results can be used to study the molecular characteristics and functional differences of different cell types under physiological and pathological conditions, thus providing insight into the pathogenesis and treatment of diseases such as leukoaraiosis syndrome, skin damage, and cytomegalovirus infection.

Case report: Novel ETFDH compound heterozygous mutations identified in a patient with late-onset glutaric aciduria type II.

Glutaric aciduria type II (GA II) is an autosomal recessive metabolic disorder of fatty acid, amino acid, and choline metabolism. The late-onset form of this disorder is caused by a defect in the mitochondrial electron transfer flavoprotein dehydrogenase or the electron transfer flavoprotein dehydrogenase (ETFDH) gene. Thus far, the high clinical heterogeneity of late-onset GA II has brought a great challenge for its diagnosis. In this study, we reported a 21-year-old Chinese man with muscle weakness, vomiting, and severe pain. Muscle biopsy revealed myopathological patterns of lipid storage myopathy, and urine organic acid analyses showed a slight increase in glycolic acid. All the aforementioned results were consistent with GA II. Whole-exome sequencing (WES), followed by bioinformatics and structural analyses, revealed two compound heterozygous missense mutations: c.1034A > G (p.H345R) on exon 9 and c.1448C>A (p.P483Q) on exon 11, which were classified as "likely pathogenic" according to American College of Medical Genetics and Genomics (ACMG). In conclusion, this study described the phenotype and genotype of a patient with late-onset GA II. The two novel mutations in ETFDH were found in this case, which further expands the list of mutations found in patients with GA II. Because of the treatability of this disease, GA II should be considered in all patients with muscular symptoms and acute metabolism decompensation such as hypoglycemia and acidosis.

Features of MRI honeycomb edema signals in cancer-associated dermatomyositis patients: a brief report.

Dermatomyositis (DM) is an autoimmune inflammatory disease that is a possible paraneoplastic phenomenon. The aim of this study was to explore the difference in thigh MRI findings between DM patients with and without cancer to further assist clinicians in the early discovery of underlying malignancy. Thigh muscle MRI with T2 fs/STIR images obtained from 47 patients diagnosed with DM at a single center were retrospectively assessed for the involvement of muscle compartments, as well as the pattern and distribution of the edema signal. Among 47 patients, 14 had cancer within three years of DM diagnosis. Honeycomb edema signals were more frequently observed in cancer patients (10 in the cancer group, 11 in the noncancer group, p = 0.020), while foggy signals were not found in cancer patients. Among patients with honeycomb signals, we found that cancer patients had a relatively longer disease duration (p = 0.012), lower creatine kinase levels (p = 0.011), and barely showed adductor involvement (p = 0.016). Logistic regression analysis identified honeycomb edema signals in the quadriceps without adductor involvement as an independent risk factor for having cancer in DM patients. Honeycomb pattern edema signals showed in quadriceps but not adductors on thigh muscle MRI STIR/T2 fs sequence were more frequently found in cancer-associated DM patients. Key points • MRI honeycomb edema signals in the quadriceps without adductor involvement may be a predictor for underlying cancer in DM patients.

Spatial Pattern Characteristics and Factors for the Present Status of Rural Settlements in the Lijiang River Basin Based on ArcGIS.

In China, rural settlements have undergone significant changes in response to dramatic socioeconomic shifts. However, there has not been any report on rural settlements in the Lijiang River Basin. In this study, ArcGIS 10.2 (including hot spot analysis and kernel density estimation) and Fragstats 4.2 (such as the landscape pattern index) software were used to analyze the spatial pattern and causes of rural settlements in the Lijiang River Basin. The Lijiang River Basin is mainly dominated by micro- and small-sized rural settlements with small areas. Moreover, the results of a hot spot analysis showed that micro- and small-sized rural settlements were mainly located in the upper reaches, and medium- and large-sized rural settlements were mainly located in the middle and lower reaches. The kernel density estimation results showed that the distribution characteristics of the rural settlements in the upper, middle, and lower reaches were significantly different. The spatial forms of rural settlements were affected by physiographic factors such as elevation and slope, karst landforms, and river trunk channels as well as the national policy system, tourism economic development, town distribution, historical heritage, and minority culture. This study is the first to systematically elaborate on the rural settlement pattern and its internal logic from the perspective of the Lijiang River Basin, providing a basis for the optimization and construction of the rural settlement pattern.

Exogenous application of melatonin to mitigate drought stress-induced oxidative damage in Phoebe sheareri seedlings.

Background: Drought stress is a major prevalent environmental factor impairing growth. Melatonin mitigates the impacts of drought stress on plants. However, melatonin's role in Phoebe sheareri (Hemsl.) Gamble (P. sheareri) is unknown. We aimed to reveal the protective effects of melatonin on P. sheareri seedlings under drought conditions. Methods: Melatonin was sprayed under drought or normal water conditions. The parameters, including growth, physiological factors, and phytohormones of P. sheareri, were examined. Results: Compared to the normal control group, drought stress inhibited the growth of seedlings and significantly reduced the content of carotenoids, SOD, POD, APX, PPO, CAT, GR, and soluble sugars, and increased the contents of MDA, O2 •-, proline, soluble proteins, ABA, and JA-Me in P. sheareri seedlings. However, melatonin treatment significantly reversed the adverse drought-induced responses and promoted the P. sheareri seedling's growth. Moreover, the heatmap and principal component analysis suggested a high similarity in the behavior patterns of the six measured antioxidant enzymes in P. sheareri seedlings. Conclusion: Our study reported for the first time that melatonin has a protective role in P. sheareri seedlings under drought-stress conditions. This role is related to ROS scavenging, activation of antioxidant enzymes, and crosstalk of phytohormones. This study provided a theoretical basis for improving the ability of P. sheareri adapted to arid environments.

Konjac glucomannan/xanthan gum/sodium alginate composite hydrogel simulates fascial tissue by pre-stretching and moisture regulation.

Improving the mechanical strength and creating an anisotropic structure of edible macromolecular hydrogels is crucial to accurately simulate the texture of connective tissues. In this study, konjac glucomannan (KGM), xanthan gum (XG), and sodium alginate (SA) were used to construct hydrogels, and the effects of different pre-stretching degrees and moisture control on the composite gels were investigated. The results of the mechanical property tests and microstructure tests indicate that pre-stretching and moisture control can significantly enhance the strength of the gels and induce anisotropic structures. In addition, the feasibility of the composite gel structure in simulating brisket fascia was investigated, and it was concluded that 1.5 × -DR samples were most suitable for simulating connective tissue. This study provides compelling evidence for the potential of macromolecular hydrogels in simulating connective tissue and provides theoretical guidance for regulating gel texture.

Effectiveness and Safety of Chinese Medicine at Shenque (CV 8) for Primary Dysmenorrhea: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Primary dysmenorrhea (PD) is the most common complaint associated with menstruation and affects up to three-quarters of women at some stage of their reproductive life. In Chinese medicine, navel therapy, treatment provided at Shenque (CV 8), is used as a treatment option for PD. OBJECTIVE: To evaluate the effect of navel therapy on pain relief and quality of life in women with PD, compared with Western medicine (WM). METHODS: China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), SinoMed and Wanfang Database, MEDLINE, the Cochrane Library, Embase, Web of Science, and the International Clinical Trial Registry of the U.S. National Institutes of Health were searched from their inceptions to April 1, 2021. Randomized controlled trials (RCTs) assessing therapeutic effects of navel therapy on PD were eligible for inclusion. RevMan 5.4 software was used for data analyses. The certainty of the evidence was assessed using the online GRADEpro tool. RESULTS: Totally 24 RCTs involving 2,614 participants were identified. Interventions applied to acupuncture point CV 8 included: herbal patching, moxibustion or combined navel therapy (using at least 2 types of stimulation). Compared to placebo, there was a significant effect in favor of navel therapy on reducing overall menstrual symptom scores at the end of treatment [mean difference: -0.82, 95% confidence interval (CI): -1.00 to -0.64, n=90; 1 RCT]. As compared with Western medicine, navel therapy had a superior effect on pain intensity as assessed by Visual Analogue Scale at the end of treatment [standardized mean difference (SMD): -0.64, 95% CI: -1.22 to -0.06, I2=80%, n=262; 3 RCTs]; on symptom resolution rate at 3-month follow-up (risk ratio: 1.94, 95% CI: 1.47 to 2.56, n=1527, I2=38%; 13 RCTs); and on global menstrual symptoms score at the end of treatment (SMD: -0.67, 95% CI: -0.90 to -0.45, I2=63%, n=990; 12 RCTs). Subgroup analyses showed either a better or an equivalent effect comparing navel therapy with Western medicine. No major adverse events were reported. The methodological quality of included trials was poor overall. CONCLUSIONS: Navel therapy appears to be more effective than Western medicine in decreasing menstrual pain and improving overall symptoms of PD. However, these findings need to be confirmed by well-designed clinical trials with adequate sample size (Systematic review registration at PROSPERO, No. CRD42021240350).

Heterogeneity of White Matter Hyperintensity and Cognitive Impairment in Patients with Acute Lacunar Stroke.

Background: The severity of white matter hyperintensity (WMH) in patients with acute lacunar stroke (ALS) may be not completely parallel to cognitive impairment. Controversies persist about the effects of WMH on cognitive dysfunction. It is vital to explore whether the association may be affected by certain factors and whether a subsequent subgroup analysis is necessary. The aim of this study was to evaluate the relationship between WMH and cognitive impairment in acute lacunar stroke patients and the possible causal factors. Methods: We continuously enrolled patients with ALS who were hospitalized at the First Affiliated Hospital of Soochow University between October 2017 and June 2022. The cognitive function of all patients was assessed by using the Montreal Cognitive Assessment (MoCA) scale 14 ± 2 days after the onset of AIS, and the results were adjusted to the education level. The MoCA scale was reevaluated at the 6-month (day 182 ± 7) follow-up by outpatient visit or video. Demographic and clinical data were collected. The manifestations of chronic cerebral small-vessel disease (CSVD), including the total Fazekas score and total CSVD burden score, were assessed with an MRI scan. A mismatch refers to an inconsistency between the severity of WMH and cognitive dysfunction. A Type 1 mismatch refers to cognitive impairment with mild WMH (total Fazekas score = 0−1), and a Type 2 mismatch refers to severe WMH (total Fazekas score = 5−6) in patients with normal cognitive function. Results: Among 213 enrolled ALS patients, 66 patients (31.0%) had cognitive dysfunction, and 40 patients (18.8%) had mismatches. Twenty-seven cases (12.7%) were Type 1 mismatched, and seventeen cases (8.0%) were Type 2 mismatched. Age, gender, fibrinogen and cerebral infarction history were independent risk factors for cognitive impairment in ALS patients. Imaging features, including moderate to severe WMH, deep WMH and the total CSVD burden score, were also independently associated with cognitive impairment. The patients in the mismatched group were older, had more severe deep WMH and had a higher occurrence of depression (p < 0.05). The NIHSS score, depression and microbleeds were significantly different between the Type 1 mismatched group and the matched group (p = 0.018, p = 0.012 and p = 0.047). Patients in the Type 2 mismatched group were male (p = 0.04), had a lower level of fibrinogen (p = 0.005), a lower incidence of CMBs (p = 0.003), a lower total CSVD burden score (p = 0.017), more severe paraventricular WMH (p = 0.035) and milder deep WMH (p = 0.026). Conclusions: Our study examined a homogeneous study cohort of recruited patients with symptomatic ALS. We found heterogeneity between WMH and cognitive function in ALS patients. Despite a similar WMH severity, some baseline clinical features and other conventional CSVD imaging characteristics may account for this heterogeneity phenomenon. Our findings provide data for the early diagnosis and prevention of cognitive impairment in ALS patients and suggest that the severity of WMH is not completely parallel to cognitive impairment. The white matter microstructural injury and remote WMH effects may account for the mismatch phenomenon. More attention should be paid to understanding the underlying mechanisms and finding new imaging markers.