IL-24 promotes atopic dermatitis-like inflammation through driving MRSA-induced allergic responses.

Atopic dermatitis (AD) is a prevalent inflammatory skin disorder in which patients experience recurrent eczematous lesions and intense itching. The colonization of Staphylococcus aureus (S. aureus) is correlated with the severity of the disease, but its role in AD development remains elusive. Using single-cell RNA sequencing, we uncovered that keratinocytes activate a distinct immune response characterized by induction of Il24 when exposed to methicillin-resistant S. aureus (MRSA). Further experiments using animal models showed that the administration of recombinant IL-24 protein worsened AD-like pathology. Genetic ablation of Il24 or the receptor Il20rb in keratinocytes alleviated allergic inflammation and atopic march. Mechanistically, IL-24 acted through its heterodimeric receptors on keratinocytes and augmented the production of IL-33, which in turn aggravated type 2 immunity and AD-like skin conditions. Overall, these findings establish IL-24 as a critical factor for onset and progression of AD and a compelling therapeutic target.

A chromosome-level genome assembly of the spider mite Tetranychus piercei McGregor.

Despite the rapid advances in sequencing technology, limited genomic resources are currently available for phytophagous spider mites, which include many important agricultural pests. One of these pests is Tetranychus piercei (McGregor), a serious banana pest in East Asia exhibiting remarkable tolerance to high temperature. In this study, we assembled a high-quality genome of T. piercei using a combination of PacBio long reads and Illumina short reads sequencing. With the assistance of chromatin conformation capture technology, 99.9% of the contigs were anchored into three pseudochromosomes with a total size of 86.02 Mb. Repetitive elements, accounting for 14.16% of this genome (12.20 Mb), are predominantly composed of long-terminal repeats (30.7%). By combining evidence of ab initio prediction, transcripts, and homologous proteins, we annotated 11,881 protein-coding genes. Both the genome and proteins have high BUSCO completeness scores (>94%). This high-quality genome, along with reliable annotation, provides a valuable resource for investigating the high-temperature tolerance of this species and exploring the genomic basis that underlies the host range evolution of spider mites.

The Sympathetic-Immune Milieu in Metabolic Health and Diseases: Insights from Pancreas, Liver, Intestine, and Adipose Tissues.

Sympathetic innervation plays a crucial role in maintaining energy balance and contributes to metabolic pathophysiology. Recent evidence has begun to uncover the innervation landscape of sympathetic projections and sheds light on their important functions in metabolic activities. Additionally, the immune system has long been studied for its essential roles in metabolic health and diseases. In this review, the aim is to provide an overview of the current research progress on the sympathetic regulation of key metabolic organs, including the pancreas, liver, intestine, and adipose tissues. In particular, efforts are made to highlight the critical roles of the peripheral nervous system and its potential interplay with immune components. Overall, it is hoped to underscore the importance of studying metabolic organs from a comprehensive and interconnected perspective, which will provide valuable insights into the complex mechanisms underlying metabolic regulation and may lead to novel therapeutic strategies for metabolic diseases.

The genome sequence of a spider mite, Tetranychus truncatus, provides insights into interspecific host range variation and the genetic basis of adaptation to a low-quality host plant.

The phytophagous mite Tetranychus truncatus is a serious pest in East Asia but has a relatively narrower host range than the pest mite Tetranychus urticae, which can feed on over 1200 plant species. Here, we generated a high-quality chromosomal level genome of T. truncatus and compared it with that of T. urticae, with an emphasis on the genes related to detoxification and chemoreception, to explore the genomic basis underlying the evolution of host range. We also conducted population genetics analyses (in 86 females from 10 populations) and host transfer experiments (in 4 populations) to investigate transcription changes following transfer to a low-quality host (Solanum melongena, eggplant), and we established possible connections between fitness on eggplant and genes related to detoxification and chemoreception. We found that T. truncatus has fewer genes related to detoxification, transport, and chemoreception than T. urticae, with a particularly strong reduction in gustatory receptor (GR) genes. We also found widespread transcriptional variation among T. truncatus populations, which varied in fitness on eggplant. We characterized selection on detoxification-related genes through ω values and found a negative correlation between expression levels and ω values. Based on the transcription results, as well as the fitness and genetic differences among populations, we identified genes potentially involved in adaptation to eggplant in T. truncatus. Our work provides a genomic resource for this pest mite and new insights into mechanisms underlying the adaptation of herbivorous mites to host plants.

Roles of cancer stem cells in gastrointestinal cancers.

Cancer stem cells (CSCs) are the main cause of tumor growth, invasion, metastasis and recurrence. Recently, CSCs have been extensively studied to identify CSC-specific surface markers as well as signaling pathways that play key roles in CSCs self-renewal. The involvement of CSCs in the pathogenesis of gastrointestinal (GI) cancers also highlights these cells as a priority target for therapy. The diagnosis, prognosis and treatment of GI cancer have always been a focus of attention. Therefore, the potential application of CSCs in GI cancers is receiving increasing attention. This review summarizes the role of CSCs in GI cancers, focusing on esophageal cancer, gastric cancer, liver cancer, colorectal cancer, and pancreatic cancer. In addition, we propose CSCs as potential targets and therapeutic strategies for the effective treatment of GI cancers, which may provide better guidance for clinical treatment of GI cancers.

Membranous nephropathy: Mechanistic insights and therapeutic perspectives.

Membranous nephropathy (MN) is one of the most common causes of non-diabetic nephrotic syndrome in adults. About 80% of cases are renal limited (primary MN) and 20% are associated with other systemic diseases or exposures (secondary MN). Autoimmune reaction is the main pathogenic factor of MN, and the discovery of autoantigens including the phospholipase A2 receptor and thrombospondin type-1 domain-containing protein 7A has led to new insights into the pathogenesis, they can induce humoral immune responses led by IgG4 makes them suitable for the diagnosis and monitoring of MN. In addition, complement activation, genetic susceptibility genes and environmental pollution are also involved in MN immune response. In clinical practice, due to the spontaneous remission of MN, the combination of supportive therapy and pharmacological treatment is widely used. Immunosuppressive drugs are the cornerstone of MN treatment, and the dangers and benefits of this approach vary from person to person. In summary, this review provides a more comprehensive review of the immune pathogenesis, interventions and unresolved issues of MN in the hope of providing some new ideas for clinical and scientific researchers in the treatment of MN.

Moshen granule ameliorates membranous nephropathy by blocking intrarenal renin-angiotensin system signalling via the Wnt1/ß-catenin pathway.

BACKGROUND: Membranous nephropathy (MN) is one of the cardinal causes of nephrotic syndrome in adults, but an adequate treatment regimen is lacking. PURPOSE: We assessed the effect of Moshen granule (MSG) on patients with MN and cationic bovine serum albumin (CBSA)-induced rats. We further identified the bioactive components of MSG and revealed the underlying molecular mechanism of its renoprotective effects. METHODS: We determined the effect of MSG on patients with MN and CBSA-induced rats and its components on podocyte injury in zymosan-activated serum (ZAS)-elicited podocytes and revealed their regulatory mechanism on the Wnt/ß-catenin/renin-angiotensin system (RAS) signalling axis. RESULTS: MSG treatment improved renal function and reduced proteinuria in MN patients and significantly reduced proteinuria and preserved the protein expression of podocin, nephrin, podocalyxin and synaptopodin in CBSA-induced MN rats. Mechanistically, MSG treatment significantly inhibited the protein expression of angiotensinogen, angiotensin converting enzyme and angiotensin II type 1 receptor, which was accompanied by inhibition of the protein expression of Wnt1 and ß-catenin and its downstream gene products, including Snail1, Twist, matrix metalloproteinase-7, plasminogen activator inhibitor-1 and fibroblast-specific protein 1, in CBSA-induced MN rats. We further identified 81 compounds, including astragaloside IV (AGS), calycosin, barleriside A and geniposidic acid, that preserve the podocyte-specific protein expression in ZAS-induced podocytes. Among these four compounds, AGS exhibited the strongest inhibitory effects on podocyte protein expression. AGS treatment significantly inhibited the protein expression of RAS components and Wnt1 and ß-catenin and its downstream gene products in ZAS-induced podocytes. In contrast, the inhibitory effect of AGS on podocyte-specific proteins, ß-catenin downstream gene products and RAS components was partially abolished in ZAS-induced podocytes treated with ICG-001 and ß-catenin siRNA. CONCLUSION: This study first demonstrates that AGS mitigates podocyte injury by inhibiting the activation of RAS signalling via the Wnt1/ß-catenin pathway by both pharmacological and genetic methods. Therefore, AGS might be considered a new ß-catenin inhibitor that inhibits the Wnt1/ß-catenin pathway to retard MN in patients.

The relationship between Chinese university students' learning preparation and learning achievement within the EFL blended teaching context in COVID-19 post-epidemic era: The mediating effect of learning methods.

The effectiveness of the blended teaching model in improving university students' English learning achievement has been frequently reported in China in the post-pandemic era. However, such research has seldom explored the students' entire EFL (English as a foreign language) learning process and mechanism from the perspective of learners within this model. This study therefore used the 3P (presage, process and product) teaching and learning theory to explore the mediating role of learning methods (i.e., learning engagement and academic procrastination) in the relationship between learning preparation (i.e., academic self-concept and course experience) and learning achievement within the Chinese EFL blended teaching context from the perspective of learners. In this study, 942 Chinese university students (male: N = 447; female: N = 495) participated in a survey and completed electronic questionnaires on EFL-related academic self-concept, learning engagement, academic procrastination, and learning achievement. The data were analyzed using AMOS software and a structural equation modeling (SEM) technique. The results showed that both students' academic self-concept and course experience directly and positively predicted their English learning achievement. Moreover, students' academic self-concept of learning achievement was partially mediated by learning engagement and academic procrastination, whereas the effect of course experience on learning achievement was fully mediated by learning engagement and academic procrastination. After discussing these findings, suggestions as well as limitations for future studies will be given.

Simultaneous determination of seven different components in Cynomorium songaricum Rupr. by QAMS / 药学学报

A quantitative analysis of multi-components by single marker method (QAMS) was established for simultaneous determination of gallic acid, protocatechuic acid, catechin, epicatechin, p-coumaric acid, ferulic acid and phloridzin in Cynomorium songaricum Rupr. The analysis was performed on a ChromCore Polae C18 column (250 mm×4.6 mm, 5 μm) , with a mobile phase consisting of acetonitrile-0.3% phosphoric acid aqueous solution for gradient elution. The volume flow rate, column temperature and sample injection volume were set at 1.0 mL·min-1, 25 ℃, and 40 µL, respectively. The relative correction factors of gallic acid and protocatechuic acid, catechin, epicatechin, p-coumaric acid, ferulic acid and phloridzin were calculated and the durability was also investigated. The contents of these seven compounds in fourteen batches of Cynomorium songaricum Rupr. from different producing areas or batches were determined by external standard method (ESM) and quantitative analysis of multi-components with a single-marker method (QAMS), respectively. SPSS and Origin Pro software were employed for principal components assay, similarity evaluation and cluster analysis. The specificity, precision, repeatability, stability and linear range (R2 > 0.999 0) of the seven components were all good. The average recovery was 96.89%-103.16% and RSD was 0.55%-2.76%. Then gallic acid was chosen as internal reference for calculation the correction factors for the other six components, the average relative correction factors of protocatechuic acid, catechin, epicatechin, p-coumaric acid, ferulic acid and phloridzin were 1.141 5, 0.200 5, 0.208 0, 2.361 9, 1.867 7, 0.204 6, respectively. Student's test results showed that there was no significant difference between the data analyzed by ESM and the data obtained from QAMS method. Through data visualization analysis, the contents of gallic acid, protocatechuic acid, catechin and epicatechin in different samples were significantly different, indicating that these four components might be the main quality markers of Cynomorium songaricum Rupr. for gaving more contributes to the principal components. The cluster analysis showed that samples from Xinjiang and samples from Inner Mongolia were clustered in significantly different categories, meaning that the quality of Cynomorium songaricum Rupr. had great relation with producing areas. The method of QAMS established in this study is a simple, economical and practical method with scientific and applicable charactistics for evaluating the quality of Cynomorium songaricum Rupr. efficiently and scientifically.

The relationship between sleep arousal, ambulatory blood pressure and heart failure in elderly patients with obstructive sleep apnea / 中华老年医学杂志

Objective:To evaluate the relationship between sleep arousal, ambulatory blood pressure and new-onset heart failure(NOHF)in elderly patients with obstructive sleep apnea(OSA).Methods:A total of 584 elderly patients with OSA who were diagnosed and treated in our hospital between March 2015 and March 2019 were prospectively and consecutively selected, with a mean age of(70.1±7.2)years.Polysomnography(PSG)results were obtained at baseline, and the arousal index(AI)was calculated.Based on the quartiles of AI, patients were divided into 4 groups: a low-level group(AI<18.4/h, 186 cases), a low-medium level group(18.4-29.1/h, 177 cases), a medium-high level group(29.2-41.2/h, 137 cases)and a high-level group(>41.2 /h, 84 cases). Participants were followed up for 18 months, the results of ambulatory blood pressure were recorded and compared, and the relationship between AI and the risk of NOHF was analyzed.Results:Compared with the low-level group, patients in the low-medium, medium-high, and high-level groups were older(70.1, 70.3, 73.3 vs.68.7 years, F=2.726, P=0.043)and had more smokers(43.8%, 49.6%, 54.8% vs.38.2%, χ2=8.809, P=0.032), a larger body mass index(26.3, 26.7, 27.6 vs.25.4 kg/m 2, F=2.731, P=0.042), a higher Epworth sleepiness scale score(7.83, 8.50, 9.91 vs.7.64, F=5.124, P=0.018), a higher apnea hypopnea index(23.5, 34.8, 52.7 vs.17.6, F=5.632, P=0.007), lower nocturnal oxygen saturation(80.2, 75.3, 72.1 vs.83.7 mmHg, F=4.811, P=0.024), and higher N-terminal pro-B-type natriuretic peptide(NT-proBNP)levels(317.5, 337.5, 359.2 vs.267.5 pg/L, F=4.307, P=0.033). At the median follow-up(18 months, 14-24 months), the results of ambulatory blood pressure monitoring showed that 24-hour systolic blood pressure(24 h SBP)(147.3, 148.6, 156.2 vs.143.8 mmHg, F=5.4311, P=0.013), 24-hour diastolic blood pressure(24 h DBP)(80.1, 79.5, 83.7 vs.76.5 mmHg, F=5.679, P=0.011)in the low-medium, medium-high and high-level groups were higher than those in the low-level group.The results of survival analysis showed that there were 75(12.8%)cases of NOHF, mostly with preserved ejection fraction(47 cases)or mid-range ejection fraction heart failure(20 cases). The incidences of NOHF were 6.5%, 12.4%, 16.1% and 22.4%, respectively for the low level, low-medium, medium-high and high-level groups, and the risk of NOHF in the low-medium, medium-high and high-level groups was significantly higher than in the low level group(log-rank χ2=11.624, P=0.007). Variables with P<0.2 in the univariate analysis, age and sex were included in the multivariate Cox regression analysis.The results showed that age( HR=1.724, 95% CI: 1.216-3.135), diabetes( HR=1.514, 95% CI: 1.127-3.058), NT proBNP( HR=1.517, 95% CI: 1.232-2.366), nocturnal diastolic blood pressure( HR=2.004, 95% CI: 1.332-4.638), and middle-high AI level( HR=1.611, 95% CI: 1.204-2.967)and high AI level( HR=1.863, 95% CI: 1.272-3.538)were independent factors of NOHF in elderly OSA patients. Conclusions:Sleep arousal in elderly patients with OSA increases blood pressure levels and the risk of NOHF.

Recompensation of complications in patients with hepatitis B virus-related decompensated cirrhosis treated with entecavir antiviral therapy / 中华肝脏病杂志

Objective: To analyze the occurrence of recompensation conditions in patients with chronic hepatitis B virus-related decompensated cirrhosis after entecavir antiviral therapy. Methods: Patients with hepatitis B virus-related decompensated cirrhosis with ascites as the initial manifestation were prospectively enrolled. Patients who received entecavir treatment for 120 weeks and were followed up every 24 weeks (including clinical endpoint events, hematological and imaging indicators, and others) were calculated for recompensation rates according to the Baveno VII criteria. Measurement data were compared using the Student t-test or Mann-Whitney U test between groups. Categorical data were compared by the χ (2) test or Fisher's exact probability method between groups. Results: 283 of the 320 enrolled cases completed the 120-week follow-up, and 92.2% (261/283) achieved a virological response (HBV DNA 20 IU/ml). Child-Pugh and MELD scores were significantly improved after treatment (8.33 ± 1.90 vs. 5.77 ± 1.37, t = 12.70, P < 0.001; 13.37 ± 4.44 vs. 10.45 ± 4.58, t = 5.963, P < 0.001). During the 120-week follow-up period, 14 cases died, two received liver transplants, 19 developed hepatocellular cancer, 11 developed gastroesophageal variceal bleeding, and four developed hepatic encephalopathy. 60.4% (171/283) (no decompensation events occurred for 12 months) and 56.2% (159/283) (no decompensation events occurred for 12 months and improved liver function) of the patients had achieved clinical recompensation within 120 weeks. Patients with baseline MELD scores > 15 after active antiviral therapy achieved higher recompensation than patients with baseline MELD scores ≤15 [50/74 (67.6%) vs. 109/209 (52.2%), χ (2) = 5.275, P = 0.029]. Conclusion: Antiviral therapy can significantly improve the prognosis of patients with hepatitis B virus-related decompensated cirrhosis. The majority of patients (56.2%) had achieved recompensation. Patients with severe disease did not have a lower probability of recompensation at baseline than other patients.

The impact of self-directed learning experience and course experience on learning satisfaction of university students in blended learning environments: the mediating role of deep and surface learning approach.

Introduction: With the rapid development of technology and the evolution of educational ideas, the blended learning model has become the new norm in higher education. Therefore, based on Biggs' learning process theory, this study aims to investigate the relationships between learning experience, learning approaches, and learning satisfaction of university students within the Chinese blended learning context to explore the dynamic process and mechanism of blended learning. Methods: The Chinese modified versions of the Self-Rating Scale of Self-Directed Learning, the Course Experience Questionnaire, and the Revised Study Process Questionnaire were administered to 939 Chinese university first-grade students (444 men, 495 women). The data were analyzed by using the covariance-based structural equation modeling (CB-SEM) technique. Results: The results demonstrated that, among Chinese university students, there were significant correlations between the self-directed learning experience, the course experience, the deep learning approach, the surface learning approach, and learning satisfaction. Additionally, the learning approaches mediated the association between the self-directed learning experience and learning satisfaction and between the course experience and learning satisfaction. Conclusion: This study provides insight into the facilitative effect of university students' self-directed learning experience and course experience on their learning satisfaction and how this effect is triggered through the mediating role of different learning approaches with the blended learning context. This study shows the learning behaviors and psychology in a blended learning environment, thus revealing the new learning characteristics of university students by integrating the self-learning characteristics of blended learning into the framework of learning process theory. The findings contribute to assisting blended learning providers in delivering targeted interventions to enhance students' learning satisfaction.

Methyl ferulic acid ameliorates ethanol-induced L02 cell steatosis through microRNA-378b-mediated CaMKK2-AMPK pathway / 中国中药杂志

Alcoholic liver disease(ALD), with its increasing morbidity and mortality, has seriously and extensively affected the health of people worldwide. Methyl ferulic acid(MFA) has been proven to significantly inhibit alcohol-induced lipid production in L02 cells through the AMP-activated protein kinase(AMPK) pathway, but its in-depth mechanism remains unclear. This study aimed to further clarify the mechanism of MFA in improving lipid accumulation in L02 cells through the microRNA-378b(miR-378b)-mediated calcium/calmodulin-dependent protein kinase kinase 2(CaMKK2)-AMPK signaling pathway based on existing researches. L02 cells were induced by 100 mmol·L~(-1) ethanol for 48 h to establish the model of ALD in vitro, and 100, 50, and 25 μmol·L~(-1) concentration of MFA was treated. MiR-378b plasmids(containing the overexpression plasmid-miR-378b mimics, silence plasmid-miR-378b inhibitor, and their respective negative control-miR-378b NCs) were transfected into L02 cells by electroporation to up-regulate or down-regulate the levels of miR-378b in L02 cells. The levels of total cholesterol(TC) and triglyceride(TG) in cells were detected by commercial diagnostic kits and automatic biochemical analyzers. The expression levels of miR-378b in L02 cells were detected by real-time quantitative polymerase chain reaction(qRT-PCR). CaMKK2 mRNA levels were detected by PCR, and protein expressions of related factors involved in lipid synthesis, decomposition, and transport in lipid metabolism were detected by Western blot. The results displayed that ethanol significantly increased TG and TC levels in L02 cells, while MFA decreased TG and TC levels. Ethanol up-regulated the miR-378b level, while MFA effectively inhibited the miR-378b level. The overexpression of miR-378b led to lipid accumulation in ethanol-induced L02 cells, while the silence of miR-378b improved the lipid deposition induced by ethanol. MFA activated the CaMKK2-AMPK signaling pathway by lowering miR-378b, thus improving lipid synthesis, decomposition, and transport, which improved lipid deposition in L02 cells. This study shows that MFA improves lipid deposition in L02 cells by regulating the CaMKK2-AMPK pathway through miR-378b.

Aryl hydrocarbon receptor: From pathogenesis to therapeutic targets in aging-related tissue fibrosis.

Aging promotes chronic inflammation, which contributes to fibrosis and decreases organ function. Fibrosis, the excessive synthesis and deposition of extracellular matrix components, is the main cause of most chronic diseases including aging-related organ failure. Organ fibrosis in the heart, liver, and kidneys is the final manifestation of many chronic diseases. The aryl hydrocarbon receptor (AHR) is a cytoplasmic receptor and highly conserved transcription factor that is activated by a variety of small-molecule ligands to affect a wide array of tissue homeostasis functions. In recent years, mounting evidence has revealed that AHR plays an important role in multi-organ fibrosis initiation, progression, and therapy. In this review, we summarise the relationship between AHR and the pathogenesis of aging-related tissue fibrosis, and further discuss how AHR modulates tissue fibrosis by regulating transforming growth factor-ß signalling, immune response, and mitochondrial function, which may offer novel targets for the prevention and treatment of this condition.

A two-year follow-up study on the first manic episode due to mood-incongruent psychosis.

BACKGROUND: Mood-incongruent psychosis during bipolar disorder has been associated with poor outcomes. However, it remains unknown whether this is secondary to persistent affective or psychotic symptoms or both. METHOD: Sixty-eight patients with bipolar disorder between the ages of 16 and 45 were recruited during their first psychiatric hospitalization for mania. These patients were evaluated using structured and semi-structured clinical interview then followed longitudinally. Outcomes during the first twenty-four months of follow-up were compared between patients with mood-incongruent psychosis and those without (i.e., patients with mood-congruent psychosis or no psychosis) during the index manic episode. Specifically, ratings of the percent of weeks during follow-up with the duration of mood incongruent psychotic symptom, any psychotic symptom, affective syndromes, and scores of global outcomes were compared. RESULTS: Comparing the 24-month follow-up results between the two groups, patients with mood incongruent psychotic symptoms had a lower global functional rating scale, efficacy index, while the duration of mood incongruent psychotic symptom, any psychotic symptom, and complete affective symptom showed statistically significant differences between the two groups. There were also statistically significant differences between the two groups in the duration of mood stabilizers, and antidepressants use, typical antipsychotics, and atypical antipsychotics. Partial correlation analysis reveals the scores of the global assessment of functioning scale (GAF) after 24 months showed a significant negative correlation with the length of time of incongruent psychotic symptoms. Still, the correlation was intermediate (correlation coefficients less than 0.5，r2 = -0.471, P < 0.001). CONCLUSION: Mood-incongruent psychosis that occurs during the first manic episode appears to predict an increased likelihood of persistent psychotic symptoms during the subsequent twenty-four months. This persistence of psychosis is associated with a worse overall course of illness than patients without mood-incongruent psychosis. LIMITATIONS: These results apply to a relatively short outcome period, and the sample size is relatively small.

Social Distancing and Adolescent Psychological Well-Being: The Role of Practical Knowledge and Exercise.

BACKGROUND AND OBJECTIVES: This intensive longitudinal study investigated 1) the extent to which engaging in social distancing predicted adolescents' same- and next-day stress and positive affect and 2) whether COVID-19-related knowledge and exercise moderated these links during statewide stay-at-home orders that mandated schools and nonessential businesses to close during the coronavirus pandemic. METHODS: Over the course of 28 days at the onset of the COVID-19 pandemic, a nationwide sample of 349 adolescents (Mean age = 15.0; 40% male; 44% Black, 39% White, 9% Latinx, 6% Asian American, 2% Native American) completed daily surveys about their social distancing behaviors, knowledge about the coronavirus, and exercise habits. Analysis was conducted on a total of 9372 assessments using longitudinal multilevel modeling approaches. RESULTS: Daily engagement in social distancing predicted increases in adolescents' stress and decreases in their positive affect. Practical knowledge about COVID-19 and daily exercise moderated these links. Specifically, practical knowledge and exercise weakened the positive link between social distancing and stress as well as the negative link between social distancing and positive affect. CONCLUSIONS: Adolescents' practical knowledge and exercise have the potential to buffer against the adverse effects of social distancing on stress and positive affect. However, it is critical for health care providers to recognize that youth are experiencing significant stress due to the disruption of developmentally normal patterns of social interaction. Pediatricians should focus on explaining the rationale behind social distancing while encouraging exercise as an adaptive coping mechanism that has benefits for psychological well-being.

Postoperative changes in 25-hydroxy vitamin D and parathyroid hormone levels in obese patients / 中华临床营养杂志

Objective:To investigate the postoperative changes in levels of 25-hydroxy vitamin D (25-[OH]D], parathyroid hormone (PTH) and other relevant biomarkers in obese patients receiving metabolic surgery and analyze the dynamic changes in relevant biomarkers in the short term (after 3-6 months) and the long term (after 12-24 months).Methods:A total of 96 obese patients who underwent metabolic surgery and received follow-up examinations from January 2018 to January 2020 were included. Baseline and postoperative data were collected, including anthropometric data (height, weight, neck circumference, waistline and hipline) and laboratory test results (fasting glucose, glycated hemoglobin, 25-[OH)D, PTH, serum calcium and serum phosphorus). Body mass index (BMI) and waist-hip ratio were calculated. The anthropometric data were analyzed by repeated measures analysis of variance and laboratory data were compared between groups using t test and Kruskal-Wallis test. Results:96 patients (33 males and 63 females) were included, of whom 49 were complicated with diabetes. Prior to surgery, 79 (79.17%) of the patients had 25-(OH)D deficiency (< 20 μg/L), 16 (16.67%) had 25-(OH)D insufficiency (≥ 20 μg/L and < 30 μg/L) and 23 (23.96%) had high PTH levels (> 70 ng/L). After the surgery, 25-(OH)D level was transiently increased in the short term ( P = 0.01) but declined thereafter in the long term ( P < 0.01) to levels lower than baseline ( P = 0.023). Long-term PTH level was higher than baseline ( P = 0.012), with 11 patients showing PTH levels higher than normal (> 70 ng/L). Serum phosphorus level was increased in both the short term and the long term ( P < 0.01). Conclusions:Obese patients have 25-(OH)D deficiency/insufficiency before metabolic surgery and experience further decrease in the long term after surgery, despite a transient increase. Secondary increase in PTH level occurs in some of the patients after surgery. Long-term nutritional supplements and comprehensive nutritional management play important roles in postoperative management of obese patient.

Association of weight loss with diabetes remission after metabolic surgery in patients with type 2 diabetes for 10 years and above / 中华临床营养杂志

Objective:To explore the association of weight loss with diabetes remission after metabolic surgery in patients with type 2 diabetes mellitus(T2DM) for 10 years and more.Methods:Data of T2DM patients with obesity who underwent metabolic surgery in the General Surgery Department & Obesity and Metabolic Disease Center of China-Japan Friendship Hospital from November 2017 to June 2021 were retrospectively collected and analyzed. Remission of diabetes was defined as glycated hemoglobin (HbA1c) < 6.5% or fasting blood glucose < 7.0 mmol/L after discontinuing anti-diabetic medication for more than 3 months. The patients were followed up and divided into two groups according to whether the percentage total weight loss (%TWL) was ≥ 20% or not. The age, sex, body mass index (BMI), fasting C-peptide, and HBA1c were compared between the two groups.Results:Among 65 (28 males and 37 females) patients with T2DM for ≥ 10 years , 50 (76.9%) achieved diabetes remission after a median of 12-month follow-up. 6.2%, 41.5% , 38.5% and 13.8% of the patients achieved %TWL < 10%, 10~20%, 20~30% and ≥ 30% , respectively. The diabetes remission rates were 50%, 63.0%, 92.0% and 88.9%, respectively. Compared with the %TWL < 20% group, the preoperative weight [(95.5±18.8) kg vs (85.5±11.0) kg, P = 0.012] and BMI [(34.4±6.0) vs (30.9±3.3) , P = 0.006] were significantly higher in the %TWL ≥ 20% group, and diabetes remission rates was aslo significantly higher in the %TWL ≥ 20% group (91.2% vs 61.3%, P = 0.010) . After adjusting for age, preoperative BMI, fasting C-peptide and duration of T2DM, Cox multivariate regression analysis showed that %TWL ≥ 20% was independently associated with diabetic remission after metabolic surgery in patients with T2DM for ≥ 10 years (HR = 1.99, 95% CI: 1.03 to 3.83, P = 0.04). Conclusions:More than 70% of patients with T2DM for ≥ 10 years could achieve diabetes remission after metabolic surgery. %TWL ≥ 20% may be one independent factor of diabetes remission in patients with long-duration T2DM.

Targeting the Wnt/ß-Catenin Signaling Pathway as a Potential Therapeutic Strategy in Renal Tubulointerstitial Fibrosis.

The Wnt/ß-catenin signaling pathway plays important roles in embryonic development and tissue homeostasis. Wnt signaling is induced, and ß-catenin is activated, associated with the development and progression of renal fibrosis. Wnt/ß-catenin controls the expression of various downstream mediators such as snail1, twist, matrix metalloproteinase-7, plasminogen activator inhibitor-1, transient receptor potential canonical 6, and renin-angiotensin system components in epithelial cells, fibroblast, and macrophages. In addition, Wnt/ß-catenin is usually intertwined with other signaling pathways to promote renal interstitial fibrosis. Actually, given the crucial of Wnt/ß-catenin signaling in renal fibrogenesis, blocking this signaling may benefit renal interstitial fibrosis. There are several antagonists of Wnt signaling that negatively control Wnt activation, and these include soluble Fzd-related proteins, the family of Dickkopf 1 proteins, Klotho and Wnt inhibitory factor-1. Furthermore, numerous emerging small-molecule ß-catenin inhibitors cannot be ignored to prevent and treat renal fibrosis. Moreover, we reviewed the knowledge focusing on anti-fibrotic effects of natural products commonly used in kidney disease by inhibiting the Wnt/ß-catenin signaling pathway. Therefore, in this review, we summarize recent advances in the regulation, downstream targets, role, and mechanisms of Wnt/ß-catenin signaling in renal fibrosis pathogenesis. We also discuss the therapeutic potential of targeting this pathway to treat renal fibrosis; this may shed new insights into effective treatment strategies to prevent and treat renal fibrosis.

Machine Learning Algorithms are Superior to Conventional Regression Models in Predicting Risk Stratification of COVID-19 Patients.

BACKGROUND: It is very important to determine the risk of patients developing severe or critical COVID-19, but most of the existing risk prediction models are established using conventional regression models. We aim to use machine learning algorithms to develop predictive models and compare predictive performance with logistic regression models. METHODS: The medical record of 161 COVID-19 patients who were diagnosed January-April 2020 were retrospectively analyzed. The patients were divided into two groups: asymptomatic-moderate group (132 cases) and severe or above group (29 cases). The clinical features and laboratory biomarkers of these two groups were compared. Machine learning algorithms and multivariate logistic regression analysis were used to construct two COVID-19 risk stratification prediction models, and the area under the curve (AUC) was used to compare the predictive efficacy of these two models. RESULTS: A machine learning model was constructed based on seven characteristic variables: high sensitivity C-reactive protein (hs-CRP), procalcitonin (PCT), age, neutrophil count (Neuc), hemoglobin (HGB), percentage of neutrophils (Neur), and platelet distribution width (PDW). The AUC of the model was 0.978 (95% CI: 0.960-0.996), which was significantly higher than that of the logistic regression model (0.827; 95% CI: 0.724-0.930) (P=0.002). Moreover, the machine learning model's sensitivity, specificity, and accuracy were better than those of the logistic regression model. CONCLUSION: Machine learning algorithms improve the accuracy of risk stratification in patients with COVID-19. Using detection algorithms derived from these techniques can enhance the identification of critically ill patients.