Orientation-dependent electronic structure in interfacial superconductors LaAlO3/KTaO3.

Emergent superconductivity at the LaAlO3/KTaO3 interfaces exhibits a mysterious dependence on the KTaO3 crystallographic orientations. Here by soft X-ray angle-resolved photoemission spectroscopy, we directly resolve the electronic structure of the LaAlO3/KTaO3 interfacial superconductors and the non-superconducting counterpart. We find that the mobile electrons that contribute to the interfacial superconductivity show strong k⊥ dispersion. Comparing the superconducting and non-superconducting interfaces, the quasi-three-dimensional electron gas with over 5.5 nm spatial distribution ubiquitously exists and shows similar orbital occupations. The signature of electron-phonon coupling is observed and intriguingly dependent on the interfacial orientations. Remarkably, the stronger electron-phonon coupling signature correlates with the higher superconducting transition temperature. Our observations help scrutinize the theories on the orientation-dependent superconductivity and offer a plausible and straightforward explanation. The interfacial orientation effect that can modify the electron-phonon coupling strength over several nanometers sheds light on the applications of oxide interfaces in general.

Dual-layer spectral-detector CT for detecting liver steatosis by using proton density fat fraction as reference.

OBJECTIVES: To evaluate the diagnostic accuracy of liver dual-layer spectral-detector CT (SDCT) derived parameters of liver parenchyma for grading steatosis with reference to magnetic resonance imaging-based proton density fat fraction (MRI-PDFF). METHODS: Altogether, 320 consecutive subjects who underwent MRI-PDFF and liver SDCT examinations were recruited and prospectively enrolled from four Chinese hospital centers. Participants were classified into normal (n = 152), mild steatosis (n = 110), and moderate/severe(mod/sev) steatosis (n = 58) groups based on MRI-PDFF. SDCT liver parameters were evaluated using conventional polychromatic CT images (CTpoly), virtual mono-energetic images at 40 keV (CT40kev), the slope of the spectral attenuation curve (λ), the effective atomic number (Zeff), and liver to spleen attenuation ratio (L/S ratio). Linearity between SDCT liver parameters and MRI-PDFF was examined using Spearman correlation. Cutoff values for SDCT liver parameters in determining steatosis grades were identified using the area under the receiver-operating characteristic curve analyses. RESULTS: SDCT liver parameters demonstrated a strong correlation with PDFF, particularly Zeff (rs = -0.856; p < 0.001). Zeff achieved an area under the curve (AUC) of 0.930 for detecting the presence of steatosis with a sensitivity of 89.4%, a specificity of 82.4%, and an AUC of 0.983 for detecting mod/sev steatosis with a sensitivity of 93.1%, a specificity of 93.5%, the corresponding cutoff values were 7.12 and 6.94, respectively. Zeff also exhibited good diagnostic performance for liver steatosis grading in subgroups, independent of body mass index. CONCLUSION: SDCT liver parameters, particularly Zeff, exhibit excellent diagnostic accuracy for grading steatosis. CRITICAL RELEVANCE STATEMENT: Dual-layer SDCT parameter, Zeff, as a more convenient and accurate imaging biomarker may serve as an alternative indicator for MRI-based proton density fat fraction, exploring the stage and prognosis of liver steatosis, and even metabolic risk assessment. KEY POINTS: Liver biopsy is the standard for grading liver steatosis, but is limited by its invasive nature. The diagnostic performance of liver steatosis using SDCT-Zeff outperforms conventional CT parameters. SDCT-Zeff accurately and noninvasively assessed the grade of liver steatosis.

Validation of Jianpi Qingre Tongluo Recipe in Reducing Inflammation and Dyslipidemia in Osteoarthritis via Lnc RNA HOTAIR/APN/PI3K/AKT.

Objective: Jianpi Qingre Tongluo Recipe (JQP) has been widely used in clinical practice, and its anti-Osteoarthritis (OA) effectiveness and specific mechanism have been concerned. This study aims to explore the clinical effect of JQP in reducing inflammation and dyslipidemia in OA and the molecular mechanism. Methods: The clinical efficacy of JQP in OA treatment was assessed through data mining. Through the network pharmacology technology, the interactive network of "active component-target-disease" was developed, the interaction relationship of the related proteins was analyzed, and enrichment analysis of gene pathway biological process was conducted. Molecular docking was carried out with PyMOL and AutodockTools-1.5.7. Finally, cell experiments were used to verify JQP's delay of immune inflammation in OA. Results: We found that JQP could ameliorate the immune inflammatory and lipid metabolism indicators; reduce VAS and SAS score in OA. A total of 98 genes overlapped between target genes of JQP and OA. TNF, IL-6, IL-1ß, and AKT1 shared the highest centrality among all target genes. KEGG analysis unveiled that 98 intersection genes were predominantly enriched in PI3K/AKT pathway in the anti-OA system. In vitro, after peripheral blood mononuclear cell (PBMC) stimulation, inflammatory cytokines imbalances and the expressions of adiponectin (APN) were decreased in osteoarthritis-chondrocytes (OA-CH). Furthermore, JQP-containing serum protected OA-CHs through down-regulating HOTAIR levels, thereby up-regulating APN and depressing PI3K/AKT pathway. Conclusion: This study suggests that JQP might reduce inflammation and improve lipid metabolism of OA by regulating HOTAIR/APN/PI3K/AKT. Our results bring a new solution for OA.

Jianpi Qingre Tongluo Decoction exerted an anti-inflammatory effect on AS by inhibiting the NONHSAT227927.1/JAK2/STAT3 axis.

Purpose: This study aims to determine whether Jianpi Qingre Tongluo Decoction (JQP) alleviates ankylosing spondylitis (AS) inflammation via the NONHSAT227927.1/JAK2/STAT3 axis. Methods: The effect of JQP on immune-inflammatory indicators in AS patients was explored through a combination of data mining, association rule analysis, and random walk model evaluation. Subsequently, network pharmacology and molecular docking were performed to screen out the potential signaling pathway. ELISA, PCR and wb were used to evaluate the effect of JQP on AS-FLS activity and inflammatory factors. The role of NONHSAT227927.1/JAK2/STAT3 combination in inflammation was studied by editing NONHSAT227927.1 and adding the JAK2/STAT3 inhibitor AG490. Involvement of the JAK2/STAT3 pathway was detected by PCR, WB, or immunofluorescence analysis. Results: Retrospective data mining results show that JQP can effectively reduce the immune inflammatory response in AS patients. Through network pharmacology and molecular docking, it is speculated that JQP exerts its effect on AS through the JAK2/STAT3 pathway. Overexpression of NONHSAT227927.1 activated the JAK2/STAT3 pathway and promoted the expression of inflammatory factors, while serum containing JQP reversed the effects of NONHSAT227927.1 overexpression. NONHSAT227927.1 silencing inhibits the proliferation of AS-FLSs, inhibits the levels of inflammatory factors, and reduces the expression of JAK2/STAT3 protein. After adding the pathway blocker AG490, it was observed that the cell viability of AS-FLSs was reduced by inflammatory factors and the levels of JAK2/STAT3 were inhibited. , and overexpression of NONHSAT227927.1 can reverse this trend. Conclusions: JQP exerted an anti-inflammatory effect on AS by inhibiting the NONHSAT227927.1/JAK2/STAT3 axis.

FSGT capsule inhibits IL-1ß-induced inflammation in chondrocytes and ameliorates osteoarthritis by upregulating LncRNA PACER and downregulating COX2/PGE2.

OBJECTIVE: To explore the efficacy and potential mechanism of Fengshi Gutong capsule (FSGTC) in osteoarthritis (OA) inflammation. METHODS: The impact of FSGTC on laboratory indicators of OA patients was explored using data mining technology and association rule analysis. Then, the OA cell model was constructed by inducing chondrocytes (CHs) with interleukin-1ß (IL-1ß). In the presence of FSGTC intervention, the regulatory mechanism of PACER/COX2/PGE2 in OA-CH viability and inflammatory responses was evaluated. RESULTS: Retrospective data mining showed that FSGTC effectively reduced inflammation indexes (ESR, HCRP) of OA patients. Cell experiments showed that LncRNA PACER (PACER) silencing inhibited the proliferation activity of OA-CHs, increased the level of COX2 protein, elevated the levels of PGE2, TNF-α, and IL-1ß, and decreased the levels of IL-4 and IL-10 (p < .01). On the contrary, FSGTC-containing serum reversed the effect of PACER silencing on OA-CHs (p < .01). After the addition of COX2 pathway inhibitor, the proliferation activity of OA-CHs was enhanced; the levels of PGE2, TNF-α, and IL-1ß were decreased while the levels of IL-4 and IL-10 were increased (p < .01). CONCLUSION: FSGTC inhibits IL-1ß-induced inflammation in CHs and ameliorates OA by upregulating PACER and downregulating COX2/PGE2.

Left ventricular strain changes at high altitude in rats: a cardiac magnetic resonance tissue tracking imaging study.

BACKGROUND: Long-term exposure to a high altitude environment with low pressure and low oxygen could cause abnormalities in the structure and function of the heart. Myocardial strain is a sensitive indicator for assessing myocardial dysfunction, monitoring myocardial strain is of great significance for the early diagnosis and treatment of high altitude heart-related diseases. This study applies cardiac magnetic resonance tissue tracking technology (CMR-TT) to evaluate the changes in left ventricular myocardial function and structure in rats in high altitude environment. METHODS: 6-week-old male rats were randomized into plateau hypoxia rats (plateau group, n = 21) as the experimental group and plain rats (plain group, n = 10) as the control group. plateau group rats were transported from Chengdu (altitude: 360 m), a city in a plateau located in southwestern China, to the Qinghai-Tibet Plateau (altitude: 3850 m), Yushu, China, and then fed for 12 weeks there, while plain group rats were fed in Chengdu(altitude: 360 m), China. Using 7.0 T cardiac magnetic resonance (CMR) to evaluate the left ventricular ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV) and stroke volume (SV), as well as myocardial strain parameters including the peak global longitudinal (GLS), radial (GRS), and circumferential strain (GCS). The rats were euthanized and a myocardial biopsy was obtained after the magnetic resonance imaging scan. RESULTS: The plateau rats showed more lower left ventricular GLS and GRS (P < 0.05) than the plain rats. However, there was no statistically significant difference in left ventricular EDV, ESV, SV, EF and GCS compared to the plain rats (P > 0.05). CONCLUSIONS: After 12 weeks of exposure to high altitude low-pressure hypoxia environment, the left ventricular global strain was partially decreased and myocardium is damaged, while the whole heart ejection fraction was still preserved, the myocardial strain was more sensitive than the ejection fraction in monitoring cardiac function.

Evaluation of cardiac index and right ventricular hypertrophy index in rats under a chronic hypoxic environment at high altitude.

High-altitude areas are characterized by low pressure and hypoxia, which have a significant impact on various body systems. This study aimed to investigate the alterations in cardiac index and right ventricular hypertrophy index(RVHI) in rats at different altitudes.Twenty-one male Sprague-Dawley (SD) rats aged 4 weeks were randomly divided into three groups based on altitude. The rats were raised for 28 weeks and then transferred to Qinghai University Plateau Medicine Laboratory. Body weight was measured, heart organs were isolated and weighed, and cardiac index and right ventricular hypertrophy index were determined. Statistical analysis was performed on the data from the three groups. Compared with the plain group, the body weight of the middle-altitude group was significantly decreased (P < 0.05), and cardiac index, RVHI-1, RVHI-2 increased significantly ((P < 0.05). The body weight, whole heart mass, right ventricular mass were significantly decreased in high-altitude group (P < 0.05), RVHI-1 and RVHI-2 were significantly increased (P < 0.05). Compared with the middle-altitude group, the body weight, whole heart mass and right ventricular mass of the high-altitude group were significantly decreased (P < 0.05), and RVHI-1 and RVHI-2 were significantly increased (P < 0.05). Increasing altitude led to a decrease in body weight, whole heart mass, and right ventricular mass in rats, indicating structural changes in the right heart. Additionally, the proportion of right heart to body weight and whole heart increased with altitude.

Organic iontronic memristors for artificial synapses and bionic neuromorphic computing.

To tackle the current crisis of Moore's law, a sophisticated strategy entails the development of multistable memristors, bionic artificial synapses, logic circuits and brain-inspired neuromorphic computing. In comparison with conventional electronic systems, iontronic memristors offer greater potential for the manifestation of artificial intelligence and brain-machine interaction. Organic iontronic memristive materials (OIMs), which possess an organic backbone and exhibit stoichiometric ionic states, have emerged as pivotal contenders for the realization of high-performance bionic iontronic memristors. In this review, a comprehensive analysis of the progress and prospects of OIMs is presented, encompassing their inherent advantages, diverse types, synthesis methodologies, and wide-ranging applications in memristive devices. Predictably, the field of OIMs, as a rapidly developing research subject, presents an exciting opportunity for the development of highly efficient neuro-iontronic systems in areas such as in-sensor computing devices, artificial synapses, and human perception.

Triptolide alleviates the development of inflammation in ankylosing spondylitis via the NONHSAT227927.1/JAK2/STAT3 pathway.

Ankylosing spondylitis (AS) is a chronic inflammatory disease that can destroy the affected joints. Triptolide (TPL), a key active ingredient of the traditional Chinese medicine Tripterygium wilfordii exhibits promising efficacy in rheumatic immune disease with its anti-inflammatory effects. The present study aimed to elucidate the mechanism of TPL in treatment of AS by regulating the long non-coding RNA (lncRNA) NONHSAT227927.1. The role and underlying mechanisms of TPL in the development of inflammation in AS were assessed. In vivo, the expression of NONHSAT227927.1 in AS was detected by reverse transcription-quantitative (RT-q)PCR. Correlation analysis and binary logistic regression were performed between immune and inflammatory indicators, perception scale scores of patients and NONHSAT227927.1. In vitro, Cell Counting Kit-8 was used to evaluate the activity of AS-fibroblast-like synoviocytes (FLSs) following TPL exposure. AS-FLS inflammation was assessed by qPCR and ELISA. The interaction between TPL and JAK2 and STAT3 was verified by molecular docking and the JAK2/STAT3 pathway components were detected by western blotting. NONHSAT227927.1 was knocked down by small interfering RNA to determine its role. NONHSAT227927.1 was highly expressed in vivo and positively correlated with disease duration, disease duration, Body mass index (BMI), C-reactive protein (CRP), Visual analog scale (VAS), Visual analog scale (VAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Metrology Index, among which ESR and VAS and BASDAI score were risk factors for NONHSAT227927.1. TPL downregulated pro-inflammatory factors in AS-FLSs and inhibited the JAK2/STAT3 pathway via NONHSAT227927.1. TPL inhibited inflammatory factors in AS-FLSs and alleviated inflammatory responses via the NONHSAT227927.1/JAK2/STAT3 axis.

Evaluation of Myocardial Microcirculation in Rats under a High-Altitude Hypoxic Environment by Computed Tomography Myocardial Perfusion Imaging.

This study aims to examine the changes in myocardial microcirculation in rats in a high-altitude hypoxic environment via computed tomography (CT) myocardial perfusion imaging technology. Rats in two groups were raised in different environments from 4 weeks of age for a period of 24 weeks. At 28 weeks of age, both groups underwent CT myocardial perfusion scanning, and the following myocardial perfusion parameters were measured: time to peak (TTP), mean transit time (MTT), blood flow (BF), and blood volume (BV). Following the scan, the rats were sacrificed, the cardiac index and right ventricular hypertrophy index were obtained, and hematoxylin-eosin (HE) staining was utilized to observe the pathological changes in the myocardium. In the group of rats that are subject to a high-altitude hypoxic environment for 24 weeks (the high-altitude group), the TTP and MTT values were increased (P < 0.05), the BF and BV values were lower (P < 0.05), the right heart mass was higher (P < 0.05) than that in the low-altitude group. As shown by the pathological results of HE staining, the gap between cardiomyocytes in the high-altitude group was widened, the arrangement of cardiomyocytes was irregular, and the cells were filled with a few fat vacuoles. The myocardial microcirculation is altered in a high-altitude hypoxic environment. In particular, the myocardium is in a state of inadequate perfusion, the BF in the myocardium slows down, and the right heart displays compensatory hypertrophy.

LncRNA HOTAIR regulates the PI3K/AKT pathway via the miR-126-3p/PIK3R2 axis to participate in synovial angiogenesis in rheumatoid arthritis.

BACKGROUND: The abnormal expression of long noncoding RNA (LncRNA) HOTAIR has been associated with synovial angiogenesis in rheumatoid arthritis (RA). The aim of this study is to investigate whether LncRNA HOTAIR plays a role in synovial angiogenesis in RA by regulating the phosphoinositide 3-kinase/protein kinase B (PI3K/AKT) pathway through the miR-126-3p/PIK3R2 axis. METHODS: In this study, we conducted in vitro experiments by designing overexpression plasmids and small interfering RNAs targeting LncRNA HOTAIR and then transfected them into rheumatoid arthritis fibroblast-like synoviocytes (RA-FLS). We then co-cultured the RA-FLS with human umbilical vein endothelial cells (HUVEC) to establish a RA-FLS-induced HUVEC model. We investigated the effects of LncRNA HOTAIR on the proliferation, migration, lumen forming ability of HUVEC, as well as the expression of synovial endothelial cell markers, angiogenic factors, and the PI3K/AKT pathway. To validate the interactions between LncRNA HOTAIR, miR-126-3p, and PIK3R2, we used bioinformatics and luciferase reporter experiments. We also employed real-time fluorescence quantitative, Western blotanalysis, and immunofluorescence techniques to analyze the target genes and proteins. RESULTS: The expression of LncRNA HOTAIR was upregulated in HUVEC induced by RA-FLS. The overexpression of LncRNA HOTAIR significantly increased the expression of vascular endothelial growth factor, basic fibroblast growth factor, CD34, and CD105 in HUVEC, promoting their proliferation, migration, and lumen formation. At the same time, the overexpression of LncRNA HOTAIR inhibited the expression of miR-126-3p, promoted the expression of PIK3R2, activated the PI3K/AKT pathway, and promoted the expression of PI3K, AKT and phosphorylated-AKT, while the silence of LncRNA HOTAIR reversed these expressions. Bioinformatics and double luciferase reporter gene experiments confirmed the targeting relationship among LncRNA HOTAIR, miR-126-3p, and PIK3R2. Finally, the rescue experiments showed that PI3K agonists could reverse the inhibitory effect of silent LncRNA HOTAIR on HUVEC. CONCLUSION: LncRNA HOTAIR has the potential to activate the PI3K/AKT pathway, likely through the regulatory axis involving miR-126-3p/PIK3R2, consequently contributing to synovial angiogenesis in RA.

Deep residual-dense network based on bidirectional recurrent neural network for atrial fibrillation detection.

Atrial fibrillation easily leads to stroke, cerebral infarction and other complications, which will seriously harm the life and health of patients. Traditional deep learning methods have weak anti-interference and generalization ability. Therefore, we propose a new-fashioned deep residual-dense network via bidirectional recurrent neural network (RNN) model for atrial fibrillation detection. The combination of one-dimensional dense residual network and bidirectional RNN for atrial fibrillation detection simplifies the tedious feature extraction steps, and constructs the end-to-end neural network to achieve atrial fibrillation detection through data feature learning. Meanwhile, the attention mechanism is utilized to fuse the different features and extract the high-value information. The accuracy of the experimental results is 97.72%, the sensitivity and specificity are 93.09% and 98.71%, respectively compared with other methods.

Highly Efficient Luminescence from a Red Thermally Activated Delayed Fluorescence Emitter with Flexible Conformation of Ancillary Groups.

Robust scaffolds were typically applied in thermally activated delayed fluorescence (TADF) molecules to suppress the non-radiative decay, trigger the fast spin-flipping, and enhance the light out-coupling efficiency. Herein, we disclosed for the first time the positive effect of flexible conformation of ancillary groups on the photophysical properties of TADF emitter. The red TADF emitter Ph-TPA with flexible conformation demonstrated small excited-state structural distortion and low reorganization energy compared to the counterpart Mc-TPA with a rigid macrocycle. Consequently, Ph-TPA showed an excellent photoluminescent quantum yield (PLQY) of 92 % and a state-of-the-art external quantum efficiency (EQE) of 30.6 % at 630 nm. This work could deepen our understanding of structure-property relationships of organic luminophores and help us to rationalize the design of efficient TADF materials.

[Correlation between traditional Chinese medicine and reduced risk of readmission in rheumatoid arthritis patients with hypoproteinemia:a retrospective cohort study].

This study aimed to explore the correlation between traditional Chinese medicine(TCM) and reduced risk of readmission in patients having rheumatoid arthritis with hypoproteinemia(RA-H). A retrospective cohort study was conducted on 2 437 rheumatoid arthritis patients in the information system database of the First Affiliated Hospital of Anhui University of Chinese Medicine from 2014 to 2021, and 476 of them were found to have hypoproteinemia. The patients were divided into TCM users and non-TCM users by propensity score matching. Exposure was defined as the use of oral Chinese patent medicine or herbal decoction for ≥1 month. Cox regression analysis was performed to explore the risk factors of clinical indicators of rheumatoid arthritis. Additionally, the use of TCM during hospitalization was analyzed, and analysis of association rules was conducted to investigate the correlation between TCM, improvement of indicators and readmission of patients. Kaplan-Meier survival curve was plotted to compare the readmission rate of TCM users and non-TCM users. It was found the readmission rate of RA-H patients was significantly higher than that of RA patients. By propensity score matching, 232 RA-H patients were divided into TCM group(116 cases) and non-TCM group(116 cases). Compared with the conditions in the non-TCM group, the readmission rate of the TCM group was lowered(P<0.01), and the readmission rate of middle-aged and elderly patients was higher than that of young patients(P<0.01). Old age was a risk factor for readmission of RA-H patients, while TCM, albumin(ALB) and total protein(TP) were the protective factors. During hospitalization, the TCMs used for RA-H patients were mainly divided into types of activating blood and resolving stasis, relaxing sinew and dredging collaterals, clearing heat and detoxifying, and invigorating spleen and resolving dampness. The improvement of rheumatoid factor(RF), immunoglobulin G(IgG), erythrocyte sedimentation rate(ESR), C-reactive protein(CRP) and ALB was closely related to TCM. On the basis of western medicine treatment, the application of TCM could reduce the readmission rate of RA-H patients, and longer use of TCM indicated lower readmission rate.

Expression of long non­coding RNA NONHSAT227927.1 and its effect on the JAK2/STAT3 signaling pathway and inflammation in patients with ankylosing spondylitis.

Long non-coding RNAs (lncRNAs) assume pivotal roles in various autoimmune diseases including ankylosing spondylitis (AS). Inflammation affects the progression of multiple diseases. The current research aimed at dissecting out the possible role and mechanism of lncRNAs NONHSAT227927.1 in the pathogenesis of AS. In clinical trials, 50 patients with AS and 30 healthy persons were enrolled, followed by the extraction of peripheral blood mononuclear cells (PBMCs). NONHSAT227927.1 expression was detected using reverse transcription quantitative PCR. Enzyme-linked immunosorbent assay was used to determine the levels of inflammatory cytokines. Human fibroblast-like synoviocytes (FLSs) were induced by PBMC supernatant, after which the activity of FLSs was measured by Cell Counting Kit-8 and the signaling pathway were detected by western blotting. Cell migratory capacity was assessed by Transwell migration assay. NONHSAT227927.1 expression was obviously enhanced in the PBMCs of AS patients. NONHSAT227927.1 expression was positively correlated with immunoglobin A (IgA), erythrocyte sedimentation rate (ESR), complement C3 (C3), visual analog scale, IL-17, and IL-23 Levels but was negatively correlated with IL-10 level. The results of association rules showed that the increase of NONHSAT227927.1 expression was strongly associated with the elevation of IgA, C3, ESR, self-rating anxiety scale and IL-17 levels. Overexpression of NONHSAT227927.1 remarkably augmented the proliferation and migration of AS-PBMCs stimulated by AS-FLSs, facilitated the levels of IL-17 and IL-23, and reduced the IL-10 level. By contrast, NONHSAT227927.1 knockdown decreased cell proliferation and migration and cell viability as well as the levels of IL-17 and IL-23, but increased the level of IL-10. overexpression of NONHSAT227927.1 promoted the phosphorylation of JAK2 and STAT3 proteins, while knockout of NONHSAT227927.1 decreased their phosphorylation. Conclusively, lncRNA NONHSAT227927.1 was overexpressed in AS, which activated the JAK2/STAT3 signaling pathway to upregulate inflammatory factors.

Analysis of the changing trend of economic burden of patients with chronic diseases under the Integrated Medical and Health Service System.

BACKGROUND: Integrating medical resources is one of the explorations of medical mechanism reform to meet the needs of whole-cycle health management and is an important initiative in the current round of China's healthcare system reform. 2015 saw the construction of county medical communities to promote the balanced layout of medical resources, which opened a new exploration of the construction of an integrated healthcare service system in China. 2017 saw the promotion of the pilot construction of compact county medical communities in Zhejiang Province, China. OBJECTIVE: From the perspective of alleviating the financial burden on those in need of health services, the characteristics of chronic disease patients' access to health care and the composition and changing curve of the medical cost burden are analyzed to provide a basis for the construction path of an integrated health care service system. METHODS: A retrospective cohort study was conducted to select 5739 permanent residents who met the inclusion and exclusion criteria in Z town, H city, Zhejiang province. This population's health insurance utilization data from 2015 to 2018 were retrieved, and their average annual costs, cost composition, and health insurance payments were analyzed. RESULTS: The average annual growth rates of medical insurance and out-of-pocket costs before and after the implementation of the Medical Community were 12.85% and 9.72%, respectively. The increase narrowed significantly after the construction of the Medical Community, with the ringgit growth rate dropping to 2.73% in 2018. The top three medical expenses that accounted for the highest percentage were drug, consultation, and treatment fees. The frequency of visits to primary health care consulting hospitals has increased yearly. CONCLUSIONS: By implementing various measures to strengthen the grassroots level, patients' choice of primary care has increased year by year in the early stages of the construction of the Medical Community. From the perspective of cost control, strengthening the regulation of drugs and tests and restricting the use of high-value consumables can further reduce medical costs and ease their financial burden.

Carbon Nanodots Memristor: An Emerging Candidate toward Artificial Biosynapse and Human Sensory Perception System.

In the era of big data and artificial intelligence (AI), advanced data storage and processing technologies are in urgent demand. The innovative neuromorphic algorithm and hardware based on memristor devices hold a promise to break the von Neumann bottleneck. In recent years, carbon nanodots (CDs) have emerged as a new class of nano-carbon materials, which have attracted widespread attention in the applications of chemical sensors, bioimaging, and memristors. The focus of this review is to summarize the main advances of CDs-based memristors, and their state-of-the-art applications in artificial synapses, neuromorphic computing, and human sensory perception systems. The first step is to systematically introduce the synthetic methods of CDs and their derivatives, providing instructive guidance to prepare high-quality CDs with desired properties. Then, the structure-property relationship and resistive switching mechanism of CDs-based memristors are discussed in depth. The current challenges and prospects of memristor-based artificial synapses and neuromorphic computing are also presented. Moreover, this review outlines some promising application scenarios of CDs-based memristors, including neuromorphic sensors and vision, low-energy quantum computation, and human-machine collaboration.

Chinese herbal compound Huangqin Qingrechubi capsule reduces lipid metabolism disorder and inflammatory response in gouty arthritis via the LncRNA H19/APN/PI3K/AKT cascade.

CONTEXT: Gouty arthritis (GA) is a characteristically inflammatory disease often associated with lipid metabolism disorder. Huangqin Qingrechubi capsule (HQC) has been used for the treatment of GA. OBJECTIVE: To explore the mechanism of HQC in the treatment of GA. MATERIALS AND METHODS: A total of 30 GA patients (GA group) and 30 healthy subjects [normal control (NC) group] were recruited. The GA group was treated with HQC (3.6 g/d) for 10 days. Lipid metabolism and inflammation indexes were detected. Five herbal names of HQC, or 'gouty arthritis', 'hyperlipidemia' and 'inflammation' were used as key words to search related databases for network pharmacological analysis. Subsequently, GA-fibroblast-like synoviocytes (FLSs) were stimulated with GA-peripheral blood mononuclear cells (PBMCs) (3:1) and treated with HQC drug-containing serum (20%). RT-qPCR, Western blot, and ELISA were conducted to further explore the mechanism of HQC in improving GA. RESULTS: In clinical observation, HQC decreased the expression of lncRNA H19 and IL-1ß, and increased the expression of adiponectin (APN) and IL-4 in the GA group (about half). Through network pharmacology, the PI3K/AKT signaling pathway was identified. Cell experiments showed that HQC treatment reduced the viability of GA-FLSs (49.61%), up-regulated the expression of IL-4 (155.18%), IL-10 (165.13%), and APN (31.24%), and down-regulated the expression of lncRNA H19 (33.70%), IL-1ß (64.70%), TNF-α (78.32%), p-PI3K (48.80%), and p-AKT (53.48%). DISCUSSION AND CONCLUSIONS: HQC improved lipid metabolism disorder and inflammatory response of GA by regulating the lncRNA H19/APN/PI3K/AKT. Maintaining the stability of lipid metabolism may be an effective way to alleviate GA.

Clinical characteristics of venous thromboembolism onset from severe high altitude pulmonary edema in plateau regions.

BACKGROUND: To investigate venous thromboembolism (VTE) in hospitalized patients with severe high altitude pulmonary edema (HAPE), we performed a single center retrospective study to evaluate its clinical characteristics, prognosis, and potential thromboprophylaxis strategies in a large referral and treatment center in plateau regions. METHODS: We studied a total of 18 patients with severe HAPE from January 1, 2012 to December 31, 2021. Demographic and clinical data, laboratory data, including ultrasound scans of the lower extremities and cardiac ultrasound, and computed tomographic pulmonary angiography (CTPA) variables were obtained, and comparisons were made between groups with and without VTE. RESULTS: Of the 18 patients hospitalized with severe HAPE (age 43 (range, 34-54) years, 14 [77.8%] men), 7 patients developed VTE (38.9%), including 5 with deep vein thrombosis (DVT) and pulmonary embolism (PE), 2 of whom had DVT only. Eighteen patients are all firstly rapid ascent to high altitudes which the mean altitude was 3700 m (3656-4050 m). Compared with patients who did not have VTE, patients with VTE had a longer time in hospital (13 [11, 19] versus 9 [7, 12]; P = 0.027), respiratory failure (6 [85.7%] versus 2 [18.2%]; P = 0.013), the shortened APTT (21.50 [19.00, 27.50] versus 26.30 [24.80, 30.10]; P = 0.044) and the higher level of D-dimer (7.81 [4.62, 9.60] versus 2.90 [1.75, 3.37]; P = 0.003). The proportion of thromboprophylaxis is too low in our cohort which 2 of 18 (11.1%) patients were given VTE prophylaxis. There was no statistically significant difference between the VTE and non-VTE groups (0 [0.0%] versus 2 [18.2%]; P = 0.497). CONCLUSIONS: The prevalence of VTE is high in hospitalized patients with severe high altitude pulmonary edema (HAPE). Prophylaxis for venous thromboembolism may be protective in severe HAPE patients after admission. Our data seem to suggest that VTE is probably an additional prognostic factors in patients with severe HAPE.

Regulation of autophagy by circular RNAs in rheumatoid arthritis: Potential targets of action.

Previous studies have shown that autophagic pathogenesis of rheumatoid arthritis (RA) is regulated by circular RNAs (circRNAs), which accelerate bone damage by participating in the immune inflammatory response. Therefore, exploring the mechanisms underlying circRNA regulation of autophagy is essential for maintaining homeostasis of the skeletal microenvironment in RA and may improve our understanding of the specific pathways involved in the development of therapeutics. In this review, we discuss autophagic imbalance in RA and the regulatory mechanisms of circRNAs. We also explore possible targets for circRNA regulation of autophagy in RA, which may provide us with improved knowledge regarding the pathogenesis of RA.