Comparative analysis of key precursors and metabolites involved in flavor formation of different rapid-fermented Chinese fish sauces based on untargeted metabolomics analysis.

Our study aimed to characterize the flavor precursors and metabolite profiles during fermentation of three rapid-fermented fish sauces (koji fermentation (YQ), insulation fermentation with koji (BWQ) and insulation fermentation with enzyme (BWE)) by a comparative metabolomics analysis. The total amount of free amino acids and free fatty acids in BWQ and BWE samples was significantly higher than that in YQ sample during fermentation, and C16:0, C22:6, C18:1, C14:1, C18:0 and C20:5 were deemed as key flavor precursors of three fish sauces. We identified 51, 47 and 45 differential metabolites as crucial components in YQ, BWE and BWQ samples. Specific metabolites in three samples were mainly related to amino acid metabolism, especially histidine, cysteine and methionine metabolism. Furthermore, 5 bacteria genera exhibited positive impacts on the generation of various flavor-related metabolites. This study provides a theoretical basis for targeted control of flavor and quality in the production of rapid-fermented fish sauce.

A new multi-parameter imaging platform for in vivo drug efficacy evaluation of ischemic stroke.

Ischemic stroke with high incidence and disability rate severely endangers human health. Current clinical treatment strategies are quite limited, new drugs for ischemic stroke are urgently needed. However, most existing methods for the efficacy evaluation of new drugs possess deficiencies of divorcing from the true biological context, single detection indicator and complex operations, leading to evaluation biases and delaying drug development process. In this work, leveraging the advantages of fluorescence imaging with non-invasive, real-time, in-situ, high selectivity and high sensitivity, a new multi-parameter simultaneous fluorescence imaging platform (MPSFL-Platform) based on two fluorescence materials was constructed to evaluate the efficacy of new drug for ischemic stroke. Through simultaneous fluorescence observing three key indicators of ischemic stroke, malondialdehyde (MDA), formaldehyde (FA), and monoamine oxidase A (MAO-A), the efficacy evaluations of three drugs for ischemic stroke were real-time and in-situ performed. Compared with edaravone and butylphthalide, edaravone dexborneol exhibited better therapeutic effect by using MPSFL-Platform. The successful establishment of MPSFL-Platform is serviceable to accelerate the conduction of preclinical trial and the exploration of pathophysiology mechanism for drugs related to ischemic stroke and other brain diseases, which is perspective to promote the efficiency of new drug development.

Alterations of gut microbiota and its correlation with the liver metabolome in the process of ameliorating Parkinson's disease with Buyang Huanwu decoction.

ETHNOPHARMACOLOGICAL RELEVANCE: Buyang Huanwu decoction (BHD), a famous traditional Chinese medicine (TCM) formula, was first recorded in Qing Dynasty physician Qingren Wang's Yi Lin Gai Cuo. BHD has been widely utilized in the treatment of patients with neurological disorders, including Parkinson's disease (PD). However, the underlying mechanism has not been fully elucidated. In particular, little is known about the role of gut microbiota. AIM OF THE STUDY: We aimed to reveal the alterations and functions of gut microbiota and its correlation with the liver metabolome in the process of improving PD with BHD. MATERIALS AND METHODS: The cecal contents were collected from PD mice treated with or without BHD. 16S rRNA gene sequencing was performed on an Illumina MiSeq-PE250 platform, and the ecological structure, dominant taxa, co-occurrence patterns, and function prediction of the gut microbial community were analyzed by multivariate statistical methods. The correlation between differential microbial communities in the gut and differentially accumulated metabolites in the liver was analyzed using Spearman's correlation analysis. RESULTS: The abundance of Butyricimonas, Christensenellaceae, Coprococcus, Peptococcaceae, Odoribacteraceae, and Roseburia was altered significantly in the model group, which was by BHD. Ten genera, namely Dorea, unclassified_Lachnospiraceae, Oscillospira, unidentified_Ruminococcaceae, unclassified_Clostridiales, unidentified_Clostridiales, Bacteroides, unclassified_Prevotellaceae, unidentified_Rikenellaceae, and unidentified_S24-7, were identified as key bacterial communities. According to the function prediction of differential genera, the mRNA surveillance pathway might be a target of BHD. Integrated analysis of gut microbiota and the liver metabolome revealed that several gut microbiota genera such as Parabacteroides, Ochrobactrum, Acinetobacter, Clostridium, and Halomonas, were positively or negatively correlated with some nervous system-related metabolites, such as L-carnitine, L-pyroglutamic acid, oleic acid, and taurine. CONCLUSIONS: Gut microbiota might be a target of BHD in the process of ameliorating PD. Our findings provide novel insight into the mechanisms underlying the effects of BHD on PD and contribute to the development of TCM.

Pharmacodynamics and pharmacological mechanism of Moluodan concentrated pill in the treatment of atrophic gastritis: A network pharmacological study and in vivo experiments.

ETHNOPHARMACOLOGICAL RELEVANCE: Moluodan concentrated pill (MLD) is a traditional herbal formula used in China for the treatment of chronic atrophic gastritis (CAG). However, its pharmacological mechanism of action remains unclear. AIM OF THE STUDY: The aim of this study was to investigate the therapeutic effect and mechanism of action of MLD in the treatment of CAG using network pharmacology and in vivo experiments. MATERIALS AND METHODS: The active compounds of MLD were determined using network pharmacology, utilizing various Chinese medicine databases such as the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform, Traditional Chinese Medicine Integrated Database, Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine, and a comprehensive database of Traditional Chinese Medicine on Immuno-Oncology. The compounds found in the root of Anemone altaica Fisch. were extracted from the China National Knowledge Infrastructure literature database. Additionally, the Swiss Target Prediction database and Similarity Ensemble Approach were employed to identify the potential targets of these components. CAG-related targets were gathered from the GeneCards and DisGeNET databases. Protein-protein interactions (PPIs) of the genes associated with the drug-disease crossover were examined, and a core PPI network was constructed using the STRING database (version 11.5) and Cytoscape (version 3.7.2). A gene-pathway network was established to identify significant target genes and pathways through Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. Finally, based on these findings and existing data, the tumor necrosis factor (TNF) signaling pathway was selected for further validation through in vivo experiments. RESULTS: A total of 724 active molecules in MLD yielded 961 identified target genes, of which 179 were found to be potentially associated with CAG. From the common targets, a PPI network revealed ten core targets. Enrichment analysis suggested that MLD may primarily target TNF and AKT in the treatment of CAG. Essential signaling pathways, such as the PI3K-AKT and TNF pathways, were found to be crucial for the therapeutic effects of MLD on CAG. Furthermore, potential interactions and crosstalk between these pathways were identified. Moreover, we confirmed that MLD effectively improved gastric mucosa atrophy and cellular ultrastructural damage, while increasing pepsinogen secretion and decreasing gastrin, somatostatin, and motilin levels. Subsequent molecular biology studies in rat models of CAG demonstrated that MLD treatment significantly reduced the expression levels of TNF-α, phosphatidylinositol 3'-kinase (PI3K), and phosphorylated Akt (P < 0.05). Notably, the expression of nuclear factor kappa-B (NF-κB) exhibited a contrasting trend (P < 0.05), potentially associated with the crucial tumor suppressor role of NF-κB p105. CONCLUSION: This study provides evidence that MLD effectively alleviates stomach mucosal atrophy through modulation of the TNF/PI3K/AKT signaling pathway. These findings establish a solid theoretical foundation for the practical management of CAG.

Lipopolysaccharides from a Shiraia fruiting body-associated bacterium elicit host fungal hypocrellin A biosynthesis through nitric oxide generation.

Hypocrellin A (HA) is an excellent perylenequinone photosensitizer from Shiraia fruiting bodies. A dominant bacterium Pseudomonas fulva SB1 in the fruiting body was found to promote HA biosynthesis. The bacterial LPS were purified and the O-specific polysaccharide (OPS) consisted of rhamnose (Rha), galactose (Gal) and N-acetyl-galactosamine (GalNAc) with an average molecular weight of 282.8 kDa. Although the OPS composing of Rhap and Galp backbone showed elicitation capability on fungal HA accumulation, the highest HA production (303.76 mg/L) was achieved by LPS treatment at 20 µg/mL on day 3 of the mycelium culture. The generation of nitric oxide (NO) in Shiraia mycelia was triggered by LPS, which was partially blocked by inhibitors of nitric oxide synthase (NOS) and nitrate reductase (NR), leading to the depressed HA production. Transcriptome analysis revealed that NO mediated LPS-induced HA production via upregulating the expressions of critical genes associated with central carbon metabolism and downstream HA biosynthesis genes. This is the first report of LPS-induced NO to regulate fungal secondary metabolite production, which provides new insights on the role of bacterial LPS in bacterium-fungus interactions and an effective strategy to enhance hypocrellin production.

Comparative metabolome profiling of Paris polyphylla var. yunnanensis cultivars and Paris luquanensis and their biological activity in zebrafish model.

ETHNOPHARMACOLOGICAL RELEVANCE: Paris polyphylla var. Yunnanensis (Franch.) Hand.-Mazz., a perennial medicinal herb commonly known as "Chonglou" in Chinese, is mainly effective against innominate toxin swelling, insect sting, snake bite, traumatic injuries and various inflammatory. It is also recorded with mild toxicity. The rare species Paris luquanensis H. Li has been also used as folk medicine in Yunnan province for the same effects. Compared with P. polyphylla var. Yunnanensis (35-100 cm in height), this species has variegated leaves, and grows slower and is therefore shorter (6-23 cm in height). There are a number of different cultivars based on the shape of the petal and the height of Paris plant. However, currently, investigations into the differences of the chemical profiling of these cultivars are lacking. AIM OF THE STUDY: This study aims to: (1) examine metabolites variations in Paris polyphylla var. Yunnanensis cultivars and Paris luquanensis; (2) investigate the different metabolite accumulation patterns between rhizomes and leaves and provide more useful information for the application of P. polyphylla var. Yunnanensis leaves; (3) compare in vivo effects on the recruitment of reactive oxygen species (ROS) and Neutrophils and toxic effects in zebrafish model between leaves and rhizomes of P. polyphylla var. Yunnanensis and P. luquanensis. MATERIALS AND METHODS: The change patterns of metabolites in the leaves and rhizomes of four P. polyphylla var. Yunnanensis cultivars and one P. luquanensis cultivar were analyzed using an UPLC-ESI-MS/MS system. The total phenolic acid, total flavonoid, total saponin components and in vitro antioxidant activities were determined by spectrophotometric methods. The in vivo toxicity and their effects on the recruitment of ROS and neutrophils in zebrafish model were performed. RESULTS: The widely targeted metabolomics method detected 695 metabolites in tested samples and classified as 15 known classes according to structures of the metabolites. By overall-comparing the SDMs discerned between leaves and rhizomes of each samples, 161 metabolites were substantially altered in all the cultivars. There are 62 and 64 SDMs showing constitutive differential accumulation between leaves and rhizomes of P. polyphylla var. Yunnanensis (samples A-D) and P. luquanensis (sample E), respectively. The levels of TSC, TPC and TFC decreased significantly in leaves as compared to rhizomes for all cultivars, with the exception of TPC in cultivar A, which is almost the same in leave and rhizome. The DPPH scavenging property and FRAP values of rhizomes are higher than those of leaves for all cultivars. However, there is no distinct different between leaves and rhizomes of different sample extracts for in vivo effects on the recruitment of ROS and neutrophils in zebrafish model. BL extracts showed high toxicity to the developing embryos. CONCLUSION: As far as we are concerned, this study analyzes the P. polyphylla var. Yunnanensis and P. luquanensis variegation from the perspective of the metabolites pattern for the first time. The results give a valuable insight into the specie metabolic profiling and in vivo anti-oxidant, anti-inflammatory and toxic effects of these Paris plants.

Quantitative proteomics based bioactive proteins discovery and quality control of medicinal leeches.

ETHNOPHARMACOLOGICAL RELEVANCE: Leech, a classical traditional Chinese medicine for promoting blood circulation and removing blood stasis, is mainly used in the clinical treatment of cardiovascular and cerebrovascular diseases. The discovery of activity proteins or peptides in the dead and dried medicinal leech is an important task with great challenges. AIM OF THE STUDY: The aim of this study was to provide a basic proteome profile and help further discover active proteins and quality control for medicinal leeches, which would also provide insight into the research of animal medicines. MATERIALS AND METHODS: Seventeen batches of dried medicinal leeches covering three species were collected from medicinal markets, which were authenticated by DNA barcoding. Then the proteome of different species leeches was profiled to reveal the significantly different proteins using label-free proteomics. The characteristic peptides were screened out based on biological pathways analysis, which were further absolutely quantified using the developed stable isotope-labeled based parallel reaction monitoring method. RESULTS: Seventeen batches of leech materials were Whitmania pigra Whitman (WP), Whitmania laevis Whitman (WL) and Poecilobdella manillensis Lesson (PM), respectively. A total of 1,035 proteins (452 in WP, 425 in WL and 158 in PM) were identified. Among them, 90 overlapping proteins were mainly concentrated in diverse metabolic pathways and primarily localized in the cytoplasm and mitochondrial inner membrane, which mainly related to ATP binding, catalytic activity and structural molecular activity. In total of 51 uniquely expressed proteins (21 in WP, 23 in WL and 7 in PM), associated with multiple key signaling pathways, including Rap1, cGMP-PKG, PI3K-Akt, Wnt and HIF-1, etc., relevant to treating cardiovascular diseases, diabetes, cancer and even a variety of neurodegenerative diseases. Three proteins with potential bioactivities, including Neurohemerythrin, Hirudin and Eglin C, were selected as the quality makers and then quantified based on the characteristic peptides. CONCLUSIONS: This work profiled the proteome of three species of leeches, and addressed potential active proteins of the medicinal leech, which would help to provide the potential molecular mechanisms involved in disease treatment. The proteomics-based approach developed in this work is not only useful for the discovery of proteins with potential bioactivities but also helpful for the bioactivity relevant quality control of animal medicines.

Effects of vegetation roots on the structure and hydraulic properties of soils: A perspective review.

This paper aims to provide a state-of-the-art review on the effects of vegetation roots on the soil structure and soil hydraulic properties. After a thorough review of current studies, the effects of vegetation roots are summarized into four: root exudation, root penetration, root water uptake and root decay. Root exudates alter the size and stability of aggregates, the contact angle of soil, and the viscosity and surface tension of pore fluid; root exudates of crops always increase the soil water retention capacity and decrease the soil saturated hydraulic conductivity. Root penetration creates new pores or clogs existing pores during root growth, and root parameters (e.g., root biomass density, root diameter and root length density) are well correlated to soil hydraulic properties. Root water uptake can apparently increase the soil water retention capacity by providing an additional negative pressure and induce micro-fissures and macropores in the rhizosphere soil. Root decay modifies the pore structure and water repellency of soil, resulting in the increase of soil macro-porosity, soil water retention, and the saturated hydraulic conductivity or steady infiltration rate. Some of the above four effects may be difficult to be distinguished, and most importantly each is highly time-dependent and influenced by a multitude of plant-related and soil-related factors. Therefore, it remains a significant challenge to comprehend and quantify the effects of vegetation roots on the soil structure and soil hydraulic properties. Unsolved questions and disputes that require further investigations in the future are summarized in this review.

Fibrous whey protein mediated homogeneous and soft-textured emulsion gels for elderly: Enhancement of bioaccessibility for curcumin.

Homogeneous and soft-textured food gels are critical for designing precise and personalized nutrient food for elderly. Effects of whey protein morphology (fibrous and granular) with/without NaCl addition on oil-water state and texture properties of protein emulsion gels were investigated, to explore the feasibility of developing homogeneous and soft-textured food for elderly. Lower gelation temperature and higher stability of its emulsion droplets, resulted in fibrous whey protein emulsion gels (FWPG) had even distribution of embedded oil droplets, compared to native whey protein emulsion gels. FWPG had the lowest hardness and chewiness, and exhibited better tolerance to the harden effects of NaCl on emulsion gels. FWPG can deliver curcumin more effectively during simulated gastrointestinal digestion, as evidenced by higher retention ratio and enhancement of bioaccessibility (increased by âˆ¼ 20 %). This study provided new strategy to fabricate a homogenous emulsion gel using fibrous whey protein and to design multi-nutrient food gels for elderly.

Removal and recovery of phosphate by modified oyster shell and its fertilizer application.

The resource utilization of oyster shell (OS) is essential for environmental and human health because its random disposal can induce the environmental pollution and disease spread. Herein, MnFe2O4 loaded-oyster shell (OMFs) was prepared by co-precipitation method for phosphate removal and recovery. The salt etching and MnFe2O4 (MF) loading improved the adsorption performance of OS, and the maximum adsorption capacity of OMF0.02 reached 87.39 mg P/g. Phosphate adsorption was dominated by chemisorption and its rate was limited by membrane diffusion and intra-particle diffusion. Phosphate adsorption by OMF0.02 was involved with electrostatic attraction, surface precipitation and ligand exchange. 98.95 % phosphate on saturated adsorbent could be desorbed by 0.1 mol/L malic acid and 92.31 % adsorbed phosphate was released by 0.5 mol/L NaHCO3. Furthermore, phosphate adsorbed on OMF0.02 was plant-available basing on the results of water spinach growth trial. All the results implied the bright prospect of OMF0.02 in phosphate removal and recovery from wastewater.

Biodegradation of sulfadiazine by ryegrass (Lolium perenne L.) in a soil system: Analysis of detoxification mechanisms, transcriptome, and bacterial communities.

The indiscriminate use of sulfadiazine has caused severe harm to the environment, and biodegradation is a viable method for the removal of sulfadiazine. However, there are few studies that consider sulfadiazine biodegradation mechanisms. To comprehensively investigate the process of sulfadiazine biodegradation by plants in a soil system, a potted system that included ryegrass and soil was constructed in this study. The removal of sulfadiazine from the system was found to be greater than 95% by determining the sulfadiazine residue. During the sulfadiazine removal process, a significant decrease in ryegrass growth and a significant increase in antioxidant enzyme activity were observed, which indicates the toxic response and detoxification mechanism of sulfadiazine on ryegrass. The ryegrass transcriptome and soil bacterial communities were further investigated. These results revealed that most of the differentially expressed genes (DEGs) were enriched in the CYP450 enzyme family and phenylpropanoid biosynthesis pathway after sulfadiazine exposure. The expression of these genes was significantly upregulated. Sulfadiazine significantly increased the abundance of Vicinamibacteraceae, RB41, Ramlibacter, and Microvirga in the soil. These key genes and bacteria play an important role in sulfadiazine biodegradation. Through network analysis of the relationship between the DEGs and soil bacteria, it was found that many soil bacteria promote the expression of plant metabolic genes. This mutual promotion enhanced the sulfadiazine biodegradation in the soil system. This study demonstrated that this pot system could substantially remove sulfadiazine and elucidated the biodegradation mechanism through changes in plants and soil bacteria.

Hg2+ detection and information encryption of new [1+1] lanthanide cluster.

The sensing of heavy metal ion and information encryption are two very important research areas. Therefore, developing multi-functional materials capable of sensing heavy metal ions and encrypting information is highly important. In this work, three [1 + 1] lanthanide clusters [Ln(TFBA)3(dmp) (H2O)2]2 (Ln = Tb3+Tb1+1, Eu3+Eu1+1, Gd3+Gd1+1, HTFBA = 2,3,4,5-tetrafluorobenzoic acid, dmp = 4,7-dimethyl-1,10-phenanthroline) were designed and synthesized. Among them, Tb1+1 shows excellent luminescence sensing towards Hg2+ (Ex = 350 nm, Em = 545 nm). Results demonstrates the sensing with high selectivity, strong anti-interference, 20-s response time, high accuracy, excellent linear relationship in 0-20.0 µM, and a very low limit of detection (0.02 ppb). Furthermore, paper strips based on Tb1+1 is fabricated for visual detection of Hg2+ in real samples of tap water, lake water, human urine, and human serum. More interestingly, a new method for confidentiality of information is realized through multi-color anti-counterfeiting patterns with the [1 + 1] lanthanide cluster ink, based on the luminescence "on-off" sensing towards Hg2+.

Increased brain nucleus accumbens functional connectivity in melancholic depression.

BACKGROUND: Melancholic depression, marked by typical symptoms of anhedonia, is regarded as a homogeneous subtype of major depressive disorder (MDD). However, little attention was paid to underlying mechanisms of melancholic depression. This study aims to examine functional connectivity of the reward circuit associated with anhedonia symptoms in melancholic depression. METHODS: Fifty-nine patients with first-episode drug- naive MDD, including 31 melancholic patients and 28 non-melancholic patients, were recruited and underwent resting-state functional magnetic resonance imaging (rs-fMRI). Thirty-two healthy volunteers were recruited as controls. Bilateral nucleus accumbens (NAc) were selected as seed points to form functional NAc network. Then support vector machine (SVM) was used to distinguish melancholic patients from non-melancholic patients. RESULTS: Relative to non-melancholic patients, melancholic patients displayed increased functional connectivity (FC) between bilateral NAc and right middle frontal gyrus (MFG) and between right NAc and left cerebellum lobule VIII. Compared to healthy controls, melancholic patients showed increased FC between right NAc and right lingual gyrus and between left NAc and left postcentral gyrus; non-melancholic patients had increased FC between bilateral NAc and right lingual gyrus. No significant correlations were observed between altered FC and clinical variables in melancholic patients. SVM results showed that FC between left NAc and right MFG could accurately distinguish melancholic patients from non-melancholic patients. CONCLUSION: Melancholic depression exhibited different patterns of functional connectivity of the reward circuit relative to non-melancholic patients. This study highlights the significance of the reward circuit in the neuropathology of melancholic depression.

Mechanism of PARP inhibitor resistance and potential overcoming strategies.

PARP inhibitors (PARPi) are a kind of cancer therapy that targets poly (ADP-ribose) polymerase. PARPi is the first clinically approved drug to exert synthetic lethality by obstructing the DNA single-strand break repair process. Despite the significant therapeutic effect in patients with homologous recombination (HR) repair deficiency, innate and acquired resistance to PARPi is a main challenge in the clinic. In this review, we mainly discussed the underlying mechanisms of PARPi resistance and summarized the promising solutions to overcome PARPi resistance, aiming at extending PARPi application and improving patient outcomes.

FHUSP-NET: A Multi-task model for fetal heart ultrasound standard plane recognition and key anatomical structures detection.

In prenatal ultrasound screening, rapid and accurate recognition of the fetal heart ultrasound standard planes(FHUSPs) can more objectively predict fetal heart growth. However, the small size and movement of the fetal heart make this process more difficult. Therefore, we design a deep learning-based FHUSP recognition network (FHUSP-NET), which can automatically recognize the five FHUSPs and detect tiny key anatomical structures at the same time. 3360 ultrasound images of five FHUSPs from 1300 mid-pregnancy pregnant women are included in this study. 10 fetal heart key anatomical structures are manually annotated by experts. We apply spatial pyramid pooling with a fully connected spatial pyramid convolution module to capture information about targets and scenes of different sizes as well as improve the perceptual ability and feature representation of the model. Additionally, we adopt the squeeze-and-excitation networks to improve the sensitivity of the model to the channel features. We also introduce a new loss function, the efficient IOU loss, which makes the model effective for optimizing similarity. The results demonstrate the superiority of FHUSP-NET in detecting fetal heart key anatomical structures and recognizing FHUSPs. In the detection task, the value of mAP@0.5, precision, and recall are 0.955, 0.958, and 0.931, respectively, while the accuracy reaches 0.964 in the recognition task. Furthermore, it takes only 13.6 ms to detect and recognize one FHUSP image. This method helps to improve ultrasonographers' quality control of the fetal heart ultrasound standard plane and aids in the identification of fetal heart structures in a less experienced group of physicians.

Study on the difference and regularity of tongue images in 309 patients with different pathological stages of non-small cell lung cancer.

BACKGROUND: Tongue diagnosis is a crucial traditional Chinese medicine (TCM) inspection method for TCM syndrome differentiation and treatment. OBJECTIVE: The primary research focus was on tongue image characteristic parameters of patients with non-small cell lung cancer (NSCLC). Analysis of the tongue image parameters of various pathological stages of NSCLC provides technical support for establishing an integrated Chinese and Western auxiliary diagnosis and efficacy evaluation medicine system for lung cancer that integrates tongue image features. METHODS: Tongue image characteristics of 309 patients with NSCLC and 206 controls were collected and analyzed clinically. The T-test or rank sum test and logistic regression analysis were applied to analyze the characteristics of tongue image indicators of different pathological stages of NSCLC. RESULTS: There were differences in tongue image characteristics in the NSCLC group compared to the control group. The tongue quality and brightness of the tongue coating in the NSCLC group increased, the red component was reduced, the tongue coating thickened, and the yellow component increased compared to the healthy control group. A comparison of tongue image indexes of NSCLC in different pathological stages showed that stage IV had lower TB-b and higher TB-a than stage I. In addition, stage IV had lower TB-b than stage II + III, showing an increase in the blue and red components of the tongue in stage IV and the appearance of cyanotic tongue features. CONCLUSION: The tongue image characteristics of NSCLC patients differed from those of the control group. Tongue imaging indicators can reflect the characteristics of tongue images of patients with NSCLC. The tongue image characteristics of patients with stage IV lung cancer are bluish and purple compared with those with stage I, II, and III. It is suggested that the tongue's image characteristics can be used as a reference for the pathological classification of NSCLC and judgment of the disease process.

Individual-Level Health Care Costs Attributable to Noncommunicable Diseases: A Longitudinal Study Based on the Older Adults in China.

Noncommunicable chronic diseases among the elderly population represent a significant economic burden in China. However, previous disease-related health cost studies lacked representation of older adults and comparability of the burden of multiple chronic diseases. The objective of this study was to determine the fraction of health care costs attributable to the 6 most prevalent chronic diseases and comorbidities in the sample of older adults. This study employed data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), with 3 waves in 2011, 2014, and 2018, and included 18 349 observations in total. Outpatient costs, inpatient costs, and total health care costs were included in this study. Based on a 2-part random effects model, the effect of chronic disease on health service utilization was first explored by constructing a dummy variable for whether or not to utilize health care, followed by estimation of attributable costs in the population with health care utilization. Among the older adults in the sample, hypertension, heart disease, cataracts, arthritis, stroke or Cerebrovascular disease (CVD) and chronic lung disease are the 6 most prevalent chronic conditions. The costs attributable to the 6 chronic diseases mentioned above were 36.00% of outpatient costs, 55.92% of inpatient costs, and 45.05% of total health care costs for older adults. Of these, heart disease, stroke or CVD, and chronic lung disease accounted for 22.11%, 13.24%, and 10.56% of total health care costs, respectively. Moreover, the proportion of health care costs attributable to chronic diseases was higher for older adults who were male, lived in urban areas, and had a lower level of education. The proportion of health care costs attributable to chronic diseases is substantial among older adults in China. Health care costs associated with chronic diseases can be decreased with well-targeted interventions and comprehensive access to health services.

Maternal Prenatal Depressive Symptoms and Fetal Growth During the Critical Rapid Growth Stage.

Importance: Fetal growth in the critical rapid growth stage (CRGS) before delivery, approximately between 30 to 37 gestational weeks, carries significant implications for subsequent overweight, obesity, and arterial health. Previous evidence has demonstrated the association between maternal depressive symptoms and fetal growth trajectories from early to late pregnancy, but there remains limited understanding of the association of these symptoms with the longitudinal fetal growth change within the CRGS. Objective: To investigate the association between maternal depressive symptoms and fetal growth during the CRGS before delivery. Design, Setting, and Participants: This prospective birth cohort study was conducted from January 2018 to December 2020. Volunteer pregnant women were enrolled in their first trimester of prenatal visits. Women with severe disease before pregnancy and multiple births, fetuses with congenital anomalies, and preterm or postterm births were excluded. This multicenter study was based in 13 hospitals covering 81 counties across 12 cities in Sichuan Province, China. Follow-up visits were performed at the second trimester, the third trimester, and 24 hours after delivery. The analysis was conducted from January to May 2023. Exposures: Maternal depressive symptoms, as a continuous variable, measured by the Edinburgh Postpartum Depression Scale (EPDS) at a median gestational week of 24 (range, 14 to 27) weeks of gestation. A higher score on the EPDS indicates worse depressive symptoms. Main Outcomes and Measures: The main outcomes included ultrasonography-measured biparietal diameter (BPD), femur length (FL), and abdominal circumference (AC), along with calculated estimated fetal weight (EFW). These parameters were evaluated longitudinally at a median gestational week of 30 (range, 28 to 32) and 37 (range, 35 to 39) weeks. Linear mixed models were used to estimate the associations between maternal depressive symptoms and fetal growth parameters. Results: A total of 2676 mother-offspring dyads were included, in which the mean (SD) age of mothers was 28.0 (4.4) years, and 1294 (48.4%) of the offspring were female. The median (IQR) maternal EPDS score was 5.0 (4.0 to 9.0). After adjustment for confounders, a significant correlation was found between a higher score of depressive symptoms in mothers and a slower rate of fetal growth across FL (ß = -0.40; 95% CI, -0.58 to -0.22), AC (ß = -1.97; 95% CI, -2.90 to -1.03), and EFW (ß = -50.11; 95% CI, -68.46 to -31.75). These associations were stronger in female fetuses or those with better family socioeconomic conditions. Conclusions and Relevance: In this prospective cohort study, maternal depressive symptoms were associated with slower fetal growth rate in the CRGS before delivery. Early screening for depressive disorders in pregnant women appears to be essential for fetal growth and later health.