Marital Status as a Moderator:Exploring the Relationship between Social Engagement and Depressive Symptoms in China’s Older Adult Population

Objective This study aims to explore the complex relationship between social engagement and depressive symptoms among older adults in China,focusing particularly on the moderating role of marital status.Methods This study used data from the latest Chinese Longitudinal Healthy Longevity Survey(CLHLS).The analysis used the latent class analysis to delineate personality clusters and hierarchical linear regression,supplemented by the PROCESS macro,to investigate the effects of social engagement and marital status on depressive symptoms.Results The analysis encompassed 7,789 respondents(mean age:82.53[s=11.20]years),with 54%female.The personality analysis categorized participants into four clusters,with the majority(77.60%)classified as Confident Idealists,who exhibited the lowest levels of depressive symptoms.Hierarchical linear regression analysis yielded several significant findings:Higher levels of social engagement were significantly associated with fewer depressive symptoms(t=-7.932,P<0.001,B=-0.463).Marital status was a significant factor;married individuals reported fewer depressive symptoms compared to their unmarried counterparts(t=-6.368,P<0.001,B=-0.750).There was a significant moderating effect of marital status on the relationship between social engagement and depressive symptoms(t=-2.092,P=0.037,B=-0.217).Conclusion This study demonstrates that,among Chinese older adults,both social engagement and marital status significantly influence depressive symptoms.Higher social engagement,particularly in other activities like doing household chores,gardening,reading newspapers or books,and playing cards or Mahjong,is associated with fewer depressive symptoms,especially among married individuals.

膳食模式与动脉粥样硬化关系的多种族研究

目的人们对膳食模式、代谢紊乱与左心室功能的关系研究报道不多,本研究旨在探讨膳食模式和左心室功能之间的关系以及代谢紊乱与动脉粥样硬化的关系。方法膳食模式采用降秩回归(reduced rankregression,RRR)方法构建;左室重量、心搏量和左室射血分数采用磁共振成像测量;膳食模式和左室指数之间的关系采用横断面分析法。结果选用4 601例45～84岁、无临床心血管疾病受试者,RRR膳食模式得分数与高血糖指数、高脂肉类、奶酪、加工食品的摄入量呈正相关,而与蔬菜、大豆、水果、绿茶、黑茶、低脂甜点、种子、坚果和鱼肉的低摄入量呈负相关。多变量分析显示,RRR膳食模式得分增加1个单位,左室重量/体表面积就增加0.32g/m2,心博量减少0.43mL/m2,左室射血分数则减少0.21%。调整代谢综合征组分后,RRR膳食模式得分与左室重量和心搏指数之间的相关性减低,变为差异有统计学意义(P<0.05)。结论 RRR膳食模式、代谢紊乱与左室功能紊乱有关。本研究属于横断面研究,结果的可靠性有待前瞻性研究进一步证实。

Endoscopic therapy in acute recurrent pancreatitis

Endoscopic retrograde cholangiopancreatography (ERCP) has evolved from a largely diagnostic to a largely therapeutic modality. Cross-sectional imaging, such as computed tomography (CT) and magnetic resonance imaging (MRI), and less invasive endoscopy, especially endoscopic ultrasound (EUS), have largely taken over from ERCP for diagnosis. However, ERCP remains the "first line" therapeutic tool in the management of mechanical causes of acute recurrent pancreatitis, including bile duct stones (choledocholithiasis), ampullary masses (benign and malignant), congenital variants of biliary and pancreatic anatomy (e.g. pancreas divisum, choledochoceles), sphincter of Oddi dysfunction (SOD), pancreatic stones and strictures, and parasitic disorders involving the biliary tree and/or pancreatic duct (e.g Ascariasis, Clonorchiasis).

肿瘤坏死因子-α抑制剂己酮可可碱对糖尿病大鼠阴茎海绵体RhoA/Rho激酶信号通路的影响

目的:研究糖尿病大鼠阴茎海绵体组织中RhoA/Rho激酶信号通路改变以及肿瘤坏死因子(TNF)吨抑制剂己酮可可碱(PTX)对该信号通路和阴茎勃起功能的影响。方法:SD大鼠分为对照组、糖尿病组和糖尿病药物干预组;高脂喂养联合低剂量链脲佐菌素注射诱导糖尿病;腹腔埋置微渗透泵持续慢性给药;在体记录阴茎海绵体窦内压(ICP):ELISA检测血清TNF-α浓度;Western blot检测海绵体组织中内皮型一氧化氮合酶(eNOS)和神经型一氧化氮合酶(nNOS)以及RhoA/Rho激酶信号通路分子的蛋白表达水平。结果:与糖尿病组比,糖尿病药物干预组血清TNF-α浓度明显下降(P<0.01),阴茎海绵体组织中RhoA、ROCK1和p-MYPT1表达下调(P<0.05),eNOS和nNOS表达增加(P<0.05),阴茎ICP指数显著升高(P<0.05)。结论:TNF-α促进阴茎海绵体组织RhoA/Rho激酶信号通路的激活与表达上调,参与糖尿病性勃起功能障碍的发病机制:PTX对糖尿病大鼠的勃起功能有保护作用。

CT辐射量降低和投影数目研究（英文）

改进CT技术的最终目标是用较低的辐射剂量重建出更高质量的图像以降低患癌症的风险。近年来受压缩感知理论的启发,减少投影角度重建一直是减少辐射量的一个热门课题。但是,当辐射剂量固定,减少投影角度并不总是意味着更好的图像质量。本文研究固定辐射剂量下图像质量和扫描角度数目的关系。数值实验表明对于固定的辐射剂量,起初图像质量随着扫描角度数目的增加而提高,但是当扫描角度数目足够大之后图像质量反而下降了。在等角全扫描模式下,对于我们测试的辐射剂量和图像,产生最佳图像质量的最佳扫描角度数目是300,这对于实际的应用具有借鉴意义.

推进式食管-胃-十二指肠镜的病灶检出率依赖于隐匿性胃肠道出血的类型

Background and study aims: Many lesions found during push enteroscopy to evaluate obscure gastrointestinal bleeding are within the reach of standard endoscopes. The aim of this study was to determine whether the rate of proximal lesions varies in relation to the type of obscure bleeding that is present. Patients and methods: A retrospective review of consecutive push enteroscopies carried out for obscure gastrointestinal bleeding between July 1996 and July 2000 was conducted. The patients were categorized into three groups: those with recurrent obscure/overt gastrointestinal bleeding; those with persistent obscure/overt gastrointestinal bleeding; and those with obscure/ occult gastrointestinal bleeding. Results: A total of 63 patients (24 men, 39 women; mean age 69.8) were included. Push enteroscopy examinations were conducted for recurrent obscure/overt bleeding in 32 patients; for persistent obscure/overt bleeding in 12 patients; and for obscure/occult bleeding in 19 patients. The overall diagnostic yield of push enteroscopy was 47% (15 of 32) in the group with recurrent obscure/overt bleeding; 66% (eight of 12) in the group with persistent obscure/overt bleeding; and 63% (12 of 19) in the group with obscure/occult bleeding. However, when lesions within the reach of standard esophagogastroduodenoscopy (EGD)were excluded, the yield of push enteroscopy was slightly higher in the group with recurrent obscure/overt bleeding (41% ) than in the groups with persistent obscure/overt bleeding (33% ) and obscure/ occult bleeding (26% ). There were fewer lesions within the reach of EGD in the group with recurrent obscure/overt bleeding than in the groups with persistent obscure/overt bleeding (6% vs. 33% ; P < 0.05) or obscure/occult bleeding (6% vs. 37% ; P < 0.05). Conclusions: Patients undergoing push enteroscopy for recurrent obscure/overt bleeding were significantly less likely to have lesions within the reach of EGD than patients with persistent obscure/overt bleeding or obscure/occult bleed-ing. Patients in the latter two groups would be able to undergo a repeat EGD examination before more intense evaluation with push enteroscopy or capsule endoscopy.

轻至中度慢性静脉功能不全常见皮肤瘙痒、疼痛及烧灼感及其对生活质量的影响

To our knowledge there are no studies evaluating the prevalence and characteristics of itch, pain, and burning sensation among patients with mild to moderate chronic venous insufficiency or assessing the impact of these symptoms on quality of life. In this report 100 patients met the inclusion criteria. Patients who suffered from itch were also assessed with the use of a validated questionnaire and a modified Skindex- 16 questionnaire. We found that the prevalence of itch was 66% . Concomitant itch and burning sensation as well as itch and pain were noted in 47% and 44% of the patients, respectively. No correlation was noted between the severity of these symptoms and the degree of venous insufficiency. Itch had a negative impact on quality of life. A limitation of this study is that the participants, who were primarily hospital employees, are more likely to develop these symptoms. Therefore this study does not reflect the true prevalence of these symptoms in the general population. This study found that itch, pain, and burning sensation are common symptoms of mild to moderate chronic venous insufficiency with a significant impact on quality of life.

对高危冠状动脉搭桥术患者施行单次交叉钳夹可改善6个月认知预后:简化主动脉操作的效果

Objective: We hypothesized that a strategy that reduced aortic manipulation would reduce the incidence of cognitive deficits in patients undergoing coronary artery bypass grafting compared with the “ traditional” approach and that neurobehavioral outcomes with the reduced aortic manipulation strategy would approach those obtained with off-pump coronary artery bypass surgery. Methods: Consenting high-risk patients(those with older age, diabetes, or hypertension) scheduled for coronary artery bypass grafting and cardiopulmonary bypass were randomly assigned to 1 of 2 aortic management protocols:(1) a traditional approach in which distal anastomoses were accomplished while the aorta was crossclamped but in which proximal anastomoses were sewn while a partial occlusion clamp was applied to the aorta(multiple aortic clamping group) or(2) a reduced aortic manipulation approach in which the aorta was clamped a single time with a reduced-pressure clamp(single aortic clamping group) and the partial occlusion clamp was not used. A contemporaneous group of patients undergoing off-pump coronary artery bypass surgery without cardiopulmonary bypass was also enrolled. Subjects in all 3 groups underwent neurologic and neuropsychological testing before and after surgery. After randomization, patients assigned to either approach could be changed to another strategy if the attending surgeon determined that patient safety demanded this change. The study design anticipated that surgical techniques would evolve over the course of patient enrollment and anticipated that some patients would have intraoperative echocardiographic findings that would demand that the traditional approach(eg, severe aortic atherosclerosis) or the reduced manipulation protocol(eg, severe ischemia or poor left ventricular function) be abandoned. Thus, an unequal distribution of patients was expected. By surgeon decision, 20 of 84 multiple aortic clamping patients crossed over to single aortic clamping, and 3 of 85 single aortic clamping patients switched to multiple aortic clamping. Eligible patients had a battery of neuropsychological tests before surgery and at 6 months after surgery. A 20% decrement in 2 or more tests was defined as a neuropsychological deficit. Results: MAC OPCAB SAC Hospital mortality 3/67(4% ) 1/68(1% ) 0/102(0% ) Hospital stroke 3/67(4% ) 1/68(1% ) 3/102(3% ) Tested patients NPD 3- 5 d 25/42(60% ) 33/47(70% ) 44/74(60% ) Tested patients NPD 3- 6 wk 25/49(51% ) 20/51(40% ) 27/85(32% ) Tested patients NPD 6 mo 24/42(57% ) 13/41(32% * ) 22/74(30% * ) MAC, Multiple aortic clamping; OPCAB, off-pump coronary artery bypass; SAC, single aortic clamping; NPD, neuropsychological deficit. * P < .05 vs MAC. Conclusions: A surgical strategy designed to minimize aortic manipulation can significantly reduce the incidence of cognitive deficits in coronary artery bypass grafting patients compared with traditional techniques. In this series, the results of the reduced aortic manipulation strategy were not significantly different from those in patients having off-pump coronary artery bypass surgery, thus emphasizing surgical technique as the primary cause of brain damage in coronary artery bypass grafting patients.

An osteosarcoma-on-a-chip model for studying osteosarcoma matrix-cell interactions and drug responses

Marrow niches in osteosarcoma(OS)are a specialized microenvironment that is essential for the maintenance and regulation of OS cells.However,existing animal xenograft models are plagued by variability,complexity,and high cost.Herein,we used a decellularized osteosarcoma extracellular matrix(dOsEM)loaded with extracellular vesicles from human bone marrow-derived stem cells(hBMSC-EVs)and OS cells as a bioink to construct a micro-osteosarcoma(micro-OS)through 3D printing.The micro-OS was further combined with a microfluidic system to develop into an OS-on-a-chip(OOC)with a built-in recirculating perfusion system.The OOC system successfully integrated bone marrow niches,cell‒cell and cell-matrix crosstalk,and circulation,allowing a more accurate representation of OS characteristics in vivo.Moreover,the OOC system may serve as a valuable research platform for studying OS biological mechanisms compared with traditional xenograft models and is expected to enable precise and rapid evaluation and consequently more effective and comprehensive treatments for OS.

Decellularized extracellular matrix mediates tissue construction and regeneration

Contributing to organ formation and tissue regeneration,extracellular matrix(ECM)constituents provide tissue with three-dimensional(3D)structural integrity and cellular-function regulation.Containing the crucial traits of the cellular microenvironment,ECM substitutes mediate cell–matrix interactions to prompt stem-cell proliferation and differentiation for 3D organoid construction in vitro or tissue regeneration in vivo.However,these ECMs are often applied generically and have yet to be extensively developed for specific cell types in 3D cultures.Cultured cells also produce rich ECM,particularly stromal cells.Cellular ECM improves 3D culture development in vitro and tissue remodeling during wound healing after implantation into the host as well.Gaining better insight into ECM derived from either tissue or cells that regulate 3D tissue reconstruction or organ regeneration helps us to select,produce,and implant the most suitable ECM and thus promote 3D organoid culture and tissue remodeling for in vivo regeneration.Overall,the decellularization methodologies and tissue/cell-derived ECM as scaffolds or cellular-growth supplements used in cell propagation and differentiation for 3D tissue culture in vitro are discussed.Moreover,current preclinical applications by which ECM components modulate the wound-healing process are reviewed.

ROBUST FRAME BASED X-RAY CT RECONSTRUCTION

As X-ray computed tomography （CT） is widely used in diagnosis and radiotherapy, it is important to reduce the radiation dose as low as reasonably achievable. For this pur- pose, one may use the TV based methods or wavelet frame based methods to reconstruct high quality images from reduced number of projections. Furthermore, by using the in- terior tomography scheme which only illuminates a region-of-interest （ROI）, one can save more radiation dose. In this paper, a robust wavelet frame regularization based model is proposed for both global reconstruction and interior tomography. The model can help to reduce the errors caused by mismatch of the huge sparse projection matrix. A three-system decomposition scheme is applied to decompose the reconstructed images into three differ- ent parts： cartoon, artifacts and noise. Therefore, by discarding the estimated artifacts and noise parts, the reconstructed images can be obtained with less noise and artifacts. Similar to other frame based image restoration models, the model can be efficiently solved by the split Bregman algorithm. Numerical simulations show that the proposed model outperforms the FBP and SART＋TV methods in terms of preservation of sharp edges, mean structural similarity （SSIM）, contrast-to-noise ratio, relative error and correlation- s. For example, for real sheep lung reconstruction, the proposed method can reach the mean structural similarity as high as 0.75 using only 100 projections while the FBP and the SART^TV methods need more than 200 projections. Additionally, the proposed ro- bust method is applicable for interior and exterior tomography with better performance compared to the FBP and the SART＋TV methods.

Personalized prostate cancer therapy based on systems analysis of the apoptosis regulatory networ

Targeting the androgen receptor axis provides only temporary relief for advanced prostate cancer, which often evolves into androgen-independent disease, The wide variety of signaling mechanisms connected with the pathophysiology of androgen-independent prostate cancer poses both conceptual and practical challenges for the design of efficient therapies, Analysis of apoptosis regulation in prostate cancer suggests the potential value of a systems approach that integrates information on the topology of the antiapoptotic signaling network, the signal transduction pathways that inhibit apoptosis, and the expression of proteins of the Bcl2 family, This approach could be used to identify patients most likely to respond to treatments with drugs that inhibit the signaling pathways controlling apoptosis.