Yue Bei People's Hospital

This study aimed to evaluate the effects of different physical activity (PA) types on executive functions (EFs) in children (6-12 years) and adolescents (13-18 years). Data were analyzed using Bayesian network meta-analysis combined with model-based dose-response modeling. PA dose was standardized to metabolic equivalent of task minutes per week (METs-min/week). Effect sizes were estimated using standardized mean differences (SMDs) and 95% credible intervals (CrIs). Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool, and certainty of evidence was evaluated with CINeMA. The protocol was registered in PROSPERO (CRD42023422762). Dance was identified as the most effective PA for enhancing working memory accuracy (SMD = 0.64, 95% CrI: 0.20 to 1.07) and cognitive flexibility reaction time (SMD = -0.99, 95% CrI: -1.91 to -0.06) at optimal doses of 500 METs-min/week and 150 METs-min/week, respectively. Mixed exercise significantly improved inhibitory control accuracy (SMD = 0.52, 95% CrI: 0.21 to 0.82) at an optimal dose of 1500 METs-min/week. The certainty of evidence varied, with moderate confidence for some outcomes and low to very low confidence for others. These findings highlight the importance of structured PA interventions optimized according to the most effective PA modality and dosage thresholds for improving specific executive function components. Such tailored PA programs may provide a more effective approach for enhancing cognitive development in children and adolescents.

Patients in the intensive care unit (ICU) who are comatose face respiratory complications and a process of long-term rehabilitation. This study evaluates the combined effect of nurse-led early graded rehabilitation (EGR) and comprehensive chest physical therapy (CCPT) guided by pulmonary ultrasound (PU) on neurological function, respiratory outcomes, and complications in comatose ICU patients. This retrospective study included 120 comatose patients admitted to the ICU from July 2024 to February 2025, divided into a conventional treatment group and a combination treatment group. The latter accepted the CCPT guided by EGR and PU. Evaluate the results using Glasgow Coma Scale, Barthel Index, respiratory parameters, and incidence of complications. The data were analyzed using t-test and logistic regression. The combination therapy group demonstrated significant improvements in the Glasgow Coma Scale (6.32 ± 1.15 vs 5.85 ± 1.26; P = .035). Respiratory parameters, including higher tidal volumes (239.57 ± 76.07 mL vs194.78 ± 55.34 mL; P < .001) and oxygenation indices (245.67 ± 27.51 mm Hg vs 235.34 ± 25.08 mm Hg; P = .034), were also enhanced. Significant reductions in pulmonary infection (1.67% vs 15%; P = .021) and deep vein thrombosis (1.67% vs 13.33%; P = .038) were observed. Integrating EGR with PU-guided CCPT significantly improves neurological function, functional independence, and respiratory outcomes while reducing critical complications in comatose ICU patients. This combined therapeutic strategy represents a highly effective approach to enhancing recovery in critical care settings.

ABSTRACTScrub typhus, an acute zoonotic disease from Orientia tsutsugamushi, is uncommon in newborns and presents atypical symptoms. Untimely diagnosis and treatment can lead to a prolonged and potentially fatal course. Early diagnosis and treatment are essential for better patient outcomes. Metagenomic next‐generation sequencing can rapidly and accurately diagnose pathogens, aiding precise treatment.

A significant subset of Neuromyelitis Optica Spectrum Disorder (NMOSD) cases occurs as a paraneoplastic syndrome, where an underlying tumor triggers a devastating autoimmune attack against the central nervous system. This autoimmune response is driven by pathogenic aquaporin-4 autoantibodies (AQP4-IgG), likely initiated by the tumor’s expression of AQP4 in a phenomenon of molecular mimicry. Understanding the precise immune mechanisms that link a patient’s cancer to their neurological disease is critical for early diagnosis of the occult malignancy and for improved patient outcomes. This review explores how multi-omics technologies are revolutionizing the investigation of T and B cell functional dynamics in this specific context, offering unprecedented resolution into the pathogenesis of paraneoplastic NMOSD. The application of integrated multi-omics—including genomics, epigenomics, transcriptomics (particularly single-cell RNA-seq), proteomics, and metabolomics—provides a holistic framework to dissect the specific immune response directed against both the tumor and the CNS. Transcriptomics, notably scRNA-seq, can deconstruct the heterogeneity of tumor-infiltrating and circulating T and B cells to identify the pathogenic subsets responsible for the autoimmune pathology. Proteomics can aid in identifying tumor-specific biomarkers, while metabolomics offers insights into the metabolic vulnerabilities of the autoreactive immune cells. Multi-omics analyses reveal the cellular and molecular cascade of the paraneoplastic response. High-throughput T-cell receptor (TCR) and B-cell receptor (BCR) sequencing provides direct evidence of oligoclonal expansions, identifying the specific T and B cell clones that likely recognize shared AQP4 epitopes on both the cancer cells and CNS astrocytes. These expanded B cells show hallmarks of a mature, antigen-driven response, including class-switching and affinity maturation of the pathogenic AQP4-IgG. Furthermore, analyses of T cell dynamics reveal a pro-inflammatory environment, with functional impairment of regulatory T cells (Tregs) and a skewed balance towards Th17 and Th1 cells, which is likely initiated by the tumor and perpetuated in the CNS via critical T-B cell interactions, such as the IFN-I → B-cell → IL-6 → pathogenic Th17 axis. Despite these insights, substantial challenges remain in translating these findings into clinical practice. A key hurdle is using multi-omics to develop a reliable molecular signature that can distinguish paraneoplastic from idiopathic NMOSD at diagnosis, thereby streamlining cancer screening for high-risk patients. Advanced computational tools, including AI and machine learning, are needed to integrate the immense volume of data and identify the subtle differences. Future research must prioritize the analysis of longitudinal samples (before and after tumor treatment) and the functional validation of the identified pathogenic pathways. In conclusion, multi-omics is profoundly enhancing our understanding of how tumors can initiate and sustain a specific, targeted autoimmune response in paraneoplastic NMOSD. This deep mechanistic investigation not only promises to improve diagnostics and personalized therapies for these complex patients but also serves as a powerful model for understanding other paraneoplastic syndromes, ultimately bridging the fields of oncology and neuroimmunology.

ObjectivesPeriodontal ligament cells (PDLCs) are considered ideal seed cells for periodontal tissue engineering and regeneration, and optimizing their efficacy is a pressing challenge. Although basic fibroblast growth factor (bFGF) has been extensively studied for promoting periodontal regeneration, its instability limits its application. This study introduces a smaller, less degradable peptide, CH02, to address this issue. Therefore, this study aims to explore the promoting effect of the CH02 peptide on the osteogenic differentiation of PDLCs, providing new support for periodontal regeneration.MethodsExtracted PDLCs from human premolars; used bFGF as a positive control to analyze the effects of CH02 on the proliferation, toxicity, migration, osteogenic differentiation, and calcification ability of PDLCs; RT-qPCR analysis of osteogenesis-related gene expression; Construct a rat periodontal bone defect model, deliver PDLCs encapsulated in Matrigel to the defect site, and intervene with CH02 for 2 and 4 weeks. Subsequently, evaluate bone regeneration through Micro-CT, HE staining, Masson staining, and immunohistochemical analysis.ResultsPDLCs were successfully extracted. In vitro experiments showed that CH02 was comparable to bFGF in promoting PDLCs proliferation, but CH02 was more effective in promoting cell migration and osteogenic differentiation. CH02 enhanced the expression of osteogenic-related genes (such as RUNX2, OCN, and COL-1) in PDLCs. In vivo experiments demonstrated that CH02 could promote PDLCs to repair rat periodontal bone defects.ConclusionCH02 promotes osteogenic differentiation of PDLCs in vitro more effectively than bFGF; in vivo, CH02 effectively promotes PDLCs to repair rat periodontal bone defects.

Studies have shown that approximately 30% of patients with Bell's palsy may experience permanent disfigurement due to muscle weakness affecting facial expressions. The prognosis for Bell's palsy is often correlated with the degree of impairment in facial nerve function observed in the early stages of the condition. Selecting appropriate assessment tools is essential for the effective treatment and prognosis of patients with Bell's palsy. Examine and compare three scales used to measure Bell's palsy: the House-Brackmann Grading Scale (HBGS), the Sunnybrook Facial Grading System (SFGS), and the Modified Portmann Scale (MPS). A retrospective study involved 97 patients with Bell's palsy treated at the authors' institution from 2021 to 2022. The authors accessed these data for research purposes in February 2025. The patient cohort underwent HBGS, SFGS, and MPS to assess facial nerve function before and after treatment. We compared the results of these three evaluation methods. Additionally, we performed correlation analyses and receiver operating characteristic (ROC) analyses of the post-treatment data to examine the relationships between HBGS and SFGS and between HBGS and MPS, using the internationally recognized and most widely utilized HBGS as the standard. The HBGS demonstrated moderate consistency with both the FSGS and MPS, revealing significant negative correlations (r = -0.876, P < 0.01; r = -0.860, P < 0.01). All three scales exhibited high reactivity and showed no ceiling/floor effect. The optimal cut-off values for the FSGS and MPS were determined to be ≤ 68 and ≤ 16 points, respectively, with AUC of 0.948 (95% CI: 0.910-0.984) and 0.931 (95% CI: 0.883-0.968). HBGS, SFGS, and MPS are all appropriate tools for assessing Bell's palsy. The severity of facial nerve palsy can be clinically classified using a transect score of 68 on the SFGS and 16 on the MPS. However, the results should be interpreted with caution, as objective indicators were not utilized as criteria.

Abstract The prognosis of colorectal cancer (CRC) is often fatal, and the underlying mechanisms are unclear. Dysregulation of enhancers is involved in several tumors, and this area is expected to become a new frontier in tumor therapy. Here, we identified a novel activated enhancer ‘Enhancer X’ from the Gene Expression Omnibus database and experimentally verified its associated RNA (EX-eRNA) in CRC. To date, there are no reports on the function of Enhancer X, and its role in CRC remains unknown. We aimed to investigate the biological functions and underlying mechanism of Enhancer X in CRC. EX-eRNA expression was elevated in CRC cells and tissues and positively correlated with CRC metastasis and shorter survival. Enhancer X knockout (CRISPR/Cas9) or EX-eRNA knockdown (siRNAs) inhibited CRC cell growth in vivo and in vitro. Mechanistically, Enhancer X activation and transcription to EX-eRNA require the binding of CEBPB to a “GTTGTGTCAC” motif within the enhancer region. Subsequently, EX-eRNA, serves as a scaffold for MED25 to stabilize the chromatin loop between Enhancer X region and the KRT80 promoter, thereby promoting KRT80 transcription and driving CRC tumorigenesis. Thus, we conclude that novel enhancer X activated by CEBPB drives colorectal carcinogenesis via EX-eRNA-mediated DNA loop promotion of KRT80 transcription, and that targeting the CEBPB / Enhancer X / EX-eRNA / KRT80 molecular axis constitutes a promising approach to treat CRC.

Abstract Rationale: Antibiotic stewardship interventions may reduce antibiotic prescribing. The study aims to assess the effects of comprehensive antibiotic stewardship in reducing antibiotic prescribing for acute respiratory infections. Methods: We conducted a pragmatic, cluster randomized controlled trial conducted in 34 primary care facilities in rural Guangdong Province, China. Clusters were primary care facilities in two counties with a total of 1 million population. We randomized facilities to intervention or control groups in an overall 1:1 ratio stratified by county. We collected prescription data from all outpatients aged 0-75 who visited the primary care facilities during the 12-month baseline and 12-month intervention periods if they received a primary diagnosis of any acute respiratory infection except pneumonia. Interventions: Our intervention included a half-day training session for doctors using evidence-based guidelines on acute respiratory disease, regular prescription review and feedback facilitated by an app linked with electronic medical records. Patients received app-based education. Control facilities received no inputs. Main outcome and measures: The primary outcome was whether a patient was prescribed antibiotics during the 12-month trial period. We measured the percentage of patients hospitalized within 30 days for respiratory illness or sepsis as a safety indicator of withholding antibiotics. Results: We recruited 34 township hospitals (17 per county) and randomized 17 to each treatment group. Between the baseline (1 January 1 2019 to 15 December 2019) and the intervention period (1 March 2020 and 28 February 2021), the antibiotic prescribing rate decreased from 83% (88828/107314) to 26% (14521/54799) in the intervention group and from 84% (61486/72796) to 71% (30340/42440) in the control group. After adjustment for stratum and covariates, the risk difference was -39 percentage points (95% CI: -47, -29; p&amp;lt;0.001). The intervention did not affect the 30-day hospitalization rate with adjusted risk difference of 0·43 percentage points (95% CI: -0·02, 0·8; p = 0·058). Conclusions: In primary care facilities, antibiotic stewardship involving training guidelines, prescription review and feedback resulted in a substantial reduction in antibiotic prescribing rates for acute respiratory infections without safety concerns. Our trial will inform the antibiotic stewardship policy for primary care facilities in China. Trial registration: ISRCTN, ISRCTN96892547

BackgroundKidney stones are a prevalent disorder that is linked to a range of metabolic variables. The cardiometabolic index (CMI) is a newly developed combined measure used to evaluate the state of cardiometabolic health. Nevertheless, the association between CMI and kidney stone remains little investigated.MethodsIn this study, cross-sectional analysis was done on NHANES data from 2007 to 2018. The association between the prevalence of kidney stones and the CMI was investigated using a logistic regression analysis. To look into the nonlinear link between them, we used restricted cubic spline (RCS) analysis. The study was made more reliable and accurate by using sensitivity analysis and subgroup analysis to look for factors that may have contributed to the different results.ResultsA significant association was seen between increased CMI and the prevalence of kidney stones (OR = 1.19, 95% CI: 1.06-1.32). The RCS analysis revealed crucial CMI values that exhibited a robust association within a certain range. Subgroup studies revealed that this link was particularly prominent among those below the age of 50, females, obese, CKD and diabetes patients. The dependability of the study’s conclusions was further established using sensitivity analysis.ConclusionThis study established a notable association between CMI and a higher prevalence of kidney stones, emphasizing the significance of CMI as a comprehensive measure for evaluating metabolic risk. Furthermore, it suggests that monitoring CMI levels could be beneficial in identifying populations with a high prevalence of kidney stones.